Ascending Aortic Diameter

Purpose	Automate ascending aortic diameter measurement
Tag(s)	#MPA:AO
Panel	Cardiac
Define-AI ID	18040001
Originator	Jay Nance
Panel Chair	Carlo De Cecco
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Published

Clinical Implementation

Value Proposition

Pulmonary artery size is an imperfect imaging biomarker of pulmonary hypertension but has shown prognostic value in a variety of clinical situations. Cutoffs for abnormal values have been proposed and validated. Automated quantification would save the interpreting physician time via elimination of manual measurements, would prevent detection errors (missing enlarged pulmonary arteries), and would provide structured quantitative data, which could be used in later studies or risk-stratification schemes.

Narrative(s)

All patients undergoing CT examinations through the level of the main pulmonary artery should have automated quantification of arterial diameter, which should then be automatically populated into the radiology report or a report supplement. This use case will focus specifically on relevant cardiac imaging modalities, ie, electrocardiogram (ECG)-synchronized coronary artery calcium scoring, coronary CT angiography (CCTA), and full-chest CT angiography (triple rule-out scans).

Workflow Description

A patient receives ECG-synchronized CT of the chest and heart. An algorithm retrieves a volumetric imaging data set and accessible electronic medical record data, including age, sex, and body mass index. The algorithm executes and returns the following measurements: the ascending aorta at the level of the main pulmonary artery. An additional measurement is the proximal right and left pulmonary arteries. Please note, these values have shown limited value in the literature, and this feature should be considered optional. The algorithm returns all values, which could populate the report (possibly within a supplement containing other quantitative data). The algorithm flags abnormal values.

Considerations for Dataset Development

Procedures(s): ECG-synchronized CT, Chest

Sex at Birth: {Male, Female}

Age (years): [15,90]

Body Mass Index (kg/m²): [10,52]

Body Surface Area: varied

Aortic Diameter (mm): [20,40]

Abnormalities: {Congenital heart disease, ventricular septal defects}

Interventions: {Congenital heart disease repair, mitral valve replacements}

Contrast: {Contrast-enhanced (CCTA), non-contrast enhanced applications}

Technical Specifications

Inputs

DICOM Study

Procedure	ECG-synchronized CT, Chest
Data Type	DICOM
Modality	CT
Body Region	Chest
Anatomic Focus	Heart

Primary Outputs