Pulmonary Embolism Response Team AI

AI enabled detection and classification of high risk PE patients

Modality:

CT Pulmonary Angiogram (CTPA)

Pathology:

Pulmonary Embolism

Status:

Contracting


CSC Lead: Anil Mistry

Clinical lead: Narayan Karunanithy, Karen Breen

Rationale: The Pulmonary Embolism Response Team (PERT) comprises Interventional Radiologists, Haematology consultants, Cardio-thoracic surgeons, and Respiratory consultants,

Both patients arriving at GSTT, and in patients, with suspected High risk or intermediate-high risk PE will alert the PERT to allow multi-disciplinary decisions to be made for management, triage and treatment. Reduction in the time to alert PERT of high-risk PE can result in reduced length of stay, morbidity and improved patient outcomes from MDT decisions.

Triggering PERT, if the patient is not high risk, may benefit intermediate-high risk patients, however the speed of results to assign that risk category to a patient could cause delays in triggering that alert. An AI application is being evaluated to automatically pull CTPA images and calculate the Right Ventricular/Left Ventricular (RV/LV) ratio as a good indicator of right heart strain, to risk stratify patients above certain threshold as appropriate to alert the PERT, therefore speeding up the CTPA reporting and subsequent PERT engagement towards better patient outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504600/

Project Plan:

  1. Clinician Scoping - Pathway mapping to identify key points for optimisation/automation through AI. Understanding dataflows, and data availability for risk stratification.
  2. Trust Approvals
    • Information Governance
    • Information Security
    • IT Architecture Review Board
  3. On-prem hardware Deployment
  4. Software Deployment
  5. Mobile App Evaluation
  6. Retrospective Evaluation
    • CTPA imaging dataset curation
    • Dataset enrichment
  7. Prospective Evaluation



References:

Cheikh et al 2021

Bĕlohlávek et al 2013

Rosovsky et al 2018