Choledocholithiasis Detection on Ultrasound
Purpose | Detection of choledocholithiasis on ultrasound |
Tag(s) |
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Panel | Abdominal |
Define-AI ID | 20020010 |
Originator | Luther B. Adair, II |
Lead | Luther B. Adair, II |
Panel Chair | Arun Krishnaraj |
Panel Reviewers | Abdominal Panel |
License | Creative Commons 4.0 |
Status | Public Comment |
RadElement Set | RDES160 |
Clinical Implementation
Value Proposition
Choledocholithiasis is a potentially life-threatening but treatable emergency. AI meeting this use case would help in detecting, quantitating, and alerting both nonspecialists and radiologists to this potentially life-threatening abnormality. In clinical settings where a radiologist is not readily available, such detection would be of value to non-radiologists such as technologists who would perform an ultrasound for this disease entity. In clinical settings where radiologists are available, such detection could be used to alert the radiologist and prioritize its reporting and notification to the treating physicians.
Narrative(s)
A 44-year old patient presents with constant right upper quadrant pain and is taken to the emergency room at which time a right upper quadrant ultrasound is ordered.
A 67-year old patient presents to an outpatient clinic with jaundice and right upper quadrant pain and is sent to the emergency room, at which time a right upper quadrant ultrasound is ordered.
Workflow Description
An algorithm evaluates the ultrasound and categorizes whether choledocholithiasis is present, absent, or indeterminate and measures the stone size. If present, it then assesses whether there is biliary ductal dilatation present, absent, or undetermined and measures the common bile duct. For cases returned where the algorithm returns choledocholithiasis, the radiologist is made aware of the need for further evaluation or intervention. If the radiologist is not available, the non-radiologist is made aware of the need for further evaluation or intervention.
Considerations for Dataset Development
Procedures | {Ultrasound limited; Ultrasound of the abdomen complete, Ultrasound of the right upper quadrant} |
Age | [0,90] |
Sex at Birth | {Male, Female} |
Abdominal pain | {right upper quadrant pain} |
Comorbidities | {diabetes, sickle cell anemia, obesity} |
Catheter | {common bile duct stent, common bile duct drain} |
Other | {soft tissue mass in the common bile duct, pneumobilia, choldechocal cysts, distal soft tissue obstruction, cholelithiasis, cholecystectomy} |
Technical Specifications
Inputs
DICOM Study
Procedure | ultrasound limited, abdominal ultrasound complete, right upper quadrant ultrasound |
Views | Images of common bile duct |
Data Type | DICOM |
Modality | Ultrasound |
Body Region | Abdomen |
Anatomic Focus | Common bile duct |
Primary Outputs
Choledocholithiasis Detection
RadElement ID | RDE1122 |
Definition | Presence of choledocholithiasis |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Choledocholithiasis Measurement
RadElement ID | RDE1120 |
Definition | If choledocholithiasis present then determine maximal stone diameter |
Data Type | Numeric |
Value Set | N/A |
Units | mm |
Secondary Outputs
Biliary Ductal Dilation Measurement
RadElement ID | RDE1121 |
Definition | Maximal common bile duct measurement |
Data Type | Numeric |
Value Set | N/A |
Units | mm |
Biliary Ductal Dilation Detection
RadElement ID | RDE1123 |
Definition | Biliary ductal dilation detection based on measurement. Absent if measurement is less than 6 mm for patients younger than 60 years, allow 1 mm for each decade over 60 years. Present if measurement is less than or equal 6-9 mm for patients younger than 60 years, allow 1 mm for each decade over 60 years. Present if measurement is greater than 15 mm in the setting of prior cholecystectomy. |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Periductal Fluid Detection
RadElement ID | RDE1124 |
Definition | Periductal fluid detection |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Future Development Ideas
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Specify minimal acceptable imaging using ultrasound. For example, RAO parasagittal views of the common bile duct from the porta hepatis to the pancreas and then transverse images of the common bile duct through the head of the pancreas.
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Possible extension to this use case is to detect choledocholithiasis on ultrasound and assess the need for further evaluation with MRCP
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In the case of biliary ductal dilatation without an identified stone, soft tissue mass obstruction within the common bile duct, ampulla, or pancreas should be considered. Consider using this algorithm as an adjunct to the gallstone detection algorithm.
Related Datasets
No known related public datasets at this time, please alert us if you know of any.