Objectives: To assess the feasibility and reliability of the use of artificial intelligence post-processing to calculate the RV:LV diameter ratio on computed tomography pulmonary angiography (CTPA) and to investigate its prognostic value in patients with acute PE.
Methods: Single-centre, retrospective study of 101 consecutive patients with CTPA-proven acute PE. RV and LV volumes were segmented on 1-mm contrast-enhanced axial slices and maximal ventricular diameters were derived for RV:LV ratio using automated post-processing software (IMBIO LLC, USA) and compared to manual analysis in two observers, via intraclass coefficient correlation analysis. Each CTPA report was analysed for mention of the RV:LV ratio and compared to the automated RV:LV ratio. Thirty-day all-cause mortality post-CTPA was recorded.
Results: Automated RV:LV analysis was feasible in 87% (n = 88). RV:LV ratios ranged from 0.67 to 2.43, with 64% (n = 65) > 1.0. There was very strong agreement between manual and automated RV:LV ratios (ICC = 0.83, 0.77-0.88). The use of automated analysis led to a change in risk stratification in 45% of patients (n = 40). The AUC of the automated measurement for the prediction of all-cause 30-day mortality was 0.77 (95% CI: 0.62-0.99).
Conclusion: The RV:LV ratio on CTPA can be reliably measured automatically in the majority of real-world cases of acute PE, with perfect reproducibility. The routine use of this automated analysis in clinical practice would add important prognostic information in patients with acute PE.
Key Points: • Automated calculation of the right ventricle to left ventricle ratio was feasible in the majority of patients and demonstrated perfect intraobserver variability. • Automated analysis would have added important prognostic information and altered risk stratification in the majority of patients. • The optimal cut-off value for the automated right ventricle to left ventricle ratio was 1.18, with a sensitivity of 100% and specificity of 54% for the prediction of 30-day mortality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00330-020-07605-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Current Role of CT Pulmonary Angiography in Pulmonary Embolism: A State-of-the-Art Review.
J Imaging
December 2024
Radiology Department, Clinica Universidad de Navarra, Calle Santa Marta n. 1, 28027 Madrid, Spain.
The purpose of this study is to conduct a literature review on the current role of computed tomography pulmonary angiography (CTPA) in the diagnosis and prognosis of pulmonary embolism (PE). It addresses key topics such as the quantification of the thrombotic burden, its role as a predictor of mortality, new diagnostic techniques that are available, the possibility of analyzing the thrombus composition to differentiate its evolutionary stage, and the applicability of artificial intelligence (AI) in PE through CTPA. The only finding from CTPA that has been validated as a prognostic factor so far is the right ventricle/left ventricle (RV/LV) diameter ratio being >1, which is associated with a 2.
View Article and Find Full Text PDFEchocardiographic Changes in Infants with Severe Congenital Diaphragmatic Hernia After Fetoscopic Endoluminal Tracheal Occlusion (FETO).
Pediatr Cardiol
December 2024
Division of Pediatric General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Fetoscopic endoluminal tracheal occlusion (FETO) induces lung growth and may improve survival in congenital diaphragmatic hernia (CDH) but the effect on post-natal right (RV) and left (LV) ventricular size and cardiac function is unknown. Quantitative measures of heart size and function including tricuspid annular plane systolic excursion Z-score (TAPSEZ), RV fractional area change (RVFAC), RV global longitudinal and free wall strain (RVGLS, RVFWS), RV/LV ratio, LV eccentricity index (LVEI), and LV M-mode diastolic and systolic Z-scores (LVIDDZ, LVIDSZ) were compared between FETO and control patients on first post-natal echocardiogram, prior to and post CDH repair, and on last available echocardiogram using non-parametric Wilcoxon rank-sum test in a single-center, retrospective cohort study. Linear regression models evaluated change over time, adjusting for clustering and interaction of echocardiogram parameters with time.
View Article and Find Full Text PDFSafety and efficacy of catheter-directed thrombectomy without thrombolysis in acute pulmonary embolism: A systematic review and meta-analysis.
Int J Cardiol
February 2025
Division of Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. Electronic address:
Article Synopsis
- * The research reviewed 18 studies involving 803 patients and found in-hospital mortality and major bleeding rates were low, at 1.8% and 2.1% respectively.
- * Results showed significant improvements in oxygen saturation and blood pressure after the procedure, suggesting that CDT offers beneficial hemodynamic outcomes and a favorable safety profile, supporting its increased use in clinical settings.
Mid-Term Results of Pulmonary Valve-Sparing Repair for Tetralogy of Fallot With Pulmonary Stenosis.
World J Pediatr Congenit Heart Surg
November 2024
Department of Cardiac Surgery, Cardiac Anesthesia and Pediatric Cardiology, G Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India.
Objective: The transannular patch remains the most common procedure performed for patients with Tetralogy of Fallot (TOF) with pulmonary stenosis. Pulmonary regurgitation has a negative impact on early and late outcomes. To address this issue pulmonary valve-sparing repair (PVSR) has been developed.
View Article and Find Full Text PDFA Noninvasive Prediction Model With Simple Echocardiographic Variables for Shunts Closure Possibility in Patients With Posttricuspid Valve Shunt Defect.
Echocardiography
November 2024
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China.
Article Synopsis
- Researchers developed a noninvasive model called P-echo to predict if shunt closure is feasible for adult patients with congenital heart defects, specifically those with post-tricuspid valve issues like ventricular septal defects (VSD) and patent ductus arteriosus (PDA).
- The study involved analyzing 1,474 patients between 2012 and 2022 and identified key echocardiographic parameters using LASSO regression, showing that the P-echo model had excellent predictive accuracy with AUC values nearing 1.
- The P-echo model offers a reliable noninvasive alternative to invasive right heart catheterization (RHC) and can help tailor treatment decisions for patients with adult congenital heart disease.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!