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Comparative clinical and predictive value of lung perfusion blood volume CT, lung perfusion SPECT and catheter pulmonary angiography images in patients with chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty

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Abstract

Objectives

Lung perfusion blood volume (PBV) using dual-energy computed tomography has recently become an accepted technique for diagnosing pulmonary thromboembolism. We evaluated the correlation among lung PBV, single-photon emission computed tomography (SPECT) and catheter pulmonary angiography images in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after balloon pulmonary angioplasty (BPA).

Methods

In total, 17 patients and 57 sessions were evaluated with the three modalities. Segmental lung perfusion and its improvement in lung PBV and SPECT were compared with catheter pulmonary angiography as the reference standard before and after BPA.

Results

The sensitivity for detecting segmental perfusion defects using SPECT and lung PBV was 85% and 92%, the specificity was 99% and 99%, the accuracy was 92% and 95%, the positive predictive value was 99% and 99%, and the negative predictive value was 88% and 93%. The sensitivity for detecting segmental perfusion improvement using SPECT and lung PBV was 61% and 69%, the specificity was 75% and 83%, the accuracy was 62% and 70%, the positive predictive value was 97% and 98%, and the negative predictive value was 12% and 16%.

Conclusions

Lung PBV is a useful technique for evaluation of segmental lung perfusion and its improvement in patients with CTEPH.

Key Points

• BPA is a new treatment for patients with CTEPH.

• Lung PBV images may be more sensitive for pulmonary blood flow.

• The current work demonstrates that Lung PBV images are useful in evaluating patients with CTEPH.

• The current work demonstrates that Lung PBV is useful in gauging the treatment effect of BPA.

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Abbreviations

BPA:

Balloon pulmonary angioplasty

CTEPH:

Chronic thromboembolic pulmonary hypertension

PBV:

Perfusion blood volume

PE:

Pulmonary thromboembolism

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Acknowledgements

We thank Angela Morben, DVM, ELS, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

This work was supported by JSPS KAKENHI Grant Numbers 15K09894, 24591776, and 26870436.

Author information

Authors and Affiliations

  1. Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Hirofumi Koike, Eijun Sueyoshi, Ichiro Sakamoto & Masataka Uetani

  2. Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Hirofumi Koike, Eijun Sueyoshi, Ichiro Sakamoto & Masataka Uetani

  3. Department of Radiology, Nagasaki Rosai Hospital, 2-12-5 Setogoe, Sasebo, 857-0134, Japan

    Hirofumi Koike

  4. Department of Cardiovascular medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Tomoo Nakata & Kouji Maemura

  5. Department of Cardiovascular medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Tomoo Nakata & Kouji Maemura

Authors
  1. Hirofumi Koike
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  2. Eijun Sueyoshi
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  3. Ichiro Sakamoto
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  4. Masataka Uetani
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  5. Tomoo Nakata
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Corresponding author

Correspondence to Hirofumi Koike.

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Guarantor

The scientific guarantor of this publication is Eijyun Sueyoshi.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the institutional review board because this study was retrospective.

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Institutional review board approval was obtained.

Methodology

• retrospective

• case-control study

• performed at one institution

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Koike, H., Sueyoshi, E., Sakamoto, I. et al. Comparative clinical and predictive value of lung perfusion blood volume CT, lung perfusion SPECT and catheter pulmonary angiography images in patients with chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty. Eur Radiol 28, 5091–5099 (2018). https://doi.org/10.1007/s00330-018-5501-4

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  • DOI: https://doi.org/10.1007/s00330-018-5501-4

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