Main pulmonary artery diameter from attenuation correction CT scans in cardiac SPECT accurately predicts pulmonary hypertension

Burger, Irene A.; Husmann, Lars; Herzog, Bernhard A.; Buechel, Ronny R.; Pazhenkottil, Aju P.; Ghadri, Jelena R.; Nkoulou, René; Jenni, Rolf; Russi, Erich W.; Kaufmann, Philipp A.

doi:10.1007/s12350-011-9413-9

Cited by 21 publications

(13 citation statements)

References 16 publications

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“…In all included studies, most studies used RHC as the gold standard to diagnose PH, which is widely considered as an acceptable basis for PH diagnosis, 3 studies only used echocardiography as diagnostic reference. 25 , 37 , 38 Of the 20 publications, 15 had QUADAS scores ≥9, suggesting the reliable of our results. Tables 1 and 2 summarized the clinical characteristics of the studies, patient distribution in each study as well as the QUADAS scores for each publication.…”

Section: Resultssupporting

confidence: 67%

CT-Base Pulmonary Artery Measurementin the Detection of Pulmonary Hypertension

et al. 2014

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Section: Resultssupporting

confidence: 67%

CT-Base Pulmonary Artery Measurementin the Detection of Pulmonary Hypertension

et al. 2014

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“…A wide range of cut-off values for identifying RHC-confirmed pulmonary hypertension have been proposed for MPAD (from 25 to 38 mm) and PA:Ao (from 0.84 to 1.4) [4,6,7,9,10,[15][16][17][18][19][20][21][22][23][24][25][26][27][28]. We elected to use the cut-offs proposed in the European Society of Cardiology/European Respiratory Society pulmonary hypertension guideline for our main analyses [13,14], but also ran analyses using a range of values, and found that alternative cut-off values performed better.…”

Section: Discussionmentioning

confidence: 99%

Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension

Ratanawatkul

Richards

et al. 2020

ERJ Open Res

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BackgroundOn high-resolution computed tomography (HRCT), pulmonary artery (PA) dimensions may hint at the presence of pulmonary hypertension. We aimed to determine how accurately various measures of the PA, as viewed on HRCT, predict right heart catheterisation (RHC)-confirmed pulmonary hypertension.MethodsWe retrospectively reviewed patients who had HRCT and RHC between 2010 and 2018. Analyses considered respiratory cycle, pulmonary hypertension diagnostic criteria, time between HRCT and RHC, and subgroup analysis in interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD).ResultsOf 620 patients, 375 had pulmonary hypertension. For pulmonary hypertension (defined as mean PA pressure (mPAP) ≥25 mmHg) and from HRCT performed within 60 days of RHC, main PA diameter (MPAD) ≥29 mm had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88%, 42%, 0.70 and 0.70, respectively, while ratio of the diameter of the PA to the diameter of the ascending aorta (PA:Ao) ≥1.0 showed 53%, 85%, 0.84 and 0.54, respectively. In general, results were similar when the interval between HRCT and RHC varied from 7 to 60 days and when measured on expiratory images. In ILD, the sensitivity of MPAD was higher; in COPD, the specificity of PA:Ao was higher. There was moderately positive correlation between mPAP and inspiratory MPAD, PA:Ao, right PA diameter (RPAD), left PA diameter (LPAD) and (RPAD+LPAD)/2 (r=0.48, 0.51, 0.34, 0.34 and 0.36, respectively), whereas there was weak negative correlation between mPAP and PA angle (r= −0.24).ConclusionsFindings on HRCT may assist in the diagnosis of RHC-confirmed pulmonary hypertension. MPAD ≥29 mm had high sensitivity and PA:Ao ≥1.0 had high specificity. Compared with the entire cohort, MPAD had greater sensitivity in ILD and PA:Ao had higher specificity in COPD.

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“…Depending on the study population, the cut-off selected for the PA diameter (25-33.3 mm), and the gold standard used, the reported sensitivity can range between 47%-100% and the specificity between 41%-100% [10,12,13,[16][17][18][20][21][22]28]. As anticipated, there is considerable overlap in the cut-off value and some overlap with what has been reported in the population without PH (Table 1).…”

Section: Diagnostic Utility Of Pa Sizementioning

confidence: 76%

The Significance of Pulmonary Artery Size in Pulmonary Hypertension

et al. 2014

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Pulmonary hypertension (PH) has been found to have significant morbidity and mortality. The treatment of PH has advanced considerably with increasingly more effective and safer options. With an increasing effort to diagnose patients early, non-invasive techniques are often used to screen those patients likely to have PH. Computerized tomography (CT) chest scans are increasingly utilized in the evaluation of patients with exertional dyspnea, including those with suspected PH. The main role of the CT scan is to evaluate for any associated underlying diseases. There have been attempts to address the utility of CT to predict the presence of PH. This article reviews previously published investigations to summarize the relationship between pulmonary artery dimensions and PH to determine both the strength of the correlation and its discriminatory ability for use in clinical practice.

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Main pulmonary artery diameter from attenuation correction CT scans in cardiac SPECT accurately predicts pulmonary hypertension

Abstract: MPA diameter from low-dose unenhanced multi-slice CT reliably predicts PHT, providing an important added clinical value from AC for SPECT MPI.

Cited by 21 publications

References 16 publications

CT-Base Pulmonary Artery Measurementin the Detection of Pulmonary Hypertension

CT-Base Pulmonary Artery Measurementin the Detection of Pulmonary Hypertension

Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension

The Significance of Pulmonary Artery Size in Pulmonary Hypertension

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