Diagnostic Accuracy of Computed Tomography for Chronic Thromboembolic Pulmonary Hypertension: A Systematic Review and Meta-Analysis

Dong, Chao; Zhou, Min; Dingxi, Liu; Liu, Xi; Guo, Tao; Kong, Xiaoni

doi:10.1371/journal.pone.0126985

Cited by 70 publications

(49 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This technique requires high levels of expertise and is used mostly in experienced centres [15]. Recent studies have suggested that CT and magnetic resonance pulmonary angiography are superior to traditional pulmonary angiography methods in mapping lesions in proximal and segmental vessels [15,24,25].…”

Section: Imaging Of the Pulmonary Vasculaturementioning

confidence: 99%

The changing landscape of chronic thromboembolic pulmonary hypertension management

2017

View full text Add to dashboard Cite

For patients with chronic thromboembolic pulmonary hypertension (CTEPH), the current standard of care involves surgical removal of fibro-thrombotic obstructions by pulmonary endarterectomy. While this approach has excellent outcomes, significant proportions of patients are not eligible for surgery or suffer from persistent/recurrent pulmonary hypertension after the procedure. The availability of balloon pulmonary angioplasty and the approval of the first medical therapy for use in CTEPH have significantly improved the outlook for patients ineligible for pulmonary endarterectomy. In this comprehensive review, we discuss the latest developments in the rapidly evolving field of CTEPH. These include improvements in imaging modalities and advances in surgical and interventional techniques, which have broadened the range of patients who may benefit from such procedures. The efficacy and safety of targeted medical therapies in CTEPH patients are also discussed, particularly the encouraging data from the recent MERIT-1 trial, which demonstrated the beneficial impact of using macitentan to treat patients with inoperable CTEPH, including those on background therapy. As the treatment options for CTEPH improve, hybrid management involving more than one intervention in the same patient may become a viable option in the near future.

show abstract

Section: Imaging Of the Pulmonary Vasculaturementioning

confidence: 99%

The changing landscape of chronic thromboembolic pulmonary hypertension management

2017

View full text Add to dashboard Cite

show abstract

“…After installation of dual-energy CT in routine clinical practice, clinicians have been able to effectively identify this perfusion abnormality on iodine maps derived from dual-energy CT data. Furthermore, a meta-analysis reported on the capability of contrast-enhanced CTA with and without dual-energy CT or electrocardiogram-gated ADCT information for CTEPH patients (103). In this study, the patient-based analysis demonstrated a pooled sensitivity of 76%, a pooled specificity of 96%, and a pooled diagnostic odds ratio of 191.…”

Section: Dual-energy Ctmentioning

confidence: 64%

Contrast-enhanced CT- and MRI-based perfusion assessment for pulmonary diseases: basics and clinical applications

Ohno¹,

Koyama²,

Lee³

et al. 2016

Diagn Interv Radiol

View full text Add to dashboard Cite

M agnetic resonance imaging (MRI) is a widely used diagnostic tool for breast imaging in daily practice, with its high sensitivity to detect primary, recurrent, and residual breast cancer. Breast MRI serves as a reliable problem-solving tool in case of inconclusive mammography and ultrasonography (US) findings. It can be used to monitor the results of neoadjuvant chemotherapy and it may also contribute to preoperative evaluation of known lesions. With increasing use of MRI, number of breast lesions visible only on MRI and need for MRI-guided breast biopsy have increased (1). Second-look US can also be used for re-evaluation of these lesions; because US-guided biopsy is an easier, cheaper, and faster method if these lesions are visible on second-look US. According to a recently published meta-analysis, lesion detection rates with second-look US are variable in the literature (22.6%-82.1%). Mass lesions and malignant lesions were more likely to be detected at second-look US; average detection rates were 66% for masses, 29% for non-mass-like enhancement (NME) (2, 3). However, focal or NME lesions, which are less detectable than masses on second-look US, require MRI-guided biopsy in the majority of cases. According to the MRI-guided biopsy series in the literature, approximately 25%-35% of these lesions are diagnosed as malignant (4-9).Within this context, the aim of the present study is to assess the effectiveness of MRI-guided 10 Gauge (G) vacuum-assisted breast biopsies (VABB) performed at our institution and to examine the relationship between lesion characteristics and histopathologic results. B R E A S T I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to assess the effectiveness of magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy (VABB), evaluate and compare the characteristics and histopathologic findings of lesions, and overview the follow-up results of benign lesions. METHODSMRI findings and histopathologic results of breast lesions biopsied by MRI-guided VABB between 2013 and 2016 were retrospectively analyzed. MRI findings closely related with malignancy were investigated in particular. Follow-up results of benign lesions were evaluated. RESULTSMRI-guided VABB was applied to 116 lesions of 112 women. Of the lesions, 75 (65%) were benign, while 41 (35%) were malignant. Segmental (94%), clustered (89%), and clustered ring (67%) nonmass-like enhancement patterns were found to be more related with malignancy. False-negative rate of MRI-guided VABB was 12%, underestimation rate was 21%. One of the 54 followed-up benign lesions had a malignant result. CONCLUSION MRI-guided VABB is a reliable method for the diagnosis of breast lesions that are positive only on MRI. Follow-up results show that cancer detection rate is low for radio-pathologically concordant lesions. Further multicenter studies with larger patient population are needed to elucidate these results.You may cite this article as: Taşkın F, Soyder A, Tanyeri A, Öztürk VS, Ünsal A. Lesion characteristics, histopathologic r...

