Left Atrial Enlargement

Purpose	Detect left atrial enlargement
Tag(s)	#Cardiac Size on Chest Radiograph
Panel	Cardiac
Define-AI ID	18040006
Originator	Jay Nance
Panel Chair	Carlo De Cecco
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Published

                               

Value Proposition

The chest radiograph is often the first imaging study that is available. It can be used as a quick initial screening tool for cardiomegaly, which in and of itself can be used as a marker for heart disease. A quick visual assessment by a radiologist is sometimes inaccurate. An AI algorithm can be trained to make an accurate assessment of cardiomegaly based on a single-view chest radiograph (anteroposterior [AP] or posterioranterior [PA]). Additionally, the algorithm can indicate which specific chambers contribute most to the enlarged cardiac silhouette.

Narrative(s)

A 60-year-old male with no prior imaging is admitted to the emergency department for shortness of breath. A chest radiograph is obtained as part of the initial workup. The algorithm evaluates the image and determines whether the patient’s heart is enlarged. The radiologist is informed of this categorization at the time of interpretation. Additionally, the algorithm is able to evaluate for enlargement of the left atrium (or other specific chambers).

Workflow Description

The image obtained from the modality is sent to PACS and the AI engine. The image is analyzed by the engine. If the image is a PA view, a simple cardiothoracic ratio (width of heart/width of thorax) is computed. If the image is an AP view, a “modified” cardiothoracic ratio is computed. The system categorizes the heart as enlarged or normal in size based on whether the cardiothoracic ratio is greater than 0.5. If the heart is enlarged, the angle of the carina is measured by the system. If the angle is greater than 100 degrees, the presence of left atrial enlargement is detected. A message is sent to PACS from the engine with the information.

Procedures(s): X-ray, Chest

View(s): {AP, PA}

 

Sex at Birth: {Male, Female}

Inputs

DICOM Study

Procedure	XRAY, Chest
Views	AP, PA
Data Type	DICOM
Modality	XRAY
Body Region	Chest
Anatomic Focus	Heart

 

Primary Outputs

Left Atrial Enlargement

RadElement ID	RDE214
Definition	Presence of left atrial enlargement. If the cardiothoracic ratio is greater than 0.5 and the carina angle is greater than 100 degrees, then suggest left atrial enlargement.
Data Type	Categorical
Value Set	0-Unknown 1-Left atrial normal 2-Left atrial enlarged
Units	N/A

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