EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System

by Ever Fortune. AI Co.  · Based in Taiwan → — Beyond Medicine. Anytime. Anywhere. Revolutionizing healthcare with AI.
Cardiology Radiology

Contact for pricing
Regulatory Status Disclosed

Overview

The EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System is an advanced software solution designed for hospitals and clinics. It leverages artificial intelligence algorithms to automatically assess the cardiothoracic ratio (CTR) from posterior-anterior (PA) chest X-ray images. The system precisely measures the maximal transverse diameter of the heart and the maximal inner transverse diameter of the thoracic cavity to calculate the CTR. This automation aims to enhance the efficiency of report generation and provide valuable assistance to physicians in their clinical decision-making and patient care processes. Ever Fortune. AI Co. specializes in AI solutions for the healthcare sector, focusing on medical big data and cloud-based biomedical platforms to aid in diagnostics and disease prediction across various medical specialties, including cardiology, oncology, and neurology.

Reviewed by Pouyan Golshani, MD — Interventional Radiologist

Key Features

  • Automatic Cardiothoracic Ratio (CTR) assessment from chest X-rays
  • Measures maximal transverse diameter of heart and thoracic cavity
  • Utilizes artificial intelligence algorithm for analysis
  • Supports posterior-anterior (PA) chest view X-ray images
  • Outputs structured reports
  • Optimizes report generation efficiency
  • Assists physicians in clinical decision-making and patient care
  • Non-invasive software medical device
  • DICOM image analysis compatibility
  • Suitable for adults between 20-80 years of age

Use Cases

  • Screening for cardiomegaly and heart diseases
  • Assisting radiologists and physicians in efficient CTR measurement
  • Optimizing clinical workflow in cardiology and radiology departments
  • Supporting diagnostics and disease prediction in healthcare institutions

What Physicians Need to Know

Cardiac CT/MRI Analysis
The EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System analyzes DICOM chest X-ray images (PA view) to calculate the cardiothoracic ratio. It is designed to measure the maximal transverse diameter of the heart and the maximal inner transverse diameter of the thoracic cavity. The system can also suggest left atrial enlargement if the carina angle is greater than 100 degrees in cases of an enlarged heart.
Heart Failure Risk Prediction
The iCTR system assists in the assessment of cardiomegaly, which can be a marker for heart disease and potentially heart failure. While the system calculates the CTR to aid in identifying cardiomegaly, it does not implement a predictive or prognostic feature for heart failure.
Real-Time Alert Capability
The system sends information, such as the categorization of an enlarged or normal heart, to PACS at the time of interpretation.
Physician Tip

The EFAI iCTR Assessment System provides an automated, standardized calculation of the cardiothoracic ratio from chest X-rays, which can be a valuable screening tool for cardiomegaly. This can help in quickly identifying patients who may require further cardiac evaluation. The system also outputs structured reports, which can optimize report generation efficiency. However, it's important to remember that the system is an assistive tool and does not replace clinical assessment or provide standalone diagnostic or prognostic predictions. The system is suitable for adults between 20 and 80 years of age.

The EFAI iCTR Assessment System is designed to integrate into existing radiology workflows. It receives DICOM images from modalities, analyzes them, and sends the results, including structured reports and annotated images, back to PACS.

Details

Category Cardiology AI
Pricing Contact for pricing
DeploymentAvailable in cloud-based versions for small- to medium-sized clinics and localized versions for larger hospitals. Can be customized for integration with existing PACS systems.
Compliance
BAA AvailableUnknown
HIPAA CompliantUnknown
FDA Status Cleared AI-estimated
Integrations
EHR Not specified
Specialties Cardiology, Radiology

What the Web Says

The EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System is an AI-powered software designed to automatically calculate the cardiothoracic ratio from PA chest X-ray images. It is intended for use by physicians and licensed practitioners in healthcare settings to assist in clinical workflow, providing standardized and automated measurements. The system has undergone verification and validation testing, demonstrating high accuracy in its measurements compared to physician-derived CTRs.

Overall: Positive

Strengths

  • Automated and standardized CTR calculation.
  • High accuracy (0.95) compared to physician-derived CTR.
  • Aids clinicians by providing automated measurements.
  • Utilizes AI algorithms for image analysis.
  • Outputs structured reports in DICOM/JSON format.
  • FDA cleared (K212624).

Limitations

  • Not intended for stand-alone use for clinical decision-making.
  • Does not replace clinical assessment.
  • Suitable for adults between 20-80 years of age only.
  • Algorithm training data typically impacts device performance.

