Medical System for Thoracic Aortic Aneurysm Risk Stratification in Colombian Patients

Thoracic aortic aneurysm (TAA) is associated with high mortality when not diagnosed in a timely manner, and, according to the reviewed literature, Colombia currently lacks integrated computational tools for morphometric characterization validated in the local population. International diagnostic thresholds, derived mainly from European and North American cohorts, may be inadequate for Latin American patients, who present dissection and rupture events at smaller diameters relative to body surface area. This study develops and validates an integrated system for morphometric characterization and risk stratification of TAA calibrated for the Colombian population. The system, named AortaAI-Colombia, integrates aortic lumen segmentation (TotalSegmentator/nnU-Net), perpendicular diameter measurements according to Ishimaru zones, calcification quantification (Agatston scoring), a multidomain risk score (SCRA, 0–100), and a clinical alert engine. With a total of 30 patients across 43 CTA studies from Los Cobos Medical Center (Bogotá), each study was processed in 3–4 minutes on GPU hardware, supporting feasibility in mid-tier clinical settings. On nine patients (10 verifiable studies, as one patient had two studies, yielding 58 zone-level measurement pairs across the aortic segments), the morphometric analysis achieved a mean absolute error of 2.48 mm against expert radiological measurements, while diameter-based aneurysm classification reached 100% sensitivity, specificity, PPV, and NPV. The alert engine triggered a critical alert in all four cases of acute aortic syndrome, including two without aneurysmal diameter, demonstrating complementary value beyond diameter-based criteria alone. To the best of our knowledge, AortaAI-Colombia constitutes the first integrated tool of this kind validated in Colombian patients, replicating the clinical standard measurement protocol with an overall error below 8%, built entirely on open-source tools, and establishing a foundation for standardized aortic risk assessment in a historically underrepresented population.