show abstract

“…Since MDCT can examine segmental and subsegmental arterial branches, it also guides the treatment process. In addition, it provides assistance concerning pulmonary angioplasty in the presence of chronic thromboembolism in subsegmental arterial branches …”

Section: Discussionmentioning

confidence: 99%

“…In addition, it provides assistance concerning pulmonary angioplasty in the presence of chronic thromboembolism in subsegmental arterial branches. 11 The pulmonary vascular CT signs for CTEPH include >29 mm diameter of the main pulmonary artery, circumferential thrombus (wide angle) along with the vessel wall, calcification of thrombus, membranes and septa within the branches of the pulmonary arteries, narrowing and thinning of the distal pulmonary arterial branches and total occlusion. The cardiac signs of CTEPH revealed by CT are increased right ventricular diameter, bowing of the septum and right atrium enlargement.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the CT imaging findings in the diagnosis of pulmonary hypertension due to chronic thromboembolism

Gökaslan

Onrat

Gökaslan

2019

Clinical Respiratory J

View full text Add to dashboard Cite

Purpose Chronic thromboembolic pulmonary hypertension (CTEPH) is the only pulmonary hypertension that can be treated surgically. Multidedector computerized tomography angiography (MDCTA) is considered as an important tool. In this study, the important CT findings of CTEPH and the vascular MDCTA findings of CTEPH were classified as central, peripheral, central and peripheral. The aim of this study was to investigate the relationship between these groups with parenchymal and hemodynamic findings. Materials and Methods MDCTA examinations of 26 patients who had been diagnosed with CTEPH were retrospectively reviewed. Vascular, cardiac and parenchymal findings were examined in MDCTA. Patients were divided into three groups as peripheral, central and peripheral and central chronic thromboembolism. The relationship between these groups with demographic, vascular, parenchymal and hemodynamic findings was investigated. Results The most common vascular finding was the wall filling defects attached to the lobar and/or segmental arterial walls, while the parenchymal finding was the fibrotic shrinkage. There were no statistically significant differences between the three groups compared to parenchymal findings which are mosaic pattern, brochiectasis, fibrotic changes and atelectasis, pulmonary artery diameter, right atrial diameter and RV/LV ratio. Age and sex were not different in patients between the three groups. Conclusion The results of the this study confirm the important role of MDCTA in the evaluation of vascular, cardiac and parenchymal findings in the patients with CTEPH and identifying patients that would most benefit from surgical treatment by visualization of the segmental and subsegmental branches of the pulmonary arteries.

show abstract

Diagnostic Accuracy of Computed Tomography for Chronic Thromboembolic Pulmonary Hypertension: A Systematic Review and Meta-Analysis

Cited by 70 publications

References 35 publications

The changing landscape of chronic thromboembolic pulmonary hypertension management

The changing landscape of chronic thromboembolic pulmonary hypertension management

Contrast-enhanced CT- and MRI-based perfusion assessment for pulmonary diseases: basics and clinical applications

Evaluation of the CT imaging findings in the diagnosis of pulmonary hypertension due to chronic thromboembolism

Contact Info

Product

Resources

About