Assessment of Regional Xenon Ventilation, Perfusion, and Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography in Chronic Obstructive Pulmonary Disease Patients
OBJECTIVESThe aim of this study was to assess the feasibility of combined xenon-enhanced ventilation (V) and iodine-enhanced perfusion (Q) dual-energy computed tomography (DECT) to evaluate regional V and Q status in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODSCo...
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| Veröffentlicht in: | Investigative radiology 2016-05, Vol.51 (5), p.306-315 |
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| creator | Hwang, Hye Jeon Seo, Joon Beom Lee, Sang Min Kim, Namkug Oh, Sang Young Lee, Jae Seung Lee, Sei Won Oh, Yeon-Mok |
| description | OBJECTIVESThe aim of this study was to assess the feasibility of combined xenon-enhanced ventilation (V) and iodine-enhanced perfusion (Q) dual-energy computed tomography (DECT) to evaluate regional V and Q status in patients with chronic obstructive pulmonary disease (COPD).
MATERIALS AND METHODSCombined V and Q DECT imaging was performed in 52 prospectively enrolled male COPD patients. Virtual noncontrast images, V maps, and Q maps were anatomically coregistered with deformable registration and evaluated using in-house software. After normalization of the V and Q values of each pixel, normalized V and Q, V/Qratio, and VQmin (ie, the smaller of the V and Q in each pixel) maps were generated. For visual analysis, the V/Qratio pattern was determined to be matched, mismatched, or reversed mismatched and compared with the regional disease patterns—emphysema with/without bronchial wall thickening, bronchial wall thickening, or normal parenchyma—in each segment. The mean V, Q, V/Qratio, and VQmin values and the standard deviation of the V/Qratio (V/QSD) of each patient were quantified and compared with pulmonary function test (PFT) parameters using the Pearson correlation test.
RESULTSSegments with normal parenchyma showed a matched V/Qratio pattern, whereas segments with bronchial wall thickening commonly showed a reversed mismatched V/Qratio pattern. In the emphysema areas, the matched, mismatched, and reversed mismatched patterns were mixed without a dominant pattern. In quantitative analysis, the mean V, Q, VQmin, and V/Qratio values were significantly and positively correlated with PFT parameters (r = 0.290–0.819; P < 0.05). The V/QSD was significantly and negatively correlated with PFT parameters (r = −0.439 to −0.736; P < 0.001). VQmin values showed the best correlation with PFT parameters (r = 0.483–0.819; P < 0.001).
CONCLUSIONSVisual and quantitative assessment of the regional V, Q, V/Qratio, and VQmin is feasible with combined V and Q DECT imaging and significantly correlate with PFT results in COPD patients. Assessing disease patterns using conventional computed tomography images may not provide correct evaluation of regional V and Q in COPD patients with emphysema. |
| doi_str_mv | 10.1097/RLI.0000000000000239 |
| format | Article |
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MATERIALS AND METHODSCombined V and Q DECT imaging was performed in 52 prospectively enrolled male COPD patients. Virtual noncontrast images, V maps, and Q maps were anatomically coregistered with deformable registration and evaluated using in-house software. After normalization of the V and Q values of each pixel, normalized V and Q, V/Qratio, and VQmin (ie, the smaller of the V and Q in each pixel) maps were generated. For visual analysis, the V/Qratio pattern was determined to be matched, mismatched, or reversed mismatched and compared with the regional disease patterns—emphysema with/without bronchial wall thickening, bronchial wall thickening, or normal parenchyma—in each segment. The mean V, Q, V/Qratio, and VQmin values and the standard deviation of the V/Qratio (V/QSD) of each patient were quantified and compared with pulmonary function test (PFT) parameters using the Pearson correlation test.
RESULTSSegments with normal parenchyma showed a matched V/Qratio pattern, whereas segments with bronchial wall thickening commonly showed a reversed mismatched V/Qratio pattern. In the emphysema areas, the matched, mismatched, and reversed mismatched patterns were mixed without a dominant pattern. In quantitative analysis, the mean V, Q, VQmin, and V/Qratio values were significantly and positively correlated with PFT parameters (r = 0.290–0.819; P < 0.05). The V/QSD was significantly and negatively correlated with PFT parameters (r = −0.439 to −0.736; P < 0.001). VQmin values showed the best correlation with PFT parameters (r = 0.483–0.819; P < 0.001).
