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 | |
| Definition | Detection of emphysema in either lung |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Emphysema in right lung
| RadElement ID | |
| Definition | Detection of emphysema in right lung |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Emphysema in left lung
| RadElement ID | |
| Definition | Detection of emphysema in left lung |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Emphysema in left upper lobe
| RadElement ID | |
| Definition | Detection of emphysema in left superior lobe |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Emphysema in left lower lobe
| RadElement ID | |
| Definition | Detection of emphysema in left inferior lobe |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Emphysema in right upper lobe
| RadElement ID | |
| Definition | Detection of emphysema in right superior lobe |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Emphysema in right middle lobe
| RadElement ID | |
| Definition | Detection of emphysema in right middle lobe |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Emphysema in right lower lobe
| RadElement ID | |
| Definition | Detection of emphysema in right inferior lobe |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Secondary Outputs
Percent of lung zone involvement with emphysema
| RadElement ID | |
| 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 | |
| Definition | Dominant type of emphysema |
| Data Type | Categorical |
| Value Set |
|
| Units | N/A |
Percent volume of each emphysema type
| RadElement ID | |
| Definition | Percent volume of each emphysema type (centriacinar, panacinar, and paraseptal) |
| Data Type | Numeric |
| Value Set | [0,1] |
| Units | percent volume of lung |