The Value of C-Arm Computed Tomography in Addition to Conventional Digital Subtraction Angiography in the Diagnostic Work-up of Patients with Suspected Chronic Thromboembolic Pulmonary Hypertension: An Update of 300 Patients
To assess the value and possible benefit of combined C-arm computed tomography (CACT) and conventional digital subtraction angiography (DSA) of the pulmonary arteries in the diagnostic work-up of patients with suspected chronic thromboembolic pulmonary hypertension (CTEPH). We evaluated 308 pulmonar...
Gespeichert in:
| Veröffentlicht in: | Academic radiology Jg. 29 Suppl 2; S. S1 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
United States
01.02.2022
|
| Schlagworte: | |
| ISSN: | 1878-4046, 1878-4046 |
| Online-Zugang: | Weitere Angaben |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Abstract | To assess the value and possible benefit of combined C-arm computed tomography (CACT) and conventional digital subtraction angiography (DSA) of the pulmonary arteries in the diagnostic work-up of patients with suspected chronic thromboembolic pulmonary hypertension (CTEPH).
We evaluated 308 pulmonary artery angiographies of 308 consecutive patients with suspected CTEPH. Seven patients were excluded because of incomplete imaging. Thus, 301 datasets were included in our study. The pulmonary artery segments and their subsegmental branching were independently evaluated by two readers (R1, R2) using both, DSA and CACT for optimal image quality. Subsequently, the diagnostic findings were compared. Inter-modality and inter-observer agreement were calculated. Consensus reading was done and correlated to a standard of reference, representing the overall consensus of both modalities. Fisher's exact test and Cohen's Kappa were applied.
A total of 5719 pulmonary segments were evaluated of which only 28 segments (0.4%) were rated to be nondiagnostic on both, CACT and DSA. Overall, 5640 (98.6%) and 5600 (97.9%) pulmonary segments were rated to be diagnostic in DSA and CACT, respectively. The main causes of nondiagnostic image quality were motion artifacts on both, CACT (R1:81, R2:50) and DSA (R1:60, R2:48). Interobserver agreement was excellent for DSA (κ = 0.9) and CACT (κ = 0.91) and intermodality agreement was substantial (R1: κ = 0.69, R2: κ = 0.77). Compared to standard of reference, the intermodality agreement for CACT was excellent (κ = 0.96), whereas it was inferior for DSA (κ = 0.75), due to the higher number of pathologic findings in CACT read as normal on DSA.
CACT of the pulmonary arteries can provide additional information to DSA during CTEPH work-up. Moreover, the combination of CACT and DSA can minimize the portion of non-diagnostic examinations, therefore being a reasonable combination to optimize the diagnostic work-up. |
|---|---|
| AbstractList | To assess the value and possible benefit of combined C-arm computed tomography (CACT) and conventional digital subtraction angiography (DSA) of the pulmonary arteries in the diagnostic work-up of patients with suspected chronic thromboembolic pulmonary hypertension (CTEPH).
We evaluated 308 pulmonary artery angiographies of 308 consecutive patients with suspected CTEPH. Seven patients were excluded because of incomplete imaging. Thus, 301 datasets were included in our study. The pulmonary artery segments and their subsegmental branching were independently evaluated by two readers (R1, R2) using both, DSA and CACT for optimal image quality. Subsequently, the diagnostic findings were compared. Inter-modality and inter-observer agreement were calculated. Consensus reading was done and correlated to a standard of reference, representing the overall consensus of both modalities. Fisher's exact test and Cohen's Kappa were applied.
A total of 5719 pulmonary segments were evaluated of which only 28 segments (0.4%) were rated to be nondiagnostic on both, CACT and DSA. Overall, 5640 (98.6%) and 5600 (97.9%) pulmonary segments were rated to be diagnostic in DSA and CACT, respectively. The main causes of nondiagnostic image quality were motion artifacts on both, CACT (R1:81, R2:50) and DSA (R1:60, R2:48). Interobserver agreement was excellent for DSA (κ = 0.9) and CACT (κ = 0.91) and intermodality agreement was substantial (R1: κ = 0.69, R2: κ = 0.77). Compared to standard of reference, the intermodality agreement for CACT was excellent (κ = 0.96), whereas it was inferior for DSA (κ = 0.75), due to the higher number of pathologic findings in CACT read as normal on DSA.
