scholarly journals Computer Aided Detection of Pulmonary Embolism Using Multi-Slice Multi-Axial Segmentation

2020 ◽  
Vol 10 (8) ◽  
pp. 2945
Author(s):  
Carlos Cano-Espinosa ◽  
Miguel Cazorla ◽  
Germán González

Pulmonary Embolism (PE) is a respiratory disease caused by blood clots lodged in the pulmonary arteries, blocking perfusion, limiting blood oxygenation, and inducing a higher load on the right ventricle. Pulmonary embolism is diagnosed using contrast enhanced Computed Tomography Pulmonary Angiography (CTPA), resulting in a 3 D image where the pulmonary arteries appear as bright structures, and emboli appear as filling defects, with these often being difficult to see, especially in the subsegmental case. In comparison to an expert panel, the average radiologist has a sensitivity of between 77% and 94 % . Computer Aided Detection (CAD) is regarded as a promising system to detect emboli, but current algorithms are hindered by a high false positive rate. In this paper, we propose a novel methodology for emboli detection. Instead of finding candidate points and characterizing them, we find emboli directly on the whole image slice. Detections across different slices are merged into a single detection volume that is post-processed to generate emboli detections. The system was evaluated on a public PE database of 80 scans. On 20 test scans, our system obtained a per-embolus sensitivity of 68% at a regime of one false positive per scan, improving on state-of-the-art methods. We therefore conclude that our multi-slice emboli segmentation CAD for PE method is a valuable alternative to the standard methods of candidate point selection and classification.

Author(s):  
Katharina Müller-Peltzer ◽  
Lena Kretzschmar ◽  
Giovanna Negrão de Figueiredo ◽  
Alexander Crispin ◽  
Robert Stahl ◽  
...  

Purpose Since artificial intelligence is transitioning from an experimental stage to clinical implementation, the aim of our study was to evaluate the performance of a commercial, computer-aided detection algorithm of computed tomography pulmonary angiograms regarding the presence of pulmonary embolism in the emergency room. Materials and Methods This retrospective study includes all pulmonary computed tomography angiogram studies performed in a large emergency department over a period of 36 months that were analyzed by two radiologists experienced in emergency radiology to set a reference standard. Original reports and computer-aided detection results were compared regarding the detection of lobar, segmental, and subsegmental pulmonary embolism. All computer-aided detection findings were analyzed concerning the underlying pathology. False-positive findings were correlated to the contrast-to-noise ratio. Results Expert reading revealed pulmonary embolism in 182 of 1229 patients (49 % men, 10–97 years) with a total of 504 emboli. The computer-aided detection algorithm reported 3331 findings, including 258 (8 %) true-positive findings and 3073 (92 %) false-positive findings. Computer-aided detection analysis showed a sensitivity of 47 % (95 %CI: 33–61 %) on the lobar level and 50 % (95 %CI 43–56 %) on the subsegmental level. On average, there were 2.25 false-positive findings per study (median 2, range 0–25). There was no significant correlation between the number of false-positive findings and the contrast-to-noise ratio (Spearman’s Rank Correlation Coefficient = 0.09). Soft tissue (61.0 %) and pulmonary veins (24.1 %) were the most common underlying reasons for false-positive findings. Conclusion Applied to a population at a large emergency room, the tested commercial computer-aided detection algorithm faced relevant performance challenges that need to be addressed in future development projects. Key Points:  Citation Format


2011 ◽  
Vol 21 (6) ◽  
pp. 1214-1223 ◽  
Author(s):  
Kevin N. Blackmon ◽  
Charles Florin ◽  
Luca Bogoni ◽  
Joshua W. McCain ◽  
James D. Koonce ◽  
...  

2021 ◽  
Vol 8 (2) ◽  
pp. 76-79
Author(s):  
Bilal Chaudhry ◽  
Kirill Alekseyev ◽  
Lidiya Didenko ◽  
Gennadiy Ryklin ◽  
David Lee

Background: A saddle pulmonary embolism (PE) is a large embolism that straddles the bifurcation of the pulmonary trunk. This PE extends into the right and left pulmonary arteries. There is a greater incidence in males. Common features of a PE include dyspnea, tachypnea, cough, hemoptysis, pleuritic chest pain, tachycardia, hypotension, jugular venous distension, and severe cases Kussmaul sign. The Wells criteria for PE is used as the pretest probability. Diagnostics include D-dimer levels, CT pulmonary angiography (CTPA), ventilation/perfusion scintigraphy (V/Q scan), echocardiography, lower extremity venous ultrasound, chest x-ray, pulmonary angiography, and electrocardiography (ECG). Case description: We present a 65-year-old male that presented with a two-week history of dyspnea with non-radiating intermittent chest pressure. Initial V/Q scan showed a low probability for PE, but a subsequent non-contrast CT revealed that he indeed had a saddle PE.


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