Quantifying Carotid Stenosis on CTA

Purpose	To accurately assess the maximum degree of proximal carotid stenosis on CTA neck.
Tag(s)
Panel	Neuroradiology
Define-AI ID	21020022
Originator	Mark Lum
Lead	Mark Lum
Panel Chair	Alex Norbash
Panel Reviewers	Neuoradiology Panel
License	Creative Commons 4.0
Status	Public Comment
RadElement Set	RDES187

Clinical Implementation

Value Proposition

Accurate quantification of carotid stenosis is important in determining therapy such as endarterectomy. Estimation of stenosis on CTA involves submillimeter measurements (Barlett 2006), which are prone to manual measurement variability. Additionally, tortuosity or obliquity of the internal carotid arteries can make perpendicular measurements challenging further limiting accurate stenosis estimation.

Narrative(s)

60 year-old male with hypertension, hyperlipidemia, and coronary artery disease presents with intermittent transient vision loss. CTA of the neck reveals severe left carotid artery stenosis.

Workflow Description

The proximal internal carotid arteries are automatically segmented, and elongated, curved reconstructions are generated (centerline technique). Annotated images demonstrate the minimal luminal diameter reported to the tenth of a millimeter. Estimated stenosis is automatically produced based on established normative data.

Considerations for Dataset Development

Procedure	CTA neck
Age	>=18 years
Sex	Male, female
Co-morbidities	Hypertension, hyperlipidemia, smoking, obesity, diabetes

Technical Specifications

Inputs

DICOM Study

Procedure	CTA neck
Views	All
Data Type	DICOM
Modality	CT
Body Region	Neck
Anatomic Focus	Neck

Primary Outputs

Maximum carotid stenosis

RadElement ID	RDE1272
Definition	Greatest degree of stenosis of the proximal cervical internal carotid artery
Data Type	Numeric
Value Set	[0,100]
Units	Percent

References

Bartlett ES, Walters TD, Symons SP, Fox AJ. Quantification of carotid stenosis on CT angiography. AJNR Am J Neuroradiol. 2006;27(1):13-9.