Quantification of lung perfusion blood volume (lung PBV) by dual-energy CT in patients with and without pulmonary embolism: Preliminary results

Sueyoshi, Eijun; Tsutsui, Shin; Hayashida, Takuya; Ashizawa, Kazuto; Sakamoto, Ichiro; Uetani, Masataka

doi:10.1016/j.ejrad.2010.10.011

Cited by 47 publications

(33 citation statements)

References 22 publications

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“…Recently developed software allows automated quantification of pulmonary perfused blood volume (PBV) based on DE-CTPA iodine distribution maps, thus providing a quick, reader-independent tool for the assessment of global and regional pulmonary perfusion. A pilot study has found automated pulmonary PBV values to be decreased in patients with acute PE and to correlate with thrombus load [22]. The purpose of this study was to determine the diagnostic value of PBV quantification in DE-CTPA in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by correlating the quantified perfused blood volume with the results of right heart catheterization and a six-minute walk test.…”

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confidence: 99%

Automated Quantification of Pulmonary Perfused Blood Volume by Dual-Energy CTPA in Chronic Thromboembolic Pulmonary Hypertension

Meinel¹,

Graef²,

Thierfelder³

et al. 2013

Fortschr Röntgenstr

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Zusammenfassung !Zielsetzung: Ziel der Studie war es zu untersuchen, ob die automatisierte Quantifizierung des perfundierten Lungenblutvolumens (PBV) in der dual-energy CT Pulmonalis-Angiografie (DE-CTPA) zur Beurteilung des Schweregrades einer chronisch-thromboembolischen pulmonalen Hypertonie (CTEPH) genutzt werden kann. Methoden: Die automatisierte Quantifizierung des PBV wurde bei 25 konsekutiven Patienten mit CTEPH durchgeführt, die mittels DE-CTPA untersucht wurden. Die PBV-Werte wurden mit Parametern aus Rechtsherzkatheteruntersuchung (pulmonalarterieller Druck, Herzindex und pulmonalem Gefäßwiderstand) sowie der 6-Minuten-Gehstrecke korreliert. Hierbei wurde der Korrelationskoeffizient nach Pearson verwendet und mittels multivariater linearer Regression für Alter und Geschlecht adjustiert. Ergebnisse: Die aus der DE-CTPA ermittelten PBVWerte korrelierten negativ mit dem systolischen (r = -0,64, p = 0,001) und mittleren (r = -0,57, p = 0,004) pumonalarteriellen Blutdruck. Es zeigte sich ein Trend zu einer negativen Korrelation zwischen PBV-Werten und dem pulmonalen Gefäßwiderstand (r = -0,20, p = 0,35). Zwischen PBV und Herzindex sowie 6-Minuten-Gehstrecke wurden keine signifikanten Korrelationen gefunden. Durch multivariate lineare Regression wurde bestätigt, dass diese Korrelationen von Alter und Geschlecht unabhänig waren. Schlussfolgerung: Die DE-CTPA kann bei Patienten mit CTEPH für eine automatisierte Quantifizierung des perfundierten Lungenblutvolumens genutzt werden. Deren Ergebnisse korrelieren invers mit systolischem und mittlerem pulmonalarteriellen Druck und können daher den Schweregrad der pulmonalen Hypertonie bei diesen Patienten abschätzen. Abstract !Objectives: The aim of the study was to determine whether automated quantification of pulmonary perfused blood volume (PBV) in dual-energy computed tomography pulmonary angiography (DE-CTPA) can be used to assess the severity of chronic thromboembolic pulmonary hypertension (CTEPH). Methods: Automated quantification of PBV was performed in 25 consecutive CTEPH patients undergoing DE-CTPA. PBV values were correlated with cardiac index and pulmonary vascular resistance quantified by right heart catheterization and walking distance in the 6-minute walk test using Pearson's correlation coefficient and multivariate linear regression analysis to control for age and gender. Results: DE-CTPA derived PBV values inversely correlated with systolic (r = -0.64, p = 0.001) and mean (r = -0.57, p = 0.004) pulmonary arterial pressure. There was a trend for PBV values to inversely correlate with pulmonary vascular resistance (r = -0.20, p = 0.35). No significant correlation was found between PBV values and cardiac index or 6-minute walking distance. These correlations were confirmed to be independent of age and gender on multivariate linear regression analysis. Conclusion: DE-CTPA can be used for an automated quantification of pulmonary PBV in chronic thromboembolic pulmonary hypertension. PBV values correlate inversely with systolic and mean pulmonary arteria...

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confidence: 99%

Automated Quantification of Pulmonary Perfused Blood Volume by Dual-Energy CTPA in Chronic Thromboembolic Pulmonary Hypertension

Meinel¹,

Graef²,

Thierfelder³

et al. 2013

Fortschr Röntgenstr

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“…The total volume of contrast material was adapted to the patient's body weight at 1.35 ml/kg. In this study, CT scanning began at a fixed 14 s from the start of injection [3] [4]. To avoid streak artifacts due to highly concentrated contrast material in the subclavian vein or superior vena cava, scans were acquired in the caudocranial direction.…”

Section: Ct Acquisition Protocolmentioning

confidence: 99%

“…T CT angiography (CTA) images were reconstructed with a specific medium-soft convolution kernel (D30) without edge modification at a 1.0-mm slice thickness with a 1.0-mm increment. The image reconstruction system generated three stacks of axial images: 140-kV images, 80-kV images, and weighted-average images that derived 60% of the image density from the 140-kV images and 40% from the 80-kV images to achieve an image quality and a signal-to-noise ratio similar to those of single-energy 120-kV scans [3] [4].…”

