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Head-to-head comparison of lung perfusion with dual-energy CT and SPECT-CT - 04/05/20

Doi : 10.1016/j.diii.2020.02.006 
S. Si-Mohamed a, b, , C. Moreau-Triby c, P. Tylski d, V. Tatard-Leitman b, Q. Wdowik a, S. Boccalini a, R. Dessouky e, P. Douek a, b, L. Boussel a, b
a Department of Radiology, Hospices Civils de Lyon, 69500 Bron, France 
b Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France 
c Department of Nuclear Medicine, Hospices Civils de Lyon, 69500 Bron, France 
d Medical Physics and Radioprotection, Hospices Civils de Lyon, 69500 Bron, France 
e Department of Radiology, Faculty of Medicine, Zagazig University, 44519 Zagazig, Egypt 

Corresponding author. Department of Radiology, CHU Louis Pradel, 59, Boulevard Pinel, 69500 Bron, France.Department of Radiology, CHU Louis Pradel59, Boulevard PinelBron69500France

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Highlights

DECT iodine maps strongly correlate with SPECT-CT in the quantification of relative lobar perfusion.
Almost perfect agreement is found for both morphology and severity of perfusion defects between DECT iodine maps and SPECT-CT.
Sensitivity, specificity, PPV, NPV, and accuracy for lung perfusion defects of DECT iodine maps are 89.4%, 96.5%, 95.6%, 91.4%, and 93.0% using SPECT-CT as standard of reference.

El texto completo de este artículo está disponible en PDF.

Abstract

Purpose

To compare the quantitative and qualitative lung perfusion data acquired with dual energy CT (DECT) to that acquired with a large field-of-view cadmium-zinc-telluride camera single-photon emission CT coupled to a CT system (SPECT-CT).

Materials and methods

A total of 53 patients who underwent both dual-layer DECT angiography and perfusion SPECT-CT for pulmonary hypertension or pre-operative lobar resection surgery were retrospectively included. There were 30 men and 23 women with a mean age of 65.4±17.5 (SD)years (range: 18–88years). Relative lobar perfusion was calculated by dividing the amount (of radiotracer or iodinated contrast agent) per lobe by the total amount in both lungs. Linear regression, Bland-Altman analysis, and Pearson's correlation coefficient were also calculated. Kappa test was used to test agreements in morphology and severity of perfusion defects assessed on SPECT-CT and on DECT iodine maps with a one-month interval. Wilcoxon rank sum test was used to compare the sharpness of perfusion defects and radiation dose among modalities.

Results

Strong correlations for relative lobar perfusion using linear regression analysis and Pearson's correlation coefficient (r=0.93) were found. Bland-Altman analysis revealed a −0.10 bias, with limits of agreement between [−6.01; 5.81]. With respect to SPECT- CT as standard of reference, the sensitivity, specificity, PPV, NPV, accuracy for lobar perfusion defects were 89.4% (95% 
CI: 82.6−93.4%), 96.5% (95% CI: 92.1−98.5%), 95.6% (95% CI: 
90.9−97.8%), 91.4% (95% CI: 85.6−94.9%) and 93.0% (95% CI: 
87.6−96.1%) respectively. High level of agreement was found for morphology and severity of perfusion defects between modalities (Kappa=0.84 and 0.86 respectively) and on DECT images among readers (Kappa=0.94 and 0.89 respectively). A significantly sharper delineation of perfusion defects was found on DECT images (P<0.0001) using a significantly lower equivalent dose of 4.1±2.3 (SD) mSv (range: 1.9–11.85mSv) compared to an equivalent dose of 5.3±1.1 (SD) mSv (range: 2.8–7.3mSv) for SPECT-CT, corresponding to a 21.2% dose reduction (P=0.0004).

Conclusion

DECT imaging shows strong quantitative correlations and qualitative agreements with SPECT-CT for the evaluation of lung perfusion.

El texto completo de este artículo está disponible en PDF.

Keywords : Tomography, X-Ray Computed/methods, Lung, Perfusion, Emission-Computed, Single-Photon, Comparative study

Abbreviations : CTEPH, CTDIvol, CZT, DECT, FEV, PBV, PE, 99m-Tc, SPECT-CT


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© 2020  Société française de radiologie. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 101 - N° 5

P. 299-310 - mai 2020 Regresar al número
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