Variance of Manual, Radiology Reported vs. Computer Algorithm-Assisted Measurement of Ascending Aortic Aneurysms: Standardization for Clinical Practice
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0380
Submission Type:
Abstract Submission
Authors:
Samuel Ajamu (1), Abdulrhman Elnaggar (2), Anna Tarren (2), Jonathan Tomasko (3), Behzad Soleimani (4)
Institutions:
(1) Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA, (2) Penn State College of Medicine, Hershey, PA, (3) N/A, Hershey, PA, (4) N/A, N/A
Submitting Author:
Samuel Ajamu
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Penn State College of Medicine
Penn State College of Medicine
Co-Author(s):
Abdulrhman Elnaggar
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Penn State College of Medicine
Penn State College of Medicine
Anna Tarren
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Penn State College of Medicine
Penn State College of Medicine
Jonathan Tomasko
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N/A
N/A
Behzad Soleimani
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Presenting Author:
Samuel Ajamu
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Abstract:
Objective: With recent ACC/AHA guidelines for thoracic ascending aortic aneurysm (TAA) lowering the threshold for surgery, accurate and consistent means of measuring TAA are critical for clinical decision-making. This study aimed to evaluate the difference in manual, radiology reported vs. computer algorithm-assisted measurements of TAA on computerized tomography (CT) scans.
Methods: A retrospective analysis of 250 patients with a history of TAA who received their follow-up CT scans at our institution between 2010 and 2020 was completed. Exclusion criteria were patients <18 years of age, prior history of aortic repair, and scans for which the algorithm was used to generate the radiology report. TAA measurements included the sinus of Valsalva (SOV) and maximum ascending diameter (MAD). The iNtuition TeraRecon imaging platform with advanced visualization capacities was used to complete SOV and MAD algorithm-assisted measurements. These measurements were compared to the manual SOV and MAD from the patient chart review. Statistical analysis was employed to assess the agreement between the two methods. A paired t-test was done to compare the two groups. A bland-Altman plot was generated for both SOV and MAD.
Results: The algorithm-assisted measurements were significantly greater than the manual measurements by paired t-test. The two method's measurement for the SOV had a significant p-value of p< 0.01. Likewise, paired t-test of MAD measurements had a significant p-value of p < 0.01. Further analysis showed a bias of 3.1mm when taking the difference between the algorithm assisted and the manual measurements of the MAD. The bias when taking the contrast of the algorithm-assisted and manual measurements of the SOV was 1.6mm (Figure)
Conclusion: The utilization of a standard algorithm to measure the diameter of the TAA perpendicular to blood flow shows a significant variance, with an average upsizing of 1.6 mm for SOV and 3.1 mm for MAD. This variance can prove significant in clinical decision-making using the current ACC/AHA guidelines, as this advanced imaging platform could standardize TAA measurements to decrease inter-observer dependent variation in aneurysm measurements.
Methods: A retrospective analysis of 250 patients with a history of TAA who received their follow-up CT scans at our institution between 2010 and 2020 was completed. Exclusion criteria were patients <18 years of age, prior history of aortic repair, and scans for which the algorithm was used to generate the radiology report. TAA measurements included the sinus of Valsalva (SOV) and maximum ascending diameter (MAD). The iNtuition TeraRecon imaging platform with advanced visualization capacities was used to complete SOV and MAD algorithm-assisted measurements. These measurements were compared to the manual SOV and MAD from the patient chart review. Statistical analysis was employed to assess the agreement between the two methods. A paired t-test was done to compare the two groups. A bland-Altman plot was generated for both SOV and MAD.
Results: The algorithm-assisted measurements were significantly greater than the manual measurements by paired t-test. The two method's measurement for the SOV had a significant p-value of p< 0.01. Likewise, paired t-test of MAD measurements had a significant p-value of p < 0.01. Further analysis showed a bias of 3.1mm when taking the difference between the algorithm assisted and the manual measurements of the MAD. The bias when taking the contrast of the algorithm-assisted and manual measurements of the SOV was 1.6mm (Figure)
Conclusion: The utilization of a standard algorithm to measure the diameter of the TAA perpendicular to blood flow shows a significant variance, with an average upsizing of 1.6 mm for SOV and 3.1 mm for MAD. This variance can prove significant in clinical decision-making using the current ACC/AHA guidelines, as this advanced imaging platform could standardize TAA measurements to decrease inter-observer dependent variation in aneurysm measurements.
Aortic Symposium:
Ascending Aorta
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