Section: Ct Acquisition Protocolmentioning

confidence: 99%

“…As the third limitation, CT scanning began at a fixed 14 s from the start of injection based on previous reports [3] [4]. This might underestimate the PBV in patients with suspected PH where the mean pulmonary transit time may be reduced.…”

Section: Limitationsmentioning

confidence: 99%

“…These maps represent the cartography of iodine content in the lung parenchyma at the time point of the first pass of contrast media in each examination [4]. Recent softwares (Syngo MultiModality; Siemens Healthcare, Erlagen, Germany) have been suggested for quantification of lung perfusion blood volume (PBV), allowing objective evaluation [3] [4]. Few reports have investigated pulmonary perfusion correlating with pulmonary artery pressure (PAP) in patients with chronic pulmonary diseases.…”

Section: Introductionmentioning

confidence: 99%

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Correlation between Automated Quantification of Lung Perfusion Blood Volume (PBV) and Pulmonary Artery Pressure

Koike¹,

Sueyoshi²,

Sakamoto³

et al. 2016

OJRad

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Purpose: Dual-energy CT (DECT) can be used for quantification of lung perfusion blood volume (PBV), allowing objective evaluation. However, no reports have investigated pulmonary perfusion correlating with pulmonary artery pressure (PAP) in patients with chronic pulmonary diseases. The purpose was to evaluate automated quantification of the lung PBV using dual-energy CT, and its correlation with PAP. Methods: 274 patients who underwent echocardiography within two weeks also underwent CT. The population was divided into high (≥40 mmHg) and low (<40 mmHg) estimated systolic PAP (sPAP) groups (n = 63 and n = 211, respectively). We retrospectively evaluated the lung PBV using Syngo software, and correlations between the lung PBV and estimated sPAP. Results: Lung PBV values were 25.0 ± 9.6 and 29.0 ± 9.3 Hounsfield units (HU) in high and low sPAP groups, respectively, with a significant difference between them (p = 0.003). In the high sPAP group with underlying lung diseases (n = 15), chronic thromboembolism (n = 25), pulmonary artery stenosis (n = 12), and left heart failure (n = 11), using the Dana Point classification system, lung PBV values were 18.6 ± 1.6, 25.1 ± 4.5, 25.8 ± 4.5, and 32.7 ± 9.4 HU, respectively. There were significant differences in quantification of the lung PBV among them. The mean sPAP of subjects with left heart failure was significantly higher than in the others. In subjects with left heart failure, a positive correlation between the lung PBV value and sPAP was noted (R = 0.721, p < 0.0001). Conclusions: Automated quantification of the lung PBV may estimate the high sPAP. The lung PBV may contribute to clarifying the etiology of a high PAP due to left heart failure.

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Quantitative pulmonary perfusion in acute pulmonary embolism and chronic thromboembolic pulmonary hypertension

Hansen,

Poulsen,

Nielsen‐Kudsk

et al. 2024

Pulm. circ.

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Current methods for quantifying perfusion from computed tomography pulmonary angiography (CTPA) often rely on semi‐quantitative scoring systems and requires an experienced evaluator. Few studies report on absolute quantitative variables derived from the images, and the methods are varied with mixed results. Dual‐energy CTPA (DE‐CTPA) enables automatic quantification of lung and lobar perfusion with minimal user interaction by utilizing machine learning based software. We aimed to evaluate differences in DE‐CTPA derived quantitative perfusion variables between patients with acute pulmonary embolism (PE) and chronic thromboembolic pulmonary hypertension (CTEPH). This retrospective, single‐center, observational study included 162 adult patients diagnosed with PE (n = 81) or CTEPH (n = 81) and scanned using dual‐energy CT between 2020 and 2023. Mann–Whitney U tests and permutational analysis of variance (PERMANOVA) were used for comparative analyses. We found whole lung perfusion blood volume to be lower (p < 0.001) in PE patients (median 3399 mL [2554, 4284]) than in CTEPH patients (median 4094 mL [3397, 4818]). The same was observed at single lung and lobar level. PERMANOVA encompassing all perfusion variables showed a difference between the two groups (F‐statistic = 13.3, p = 0.002). Utilizing logistic regression, right and left lower lobe perfusion blood volume showed some ability to differentiate between PE and CTEPH with area under the receiver operation characteristics curve values of 0.71 (95% CI: 0.56; 0.84) and 0.72 (95% CI: 0.56; 0.86). Pulmonary perfusion is lower in patients with PE than patients with CTEPH, highlighted by differences in DECT‐derived perfusion blood volume. Quantitative perfusion variables might be useful to differentiate between the two diseases.

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Quantification of lung perfusion blood volume (lung PBV) by dual-energy CT in patients with and without pulmonary embolism: Preliminary results

Cited by 47 publications

References 22 publications

Automated Quantification of Pulmonary Perfused Blood Volume by Dual-Energy CTPA in Chronic Thromboembolic Pulmonary Hypertension

Automated Quantification of Pulmonary Perfused Blood Volume by Dual-Energy CTPA in Chronic Thromboembolic Pulmonary Hypertension

Correlation between Automated Quantification of Lung Perfusion Blood Volume (PBV) and Pulmonary Artery Pressure

Quantitative pulmonary perfusion in acute pulmonary embolism and chronic thromboembolic pulmonary hypertension

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