Added value of lung perfused blood volume images using dual-energy CT for assessment of acute pulmonary embolism

A review of imaging modalities in pulmonary hypertension

“…Recent studies have shown added value of DECT and PBV maps in the imaging and risk stratification of patients with acute PE, as well as in the assessment of prognosis. [8485] PBV maps allow increased confidence in diagnosis, and automated quantification of PBV maps also assist in prognosis. Currently, pulmonary blood volume imaging and perfusion maps are used to evaluate acute PE since they have been shown to be comparable to V/Q scintigraphy.…”

Factors affecting the lung perfused blood volume in patients with intrapulmonary clots after anti-coagulation therapy

“…Moreover, the addition of LPBV to CTPA improves detection of peripheral IPCs with better interobserver agreement, but the detections of IPCs are mainly improved at the segmental or subsegmental pulmonary arteries [11]. In the current study, repeated LPBV examinations were applied to evaluate the changes Table 1 The patient characteristics and results of initial and subsequent CT and lung perfused blood volume based on the presence of intrapulmonary clots.…”

Where do we stand? Functional imaging in acute and chronic pulmonary embolism with state-of-the-art CT

“…It has been demonstrated that CTPA and DE CTPA with PBV images are suitable for diagnosing chronic PE, with the PBV images being subjectively slightly more accurate than CTPA images alone at identifying sub-segmental abnormalities [39,[55][56][57][58][59]. As mentioned above, PBV of CTPA correlates well with acute lung perfusion.…”

“…The much shorter reading time compared with the Qanadli or Mastora obstruction score renders this technique much more suitable for the clinical workflow. The first pass iodine distribution maps generated from DE CTPA have been shown to be a valid surrogate of hypoperfusion due to acute PE, as demonstrated in several studies [36][37][38][39]. Lung parenchyma iodine perfusion maps provide a quick and reader-independent tool for the quantitative assessment of pulmonary perfusion and strongly correlate with pulmonary perfusion scintigraphy and single-photon emission computed tomography (SPECT) images (Table 1) [36,37].…”

“…This is achieved by material decomposition, which allows the generation of specific ventilation maps as well as simultaneous high-resolution anatomic information [49]. If performed in dynamic acquisition mode, xenon-enhanced DECT can be used for quantitative evaluation of pulmonary function by using time-attenuation curves in a single-compartment exponential model (Kety model) [39]. One potential implication of this technique could be the detection of peripheral PE, which is invisible at conventional CTPA and further increasing accuracy in the assessment of hemodynamic significance of PE [48][49][50].…”