Craniosynostosis

Purpose	Identify premature closure of cranial sutures
Tag(s)
Panel	Pediatric Panel
Define-AI ID	19010006
Originator	Neil Lall
Lead	Neil Lall
Panel Chair	Matt Hawkins
Panel Reviewers	Pediatric Panel
License	Creative Commons 4.0
Status	Public Commenting
RadElement Set	RDES92

Clinical Implementation

Value Proposition

Craniosynostosis is a premature closure of the cranial sutures, with resulting deformity of the skull which can result in cosmetic issues and increased intracranial pressure. Early identification and cranioplasty can often alleviate these issues; however, identification of premature fusion can be difficult due to the differing milestones of normal sutural fusion for the multiple sutures. An algorithm meeting this use case will identify premature sutural fusion and abnormal sutural ridging. This automated detection will improve radiologists’ ability to focus on identifying possible sequelae of craniosynostosis and associated abnormalities as seen in syndromic conditions.

Narrative(s)

An infant presents with an abnormal head shape; the physician wants to ensure that this is related to positional flattening of the skull and not an underlying abnormal sutural fusion.

Workflow Description

A CT is performed and sent to PACS and the AI engine. The algorithm is triggered automatically by a head CT. The craniosynostosis algorithm returns an identification of any sutures that are prematurely closed or have associated ridging.

Considerations for Dataset Development

Procedures(s)	{CT Head of the skull}
View(s)	All
Sex at Birth	{Male, Female}
Age	[0,4]

Technical Specifications

Inputs

DICOM Study

Procedure	Head CT
Views	All
Data Type	DICOM
Modality	CT
Body Region	Head
Anatomic Focus	Skull

Patient Age

Data Type

Numeric

Primary Outputs

Metopic

RadElement ID	RDE552
Definition	Status of the midline frontal (metopic) suture
Data Type	Categorical
Value Set	0 - Undetermined 1 - Open, normal for age 2 - Closed, normal for age 3 - Open, abnormal for age 4 - Closed, abnormal for age 5 - Closed with ridging
Units	N/A

Sagittal

RadElement ID	RDE553
Definition	Status of the midline sagittal suture
Data Type	Categorical
Value Set	0 - Undetermined 1 - Open, normal for age 2 - Closed, normal for age 3 - Open, abnormal for age 4 - Closed, abnormal for age 5 - Closed with ridging
Units	N/A

Right Coronal

RadElement ID	RDE554
Definition	Status of the right coronal suture
Data Type	Categorical
Value Set	0 - Undetermined 1 - Open, normal for age 2 - Closed, normal for age 3 - Open, abnormal for age 4 - Closed, abnormal for age 5 - Closed with ridging
Units	N/A

Left Coronal

RadElement ID	RDE555
Definition	Status of the left coronal suture
Data Type	Categorical
Value Set	0 - Undetermined 1 - Open, normal for age 2 - Closed, normal for age 3 - Open, abnormal for age 4 - Closed, abnormal for age 5 - Closed with ridging
Units	N/A

Right Lambdoid

RadElement ID	RDE551
Definition	Status of the right lambdoid suture
Data Type	Categorical
Value Set	0 - Undetermined 1 - Open, normal for age 2 - Closed, normal for age 3 - Open, abnormal for age 4 - Closed, abnormal for age 5 - Closed with ridging
Units	N/A

Left Lambdoid

RadElement ID	RDE556
Definition	Status of the left lambdoid suture
Data Type	Categorical
Value Set	0 - Undetermined 1 - Open, normal for age 2 - Closed, normal for age 3 - Open, abnormal for age 4 - Closed, abnormal for age 5 - Closed with ridging
Units	N/A

Right Squamosal

RadElement ID	RDE557
Definition	Status of the right squamosal/temporosquamosal suture
Data Type	Categorical
Value Set	0 - Undetermined 1 - Open, normal for age 2 - Closed, normal for age 3 - Open, abnormal for age 4 - Closed, abnormal for age 5 - Closed with ridging
Units	N/A

Left Squamosal

RadElement ID	RDE558
Definition	Status of the left squamosal/temporosquamosal suture
Data Type	Categorical
Value Set	0 - Undetermined 1 - Open, normal for age 2 - Closed, normal for age 3 - Open, abnormal for age 4 - Closed, abnormal for age 5 - Closed with ridging
Units	N/A

Secondary Outputs

Wormian bones

RadElement ID	RDE559
Definition	Presence of wormian bones
Data Type	Categorical
Value Set	0 - absent 1 - 1-10 wormian bones present (within normal limits) 2 - more than 10 wormian bones (abnormal) 3- Unknown
Units	N/A

Future Development Ideas

Identification of normal sutures (and normal variant accessory sutures) for patient age can be useful in distinguishing them from fractures.
Identification of sutures on radiographs would be very useful to help in looking for craniosynostosis (as well as distinguishing from fractures).
other secondary findings such as orbital shape (e.g. harlequin orbit) or overall skull morphology would be useful to highlight to assist with more equivocal cases.
While MRI is not the common method for such evaluations, a reliable method of assessment on MRI would be beneficial in allowing it to be used for these cases.

Related Datasets

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