| Title: |
Artificial intelligence-enabled cardiac volumetry for opportunistic screening of cardiomegaly on chest CT: clinical validation with echocardiography |
| Authors: |
Fan, Christopher M; Scanio, Angelo; Yokoo, Patricia; Wiessman, Maya; Long, Michael; Lewis, Matthew A; Xi, Yin; Duan, Xinhui; McColl, Roderick; Abbara, Suhny; Peshock, Ronald; Kay, Fernando U |
| Contributors: |
Siemens Healthineers |
| Source: |
Radiology Advances ; volume 3, issue 2 ; ISSN 2976-9337 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2026 |
| Description: |
Background Cardiomegaly is a clinically significant incidental finding on chest computed tomography (CT) associated with heart failure, arrhythmias, and sudden cardiac death. Qualitative radiologist assessment is variable, and automated AI tools may enable objective opportunistic cardiac volumetry. Purpose To evaluate whether AI-enabled total cardiac volume (TCVAI) derived from non-ECG-gated, non-contrast chest CT can identify cardiomegaly as defined by echocardiography. Materials and Methods This retrospective study included 307 consecutive patients (median age, 67 years; 56% male) who underwent non-contrast chest CT at a single center on 7 scanner types (4 vendors) and clinically indicated echocardiography within 31 days. A commercially available AI tool (AI-Rad Companion, Siemens Healthineers) automatically quantified TCVAI, indexed to body surface area (TCVAI/BSA). Echocardiography reports were reviewed for chamber dilation and left ventricular hypertrophy (LVH), collectively defined as cardiomegaly. Associations between TCVAI/BSA and echocardiographic findings were assessed using correlation, ordinal regression, and receiver operating characteristic (ROC). Interscan repeatability was evaluated in 248 patients with 544 repeat CT examinations. Prespecified sex-specific thresholds were tested in a temporally independent validation cohort of 50 patients. Results Median TCVAI was higher in patients with cardiomegaly than those without (1061.9 vs 798.4 mL; P < .001). TCVAI/BSA was associated with chamber dilation and LVH severity on univariate analysis and remained associated in multivariable ordinal models, except for right ventricular dilation. Discriminatory performance was fair to good, with area under the curve (AUC) 0.81 (95% CI, 0.75-0.87) in men and 0.77 (95% CI, 0.69-0.85) in women. Interscan repeatability was excellent (intraclass correlation coefficient [ICC]: 0.93). In independent validation, performance ranged from sensitivity 89.3%/specificity 27.3% at a high-sensitivity threshold to ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/radadv/umag013 |
| DOI: |
10.1093/radadv/umag013/67273446/umag013.pdf |
| Availability: |
https://doi.org/10.1093/radadv/umag013; https://academic.oup.com/radadv/advance-article-pdf/doi/10.1093/radadv/umag013/67273446/umag013.pdf; https://academic.oup.com/radadv/article-pdf/3/2/umag013/67273446/umag013.pdf |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.8F78B58 |
| Database: |
BASE |