Evaluation of diagnostic accuracy of dual-energy computed tomography in patients with chronic thromboembolic pulmonary hypertension compared to V/Q-SPECT and pulmonary angiogram.
CTEPH: chronic thromboembolic pulmonary hypertension
V/Q SPECT
dual-energy CT (DECT)
iodine mapping
pulmonary angiogram
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2023
2023
Historique:
received:
26
03
2023
accepted:
31
05
2023
medline:
10
7
2023
pubmed:
10
7
2023
entrez:
10
7
2023
Statut:
epublish
Résumé
The relevance of dual-energy computed tomography (DECT) for the detection of chronic thromboembolic pulmonary hypertension (CTEPH) still lies behind V/Q-SPECT in current clinical guidelines. Therefore, our study aimed to assess the diagnostic accuracy of DECT compared to V/Q-SPECT with invasive pulmonary angiogram (PA) serving as the reference standard. A total of 28 patients (mean age 62.1 years ± 10.6SD; 18 women) with clinically suspected CTEPH were retrospectively included. All patients received DECT with the calculation of iodine maps, V/Q-SPECT, and PA. Results of DECT and V/Q-SPECT were compared, and the percent of agreement, concordance (utilizing Cohen's kappa), and accuracy (kappa In total, 18 patients were diagnosed with CTEPH (mean age 62.4 years ± 11.0SD; 10 women) and 10 patients had other diseases. Compared to PA, accuracy and concordance for DECT were superior to V/Q-SPECT in all patients (88.9% vs. 81.3%; k = 0.764 vs. k = 0.607) and in CTEPH patients (82.4% vs. 70.1%; k = 0.694 vs. k = 0.560). Furthermore, the mean radiation dose was significantly lower for DECT vs. V/Q-SPECT ( In our patient cohort, DECT is at least equivalent to V/Q-SPECT in diagnosing CTEPH and has the added advantage of significantly lower radiation doses in combination with simultaneous assessment of lung and heart morphology. Hence, DECT should be the subject of ongoing research, and if our results are further confirmed, it should be implemented in future diagnostic PH algorithms at least on par with V/Q-SPECT.
Identifiants
pubmed: 37425315
doi: 10.3389/fmed.2023.1194272
pmc: PMC10324648
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1194272Informations de copyright
Copyright © 2023 Schüssler, Lug, Kremer, Harth, Kriechbaum, Richter, Guth, Wiedenroth, Tello, Steiner, Seeger, Krombach and Roller.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
J Heart Lung Transplant. 2023 Jan;42(1):134-139
pubmed: 36257870
Eur Radiol. 2014 Jan;24(1):42-51
pubmed: 23982287
Eur Heart J. 2016 Jan 1;37(1):67-119
pubmed: 26320113
Lancet Respir Med. 2022 Oct;10(10):949-960
pubmed: 35926544
J Am Coll Cardiol. 2009 Jun 30;54(1 Suppl):S43-S54
pubmed: 19555858
Radiology. 2019 Jul;292(1):197-205
pubmed: 31084482
Eur Radiol. 2018 Dec;28(12):5100-5110
pubmed: 29846802
J Thorac Cardiovasc Surg. 2011 Mar;141(3):702-10
pubmed: 21335128
J Heart Lung Transplant. 2017 Jul 1;:
pubmed: 28750932
Chest. 2001 Mar;119(3):818-23
pubmed: 11243963
Eur Respir J. 2013 Feb;41(2):462-8
pubmed: 22700839
Cardiovasc Diagn Ther. 2018 Aug;8(4):414-422
pubmed: 30214856
Eur Heart J. 2022 Oct 11;43(38):3618-3731
pubmed: 36017548
Eur Respir J. 2017 Jun 8;49(6):
pubmed: 28596435
Eur Radiol. 2017 Apr;27(4):1631-1639
pubmed: 27480438
Eur Respir J. 2021 Jan 5;57(1):
pubmed: 33402372
Chest. 1982 Feb;81(2):151-8
pubmed: 7056079
Int J Cardiol. 2019 Jun 15;285:80-85
pubmed: 30905521
Pulm Circ. 2019 Mar 18;:2045894019841990
pubmed: 30880632
Eur Radiol. 2016 Nov;26(11):4011-4020
pubmed: 26976297
Rofo. 2021 Nov;193(11):1318-1326
pubmed: 34139779
Medicine (Baltimore). 2019 Aug;98(34):e16787
pubmed: 31441850
Nuklearmedizin. 2018 Jun;57(3):74-91
pubmed: 29871009
Pulm Circ. 2021 May 24;11(2):20458940211007375
pubmed: 34104420
Rofo. 2021 Jun;193(6):627-630
pubmed: 33535256
Eur Respir J. 2021 Jun 17;57(6):
pubmed: 33334946
Int J Cardiol. 2018 Dec 1;272S:69-78
pubmed: 30195840
Pulm Circ. 2016 Jun;6(2):145-54
pubmed: 27252839
Clin Chest Med. 2021 Mar;42(1):81-90
pubmed: 33541619