Clinical Significance
• Aortic dissection is associated with high rates of morbidity and mortality
• Mortality rate of 1-2% per hour during first 48 hours
• Early diagnosis and prompt intervention greatly improve patient outcomes
• FDA 510k-approved software application expedites detection, triage, and ultimately treatment of patients with suspected aortic dissection
• Viz Aortic Dissection algorithm, in collaboration with Avicenna.ai
• Objective to evaluate performance of AI algorithm across diverse clinical settings
Study Methods
• Large-scale, blinded algorithm validation study
• 1303 retrospectively collected chest and thoraco-abdominal CT angiography images
• Diverse representation of hospitals in 200+ U.S. cities
• Ground-truth consensus diagnosis determined by three board-certified radiologists
Study Results
• 1166 (89.5%) dissection-negative exams, 137 (10.5%) dissection-positive exams
• Sensitivity: 94.2%
• [95% CI: 88.8% - 97.5%]
• Specificity: 97.3%
• [95% CI: 96.2% - 98.1%]
• PPV of 80.1%, NPV of 99.3%
• 8 false negatives, largely complex cases
• 32 false positives, largely result of imaging quality
Clinical Takeaways
• Real-world validation of a deep learning AI-based detection algorithm for suspected aortic
dissection
• Allows for rapid patient triage à earlier diagnoses à accelerated care coordination à timely initiation of life-saving interventions à better patient outcomes
Citations
• Gawinecka J, Schönrath F, von Eckardstein A. Acute aortic dissection: pathogenesis, risk factors and diagnosis. Swiss Med Wkly. 2017 Aug 25;147:w14489. doi: 10.4414/smw.2017.14489. PMID: 28871571.
• Gudbjartsson T, Ahlsson A, Geirsson A, Gunn J, Hjortdal V, Jeppsson A, Mennander A, Zindovic I, Olsson C. Acute type A aortic dissection – a review. Scand Cardiovasc J. 2020 Feb;54(1):1-13. doi:
10.1080/14017431.2019.1660401. Epub 2019 Sep 23. PMID: 31542960.
• Harris KM, Nienaber CA, Peterson MD, et al. Early Mortality in Type A Acute Aortic Dissection: Insights From the International Registry of Acute Aortic Dissection. JAMA Cardiol. 2022;7(10):1009–1015.doi:10.1001/jamacardio.2022.2718
