Calcium Scoring of the Aortic Valve before TAVR

Purpose	Identify the aortic valve and measure the Calcium score, and suggest follow up care(TAVR vs. SAVR) in routine TAVR CT reports.
Tag(s)
Panel	Cardiac
Define-AI ID	19040035
Originator	Moritz H. Albrecht
Lead	Moritz H. Albrecht
Panel Chair	Carlo De Cecco
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Public Comment
RadElement Set	RDES129

Clinical Implementation

Value Proposition

More recently, the value of Calcium scoring for the decision TAVR vs. SAVR has been particularly recognized and implemented in guidelines. However, the measurement adds another work burden in manual 3D post-processing, despite the assumption that calcium scoring of the aortic valve could be easier performed than for the coronary arteries.
The amount of calcification of the aortic valve and left ventricular outflow tract can be quantified taking the Agatston convention into account. The algorithm will automatically identify the aortic valve and measure the Calcium score, and suggest the result (TAVR vs. SAVR) in routine TAVR CT reports- which will likely increase the efficiency of clinicians, improve patient outcomes, and minimize patient risk.

Narrative(s)

TAVR CT reports will be more comprehensive in terms of quantitative information and the radiologist/ cardiologist can focus more on qualitative criteria when analyzing the TAVR CT dataset prior to the procedure.

Workflow Description

Patient receives TAVR CT examination. Algorithm segments image to identify the aortic valve on usual TAVR CT examinations. Algorithm detects calcifications in the volume of interest. For each calcification, the algorithm quantifies the amount of calcium according to the Agatston convention. Following which, the algorithm then provides the calcium score and cautiously suggests the TAVR or SAVR approach.

Considerations for Dataset Development

Procedure(s)	Gated CTA of the chest
View(s)	CCTA Any volumetric imaging data set
Sex at Birth	{Male, Female}
Age	[18,70]
History	Severe Aortic stenosis
CT	Must be gated with multiple diastolic and systolic phases of the cardiac cycle
Contrast Material	{CT w/ IV arterial-phase contrast, w/o arterial-phase contrast}
Position	{Weight bearing, nonweight bearing}

Technical Specifications

Inputs

DICOM Study
Procedure	TAVR CT
Views	N/A
Data Type	DICOM
Modality	CT
Body Region	Chest
Anatomic Focus	Heart

Primary Outputs

Detect Calcifications of interest
RadElement ID	RDE851
Definition	Detect calcification in the region of interest
Data Type	Categorical
Value Set	Calcification absent Calcification present Unknown
Units	N/A

Calcium score according to Agatston convention
RadElement ID	RDE852
Definition	Calcium score according to Agatston convention
Data Type	Numeric
Value Set	Acute aortic syndrome absent Acute aortic syndrome present Unknown
Units	N/A

Recommended treatment with respect to calcification
RadElement ID	RDE853
Definition	Recommended treatment with respect to calcification
Data Type	Categorical
Value Set	TAVR SAVR Unknown
Units	N/A

Related Datasets

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