Head-to-head comparison of lung perfusion with dual-energy CT and SPECT-CT - 04/05/20
, 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
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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. |
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.
Le texte complet de cet article est 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
Plan
Vol 101 - N° 5
P. 299-310 - mai 2020 Retour au numéro
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