Pulmonary Parenchymal Emphysema

Purpose	Detect and quantitate the type and amount of emphysema in each of the five lobes of the lung on thoracic CT scans
Tag(s)
Panel	Thoracic Panel
Define-AI ID	19080008
Originator	John Newell
Lead	John Newell
Panel Chair	Eric Stern
Panel Reviewers	Thoracic Panel
License	Creative Commons 4.0
Status	Published
RadElement Set	RDES105

Clinical Implementation

Value Proposition

Quantitative CT assessment of emphysema in the lungs has been shown to correlate with decreases in pulmonary function, quality of life and increases in morbidity and mortality in patients with COPD. Emphysema has also been shown to be an independent risk factor for lung cancer. An AI algorithm that could assist the radiologist with this assessment would improve the efficiency of the radiologist and patient outcomes.

Narrative(s)

A 35 year old non-smoking woman with suspected pneumonia has a CT scan of the thorax. There is no evidence of pneumonia but the AI assessment indicates 35% by volume of pan lobular emphysema from alpha-1 anti-trypsin deficiency.
A 65-year-old active smoker with 35 pack-year smoking history received a screening LDCT which showed moderate upper lobe predominant emphysema and a 1.2 cm right upper lobe nodule with spiculated margin. The AI algorithm quantitates lobar distribution of emphysema and generates a structured report.

Workflow Description

The image is obtained from modality and sent to PACS and the AI engine. The image is analyzed by the engine. The system then detects and estimates extent of emphysema. An alert message is sent to PACS from the engine with the information, identification, and graphic highlighting the emphysema.

Considerations for Dataset Development

Age	Varied
Sex at birth:	Male, Female
Smoking History	No, Yes
Chest hyperinflation	Absent, Present
Centrilobular emphysema	Absent, present
Panlobular emphysema	Absent, present
Paraseptal emphysema	Absent, present
Paracicatricial emphysema	Absent, present
Localized emphysema	Absent, present
Idiopathic giant bullous emphysema	Absent, present
Congenital lobar emphysema	Absent, present
Pulmonary interstitial emphysema	Absent, present
Pulmonary arterial hypertension	Absent, present
lymphangiomyomatosis	Absent, present
Pulmonary Langerhans cell histiocytosis	Absent, present
Honeycomb lung	Absent, present
Bronchial and bronchiolar wall thickening	Absent, present
Severe air trapping Clinical note: can mimic emphysema	Absent, present

Technical Specifications

Inputs

DICOM Study

Procedure	Chest CT
Views	Axial, sagittal, coronal
Data Type	DICOM
Modality	CT
Body Region	Chest
Anatomic Focus	Thorax

Primary Outputs

Presence of emphysema

RadElement ID	RDE675
Definition	Detection of emphysema in either lung
Data Type	Categorical
Value Set	Emphysema absent Emphysema present Unknown
Units	N/A

Emphysema in right lung

RadElement ID	RDE676
Definition	Detection of emphysema in right lung
Data Type	Categorical
Value Set	Emphysema absent Emphysema present Unknown
Units	N/A

Emphysema in left lung

RadElement ID	RDE677
Definition	Detection of emphysema in left lung
Data Type	Categorical
Value Set	Emphysema absent Emphysema present Unknown
Units	N/A

Emphysema in left upper lobe

RadElement ID	RDE678
Definition	Detection of emphysema in left superior lobe
Data Type	Categorical
Value Set	Emphysema absent Emphysema present Unknown
Units	N/A

Emphysema in left lower lobe

RadElement ID	RDE679
Definition	Detection of emphysema in left inferior lobe
Data Type	Categorical
Value Set	Emphysema absent Emphysema present Unknown
Units	N/A

Emphysema in right upper lobe

RadElement ID	RDE680
Definition	Detection of emphysema in right superior lobe
Data Type	Categorical
Value Set	Emphysema absent Emphysema present Unknown
Units	N/A

Emphysema in right middle lobe

RadElement ID	RDE681
Definition	Detection of emphysema in right middle lobe
Data Type	Categorical
Value Set	Emphysema absent Emphysema present Unknown
Units	N/A

Emphysema in right lower lobe

RadElement ID	RDE682
Definition	Detection of emphysema in right inferior lobe
Data Type	Categorical
Value Set	Emphysema absent Emphysema present Unknown
Units	N/A

Secondary Outputs

Percent of lung zone involvement with emphysema

RadElement ID	RDE655
Definition	For any detected emphysema, measure the percent of the lobe with emphysema
Data Type	Numeric
Value Set	[0,1]
Units	Percent of lung lobe with emphysema

Dominant Type of emphysema

RadElement ID	RDE683
Definition	Dominant type of emphysema
Data Type	Categorical
Value Set	centriacinar panacinar paraseptal
Units	N/A

Percent volume of each emphysema type

RadElement ID	RDE656
Definition	Percent volume of each emphysema type (centriacinar, panacinar, and paraseptal)
Data Type	Numeric
Value Set	[0,1]
Units	percent volume of lung

Related Datasets

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Pulmonary Parenchymal Emphysema

Clinical Implementation

Value Proposition

Narrative(s)

Workflow Description

Considerations for Dataset Development

Technical Specifications

Inputs

Primary Outputs

Secondary Outputs

Related Datasets

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Clinical Implementation

Value Proposition

Narrative(s)

Workflow Description

Considerations for Dataset Development

Technical Specifications

Inputs

Primary Outputs

Secondary Outputs

Related Datasets

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