Pulmonary to Systemic Flow Ratio

Purpose	Automate measurement of pulmonary to systemic flow ratio (Qp:Qs)
Tag(s)	#Qp:Qs
Panel	Cardiac
Define-AI ID	18040022
Originator	Benoit Desjardins
Panel Chair	Carlo De Cecco
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Published

Clinical Implementation

Value Proposition

Measurement of Qp:Qs is a well-established clinical parameter to determine degree of shunting that has fundamental diagnostic, therapeutic, and prognostic implications. Cardiac Magnetic Resonance (CMR) allow accurate assessment of flow parameters. Automated Qp:Qs quantification would save the interpreting physician time via elimination of manual measurements, prevent detection errors, and provide structured quantitative data, which could be used in later studies or risk stratification schemes.

Narrative(s)

All patients undergoing CMR examinations which include flow measurements should have automated quantification of Qp:Qs if data are available, which may then be automatically populated into the radiology report or a report supplement.

Workflow Description

Patient receives MRI of the chest/heart. Algorithm retrieves aortic and pulmonary flow imaging dataset if present and may ingest additional EMR data such as age, sex, and body surface area. Algorithm executes and calculates values of Qp:Qs. Algorithm also determines direction of shunting if shunt is present. Algorithm returns all measurements, which could populate the report (possibly within a supplement containing other quantitative data). Algorithm flags abnormal values.

Considerations for Dataset Development

Procedures(s): MRI, Cardiac

View(s): CMR velocity-encoded phase contrast images, ascending thoracic aorta and pulmonary artery

Sex at Birth: {Male, Female}

Interventions: Congenital heart disease repair

Comorbidities: {Congenital heart disease, ventricular septal defects}

Pulmonary artery diameter (mm): [10,50]

Body Mass Index: [10,52]

Body Surface Area (m²): [1.0,3.5]

Other: Aliasing

Clinical Note: Alert radiologist to possible aliasing

Technical Specifications

Inputs

DICOM Study

Procedure	MRI, Cardiac
Views	CMR velocity-encoded phase contrast images, ascending thoracic aorta and pulmonary artery
Data Type	DICOM
Modality	MR
Body Region	Chest
Anatomic Focus	Heart

Primary Outputs