Pulmonary Artery to Aortic Diameter Ratio

Purpose	Calculate MPa:Ao and determined if enlarged
Tag(s)	#MPA:AO
Panel	Cardiac
Define-AI ID	18040016
Originator	Jay Nance
Panel Chair	Carlo De Cecco
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Published

Value Proposition

Pulmonary artery size is an imperfect imaging biomarker of pulmonary hypertension, but it has shown prognostic value in a variety of clinical situations. Cutoffs for abnormal values have been proposed and validated. Automated quantification would save the interpreting physician time via elimination of manual measurements, would prevent detection errors (missing enlarged pulmonary arteries), and would provide structured quantitative data, which could be used in later studies or risk-stratification schemes.

Narrative(s)

All patients undergoing CT examinations through the level of the main pulmonary artery should have automated quantification of arterial diameter, which should then be automatically populated into the radiology report or a report supplement. This use case will focus specifically on relevant cardiac imaging modalities, ie, electrocardiogram (ECG)-synchronized coronary artery calcium scoring, coronary CT angiography (CCTA), and full-chest CT angiography (triple rule-out scans).

Workflow Description

A patient receives ECG-synchronized CT of the chest and heart. An algorithm retrieves a volumetric imaging data set and accessible electronic medical record data, including age, sex, and body mass index. The algorithm executes and returns the main pulmonary artery to aortic diameter ratio (MPA:Ao). If the ratio or absolute value indicate enlarged arteries, alert the user. The algorithm returns all values, which could populate the report (possibly within a supplement containing other quantitative data). The algorithm flags abnormal values.

Procedures(s): ECG-synchronized CT, Chest

Sex at Birth: {Male, Female}

 

Age (years): [15,90]

 

Body Mass Index (kg/m²): [10,52]

 

Body Surface Area: varied

 

Aortic Diameter (mm): [20,40]

 

Abnormalities: {Congenital heart disease, ventricular septal defects}

 

Interventions: {Congenital heart disease repair, mitral valve replacements}

 

Contrast: {Contrast-enhanced (CCTA), non-contrast enhanced applications}

Inputs

DICOM Study

Procedure	ECG-synchronized CT, Chest
Data Type	DICOM
Modality	CT
Body Region	Chest
Anatomic Focus	Heart

 

Primary Outputs

Pulmonary Artery to Aortic Diameter Ratio

RadElement ID	RDE315
Definition	Main pulmonary artery to aortic diameter ratio (MPA:Ao)
Data Type	Numeric
Value Set
Units

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