CONCLUSIONSVisual and quantitative assessment of the regional V, Q, V/Qratio, and VQmin is feasible with combined V and Q DECT imaging and significantly correlate with PFT results in COPD patients. Assessing disease patterns using conventional computed tomography images may not provide correct evaluation of regional V and Q in COPD patients with emphysema.</description><identifier>ISSN: 0020-9996</identifier><identifier>EISSN: 1536-0210</identifier><identifier>DOI: 10.1097/RLI.0000000000000239</identifier><identifier>PMID: 26685105</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Aged ; Contrast Media - administration & dosage ; Feasibility Studies ; Humans ; Image Enhancement - methods ; Iodine - administration & dosage ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive - diagnostic imaging ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary Ventilation ; Respiratory Function Tests - methods ; Tomography, X-Ray Computed - methods ; Xenon - administration & dosage</subject><ispartof>Investigative radiology, 2016-05, Vol.51 (5), p.306-315</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4229-80c4e273d64d5ee951c706d9c5a85c7ece4df143a48bf3c287d0155c5c5fafd53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26685105$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hwang, Hye Jeon</creatorcontrib><creatorcontrib>Seo, Joon Beom</creatorcontrib><creatorcontrib>Lee, Sang Min</creatorcontrib><creatorcontrib>Kim, Namkug</creatorcontrib><creatorcontrib>Oh, Sang Young</creatorcontrib><creatorcontrib>Lee, Jae Seung</creatorcontrib><creatorcontrib>Lee, Sei Won</creatorcontrib><creatorcontrib>Oh, Yeon-Mok</creatorcontrib><title>Assessment of Regional Xenon Ventilation, Perfusion, and Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography in Chronic Obstructive Pulmonary Disease Patients</title><title>Investigative radiology</title><addtitle>Invest Radiol</addtitle><description>OBJECTIVESThe aim of this study was to assess the feasibility of combined xenon-enhanced ventilation (V) and iodine-enhanced perfusion (Q) dual-energy computed tomography (DECT) to evaluate regional V and Q status in patients with chronic obstructive pulmonary disease (COPD).
MATERIALS AND METHODSCombined V and Q DECT imaging was performed in 52 prospectively enrolled male COPD patients. Virtual noncontrast images, V maps, and Q maps were anatomically coregistered with deformable registration and evaluated using in-house software. After normalization of the V and Q values of each pixel, normalized V and Q, V/Qratio, and VQmin (ie, the smaller of the V and Q in each pixel) maps were generated. For visual analysis, the V/Qratio pattern was determined to be matched, mismatched, or reversed mismatched and compared with the regional disease patterns—emphysema with/without bronchial wall thickening, bronchial wall thickening, or normal parenchyma—in each segment. The mean V, Q, V/Qratio, and VQmin values and the standard deviation of the V/Qratio (V/QSD) of each patient were quantified and compared with pulmonary function test (PFT) parameters using the Pearson correlation test.
RESULTSSegments with normal parenchyma showed a matched V/Qratio pattern, whereas segments with bronchial wall thickening commonly showed a reversed mismatched V/Qratio pattern. In the emphysema areas, the matched, mismatched, and reversed mismatched patterns were mixed without a dominant pattern. In quantitative analysis, the mean V, Q, VQmin, and V/Qratio values were significantly and positively correlated with PFT parameters (r = 0.290–0.819; P < 0.05). The V/QSD was significantly and negatively correlated with PFT parameters (r = −0.439 to −0.736; P < 0.001). VQmin values showed the best correlation with PFT parameters (r = 0.483–0.819; P < 0.001).
CONCLUSIONSVisual and quantitative assessment of the regional V, Q, V/Qratio, and VQmin is feasible with combined V and Q DECT imaging and significantly correlate with PFT results in COPD patients. Assessing disease patterns using conventional computed tomography images may not provide correct evaluation of regional V and Q in COPD patients with emphysema.