Chun Xiang Tang1, Gui Fen Yang2, U Joseph Schoepf3, Zong Hong Han4, Li Qi1, Yan E Zhao1, Jiang Wu2, Chang Sheng Zhou1, Hong Zhu2, Andrew C Stubenrauch5, Stefanie Mangold5, Long Jiang Zhang6, Guang Ming Lu7. 1. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. 2. Department of Nuclear Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. 3. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China; Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29401, USA. 4. Department of Interventional Radiology, Changzhou First People's Hospital, Changzhou, Jiangsu 213003, China. 5. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29401, USA. 6. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: kevinzhlj@163.com. 7. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: cjr.luguangming@vip.163.com.
Abstract
PURPOSE: To compare diagnostic accuracy between dual-energy CT lung perfused blood volume (Lung PBV) imaging and single photon emission computed tomography (SPECT) in detecting chronic thromboembolic pulmonary hypertension (CTEPH) with histopathological results as reference standard in a canine model. MATERIALS AND METHODS: Eighteen CTEPH canines were included into this experimental study. All procedures including paracentesis, embolization, scanning, pressure measurement and feeding medicine were repeated each two weeks, until systolic/diastolic pressure in canines was ≥ 30/15 mm Hg or mean pulmonary artery pressure ≥ 20 mm Hg, and then sacrificed for histopathology examination. Two radiologists (readers 1 and 2) and two nuclear radiologists (readers 3 and 4) analyzed images of conventional CT pulmonary angiography in dual-energy CT mode, Lung PBV imaging and SPECT, respectively. The presence, numbers, and locations of pulmonary emboli (PE) were recorded on a per-lobe basis. Pathological examination was served as reference standard. Sensitivity, specificity and accuracy of Lung PBV and SPECT were calculated. Kappa statistics were used to quantify inter-reader agreement. RESULTS: With histopathological results as reference standard, the sensitivities of 72.2%, 78.8%, 81.2%, specificities of 75.9%, 87.5%, 84.8%, accuracies of 73.8%, 83.1%, 83.1%, for readers 1, 2 and both with Lung PBV, respectively. Readers 3, 4 and both had sensitivities of 14.3%, 25.7%, 33.3%, specificities of 90.0%, 86.7%, 93.3%, accuracies of 49.2%, 53.8%, 60.0% with SPECT for detecting CTEPH. Inter-reader agreements were good for dual-energy CT (kappa=0.662) and SPECT (k=0.706) for detecting CTEPH. CONCLUSION: Dual-energy CT had a higher accuracy to detect CTEPH than SPECT in this canine model study.
PURPOSE: To compare diagnostic accuracy between dual-energy CT lung perfused blood volume (Lung PBV) imaging and single photon emission computed tomography (SPECT) in detecting chronic thromboembolic pulmonary hypertension (CTEPH) with histopathological results as reference standard in a canine model. MATERIALS AND METHODS: Eighteen CTEPHcanines were included into this experimental study. All procedures including paracentesis, embolization, scanning, pressure measurement and feeding medicine were repeated each two weeks, until systolic/diastolic pressure in canines was ≥ 30/15 mm Hg or mean pulmonary artery pressure ≥ 20 mm Hg, and then sacrificed for histopathology examination. Two radiologists (readers 1 and 2) and two nuclear radiologists (readers 3 and 4) analyzed images of conventional CT pulmonary angiography in dual-energy CT mode, Lung PBV imaging and SPECT, respectively. The presence, numbers, and locations of pulmonary emboli (PE) were recorded on a per-lobe basis. Pathological examination was served as reference standard. Sensitivity, specificity and accuracy of Lung PBV and SPECT were calculated. Kappa statistics were used to quantify inter-reader agreement. RESULTS: With histopathological results as reference standard, the sensitivities of 72.2%, 78.8%, 81.2%, specificities of 75.9%, 87.5%, 84.8%, accuracies of 73.8%, 83.1%, 83.1%, for readers 1, 2 and both with Lung PBV, respectively. Readers 3, 4 and both had sensitivities of 14.3%, 25.7%, 33.3%, specificities of 90.0%, 86.7%, 93.3%, accuracies of 49.2%, 53.8%, 60.0% with SPECT for detecting CTEPH. Inter-reader agreements were good for dual-energy CT (kappa=0.662) and SPECT (k=0.706) for detecting CTEPH. CONCLUSION: Dual-energy CT had a higher accuracy to detect CTEPH than SPECT in this canine model study.
Authors: Rahul D Renapurkar; Michael A Bolen; Sankaran Shrikanthan; Jennifer Bullen; Wadih Karim; Andrew Primak; Gustavo A Heresi Journal: Cardiovasc Diagn Ther Date: 2018-08
Authors: Jan Robert Kroeger; Jakob Zöllner; Felix Gerhardt; Stephan Rosenkranz; Roman Johannes Gertz; Shir Kerszenblat; Gregor Pahn; David Maintz; Alexander C Bunck Journal: Quant Imaging Med Surg Date: 2022-02