CT angiography prior to endovascular procedures: can artificial intelligence improve reporting?

Journal: Physical and engineering sciences in medicine
Published Date:

Abstract

CT angiography prior to endovascular aortic surgery is the standard non-invasive imaging method for evaluation of aortic dimensions and access sites. A detailed report is crucial to a proper planning. We assessed Artificial Intelligence (AI)-algorithm accuracy to measure vessels diameters at CT prior to transcatheter aortic valve implantation (TAVI). CT scans of 50 patients were included. Two Radiologists with experience in vascular imaging together manually assessed diameters at nine landmark positions according to the American Heart Association guidelines: 450 values were obtained. We implemented TOST (Two One-Sided Test) to determine whether the measurements were equivalent to the values obtained from the AI algorithm. When the equivalence bound was a range of ± 2 mm the test showed equivalence for every point; if the range was equal to ± 1 mm the two measurements were not equivalent in 6 points out of 9 (p-value > 0.05), close to the aortic valve. The time for automatic evaluation (average 1 min 47 s) was significantly lower compared with manual measurements (5 min 41 s) (p < 0.01). In conclusion, our results indicate that AI-algorithms can measure aortic diameters at CT prior to endovascular surgery with high accuracy. AI-assisted reporting promises high efficiency, reduced inter-reader variabilities and time saving. In order to perform optimal TAVI procedure planning aortic root analysis could be improved, including annulus dimensions.

Authors

  • Enrico Boninsegna
    Department of Radiology, Azienda Socio Sanitaria Territoriale di Mantova, St. Lago Paiolo 10, 46100, Mantova, Italy. boninsegnae@gmail.com.
  • Stefano Piffer
    Department of Biomedical Experimental Clinical Science "M. Serio", University of Florence, Florence, Italy.
  • Emilio Simonini
    Department of Radiology, Azienda Socio Sanitaria Territoriale di Mantova, St. Lago Paiolo 10, 46100, Mantova, Italy.
  • Michele Romano
    Department of Cardiology, Azienda Socio Sanitaria Territoriale di Mantova, Mantova, Italy.
  • Corrado Lettieri
    Department of Cardiology, Azienda Socio Sanitaria Territoriale di Mantova, Mantova, Italy.
  • Stefano Colopi
    Department of Radiology, Azienda Socio Sanitaria Territoriale di Mantova, St. Lago Paiolo 10, 46100, Mantova, Italy.
  • Giampietro Barai
    Department of Medical Physics, Azienda Socio Sanitaria Territoriale di Mantova, Mantova, Italy.