Literature DB >> 20421798

Enhanced visualization of lung vessels for diagnosis of pulmonary embolism using dual energy CT angiography.

Radko Krissak1, Thomas Henzler, Miriam Reichert, Bernhard Krauss, Stefan O Schoenberg, Christian Fink.   

Abstract

OBJECTIVES: To evaluate a software algorithm highlighting vascular iodine distribution in dual energy (DE) computed tomography angiography (CTA) for the diagnosis of pulmonary embolism (PE).
MATERIAL AND METHODS: Pulmonary DE-CTA of 16 patients with PE and 16 patients without PE were analyzed using a software algorithm highlighting vascular iodine distribution. The algorithm color-codes lung vessels depending on their local iodine distribution on a 2-color scale. The diagnostic performance of the software for the detection of PE was assessed on patient and segmental basis by consensus reading of 2 blinded radiologists. The reading of the standard CTA data by an independent third radiologist and clinical follow-up served as the standard of reference for the diagnosis of PE.
RESULTS: Of 576 analyzed segments CTA revealed 88 diseased lung segments with 1 or more emboli. The software correctly highlighted 62 segments as positive. Twenty-six segments with PE were not highlighted. Seventy-five segments were highlighted false positive. All 16 patients with PE were identified as positive, but 1 of these patients had no true positive finding on a segmental basis and was therefore classified as false negative. Twenty-three segments in 8 patients without PE were highlighted as positive. Sensitivity, specificity, positive predictive value, and negative predictive value of the software algorithm were 93.8%, 50%, 65.2%, 88.9% per patient and 70.5%, 84.6%, 45.3%, 94.1% per segment, respectively.
CONCLUSION: Additional review of the DE-CTA with a dedicated software algorithm highlighting the vascular iodine distribution has a high negative predictive value important for exclusion of segmental PE.

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Year:  2010        PMID: 20421798     DOI: 10.1097/RLI.0b013e3181dfda37

Source DB:  PubMed          Journal:  Invest Radiol        ISSN: 0020-9996            Impact factor:   6.016


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