Comprehensive Summary
Abdullah Al et al. evaluated the performance of colonial walk, a lightweight machine learning method, in localizing aortic root landmarks on CT angiographies (CCTA) for transcatheter aortic valve implantation (TAVI) planning. Colonial walk uses a two-phased approach, estimating the aortic valve region and subsequently refining the localization of each landmark (three hinges, three commissures, and two coronary ostia) with a regression tree-based multi-walker search. Using 71 CCTA scans (40 non-TAVI and 31 pre-operative TAVI with heavy calcification), two experiments were performed: cross validation on non-TAVI scans with TAVI scans and cross validation on all scans. Colonial walk’s average landmark error was 2.04 ± 1.11 mm overall, with higher accuracy than the previous random tree walk (RTW) method (p < 0.05). Annulus and ostium diameter errors were below 2mm for TAVI and non-TAVI scans. Processing time on a single-core GPU was 12 ms per scan. Colonial walk outperforms RTW and is faster than manual analysis of CCTAs in clinical settings.
Outcomes and Implications
Colonial walk could streamline pre-TAVI planning by automating the localization of aortic root landmarks with high accuracy, enabling physicians to analyze CCTAs faster and more efficiently. With colonial walk’s consistent sizing of derived measurements and minimal processing needs, procedural planning and scheduling efficiency could be improved across healthcare facilities. Prior to clinical implementation, multicenter validations, testing across different scanners and reconstruction procedures, and workflow impact studies are essential.