Fully automatic deep learning pulmonary hypertension diagnosis using CT pulmonary angiography

13.01 - Pulmonary hypertension, pp. 3655

Abstract

Introduction: Invasive right heart catheterisation (RHC) is the gold standard for diagnosing pulmonary hypertension (PH), where a mean pulmonary artery pressure (mPAP) of >20mmHg is diagnostic for PH. CT pulmonary angiography (CTPA) is integral in the workup of suspected PH. The aim of this study is to develop an automated tool to diagnose PH from CTPA using segmented cardiac volumes to predict mPAP. Methods: A multi-structure (see figure) CTPA deep learning segmentation model of the heart and great vessels was developed using 200 patients with suspected PH who were manually segmented by a consultant cardiothoracic radiologist. The segmentation model was applied in 1000 consecutive patients who underwent CTPA and RHC within 48 hrs, (mPAP ≤20mmHg n=72/1000) at a tertiary PH referral centre. The acquired volumetric measurements were entered in multiple logistic regression in a training cohort (n=500) to identify a diagnostic CT model to predict mPAP >20mmHg. A ROC analysis was performed in the validation cohort (n=500). Results: A diagnostic model was identified including the pulmonary artery volume, the right ventricle to left ventricle (LV) mass ratio, and the LV eccentricity. The area under the ROC was 0.86. Conclusion: A fully automatic model for the diagnosis of PH using CTPA is presented. This has wide future potential application in automated PH screening and diagnostic workup.

Authors 15

1. Michael J. Sharkey

   University of Sheffield

   Affiliation as printed

   Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom

2. Kavita Karunasaagarar

   Sheffield Teaching Hospitals NHS Foundation Trust

   Affiliation as printed

   Radiology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

3. C S Johns

   Sheffield Teaching Hospitals NHS Foundation Trust

   Affiliation as printed

   Radiology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

4. Smitha Rajaram

   Sheffield Teaching Hospitals NHS Foundation Trust

   Affiliation as printed

   Radiology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

5. K Dwivedi

   University of Sheffield

   Affiliation as printed

   Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom

   Sheffield, United Kingdom

6. P Garg

   University of Sheffield

   Affiliation as printed

   Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom

7. Dheyaa Alkhanfar

   University of Sheffield

   Affiliation as printed

   Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom

8. Samer Alabed

   University of Sheffield

   Affiliation as printed

   Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom

9. Peter Metherall

   Sheffield Teaching Hospitals NHS Foundation Trust

   Affiliation as printed

   3DLab, Radiology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

10. J Taylor

    Sheffield Teaching Hospitals NHS Foundation Trust

    Affiliation as printed

    3DLab, Radiology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

11. Rob J. van der Geest Aachen Division of Image Processing Department of Radiology, Leiden University Medical Center

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Division of Image Processing, Department of Radiology, Leiden University Medical Centre, Leiden, Netherlands

12. R Condliffe

    Royal Hallamshire Hospital · Sheffield Teaching Hospitals NHS Foundation Trust

    Affiliation as printed

    Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

13. M Mamalakis

    University of Sheffield

    Affiliation as printed

    Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom

14. David Gerard Kiely

    Royal Hallamshire Hospital · Sheffield Teaching Hospitals NHS Foundation Trust

    Affiliation as printed

    Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

15. Andrew J. Swift

    University of Sheffield

    Affiliation as printed

    Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom