Universität zu Köln

Gertz, Roman Johannes, Gerhardt, Felix, Kroeger, Jan Robert ORCID: 0000-0003-1218-7610, Shahzad, Rahil, Caldeira, Liliana ORCID: 0000-0002-9530-5899, Kottlors, Jonathan, Grosse Hokamp, Nils, Maintz, David, Rosenkranz, Stephan and Bunck, Alexander Christian (2022). Spectral Detector CT-Derived Pulmonary Perfusion Maps and Pulmonary Parenchyma Characteristics for the Semiautomated Classification of Pulmonary Hypertension. Front. Cardiovasc. Med., 9. LAUSANNE: FRONTIERS MEDIA SA. ISSN 2297-055X

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Abstract

ObjectivesTo evaluate the usefulness of spectral detector CT (SDCT)-derived pulmonary perfusion maps and pulmonary parenchyma characteristics for the semiautomated classification of pulmonary hypertension (PH). MethodsA total of 162 consecutive patients with right heart catheter (RHC)-proven PH of different aetiologies as defined by the current ESC/ERS guidelines who underwent CT pulmonary angiography (CTPA) on SDCT and 20 patients with an invasive rule-out of PH were included in this retrospective study. Semiautomatic lung segmentation into normal and malperfused areas based on iodine density (ID) as well as automatic, virtual non-contrast-based emphysema quantification were performed. Corresponding volumes, histogram features and the ID Skewness(PerfDef)-Emphysema-Index (delta-index) accounting for the ratio of ID distribution in malperfused lung areas and the proportion of emphysematous lung parenchyma were computed and compared between groups. ResultsPatients with PH showed a significantly greater extent of malperfused lung areas as well as stronger and more homogenous perfusion defects. In group 3 and 4 patients, ID skewness revealed a significantly more homogenous ID distribution in perfusion defects than in all other subgroups. The delta-index allowed for further subclassification of subgroups 3 and 4 (p < 0.001), identifying patients with chronic thromboembolic PH (CTEPH, subgroup 4) with high accuracy (AUC: 0.92, 95%-CI, 0.85-0.99). ConclusionAbnormal pulmonary perfusion in PH can be detected and quantified by semiautomated SDCT-based pulmonary perfusion maps. ID skewness in malperfused lung areas, and the delta-index allow for a classification of PH subgroups, identifying groups 3 and 4 patients with high accuracy, independent of reader expertise.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gertz, Roman Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerhardt, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Jan Robert UNSPECIFIED orcid.org/0000-0003-1218-7610 UNSPECIFIED Shahzad, Rahil UNSPECIFIED UNSPECIFIED UNSPECIFIED Caldeira, Liliana UNSPECIFIED orcid.org/0000-0002-9530-5899 UNSPECIFIED Kottlors, Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Grosse Hokamp, Nils UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, Alexander Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-679013
DOI:	10.3389/fcvm.2022.835732
Journal or Publication Title:	Front. Cardiovasc. Med.
Volume:	9
Date:	2022
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	2297-055X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL-ENERGY CT; BLOOD-VOLUME IMAGES; LUNG PERFUSION; ARTERIAL-HYPERTENSION; COMPUTED-TOMOGRAPHY; DIAGNOSTIC-ACCURACY; ANGIOGRAPHY; EMBOLISM; EMPHYSEMA Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67901