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Updated: Mar 24, 2026
Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
Published on: January 20, 2022
Implementation and Performance of Automated Software for Computing Right-to-Left Ventricular Diameter Ratio From
Kanako K Kumamaru1, Elizabeth George, Ayaz Aghayev
1From the *Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MA; †Department of Radiology, Juntendo University, Tokyo, Japan; ‡Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX; §Biomedical Image Technologies, Universidad Politécnica de Madrid & CIBER-BBN, Madrid, Spain; ∥Surgical Planning Laboratory, Brigham and Women's Hospital, Boston; and ¶Madrid-MIT M+Visión Consortium, Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA; and #Department of Radiology, The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada.
Objective:
The aim of this study was to prospectively test the performance and potential for clinical integration of software that automatically calculates the right-to-left ventricular (RV/LV) diameter ratio from computed tomography pulmonary angiography images.
Methods:
Using 115 computed tomography pulmonary angiography images that were positive for acute pulmonary embolism, we prospectively evaluated RV/LV ratio measurements that were obtained as follows: (1) completely manual measurement (reference standard), (2) completely automated measurement using the software, and (3 and 4) using a customized software interface that allowed 2 independent radiologists to manually adjust the automatically positioned calipers.
Results:
Automated measurements underestimated (P < 0.001) the reference standard (1.09 [0.25] vs1.03 [0.35]). With manual correction of the automatically positioned calipers, the mean ratio became closer to the reference standard (1.06 [0.29] by read 1 and 1.07 [0.30] by read 2), and the correlation improved (r = 0.675 to 0.872 and 0.887). The mean time required for manual adjustment (37 [20] seconds) was significantly less than the time required to perform measurements entirely manually (100 [23] seconds).
Conclusions:
Automated CT RV/LV diameter ratio software shows promise for integration into the clinical workflow for patients with acute pulmonary embolism.