Based on reviews from: innolitics.com, parikhradiology.com, fda.gov, scribd.com

Last updated: 2026-10-30

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Press & Coverage

taiwan-healthcare.org
EverFortune.AI receives market approvals of three products in Vietnam
Ever Fortune.AI announced that Vietnam's Ministry of Health has approved three of its products for marketing: the "Intelligent Cardiothoracic Ratio (iCTR) Assessment System," "Pneumothorax Detection System," and "Pleural Effusion Detection System." The company also secured a patent in Japan for its "Risk Assessment for Genetic Testing."
2023-10
innolitics.com
EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System
The EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System is software designed for hospitals and clinics to automatically assess the cardiothoracic ratio (CTR) from chest X-ray images. It measures the maximal transverse diameter of the heart and the maximal inner transverse diameter of the thoracic cavity to calculate the CTR using an AI algorithm.
2025-12
fda.gov
EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System
The FDA granted 510(k) premarket notification to the EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System on April 4, 2022. This software is intended for use by healthcare professionals in medical institutions to estimate the cardiothoracic ratio from chest X-ray images.
2022-04
genetinfo.com
長佳智能「EFAI Intelligent Cardiothoracic Ratio (iCTR)Assessment System」獲得馬來西亞MDA上市許可核准
Ever Fortune.AI's "EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System" received market approval from the Malaysian Medical Device Authority (MDA) on May 23, 2024. This medical device software automatically analyzes posterior-anterior chest X-ray images of adults aged 20 to 80 to estimate the cardiothoracic ratio.
2024-05
parikhradiology.com
EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System
The EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System, developed by Ever Fortune.AI Co., Ltd., provides automatic cardiothoracic ratio assessment on PA chest X-ray images for adults aged 20-80. The system's results support clinician assessment and are not intended for standalone diagnostic use.
2022-04
orthogonal.io
List of FDA-Cleared SaMD
The EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System was cleared by the FDA on April 4, 2022, for radiology applications. This system is listed among other FDA-cleared Software as a Medical Device (SaMD) products.
2024-10
taiwan-healthcare.org
Ever Fortune.AI medical software nets one more approval for the US market
Ever Fortune.AI announced on September 26, 2026, that its “EFAI RT Suite CT HCAP-Segmentation System” received FDA approval, marking its 7th US approval and 11th from Taiwan's FDA. The company specializes in medical AI for neurology, cardiology, and oncology.
2026-09

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Frequently Asked Questions

The EFAI Intelligent Cardiothoracic Ratio (iCTR) Assessment System is a software that uses artificial intelligence to automatically assess the cardiothoracic ratio (CTR) from chest X-ray images in posterior-anterior (PA) views. It measures the maximal transverse diameter of the heart and the maximal inner transverse diameter of the thoracic cavity to calculate the CTR. This system is intended to aid physicians and licensed practitioners in healthcare settings for initial screening of cardiomegaly, but the results are not meant to be used as a stand-alone basis for clinical decision-making.
The EFAI iCTR system is a Class II medical device regulated under 21 CFR 892.2050, with product code QIH. It has received 510(k) clearance from the FDA. The system has undergone testing in accordance with internal, national, and international standards, including IEC 62304/FDA Guidance for software verification and validation, IEC 62366-1 for usability engineering, and FDA Guidance "Software as a Medical Device (SAMD): Clinical Evaluation" (IMDRF/SaMD WG/N41FINAL:2017).
The EFAI iCTR system is suitable for adults aged 22 years and older. Its results are intended to aid users and should not be used as a stand-alone basis for clinical decision-making, nor should they preclude clinical assessment of CTR cases. The system's trajectory of CTR does not implement a predictive or prognostic feature.
Manual calculation of CTR can introduce observer variation and is time-consuming. AI-assisted methods have shown to be significantly faster than manual methods, with one study indicating AI-assisted measurement times were almost five times faster. While AI can improve accuracy and reduce workload, the R-squared and classification-test were not reliable indicators to verify that AI-only methods could replace manual operation. Other AI algorithms are also being developed and cleared by the FDA for various cardiology applications, including automated coronary artery calcium scoring and arrhythmia detection.
The EFAI iCTR system is designed to be installed on a computer with specific system requirements. It automatically analyzes DICOM chest X-ray images in PA view and outputs the cardiac diameter, thoracic diameter, and CTR using an artificial intelligence algorithm. The system generates a structured report that includes a preview of the compressed chest X-ray image with the derived CTR result and annotation lines. In a typical workflow, the image from the modality is sent to PACS and then to the AI engine for analysis.

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Suggest an Edit → | Report an issue | Last Verified: 2026-04-18 | First Added: 2026-04-18
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