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| Home > Publications database > Dual-energy computed tomography derived pulmonary blood volume: association with pulmonary blood flow. |
| Journal Article | DKFZ-2025-02203 |
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2025
BioMed Central
London
Abstract: Distribution of ventilation and pulmonary perfusion are the major determinants of pulmonary gas exchange. To study and compare strategies of mechanical ventilation in respiratory research accurate and high-resolution methods are needed to derive distribution of ventilation and perfusion with minimal additional intervention or radiation allowing repeated measurements. Dual-energy computed tomography (DECT) is an imaging technique allowing for the derivation of regional pulmonary perfused blood volume, as a surrogate for pulmonary perfusion (PPDECT). Here accuracy of PPDECT is evaluated in comparison to pulmonary blood flow measured with fluorescence-labeled microspheres (PPFLM). Its feasibility of repeated measurements is evaluated.Agreement between PPFLM and PPDECT was assessed by regression as well as Bland-Altman analysis in three anesthetized pigs using DECT and fluorescence labelled microspheres, respectively. Measurements were performed in two-lung and, after right sided thoracotomy, at one-lung ventilation with inhaled nitric oxide. PPFLM and PPDECT were assessed in three different regions of interest (ROI): the right (non-ventilated) and left (ventilated) upper and lower lung, yielding a total of 45 paired measurements over four hours. Persistent iodine accumulation was assessed by additional DECT scans before each contrast administration.Regression analysis revealed a good overall association (R2 = 0.81) between PPFLM and PPDECT, with PPDECT substantially overestimating PPFLM up to 30%, with limits of agreement of -18 and 18%, Low PPFLM was underestimated, while high PPFLM was overestimated by PPDECT, indicating a higher sensitivity of the later. Changes of PPDECT and PPFLM had a concordance of 69.4% for all measurements. Agreement and concordance were highest in ventilated and lowest in non-ventilated ROIs. No persistent iodine enhancement was detected in the lung parenchyma after repetitive measurements per hour.Dual-energy CT based measurement of pulmonary perfusion shows promising results indicating its feasibility in translational research on strategies of mechanical ventilation.
Keyword(s): Animals (MeSH) ; Swine (MeSH) ; Pulmonary Circulation: physiology (MeSH) ; Lung: diagnostic imaging (MeSH) ; Lung: blood supply (MeSH) ; Lung: physiology (MeSH) ; Blood Volume: physiology (MeSH) ; Tomography, X-Ray Computed: methods (MeSH) ; Female (MeSH) ; Radiography, Dual-Energy Scanned Projection: methods (MeSH) ; Feasibility Studies (MeSH) ; Dual-energy CT ; Fluorescence labelled microspheres ; Regional pulmonary perfusion ; Shunt blood flow
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