Quantitative CT Evaluation of Small Pulmonary Vessels in Patients with Acute Pulmonary Embolism

Matsuoka, Shin; Kotoku, Akiyuki; Yamashiro, Tsuneo; Matsushita, Shoichiro; Fujikawa, Atsuko; Yagihashi, Kunihiro; Nakajima, Yasuo

doi:10.1016/j.acra.2017.11.013

Cited by 7 publications

(6 citation statements)

References 39 publications

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“… 160 , 161 In addition, several investigators have proposed CT-based QIBs for the management of chronic obstructive pulmonary disease (COPD), pulmonary nodules, interstitial lung disease, pulmonary thromboembolism, and pulmonary hypertension. 162 – 169 In line with this, RSNA QIBA has been working on standardizing the CT protocols and has published profiles through the following committees: (1) CT angiography, (2) CT volumetry, (3) lung density, and (4) small lung nodule. 170…”

Section: Computed Tomographymentioning

confidence: 99%

Variability and Standardization of Quantitative Imaging

et al. 2020

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Radiological images have been assessed qualitatively in most clinical settings by the expert eyes of radiologists and other clinicians. On the other hand, quantification of radiological images has the potential to detect early disease that may be difficult to detect with human eyes, complement or replace biopsy, and provide clear differentiation of disease stage. Further, objective assessment by quantification is a prerequisite of personalized/precision medicine. This review article aims to summarize and discuss how the variability of quantitative values derived from radiological images are induced by a number of factors and how these variabilities are mitigated and standardization of the quantitative values are achieved. We discuss the variabilities of specific biomarkers derived from magnetic resonance imaging and computed tomography, and focus on diffusion-weighted imaging, relaxometry, lung density evaluation, and computer-aided computed tomography volumetry. We also review the sources of variability and current efforts of standardization of the rapidly evolving techniques, which include radiomics and artificial intelligence.

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Section: Computed Tomographymentioning

confidence: 99%

Variability and Standardization of Quantitative Imaging

et al. 2020

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“…It has recently been found to be correlated to the clinical classification of pulmonary embolism severity as defined by the European Society of Cardiology (23). Finally, the QOI can be used to monitor treatment outcomes in follow-up scans (1, 2, 15, 24–29).…”

Section: Discussionmentioning

confidence: 99%

Can a Trained Radiology Technician Do Arterial Obstruction Quantification in Patients With Acute Pulmonary Embolism?

Rotzinger

Breault

Knebel

et al. 2019

Front. Cardiovasc. Med.

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Objectives: To assess interobserver variability between a trained radiology technician (RT) and an experienced radiologist in arterial obstruction quantification using the Qanadli obstruction index (QOI), in patients diagnosed with acute pulmonary embolism (APE) at CT pulmonary angiography (CTPA). Materials and Methods: A RT and a radiologist independently reviewed CTPAs of 97 consecutive, prospectively enrolled patients with APE, and calculated the QOI. They classified patients into three risk categories: high for QOI ≥40%, intermediate for QOI 20–37.5%, low for QOI <20%. Interobserver variability was investigated for QOI as a continuous variable and as a categorical variable (high, intermediate, and low-risk groups). Results: Mean QOI (±SD) was 39.5 ± 24.3% and 38.6 ± 18.9% for the RT and the radiologist, respectively. The mean QOI was not statistically different between the RT and the radiologist ( p = 0.502), and the interobserver agreement was excellent (ICC = 0.905). The RT classified 54 patients (55.7%) as high, 17 (17.53%) as intermediate, and 26 (26.8%) as low risk. The radiologist classified 55 patients (56.7%) as high, 22 (22.7%) as intermediate, and 20 (20.6%) as low risk. The interrater agreement for risk stratification was excellent (weighted kappa = 0.844). Conclusion: Once the diagnosis of APE was established, an adequately trained RT achieved an accuracy comparable to that of an experienced radiologist regarding QOI calculation and risk assessment.

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“…If the thrombus was located at the MPA, dominantly subsegment pulmonary arteries would also be blocked [8] and severe inflammation [20] would be activated, causing the peripheral pulmonary artery to constrict and aggravate the severity. [21] This is why MPA embolism presents a higher risk of deterioration than non-MPA embolism.…”

Section: Thrombus Stability Of Saddle Mpa Embolismmentioning

confidence: 99%

Saddle pulmonary embolism is not a sign of high-risk deterioration in non-high-risk patients: A propensity score-matched study

Dong

Zhao

2021

World Journal of Emergency Medicine

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BACKGROUND: There is controversy regarding whether saddle main pulmonary artery (MPA) embolism represents a high risk of deterioration in non-high-risk acute pulmonary embolism (PE) patients. This study aims to address this issue by conducting a propensity score matching (PSM) study. METHODS:A total of 727 non-high-risk acute PE patients were retrospectively evaluated. We evaluated the Bova score and risk stratification to examine the risk of deterioration. Deterioration defined as any adverse event within 30 days after admission. Computed tomographic pulmonary angiography was used to identify the embolism type. All patients were matched into four subgroups by PSM according to age, sex, Bova score, and risk stratifi cation: (1) MPA and non-MPA embolism;(2) non-saddle MPA and non-MPA embolism; (3) saddle MPA and non-saddle MPA embolism; (4) saddle MPA and non-MPA embolism. Correlations were analyzed using Cox regression analysis, and deterioration risk was compared between subgroups using Kaplan-Meier analysis.RESULTS: Cox regression analysis revealed that MPA embolism was correlated with deterioration, regardless of whether saddle MPA embolism was included or excluded. Saddle MPA embolism was not correlated with deterioration, regardless of comparison with non-saddle MPA embolism or non-MPA embolism. Patients with MPA and non-saddle MPA embolism presented a high risk for deterioration (logrank test=5.23 and 4.70, P=0.022 and 0.030, respetively), while patients with saddle MPA embolism were not at a high risk of deterioration (log-rank test=1.20 and 3.17, P=0.729 and 0.077, respetively).CONCLUSIONS: Saddle MPA embolism is not indicative of a high risk of deterioration in nonhigh-risk acute PE patients.

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Quantitative CT Evaluation of Small Pulmonary Vessels in Patients with Acute Pulmonary Embolism

Cited by 7 publications

References 39 publications

Variability and Standardization of Quantitative Imaging

Variability and Standardization of Quantitative Imaging

Can a Trained Radiology Technician Do Arterial Obstruction Quantification in Patients With Acute Pulmonary Embolism?

Saddle pulmonary embolism is not a sign of high-risk deterioration in non-high-risk patients: A propensity score-matched study

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