CACT of the pulmonary arteries can provide additional information to DSA during CTEPH work-up. Moreover, the combination of CACT and DSA can minimize the portion of non-diagnostic examinations, therefore being a reasonable combination to optimize the diagnostic work-up. To assess the value and possible benefit of combined C-arm computed tomography (CACT) and conventional digital subtraction angiography (DSA) of the pulmonary arteries in the diagnostic work-up of patients with suspected chronic thromboembolic pulmonary hypertension (CTEPH).RATIONALE AND OBJECTIVESTo assess the value and possible benefit of combined C-arm computed tomography (CACT) and conventional digital subtraction angiography (DSA) of the pulmonary arteries in the diagnostic work-up of patients with suspected chronic thromboembolic pulmonary hypertension (CTEPH).We evaluated 308 pulmonary artery angiographies of 308 consecutive patients with suspected CTEPH. Seven patients were excluded because of incomplete imaging. Thus, 301 datasets were included in our study. The pulmonary artery segments and their subsegmental branching were independently evaluated by two readers (R1, R2) using both, DSA and CACT for optimal image quality. Subsequently, the diagnostic findings were compared. Inter-modality and inter-observer agreement were calculated. Consensus reading was done and correlated to a standard of reference, representing the overall consensus of both modalities. Fisher's exact test and Cohen's Kappa were applied.MATERIALS AND METHODSWe evaluated 308 pulmonary artery angiographies of 308 consecutive patients with suspected CTEPH. Seven patients were excluded because of incomplete imaging. Thus, 301 datasets were included in our study. The pulmonary artery segments and their subsegmental branching were independently evaluated by two readers (R1, R2) using both, DSA and CACT for optimal image quality. Subsequently, the diagnostic findings were compared. Inter-modality and inter-observer agreement were calculated. Consensus reading was done and correlated to a standard of reference, representing the overall consensus of both modalities. Fisher's exact test and Cohen's Kappa were applied.A total of 5719 pulmonary segments were evaluated of which only 28 segments (0.4%) were rated to be nondiagnostic on both, CACT and DSA. Overall, 5640 (98.6%) and 5600 (97.9%) pulmonary segments were rated to be diagnostic in DSA and CACT, respectively. The main causes of nondiagnostic image quality were motion artifacts on both, CACT (R1:81, R2:50) and DSA (R1:60, R2:48). Interobserver agreement was excellent for DSA (κ = 0.9) and CACT (κ = 0.91) and intermodality agreement was substantial (R1: κ = 0.69, R2: κ = 0.77). Compared to standard of reference, the intermodality agreement for CACT was excellent (κ = 0.96), whereas it was inferior for DSA (κ = 0.75), due to the higher number of pathologic findings in CACT read as normal on DSA.RESULTSA total of 5719 pulmonary segments were evaluated of which only 28 segments (0.4%) were rated to be nondiagnostic on both, CACT and DSA. Overall, 5640 (98.6%) and 5600 (97.9%) pulmonary segments were rated to be diagnostic in DSA and CACT, respectively. The main causes of nondiagnostic image quality were motion artifacts on both, CACT (R1:81, R2:50) and DSA (R1:60, R2:48). Interobserver agreement was excellent for DSA (κ = 0.9) and CACT (κ = 0.91) and intermodality agreement was substantial (R1: κ = 0.69, R2: κ = 0.77). Compared to standard of reference, the intermodality agreement for CACT was excellent (κ = 0.96), whereas it was inferior for DSA (κ = 0.75), due to the higher number of pathologic findings in CACT read as normal on DSA.CACT of the pulmonary arteries can provide additional information to DSA during CTEPH work-up. Moreover, the combination of CACT and DSA can minimize the portion of non-diagnostic examinations, therefore being a reasonable combination to optimize the diagnostic work-up.CONCLUSIONCACT of the pulmonary arteries can provide additional information to DSA during CTEPH work-up. Moreover, the combination of CACT and DSA can minimize the portion of non-diagnostic examinations, therefore being a reasonable combination to optimize the diagnostic work-up. |
