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@ARTICLE{Wittenstein:305519,
      author       = {J. Wittenstein and R. Apolle and M. Scharffenberg and C.
                      Rothmann and S. Müller and R.-T. Hoffmann and E. Troost$^*$
                      and T. Koch and M. Gama de Abreu and R. Huhle},
      title        = {{D}ual-energy computed tomography derived pulmonary blood
                      volume: association with pulmonary blood flow.},
      journal      = {Respiratory research},
      volume       = {26},
      number       = {1},
      issn         = {1465-9921},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2025-02203},
      pages        = {293},
      year         = {2025},
      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.},
      keywords     = {Animals / Swine / Pulmonary Circulation: physiology / Lung:
                      diagnostic imaging / Lung: blood supply / Lung: physiology /
                      Blood Volume: physiology / Tomography, X-Ray Computed:
                      methods / Female / Radiography, Dual-Energy Scanned
                      Projection: methods / Feasibility Studies / Dual-energy CT
                      (Other) / Fluorescence labelled microspheres (Other) /
                      Regional pulmonary perfusion (Other) / Shunt blood flow
                      (Other)},
      cin          = {DD01},
      ddc          = {610},
      cid          = {I:(DE-He78)DD01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41126267},
      pmc          = {pmc:PMC12548200},
      doi          = {10.1186/s12931-025-03374-8},
      url          = {https://inrepo02.dkfz.de/record/305519},
}