Coronary CT Angiography

 

Purpose	Quantification of stenosis of the coronary arteries
Tag(s)
Panel	Cardiac
Define-AI ID	19040030
Originator	Kimberly Brockenbrough, MD
Lead	Kimberly Brockenbrough, MD
Panel Chair	Carlo De Cecco, MD
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Public Comment
RadElement Set	RDES145

Clinical Implementation

Value Proposition

Coronary CT Angiography offers opportunities to minimize patient risk compared to invasive coronary angiography in efforts to diagnosis coronary artery disease. While improvements in image quality have been made recently, AI that delivers metrics related to CTA would be promising for clinician efficiency and patient outcomes. Currently CTA faces some challenges to invasive procedures such as lower temporal resolution, greater frequency of motion artifacts, and higher false-positives from severe calcification.

Narratives

A 55 year old woman presents to the emergency department with chest pain. Initial blood work is negative for a myocardial infarction (heart attack). She has a history of high cholesterol putting her at an intermediate risk for an acute myocardial infarction. Her doctor orders an ECG that appears normal. A coronary CTA is ordered to look for coronary artery disease.
A 60 year old man presents to his primary care physician with a 3 week history of chest pain. Blood work and EKG are negative. The nuclear stress test is equivocal. His doctor orders a coronary CTA to look for coronary artery disease.

Workflow Description

The image is obtained from the CT scanner, sent to the AI algorithm and to the PACS. The CT images are post-processed by the algorithm. The algorithm measures the minimum diameter of the coronary arteries. The post-processed images are sent to the PACS.

Considerations for Dataset Development

Procedure(s)	{CTA coronary arteries}
View(s)	{<1 mm axial source images and 3D reconstructions}
Sex at Birth	{Male, Female}
Age	[0,105]

Technical Specifications

Inputs

DICOM Study

Procedure	CT angiogram of the coronary arteries
Views	< 1 mm axial slices
Data Type	DICOM
Modality	CT
Body Region	Heart
Anatomic Focus	Coronary arteries

Primary Outputs

 

Percent Stenosis of the Coronary Arteries

RadElement ID	RDE969
Definition	Determine degree of stenosis
Data Type	Numeric
Value Set	[0,100]
Units	percentage

Maximum Percent Stenosis of the left main coronary artery

RadElement ID	RDE970
Definition	Percent stenosis compared to the adjacent normal vessel
Data Type	Numeric
Value Set	[0,100]
Units	percentage

Maximum percent stenosis of the left anterior descending coronary artery

 

 

 

Minimum percent stenosis of the diagonal branches

 

 

Minimum percent stenosis of the ramus branch

 

 

Minimum percent stenosis of the left circumflex artery

 

 

 

Minimum percent stenosis of the obtuse marginal branch

 

 

 

Minimum percent stenosis of the right coronary artery

 

 

Minimum percent stenosis of the PDA

 

 

 

Minimum percent stenosis of the posterior lateral branch

 

 

 

 

Technical Specifications

Inputs

  

DICOM Study

Procedure	CT angiogram of the coronary arteries
Views	< 1 mm axial slices
Data Type	DICOM
Modality	CT
Body Region	Heart
Anatomic Focus	Coronary arteries

Primary Outputs

Percent Stenosis of the Coronary Arteries

RadElement ID	RDE969
Definition	Determine degree of stenosis
Data Type	Numeric
Value Set	[0,100]
Units	percentage

Maximum Percent Stenosis of the left main coronary artery

RadElement ID	RDE970
Definition	Percent stenosis compared to the adjacent normal vessel
Data Type	Numeric
Value Set	[0,100]
Units	percentage

Maximum percent stenosis of the left anterior descending coronary artery

Future Development Ideas

• The algorithm could give CAD-RADs categories
  
  

Related Datasets

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