| Author | Maschke, Sabine K Fuge, Jan Becker, Lena S Meine, Timo C Olsson, Karen M Meyer, Bernhard C Hinrichs, Jan B Werncke, Thomas Dewald, Cornelia L A Hoeper, Marius M Wacker, Frank K |
| Author_xml | – sequence: 1 givenname: Sabine K surname: Maschke fullname: Maschke, Sabine K organization: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1 30625, Hannover, Germany – sequence: 2 givenname: Thomas surname: Werncke fullname: Werncke, Thomas organization: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1 30625, Hannover, Germany – sequence: 3 givenname: Lena S surname: Becker fullname: Becker, Lena S organization: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1 30625, Hannover, Germany – sequence: 4 givenname: Cornelia L A surname: Dewald fullname: Dewald, Cornelia L A organization: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1 30625, Hannover, Germany – sequence: 5 givenname: Timo C surname: Meine fullname: Meine, Timo C organization: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1 30625, Hannover, Germany – sequence: 6 givenname: Karen M surname: Olsson fullname: Olsson, Karen M organization: Department of Respiratory Medicine, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany – sequence: 7 givenname: Jan surname: Fuge fullname: Fuge, Jan organization: Department of Respiratory Medicine, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany – sequence: 8 givenname: Marius M surname: Hoeper fullname: Hoeper, Marius M organization: Department of Respiratory Medicine, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany – sequence: 9 givenname: Frank K surname: Wacker fullname: Wacker, Frank K organization: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1 30625, Hannover, Germany – sequence: 10 givenname: Bernhard C surname: Meyer fullname: Meyer, Bernhard C organization: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1 30625, Hannover, Germany – sequence: 11 givenname: Jan B surname: Hinrichs fullname: Hinrichs, Jan B email: Hinrichs.jan@mh-hannover.de organization: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1 30625, Hannover, Germany. Electronic address: Hinrichs.jan@mh-hannover.de |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32768347$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkU1u2zAQhYkiQZ2fXqCLgstupAxFSmS6M5S0CRAgAeKkS4MSKZuuRKok1cK37VFKO06QxeDNgG_ehwFP0ZF1ViP0mUBOgFQXm1y2XuYFFJBDlQO9_IBOiOAiY8Cqo3f9DJ2GsAEgZSXoRzSjBU8N4yfo32Kt8bPsJ41dh-ts7gdcu2GcolZ44Qa38nJcb7GxeK6UicZZHF2y2D_a7ibZ4yuzMjHp49REL9u9Z25X5t1uTJQrI1fWhWha_NP5X9k07pAPMpqUFPBfE9cpIoy63bHrtXc2WRdJh8bpVH0aH6Z-SFC_xTfbUfuobUi4b4mHn0Yl4_4MCvCWe46OO9kH_emgZ-jp-_Wivsnu7n_c1vO7rGXAY6YAaCUZa1TJlWwvm5ZCyQVvBE1PHRUNU13BOyAKtJIdp7xkhIoKRAeloMUZ-vqSO3r3e9IhLgcTWt330mo3hWXBKBFFycnO-uVgnZpBq-XozZAuWr7-SvEfhF6Vow |
| CitedBy_id | crossref_primary_10_1016_j_diii_2024_02_005 crossref_primary_10_1016_j_ijcchd_2024_100536 crossref_primary_10_1053_j_ro_2022_07_003 crossref_primary_10_1016_j_acra_2023_04_034 crossref_primary_10_1016_j_acra_2023_04_033 crossref_primary_10_1186_s40644_022_00473_3 crossref_primary_10_1016_j_ejrad_2025_112047 crossref_primary_10_1016_j_crad_2025_106847 |
| ContentType | Journal Article |
| Copyright | Copyright © 2020 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. |
| Copyright_xml | – notice: Copyright © 2020 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1016/j.acra.2020.06.039 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1878-4046 |
| ExternalDocumentID | 32768347 |
| Genre | Journal Article |
| GroupedDBID | --- --K .1- .FO .GJ 0R~ 1B1 1P~ 23M 4.4 457 53G 5GY 5RE 5VS AAEDT AAEDW AALRI AAQFI AAQXK AAWTL AAXUO ABJNI ABMAC ABWVN ACGFS ACRPL ADBBV ADMUD ADNMO AENEX AEVXI AFCTW AFFNX AFJKZ AFRHN AFTJW AITUG AJUYK ALMA_UNASSIGNED_HOLDINGS AMRAJ ASPBG AVWKF AZFZN BELOY C5W CGR CS3 CUY CVF EBS ECM EFJIC EIF EJD F5P FDB FEDTE FGOYB G-Q HVGLF HZ~ IHE J1W KOM M41 MO0 NPM NQ- O9- OI~ OU0 P2P R2- ROL RPZ SEL SES SEW SJN SSZ UHS XH2 Z5R ZGI ZXP 7X8 APXCP EFKBS |
