Document Detail

Assessing Pulmonary Perfusion in Emphysema: Automated Quantification of Perfused Blood Volume in Dual-Energy CTPA.
MedLine Citation:
PMID:  23288014     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: The objective of this study was to determine whether automated quantification of lung perfused blood volume (PBV) in dual-energy computed tomographic pulmonary angiography (DE-CTPA) can be used to assess the severity and regional distribution of pulmonary hypoperfusion in emphysema.
MATERIALS AND METHODS: We retrospectively analyzed 40 consecutive patients (mean age, 67 [13] years) with pulmonary emphysema, who have no cardiopulmonary comorbidities, and a DE-CTPA negative for pulmonary embolism. Automated quantification of global and regional pulmonary PBV was performed using the syngo Dual Energy application (Siemens Healthcare). Similarly, the global and regional degrees of parenchymal hypodensity were assessed automatically as the percentage of voxels with a computed tomographic density less than -900 Hounsfield unit. Emphysema severity was rated visually, and pulmonary function tests were obtained by chart review, if available.
RESULTS: Global PBV generated by automated quantification of pulmonary PBV in the DE-CTPA data sets showed a moderately strong but highly significant negative correlation with residual volume in percentage of the predicted residual volume (r = -0.62; P = 0.002; n = 23) and a positive correlation with forced expiratory volume in 1 second in percentage of the predicted forced expiratory volume in 1 second (r = 0.67; P < 0.001; n = 23). Global PBV values strongly correlated with diffusing lung capacity for carbon monoxide (r = 0.80; P < 0.001; n = 15). Pulmonary PBV values decreased with visual emphysema severity (r = -0.46, P = 0.003, n = 40). Moderate negative correlations were found between global PBV values and parenchymal hypodensity both in a per-patient (r = -0.63; P < 0.001; n = 40) and per-region analyses (r = -0.62; P < 0.001; n = 40).
CONCLUSIONS: Dual-energy computed tomographic pulmonary angiography allows simultaneous assessment of lung morphology, parenchymal density, and pulmonary PBV. In patients with pulmonary emphysema, automated quantification of pulmonary PBV in DE-CTPA can be used for a quick, reader-independent estimation of global and regional pulmonary perfusion, which correlates with several lung function parameters.
Felix G Meinel; Anita Graef; Sven F Thieme; Fabian Bamberg; Florian Schwarz; Wieland H Sommer; Andreas D Helck; Claus Neurohr; Maximilian F Reiser; Thorsten R C Johnson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Investigative radiology     Volume:  48     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-85     Citation Subset:  IM    
From the Departments of *Clinical Radiology, and †Internal Medicine, Ludwig Maximilians-University, Munich, Germany.
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