Quantitative lobar pulmonary perfusion assessment on dual-energy CT pulmonary angiography: applications in pulmonary embolism.

Purpose: To assess quantitative lobar pulmonary perfusion on DECT-PA in patients with and without pulmonary embolism (PE).Materials and Methods: Our retrospective study included 88 adult patients (mean age 56 ± 19 years; 38 men, 50 women) who underwent DECT-PA (40 PE present; 48 PE absent) on a 384-...

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Published in:European Radiology Vol. 30; no. 5; pp. 2535 - 2543
Main Authors: Singh, Ramandeep, Nie, Ryan Zipan, Homayounieh, Fatemeh, Schmidt, Bernhard, Flohr, Thomas, Kalra, Mannudeep K.
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature May2020
Online Access:View this record in EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Quantitative lobar pulmonary perfusion assessment on dual-energy CT pulmonary angiography: applications in pulmonary embolism.
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          Singh, Ramandeep
          Nie, Ryan Zipan
          Homayounieh, Fatemeh
          Schmidt, Bernhard
          Flohr, Thomas
          Kalra, Mannudeep K.
        affil: Department of Thoracic Imaging, Massachusetts General Hospital, 75 Blossom Court, Boston, MA, USA
      sug:
        subj:
          Lung
          Pulmonary Embolism Diagnosis
          Pulmonary Circulation Physiology
          Male
          Pulmonary Embolism Physiopathology
          Female
          Middle Age
          Retrospective Design
          Human
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose: To assess quantitative lobar pulmonary perfusion on DECT-PA in patients with and without pulmonary embolism (PE).Materials and Methods: Our retrospective study included 88 adult patients (mean age 56 ± 19 years; 38 men, 50 women) who underwent DECT-PA (40 PE present; 48 PE absent) on a 384-slice, third-generation, dual-source CT. All DECT-PA examinations were reviewed to record the presence and location of occlusive and non-occlusive PE. Transverse thin (1 mm) DECT images (80/150 kV) were de-identified and exported offline for processing on a stand-alone deep learning-based prototype for automatic lung lobe segmentation and to obtain the mean attenuation numbers (in HU), contrast amount (in mg), and normalized iodine concentration per lung and lobe. The zonal volumes and mean enhancement were obtained from the Lung Analysis™ application. Data were analyzed with receiver operating characteristics (ROC) and analysis of variance (ANOVA).Results: The automatic lung lobe segmentation was accurate in all DECT-PA (88; 100%). Both lobar and zonal perfusions were significantly lower in patients with PE compared with those without PE (p < 0.0001). The mean attenuation numbers, contrast amounts, and normalized iodine concentrations in different lobes were significantly lower in the patients with PE compared with those in the patients without PE (AUC 0.70-0.78; p < 0.0001). Patients with occlusive PE had significantly lower quantitative perfusion compared with those without occlusive PE (p < 0.0001).Conclusion: The deep learning-based prototype enables accurate lung lobe segmentation and assessment of quantitative lobar perfusion from DECT-PA.Key Points: • Deep learning-based prototype enables accurate lung lobe segmentation and assessment of quantitative lobar perfusion from DECT-PA. • Quantitative lobar perfusion parameters (AUC up to 0.78) have a higher predicting presence of PE on DECT-PA examinations compared with the zonal perfusion parameters (AUC up to 0.72). • The lobar-normalized iodine concentration has the highest AUC for both presence of PE and for differentiating occlusive and non-occlusive PE.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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