Lung Perfusion with Dual-energy Multidetector-row CT (MDCT)

Pontana, François; Faivre, J; Rémy‐Jardin, Martine; Flohr, Thomas; Schmidt, Bernhard; Tacelli, Nunzia; Pansini, Vittorio; Rémy, Jacques

doi:10.1016/j.acra.2008.05.018

Cited by 222 publications

(44 citation statements)

References 32 publications

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“…Therefore, one might question the ability of contrast-enhanced DECT to accurately assess lung perfusion. As a matter of fact, several published works have shown that iodine perfusion obtained by contrast-enhanced DECT has an excellent correlation with the perfusion measured by pulmonary scintigraphy [22,23]. Several studies have also demonstrated that perfusion maps can be used to simply qualitatively and quantitatively assess areas of lung perfusion in a similar way to scintigraphy.…”

Section: Discussionmentioning

confidence: 98%

“…Thieme et al [25] showed that DECT had a sensitivity/specificity of 100/100% for pulmonary embolism, while the combination of SPECT and ventilation scintigraphy had a sensitivity/specificity of 85.7/87.5%. Nowadays, many applications are available for routine clinical use, and, for example, perfusion maps generated by DECT are well established for evaluating acute pulmonary embolism [22,23]. Moreover, and as opposed to ventilation/perfusion scanning, DECT permits a combined morphological and functional analysis of the lung, usually obtained by a single acquisition with no extra radiation dose or extra intravenous iodine contrast medium injection.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary Perfusion Changes as Assessed by Contrast-Enhanced Dual-Energy Computed Tomography after Endoscopic Lung Volume Reduction by Coils

Lador

Hachulla²,

Hohn³

et al. 2016

Respiration

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Background: Endoscopic lung volume reduction by coils (LVRC) is a recent treatment approach for severe emphysema. Furthermore, dual-energy computed tomography (DECT) now offers a combined assessment of lung morphology and pulmonary perfusion. Objectives: The aim of our study was to assess the impact of LVRC on pulmonary perfusion with DECT. Methods: Seventeen patients (64.8 ± 6.7 years) underwent LVRC. DECT was performed prior to and after LVRC. For each patient, lung volumes and emphysema quantification were automatically calculated. Then, 6 regions of interest (ROIs) on the iodine perfusion map were drawn in the anterior, mid, and posterior right and left lungs at 4 defined levels. The ROI values were averaged to obtain lung perfusion as assessed by the lung's iodine concentration (C_Lung, μg·cm^-3). The C_Lung values were normalized using the left atrial iodine concentration (C_LA) to take into account differences between successive DECT scans. Results: The 6-min walk distance (6MWD) improved significantly after the procedure (p = 0.0002). No lung volume changes were observed between successive DECT scans for any of the patients (p = 0.32), attesting the same suspended inspiration. After LVRC, the emphysema index was significantly reduced in the treated lung (p = 0.0014). Lung perfusion increased significantly adjacent to the treated areas (C_Lung/C_LA from 3.4 ± 1.7 to 5.6 ± 2.2, p < 0.001) and in the ipsilateral untreated areas (from 4.1 ± 1.4 to 6.6 ± 1.7, p < 0.001), corresponding to a mean 65 and 61% increase in perfusion, respectively. No significant difference was observed in the contralateral upper and lower areas (from 4.4 ± 1.9 to 4.8 ± 2.1, p = 0.273, and from 4.9 ± 2.0 to 5.2 ± 1.7, p = 0.412, respectively). A significant correlation between increased 6MWD and increased perfusion was found (p = 0.0027, R² = 0.3850). Conclusions: Quantitative analysis based on DECT acquisition revealed that LVRC results in a significant increase in perfusion in the coil-free areas adjacent to the treated ones, as well as in the ipsilateral untreated areas. This suggests a possible role for LVRC in the improvement of the ventilation/perfusion relationship.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Pulmonary Perfusion Changes as Assessed by Contrast-Enhanced Dual-Energy Computed Tomography after Endoscopic Lung Volume Reduction by Coils

Lador

Hachulla²,

Hohn³

et al. 2016

Respiration

View full text Add to dashboard Cite

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“…In the lung, this can be exploited to measure the degree of penetration of contrast into the tissue and thus acquire a perfusion map of the lungs. Dual-energy CT scanning shows promise in looking at perfusion [67] and has been explored in applications such as detection of pulmonary emboli and chronic thromboembolic disease (figure 8) [68, 69]. This technique has also been applied in smokers, leading to the finding that lung perfusion is compromised in regions of emphysema proportional to the degree of parenchymal destruction [70].…”

Section: Diagnosis and Monitoring Of Pulmonary Vascular Disease mentioning

confidence: 99%

Cardiopulmonary Coupling in Chronic Obstructive Pulmonary Disease

Rahaghi¹,

Beek²,

Washko³

2014

Journal of Thoracic Imaging

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“…By means of two X-ray spectra instead of one, DECT offers increased capabilities and advantages over single energy scanning methods, such as the potential for material characterization and differentiation and the calculation of virtual mono-energetic reconstructions. In the early years applications of CT were mainly in thoracic, abdominal and vascular imaging fields, for example, automated bone removal in CTA, quantification of the amount of iodine in renal masses, and detection of perfusion defects in CTA in patients with pulmonary embolism [1–6]. Later, this was followed by a more widespread implementation in other areas of the body as in the imaging of gout [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Dual-Energy CT in Head and Neck Imaging

et al. 2017

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Purpose of ReviewTo explain the technique of Dual-energy CT (DECT) and highlight its applications and advantages in head and neck radiology.Recent FindingsUsing DECT, additional datasets can be created next to conventional images. In head and neck radiology, three material decomposition algorithms can be used for improved lesion detection and delineation of the tumor. Iodine concentration measurements can aid in differentiating malignant from nonmalignant lymph nodes and benign posttreatment changes from tumor recurrence. Virtual non-calcium images can be used for detection of bone marrow edema. Virtual mono-energetic imaging can be useful for improved iodine conspicuity at lower keV and for reduction of metallic artifacts and increase in signal-to-noise ratio at higher keV.SummaryDECT and its additional reconstructions can play an important role in head and neck cancer patients, from initial diagnosis and staging, to therapy planning, evaluation of treatment response and follow-up. Moreover, it can be helpful in imaging of infections and inflammation and parathyroid imaging as supplementary reconstructions can be obtained at lower or equal radiation dose compared with conventional single energy scanning.

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Lung Perfusion with Dual-energy Multidetector-row CT (MDCT)

Cited by 222 publications

References 32 publications

Pulmonary Perfusion Changes as Assessed by Contrast-Enhanced Dual-Energy Computed Tomography after Endoscopic Lung Volume Reduction by Coils

Pulmonary Perfusion Changes as Assessed by Contrast-Enhanced Dual-Energy Computed Tomography after Endoscopic Lung Volume Reduction by Coils

Cardiopulmonary Coupling in Chronic Obstructive Pulmonary Disease

Dual-Energy CT in Head and Neck Imaging

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