Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers
Abstract Purpose Assessment of the inferior vena cava (IVC) respiratory variation may be clinically useful for the estimation of fluid-responsiveness and venous congestion; however, imaging from subcostal (SC, sagittal) region is not always feasible. It is unclear if coronal trans-hepatic (TH) IVC i...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-04-01
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| Series: | Intensive Care Medicine Experimental |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40635-023-00505-7 |
| _version_ | 1797841235206995968 |
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| author | Filippo Sanfilippo Luigi La Via Veronica Dezio Cristina Santonocito Paolo Amelio Giulio Genoese Marinella Astuto Alberto Noto |
| author_facet | Filippo Sanfilippo Luigi La Via Veronica Dezio Cristina Santonocito Paolo Amelio Giulio Genoese Marinella Astuto Alberto Noto |
| author_sort | Filippo Sanfilippo |
| collection | DOAJ |
| description | Abstract Purpose Assessment of the inferior vena cava (IVC) respiratory variation may be clinically useful for the estimation of fluid-responsiveness and venous congestion; however, imaging from subcostal (SC, sagittal) region is not always feasible. It is unclear if coronal trans-hepatic (TH) IVC imaging provides interchangeable results. The use of artificial intelligence (AI) with automated border tracking may be helpful as part of point-of-care ultrasound but it needs validation. Methods Prospective observational study conducted in spontaneously breathing healthy volunteers with assessment of IVC collapsibility (IVCc) in SC and TH imaging, with measures taken in M-mode or with AI software. We calculated mean bias and limits of agreement (LoA), and the intra-class correlation (ICC) coefficient with their 95% confidence intervals. Results Sixty volunteers were included; IVC was not visualized in five of them (n = 2, both SC and TH windows, 3.3%; n = 3 in TH approach, 5%). Compared with M-mode, AI showed good accuracy both for SC (IVCc: bias − 0.7%, LoA [− 24.9; 23.6]) and TH approach (IVCc: bias 3.7%, LoA [− 14.9; 22.3]). The ICC coefficients showed moderate reliability: 0.57 [0.36; 0.73] in SC, and 0.72 [0.55; 0.83] in TH. Comparing anatomical sites (SC vs TH), results produced by M-mode were not interchangeable (IVCc: bias 13.9%, LoA [− 18.1; 45.8]). When this evaluation was performed with AI, such difference became smaller: IVCc bias 7.7%, LoA [− 19.2; 34.6]. The correlation between SC and TH assessments was poor for M-mode (ICC = 0.08 [− 0.18; 0.34]) while moderate for AI (ICC = 0.69 [0.52; 0.81]). Conclusions The use of AI shows good accuracy when compared with the traditional M-mode IVC assessment, both for SC and TH imaging. Although AI reduces differences between sagittal and coronal IVC measurements, results from these sites are not interchangeable. |
| first_indexed | 2024-04-09T16:27:44Z |
| format | Article |
| id | doaj.art-a92205f1c9e24cd9a31a2c519e5fbe1c |
| institution | Directory Open Access Journal |
| issn | 2197-425X |
| language | English |
| last_indexed | 2024-04-09T16:27:44Z |
| publishDate | 2023-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj.art-a92205f1c9e24cd9a31a2c519e5fbe1c2023-04-23T11:03:57ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2023-04-0111111210.1186/s40635-023-00505-7Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteersFilippo Sanfilippo0Luigi La Via1Veronica Dezio2Cristina Santonocito3Paolo Amelio4Giulio Genoese5Marinella Astuto6Alberto Noto7Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, site “Policlinico G. Rodolico”Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, site “Policlinico G. Rodolico”Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, site “Policlinico G. Rodolico”Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, site “Policlinico G. Rodolico”Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, site “Policlinico G. Rodolico”Division of Anesthesia and Intensive Care, University of Messina, Policlinico “G. Martino”Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, site “Policlinico G. Rodolico”Department of Human Pathology of the Adult and Evolutive Age “Gaetano Barresi”, Division of Anesthesia and Intensive Care, University of Messina, Policlinico “G. Martino”Abstract Purpose Assessment of the inferior vena cava (IVC) respiratory variation may be clinically useful for the estimation of fluid-responsiveness and venous congestion; however, imaging from subcostal (SC, sagittal) region is not always feasible. It is unclear if coronal trans-hepatic (TH) IVC imaging provides interchangeable results. The use of artificial intelligence (AI) with automated border tracking may be helpful as part of point-of-care ultrasound but it needs validation. Methods Prospective observational study conducted in spontaneously breathing healthy volunteers with assessment of IVC collapsibility (IVCc) in SC and TH imaging, with measures taken in M-mode or with AI software. We calculated mean bias and limits of agreement (LoA), and the intra-class correlation (ICC) coefficient with their 95% confidence intervals. Results Sixty volunteers were included; IVC was not visualized in five of them (n = 2, both SC and TH windows, 3.3%; n = 3 in TH approach, 5%). Compared with M-mode, AI showed good accuracy both for SC (IVCc: bias − 0.7%, LoA [− 24.9; 23.6]) and TH approach (IVCc: bias 3.7%, LoA [− 14.9; 22.3]). The ICC coefficients showed moderate reliability: 0.57 [0.36; 0.73] in SC, and 0.72 [0.55; 0.83] in TH. Comparing anatomical sites (SC vs TH), results produced by M-mode were not interchangeable (IVCc: bias 13.9%, LoA [− 18.1; 45.8]). When this evaluation was performed with AI, such difference became smaller: IVCc bias 7.7%, LoA [− 19.2; 34.6]. The correlation between SC and TH assessments was poor for M-mode (ICC = 0.08 [− 0.18; 0.34]) while moderate for AI (ICC = 0.69 [0.52; 0.81]). Conclusions The use of AI shows good accuracy when compared with the traditional M-mode IVC assessment, both for SC and TH imaging. Although AI reduces differences between sagittal and coronal IVC measurements, results from these sites are not interchangeable.https://doi.org/10.1186/s40635-023-00505-7Critical careUltrasoundSubcostalTranshepaticInferior vena cava |
| spellingShingle | Filippo Sanfilippo Luigi La Via Veronica Dezio Cristina Santonocito Paolo Amelio Giulio Genoese Marinella Astuto Alberto Noto Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers Intensive Care Medicine Experimental Critical care Ultrasound Subcostal Transhepatic Inferior vena cava |
| title | Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers |
| title_full | Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers |
| title_fullStr | Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers |
| title_full_unstemmed | Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers |
| title_short | Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers |
| title_sort | assessment of the inferior vena cava collapsibility from subcostal and trans hepatic imaging using both m mode or artificial intelligence a prospective study on healthy volunteers |
| topic | Critical care Ultrasound Subcostal Transhepatic Inferior vena cava |
| url | https://doi.org/10.1186/s40635-023-00505-7 |
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