Pulmonary Veins Mapping Preablation Planning for CT

Purpose	Document pulmonary veins and anatomy for ablation planning
Tag(s)
Panel	Cardiac
Define-AI ID	18040017
Originator	David Wymer
Panel Chair	Carlo De Cecco
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Published

Clinical Implementation

Value Proposition

Automate the pulmonary vein measurements and pertinent cardiac anatomy to save the radiologist time from manually measuring.

Narrative(s)

A patient presents with atrial fibrillation (afib) and needs an ablation procedure based on clinical needs and/or failure of medical control.

Workflow Description

A patient receives pre-afib ablation contrast-enhanced CT (CE-CT) and triggers the algorithm. The algorithm retrieves input from imagery and electronic health record data such as age, gender, and symptom chronicity. The algorithm executes and measures pulmonary veins at the insertion to the left atrium. The algorithm then evaluates for atrial appendage thrombus and measures left atrial size, thickness of atrial septum, and left ventricular size. After evaluating for mitral and aortic valve calcification, the algorithm measures the proximity of vein ostia to the esophagus and aorta. The algorithm returns all measurements, along with the degree of valvular calcifications, positive and negative atrial thrombus, and esophagus and aorta proximity to vein ostia. The algorithm suggests the likelihood of chronic afib due to a non-atrial cause (mitral/aortic stenosis/regurgitation).

Considerations for Dataset Development

Procedures(s): CE-CT Heart

Sex at Birth: {Male, Female}

 

Age (years): [0,90]

 

Afib Chronicity: varied frequencies

 

Frailty Index: varied

 

Comorbidities: {heart failure, pulmonary artery hypertension}

Technical Specifications

Inputs

DICOM Study

Procedure	CE-CT Heart
Data Type	DICOM
Modality	CT
Body Region	Chest
Anatomic Focus	Heart

 

Primary Outputs

Pulmonary Vein Diameter

RadElement ID

RDE280

Definition	Diameter of pulmonary vein (mm)
Data Type	Categorical
Value Set
Units	mm

 

Interatrial Septal Thickness

RadElement ID	RDE281
Definition	Interatrial septal thickness (mm)
Data Type	Numeric
Value Set
Units	mm

 

Presence of Atrial Thrombus

RadElement ID	RDE282
Definition	Determine the presence of atrial thrombus
Data Type	Categorical
Value Set	0 – Unknown 1 – Present 2 –Absent
Units	N/A

 

Presence of Valvular Calcifications

RadElement ID	RDE283
Definition	Determine the presence of valvular calcifications
Data Type	Categorical
Value Set	0 – Unknown 1 – Present 2 –Absent
Units	N/A

 

Vein Ostia Proximity to Esophagus

RadElement ID	RDE284
Definition	Measure the distance between the vein ostia and esophagus(cm)
Data Type	Numeric
Value Set
Units	cm

 

Vein Ostia Proximity to Aorta

RadElement ID	RDE285
Definition	Measure the distance between the vein ostia and aorta (cm)
Data Type	Numeric
Value Set
Units	cm

Secondary Outputs 

Likelihood of Ablation Success

RadElement ID	RDE286
Definition	Estimate the probability of ablation success
Data Type	Numeric
Value Set	[0,1]
Units	% likelihood of success

Related Datasets

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