Cervical Rib Detection on X-Ray

Clinical Implementation

Value Proposition

Cervical rib, which is a congenital anomaly, is an accessory rib that grows above the first rib from C7 and can be on the right, left, or both sides. Occurring in less than 1% of the population, a cervical rib can vary in size and shape and is often an incidental finding without symptoms. However, in some cases (up to 10% of the affected individuals), cervical ribs can cause problems, such as thoracic outlet syndrome (TOS) or brachial plexopathy by compressing the brachial plexus or the subclavian vessels. While individuals with a cervical rib are ten times more likely to develop TOS, this variant is commonly overlooked in medical imaging [Viertel et al., AJNR 2012].

Narrative(s)

A 30-year-old female presents with numbness and tingling of her right upper extremity. An x-ray of the cervical spine is performed. The patient is found to have a right-sided cervical rib, causing TOS. Radiologists can easily miss a cervical rib (or ribs, if bilateral) and would benefit from an algorithm that can detect and alert the radiologists as this congenital variant has been known to cause TOS.

Workflow Description

Images obtained from the radiograph sent to the PACS/viewer and the AI model. The AI model analyzes the images. The model identifies the presence of a cervical rib or cervical ribs. A message is sent to both the PACS/viewer and the reporting solution from the model with this information.

Considerations for Dataset Development

Procedures(s)	{Cervical spine x-ray, Shoulder x-ray, Chest x-ray}
View(s)	{Frontal}
Sex at Birth	{Male, Female}
Age	[18, 60]

Technical Specifications

Inputs

 

DICOM Study

 

Procedure	Cervical spine x-ray, shoulder x-ray, chest x-ray
Views	Frontal
Data Type	DICOM
Modality	X-ray
Body Region	Cervical Spine
Anatomic Focus	Cervical Spine

Primary Outputs

Cervical Rib Detection

RadElement ID	RDE950
Definition	Cervical rib
Data Type	Categorical
Value Set	Absent Present Unknown
Units	N/A

Cervical Rib Laterality

RadElement ID	RDE951
Definition	Cervical rib location
Data Type	Categorical
Value Set	Unknown Left Right Bilateral
Units	N/A

Future Development Ideas

• Include sagittal images for the cross-sectional imaging for the detection of cervical rib. 

• Give more quantitative information about the cervical rib, such as its size or volume as well as whether it is a fully-formed bony rib or a fiber/strand.

Related Datasets

No known related public datasets at this time,  please alert us if you know of any.