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Pulmonary CT perfusion robustly measures cardiac output in the context of multilevel pulmonary occlusion: a porcine study

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Názov: Pulmonary CT perfusion robustly measures cardiac output in the context of multilevel pulmonary occlusion: a porcine study
Autori: Silva, Diogo, Muders, Thomas, Wodack, Karin, Putensen, Christian, Leonhardt, Steffen, Siepmann, Robert, Hentze, Benjamin, Reinartz, Sebastian
Zdroj: Eur Radiol Exp
European Radiology Experimental, Vol 8, Iss 1, Pp 1-12 (2024)
European radiology experimental 8(1), 51 (2024). doi:10.1186/s41747-024-00431-7
Informácie o vydavateľovi: Springer Science and Business Media LLC, 2024.
Rok vydania: 2024
Predmety: Cardiac output, Swine, R895-920, Pulmonary Artery, Swine [MeSH], Humans [MeSH], Perfusion, Cardiac Output/physiology [MeSH], Tomography (x-ray computed), Animals [MeSH], Catheterization, Swan-Ganz/methods [MeSH], Original Article, Tomography, X-Ray Computed [MeSH], Pulmonary artery, Perfusion [MeSH], Heart ventricles, Pulmonary Artery/diagnostic imaging [MeSH], 3. Good health, Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, 0302 clinical medicine, Catheterization, Swan-Ganz, Humans, Animals, Cardiac Output, Tomography, X-Ray Computed
Popis: Background To validate pulmonary computed tomography (CT) perfusion in a porcine model by invasive monitoring of cardiac output (CO) using thermodilution method. Methods Animals were studied at a single center, using a Swan-Ganz catheter for invasive CO monitoring as a reference. Fifteen pigs were included. Contrast-enhanced CT perfusion of the descending aorta and right and left pulmonary artery was performed. For variation purposes, a balloon catheter was inserted to block the contralateral pulmonary vascular bed; additionally, two increased CO settings were created by intravenous administration of catecholamines. Finally, stepwise capillary occlusion was performed by intrapulmonary arterial injection of 75-μm microspheres in four stages. A semiautomatic selection of AFs and a recirculation-aware tracer-kinetics model to extract the first-pass of AFs, estimating blood flow with the Stewart-Hamilton method, was implemented. Linear mixed models (LMM) were developed to calibrate blood flow calculations accounting with individual- and cohort-level effects. Results Nine of 15 pigs had complete datasets. Strong correlations were observed between calibrated pulmonary (0.73, 95% confidence interval [CI] 0.6–0.82) and aortic blood flow measurements (0.82, 95% CI, 0.73–0.88) and the reference as well as agreements (± 2.24 L/min and ± 1.86 L/min, respectively) comparable to the state of the art, on a relatively wide range of right ventricle-CO measurements. Conclusions CT perfusion validly measures CO using LMMs at both individual and cohort levels, as demonstrated by referencing the invasive CO. Relevance statement Possible clinical applications of CT perfusion for measuring CO could be in acute pulmonary thromboembolism or to assess right ventricular function to show impairment or mismatch to the left ventricle. Key points • CT perfusion measures flow in vessels. • CT perfusion measures cumulative cardiac output in the aorta and pulmonary vessels. • CT perfusion validly measures CO using LMMs at both individual and cohort levels, as demonstrated by using the invasive CO as a reference standard. Graphical Abstract
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 2509-9280
DOI: 10.1186/s41747-024-00431-7
DOI: 10.18154/rwth-2024-04183
Prístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38517595
https://doaj.org/article/17068ca90cbb45498edd4ae75e018ee8
https://repository.publisso.de/resource/frl:6518733
https://publications.rwth-aachen.de/record/984729
Rights: CC BY
Prístupové číslo: edsair.doi.dedup.....708bcf946915745c8cb19fa064df1fa2
Databáza: OpenAIRE
Popis
Abstrakt:Background To validate pulmonary computed tomography (CT) perfusion in a porcine model by invasive monitoring of cardiac output (CO) using thermodilution method. Methods Animals were studied at a single center, using a Swan-Ganz catheter for invasive CO monitoring as a reference. Fifteen pigs were included. Contrast-enhanced CT perfusion of the descending aorta and right and left pulmonary artery was performed. For variation purposes, a balloon catheter was inserted to block the contralateral pulmonary vascular bed; additionally, two increased CO settings were created by intravenous administration of catecholamines. Finally, stepwise capillary occlusion was performed by intrapulmonary arterial injection of 75-μm microspheres in four stages. A semiautomatic selection of AFs and a recirculation-aware tracer-kinetics model to extract the first-pass of AFs, estimating blood flow with the Stewart-Hamilton method, was implemented. Linear mixed models (LMM) were developed to calibrate blood flow calculations accounting with individual- and cohort-level effects. Results Nine of 15 pigs had complete datasets. Strong correlations were observed between calibrated pulmonary (0.73, 95% confidence interval [CI] 0.6–0.82) and aortic blood flow measurements (0.82, 95% CI, 0.73–0.88) and the reference as well as agreements (± 2.24 L/min and ± 1.86 L/min, respectively) comparable to the state of the art, on a relatively wide range of right ventricle-CO measurements. Conclusions CT perfusion validly measures CO using LMMs at both individual and cohort levels, as demonstrated by referencing the invasive CO. Relevance statement Possible clinical applications of CT perfusion for measuring CO could be in acute pulmonary thromboembolism or to assess right ventricular function to show impairment or mismatch to the left ventricle. Key points • CT perfusion measures flow in vessels. • CT perfusion measures cumulative cardiac output in the aorta and pulmonary vessels. • CT perfusion validly measures CO using LMMs at both individual and cohort levels, as demonstrated by using the invasive CO as a reference standard. Graphical Abstract
ISSN:25099280
DOI:10.1186/s41747-024-00431-7