| ID | FETCH-LOGICAL-c407t-d0036a44bd57dac9bc305787b83d00f38b4df27f01d0edaf73754138608f05832 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 9 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000758804800001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1878-4046 |
| IngestDate | Sat Sep 27 20:17:43 EDT 2025 Thu Apr 03 06:58:25 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Keywords | Digital subtraction angiography Chronic thromboembolic pulmonary hypertension Cone beam computed tomography C-arm computed tomography Balloon pulmonary angioplasty |
| Language | English |
| License | Copyright © 2020 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c407t-d0036a44bd57dac9bc305787b83d00f38b4df27f01d0edaf73754138608f05832 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| PMID | 32768347 |
| PQID | 2431825713 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2431825713 pubmed_primary_32768347 |
| PublicationCentury | 2000 |
| PublicationDate | 2022-02-00 20220201 |
| PublicationDateYYYYMMDD | 2022-02-01 |
| PublicationDate_xml | – month: 02 year: 2022 text: 2022-02-00 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Academic radiology |
| PublicationTitleAlternate | Acad Radiol |
| PublicationYear | 2022 |
| SSID | ssj0015683 |
| Score | 2.3820271 |
| Snippet | To assess the value and possible benefit of combined C-arm computed tomography (CACT) and conventional digital subtraction angiography (DSA) of the pulmonary... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | S1 |
| SubjectTerms | Angiography, Digital Subtraction - methods Computed Tomography Angiography Humans Hypertension, Pulmonary - diagnostic imaging Magnetic Resonance Angiography - methods Pulmonary Artery - diagnostic imaging Pulmonary Embolism - complications Pulmonary Embolism - diagnostic imaging Tomography, X-Ray Computed - methods |
| Title | The Value of C-Arm Computed Tomography in Addition to Conventional Digital Subtraction Angiography in the Diagnostic Work-up of Patients with Suspected Chronic Thromboembolic Pulmonary Hypertension: An Update of 300 Patients |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/32768347 https://www.proquest.com/docview/2431825713 |
| Volume | 29 Suppl 2 |
| WOSCitedRecordID | wos000758804800001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1Lj9MwELaARYgL74XlpUHiapHYTpxwQdXCai9b9dBFvVWOHa8qdZOStkj8W34Knx0v5YSQODhRFL8iT8bzzYxnGHufq1yURtRcOWW4KgBYa1OWXOSyqWqrnbc2JpvQ02m1WNSzpHDbJrfKG54YGbXrbdCRfxDY6YBmgKk-bb7xkDUqWFdTCo3b7EhClAlUrRcHK0JRxjCceQWkpAAE06GZ0b_L2CHEHRJZjN8p_yJixq3m7OH_TvIRe5CETJqMVPGY3Wq7J-zeRTKjP2U_QRz01az3LfWeTjlWm1J6B0fz_jqFsaZVRxPnolMX7XpUOXio0-fVVcg3QuA8u2E8HUGT7mr1R1vIlqgWXfkwEQp6eb7fhCFnYzTXLQU1MLqI5z0xdgrVS3Pcr5u-RVnjcbZf48vM8IPOAZuH6HTfdx8xHl1ugsoi9Cmz7He_z9jl2Zf56TlPqR64BaLccRfi4hilGldoZ2zdWPAh8JKmknjlZdUo54X2We6y1hmvQ-beXFZlVvmsAFc6Zne6vmtfMJKQMFuANI2ifGnAwHUlrfC-UbpsihP27mbtlviVgn3EdG2_3y4Pq3fCno8EsNyMMT-WUgCXSaVf_kPrV-y-CIckom_3a3bkwUjaN-yu_b5bbYe3kUZxnc4ufgFbE_QH |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+Value+of+C-Arm+Computed+Tomography+in+Addition+to+Conventional+Digital+Subtraction+Angiography+in+the+Diagnostic+Work-up+of+Patients+with+Suspected+Chronic+Thromboembolic+Pulmonary+Hypertension%3A+An+Update+of+300+Patients&rft.jtitle=Academic+radiology&rft.au=Maschke%2C+Sabine+K&rft.au=Werncke%2C+Thomas&rft.au=Becker%2C+Lena+S&rft.au=Dewald%2C+Cornelia+L+A&rft.date=2022-02-01&rft.eissn=1878-4046&rft.volume=29+Suppl+2&rft.spage=S1&rft_id=info:doi/10.1016%2Fj.acra.2020.06.039&rft_id=info%3Apmid%2F32768347&rft_id=info%3Apmid%2F32768347&rft.externalDocID=32768347 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1878-4046&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1878-4046&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1878-4046&client=summon |