Radiological Cardiothoracic Ratio as a Potential Predictor of Right Ventricular Enlargement in Patients with Suspected Pulmonary Embolism Due to COVID-19

Truszkiewicz, Krystian; Poręba, Małgorzata; Poręba, Rafał; Gać, Paweł

doi:10.3390/jcm10235703

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…This is another finding of our research on the predictive suitability of CTR. We previously demonstrated that in patients with suspected pulmonary embolism during COVID-19, CRT can be considered as a prognostic factor for right ventricular enlargement, especially as a negative predictor of right ventricular enlargement in the case of lower CTR values [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography

Truszkiewicz¹,

Macek

Poręba

et al. 2022

Radiology Research and Practice

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The aim of the study was to verify the usefulness of the radiological cardiothoracic ratio as a potential marker of left ventricular hypertrophy assessed by echocardiography. The study included 96 patients (mean age: 49.52 ± 9.64 years). Chest radiograph in the PA projection and echocardiography were performed. In CR the measurement of the cardiothoracic ratio (CTR) was performed. Assuming CTR > 0.50, heart silhouette enlargement was diagnosed. In echocardiography, four types of left ventricular geometry were assessed: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). It was shown that patients with an enlarged heart silhouette were characterized by a significantly more frequent occurrence of left ventricular hypertrophy (LVH) on echocardiography than patients with a nonenlarged heart silhouette. In the subgroup of patients with LVH compared to the subgroup of patients with normal left ventricular geometry, CTR values are statistically significantly higher, and heart silhouette enlargement is significantly more frequent. The criterion “CTR > 0.49” estimates LVH with a sensitivity of 93.3% and specificity of 82.7%, which translates into a high accuracy of 84.4%. By analyzing the prediction of left ventricular geometry types, high accuracy of CH prediction was obtained using the “CTR > 0.49” criterion of 80.2% (with a high sensitivity of 84.0% and a satisfactory specificity of 60.0%) and a high accuracy of EH prediction using the “CTR > 0.52” criterion of 71.9% (with high sensitivity 80.5% and low specificity 36.8%), as well as low CR prediction accuracy of only 57.3% (with low sensitivity 36.7%, even if high specificity 78.7%). In summary, the radiological cardiothoracic ratio may be a moderate marker of left ventricular hypertrophy assessed according to standard echocardiographic criteria, provided that its cut-off point is standardized in each population of subjects.

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Section: Discussionmentioning

confidence: 99%

Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography

Truszkiewicz¹,

Macek

Poręba

et al. 2022

Radiology Research and Practice

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“…Importantly, identifying factors explaining the discrepancies between chest radiograph parameters and CMR-LVH may improve diagnostic abilities. For example, right ventricular enlargement may cause greater TCD and CTR measures [40][41][42]. In a study of heart failure patients, Fukuta et al revealed that increased CTR correlated more strongly with the size of the right ventricle than LV [41].…”

Section: Discussionmentioning

confidence: 99%

“…In a study of heart failure patients, Fukuta et al revealed that increased CTR correlated more strongly with the size of the right ventricle than LV [41]. Recently, it has also been demonstrated that CTR could play a role in predicting right ventricular enlargement in patients with suspected pulmonary embolism during COVID-19 [42]. Elevation of the diaphragm due to high BMI can place the heart in a more horizontal position leading to an increase of TCD and CTR.…”

Section: Discussionmentioning

confidence: 99%

Clinical Data, Chest Radiograph and Electrocardiography in the Screening for Left Ventricular Hypertrophy: The CAR2E2 Score

Matusik¹,

Bryll

Pac

et al. 2022

JCM

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Left ventricular hypertrophy (LVH) is associated with adverse clinical outcomes and implicates clinical decision-making. The aim of our study was to assess the importance of different approaches in the screening for LVH. We included patients who underwent cardiac magnetic resonance (CMR) imaging and had available chest radiograph in medical documentation. Cardiothoracic ratio (CTR), transverse cardiac diameter (TCD), clinical and selected electrocardiographic (ECG)-LVH data, including the Peguero-Lo Presti criterion, were assessed. CMR–LVH was defined based on indexed left ventricular mass-to-body surface area. Receiver operating characteristics analyses showed that both the CTR and TCD (CTR: area under the curve: [AUC] = 0.857, p < 0.001; TCD: AUC = 0.788, p = 0.001) were predictors for CMR–LVH. However, analyses have shown that diagnoses made with TCD, but not CTR, were consistent with CMR–LVH. From the analyzed ECG–LVH criteria, the Peguero-Lo Presti criterion was the best predictor of LVH. The best sensitivity for screening for LVH was observed when the presence of heart failure, ≥40 years in age (each is assigned 1 point), increased TCD and positive Peguero-Lo Presti criterion (each is assigned 2 points) were combined (CAR2E2 score ≥ 3 points). CAR2E2 score may improve prediction of LVH compared to other approaches. Therefore, it may be useful in the screening for LVH in everyday clinical practice in patients with prevalent cardiovascular diseases.

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Quality Assurance of Chest X-ray Images with a Combination of Deep Learning Methods

et al. 2023

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Background: Chest X-ray (CXR) imaging is the most common examination; however, no automatic quality assurance (QA) system using deep learning (DL) has been established for CXR. This study aimed to construct a DL-based QA system and assess its usefulness. Method: Datasets were created using over 23,000 images from Chest-14 and clinical images. The QA system consisted of three classification models and one regression model. The classification method was used for the correction of image orientation, left–right reversal, and estimating the patient’s position, such as standing, sitting, and lying. The regression method was used for the correction of the image angle. ResNet-50, VGG-16, and the original convolutional neural network (CNN) were compared under five cross-fold evaluations. The overall accuracy of the QA system was tested using clinical images. The mean correction time of the QA system was measured. Result: ResNet-50 demonstrated higher performance in the classification. The original CNN was preferred in the regression. The orientation, angle, and left–right reversal of all images were fully corrected in all images. Moreover, patients’ positions were estimated with 96% accuracy. The mean correction time was approximately 0.4 s. Conclusion: The DL-based QA system quickly and accurately corrected CXR images.

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Radiological Cardiothoracic Ratio as a Potential Predictor of Right Ventricular Enlargement in Patients with Suspected Pulmonary Embolism Due to COVID-19

Cited by 5 publications

References 38 publications

Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography

Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography

Clinical Data, Chest Radiograph and Electrocardiography in the Screening for Left Ventricular Hypertrophy: The CAR2E2 Score

Quality Assurance of Chest X-ray Images with a Combination of Deep Learning Methods

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