June 9, 2019
Publications
>
Article

Automated Axial Right Ventricle to Left Ventricle Diameter Ratio Computation in Computed Tomography Pulmonary Angiography

Publicated to: PLoS One. 10 (5): e0127797- - 2015-05-22 10(5), DOI: 10.1371/journal.pone.0127797

Authors:

González, G; Jiménez-Carretero, D; Rodríguez-López, S; Kumamaru, KK; George, E; Estépar, RSJ; Rybicki, FJ; Ledesma-Carbayo, MJ
[+]

Affiliations

Brigham & Womens Hosp, Appl Imaging Sci Lab, Boston, MA 02115 USA - Author
Brigham & Womens Hosp, Surg Planning Lab, Boston, MA 02115 USA - Author
CIBER BBN, Madrid, Spain - Author
MIT, Elect Res Lab, Madrid MIT M Vis Consortium, Cambridge, MA 02139 USA - Author
Univ Politecn Madrid, Biomed Image Technol, Madrid, Spain - Author
See more

Abstract

Background and Purpose Right Ventricular to Left Ventricular (RV/LV) diameter ratio has been shown to be a prognostic biomarker for patients suffering from acute Pulmonary Embolism (PE). While Computed Tomography Pulmonary Angiography (CTPA) images used to confirm a clinical suspicion of PE do include information of the heart, a numerical RV/LV diameter ratio is not universally reported, likely because of lack in training, inter-reader variability in the measurements, and additional effort by the radiologist. This study designs and validates a completely automated Computer Aided Detection (CAD) system to compute the axial RV/LV diameter ratio from CTPA images so that the RV/LV diameter ratio can be a more objective metric that is consistently reported in patients for whom CTPA diagnoses PE. Materials and Methods The CAD system was designed specifically for RV/LV measurements. The system was tested in 198 consecutive CTPA patients with acute PE. Its accuracy was evaluated using reference standard RV/LV radiologist measurements and its prognostic value was established for 30-day PE-specific mortality and a composite outcome of 30-day PE-specific mortality or the need for intensive therapies. The study was Institutional Review Board (IRB) approved and HIPAA compliant. Results The CAD system analyzed correctly 92.4%(183/198) of CTPA studies. The mean difference between automated and manually computed axial RV/LV ratios was 0.03+/-0.22. The correlation between the RV/LV diameter ratio obtained by the CAD system and that obtained by the radiologist was high (r=0.81). Compared to the radiologist, the CAD system equally achieved high accuracy for the composite outcome, with areas under the receiver operating characteristic curves of 0.75 vs. 0.78. Similar results were found for 30-days PE-specific mortality, with areas under the curve of 0.72 vs. 0.75. Conclusions An automated CAD system for determining the CT derived RV/LV diameter ratio in patients with acute PE has high accuracy when compared to manual measurements and similar prognostic significance for two clinical outcomes.
[+]

Keywords

AdultAgedAged, 80 and overAngiographyDeathDiagnosisDysfunctionEmbolismEnlargementFemaleHeart ventriclesHelical ctHumansLungMaleManagementMiddle agedPredictive value of testsPredictorsPrognosisPulmonary embolismReproducibility of resultsSensitivity and specificitySignsTomography, x-ray computedYoung adult

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal PLoS One due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2015, it was in position 11/62, thus managing to position itself as a Q1 (Primer Cuartil), in the category Multidisciplinary Sciences.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-24:

  • Google Scholar: 18
  • WoS: 7
  • Scopus: 9
  • Europe PMC: 3
[+]

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-24:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 46.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 47 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 10.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 4 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
  • Assignment of a Handle/URN as an identifier within the deposit in the Institutional Repository: https://oa.upm.es/43624/

As a result of the publication of the work in the institutional repository, statistical usage data has been obtained that reflects its impact. In terms of dissemination, we can state that, as of

  • Views: 441
  • Downloads: 253
[+]

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (LEDESMA CARBAYO, MARIA JESUS).

[+]

Awards linked to the item

This project has been financially supported by the Comunidad de Madrid, Spain through the Madrid-MIT M+Vision Consortium. Daniel Jimenez was supported by an FPU grant by the Spain's Ministry of Education.
[+]