</description><subject>Aged</subject><subject>Contrast Media - administration & dosage</subject><subject>Feasibility Studies</subject><subject>Humans</subject><subject>Image Enhancement - methods</subject><subject>Iodine - administration & dosage</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnostic imaging</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Pulmonary Ventilation</subject><subject>Respiratory Function Tests - methods</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Xenon - administration & dosage</subject><issn>0020-9996</issn><issn>1536-0210</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EokvhDRDykQMpdhLH8bHaFqi0qFXVIm6R15lsDI69eGKqfSpeES9bqooD9sHWP9_MP9JPyGvOTjhT8v316uKEPT5lpZ6QBRdVU7CSs6dkkTVWKKWaI_IC8duekax6To7KpmkFZ2JBfp0iAuIEfqZhoNewscFrR7-CD55-ybJ1es7aO3oFcUj456t9_7hWPJToZ4uTns1Ib9H6DT1L2hXnHuJmR5dh2qYZenoTprCJejvuqPV0OcbgraGXa5xjMrP9CfQquSmvEXf0zCJozEo2yob4kjwbtEN4df8ek9sP5zfLT8Xq8uPF8nRVmLosVdEyU0Mpq76pewGgBDeSNb0yQrfCSDBQ9wOvK12366EyZSt7xoUw-Q566EV1TN4e5m5j-JEA526yaMA57SEk7LiUqpVKlHu0PqAmBsQIQ7eNdsrLd5x1-6i6HFX3b1S57c29Q1pP0D80_c0mA-0BuAtuhojfXbqD2I2g3Tz-f_ZvvBukcw</recordid><startdate>201605</startdate><enddate>201605</enddate><creator>Hwang, Hye Jeon</creator><creator>Seo, Joon Beom</creator><creator>Lee, Sang Min</creator><creator>Kim, Namkug</creator><creator>Oh, Sang Young</creator><creator>Lee, Jae Seung</creator><creator>Lee, Sei Won</creator><creator>Oh, Yeon-Mok</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201605</creationdate><title>Assessment of Regional Xenon Ventilation, Perfusion, and Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography in Chronic Obstructive Pulmonary Disease Patients</title><author>Hwang, Hye Jeon ; Seo, Joon Beom ; Lee, Sang Min ; Kim, Namkug ; Oh, Sang Young ; Lee, Jae Seung ; Lee, Sei Won ; Oh, Yeon-Mok</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4229-80c4e273d64d5ee951c706d9c5a85c7ece4df143a48bf3c287d0155c5c5fafd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Contrast Media - administration & dosage</topic><topic>Feasibility Studies</topic><topic>Humans</topic><topic>Image Enhancement - methods</topic><topic>Iodine - administration & dosage</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnostic imaging</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Pulmonary Ventilation</topic><topic>Respiratory Function Tests - methods</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Xenon - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hwang, Hye Jeon</creatorcontrib><creatorcontrib>Seo, Joon Beom</creatorcontrib><creatorcontrib>Lee, Sang Min</creatorcontrib><creatorcontrib>Kim, Namkug</creatorcontrib><creatorcontrib>Oh, Sang Young</creatorcontrib><creatorcontrib>Lee, Jae Seung</creatorcontrib><creatorcontrib>Lee, Sei Won</creatorcontrib><creatorcontrib>Oh, Yeon-Mok</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Investigative radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hwang, Hye Jeon</au><au>Seo, Joon Beom</au><au>Lee, Sang Min</au><au>Kim, Namkug</au><au>Oh, Sang Young</au><au>Lee, Jae Seung</au><au>Lee, Sei Won</au><au>Oh, Yeon-Mok</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of Regional Xenon Ventilation, Perfusion, and Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography in Chronic Obstructive Pulmonary Disease Patients</atitle><jtitle>Investigative radiology</jtitle><addtitle>Invest Radiol</addtitle><date>2016-05</date><risdate>2016</risdate><volume>51</volume><issue>5</issue><spage>306</spage><epage>315</epage><pages>306-315</pages><issn>0020-9996</issn><eissn>1536-0210</eissn><abstract>OBJECTIVESThe aim of this study was to assess the feasibility of combined xenon-enhanced ventilation (V) and iodine-enhanced perfusion (Q) dual-energy computed tomography (DECT) to evaluate regional V and Q status in patients with chronic obstructive pulmonary disease (COPD).
MATERIALS AND METHODSCombined V and Q DECT imaging was performed in 52 prospectively enrolled male COPD patients. Virtual noncontrast images, V maps, and Q maps were anatomically coregistered with deformable registration and evaluated using in-house software. After normalization of the V and Q values of each pixel, normalized V and Q, V/Qratio, and VQmin (ie, the smaller of the V and Q in each pixel) maps were generated. For visual analysis, the V/Qratio pattern was determined to be matched, mismatched, or reversed mismatched and compared with the regional disease patterns—emphysema with/without bronchial wall thickening, bronchial wall thickening, or normal parenchyma—in each segment. The mean V, Q, V/Qratio, and VQmin values and the standard deviation of the V/Qratio (V/QSD) of each patient were quantified and compared with pulmonary function test (PFT) parameters using the Pearson correlation test.
RESULTSSegments with normal parenchyma showed a matched V/Qratio pattern, whereas segments with bronchial wall thickening commonly showed a reversed mismatched V/Qratio pattern. In the emphysema areas, the matched, mismatched, and reversed mismatched patterns were mixed without a dominant pattern. In quantitative analysis, the mean V, Q, VQmin, and V/Qratio values were significantly and positively correlated with PFT parameters (r = 0.290–0.819; P < 0.05). The V/QSD was significantly and negatively correlated with PFT parameters (r = −0.439 to −0.736; P < 0.001). VQmin values showed the best correlation with PFT parameters (r = 0.483–0.819; P < 0.001).
CONCLUSIONSVisual and quantitative assessment of the regional V, Q, V/Qratio, and VQmin is feasible with combined V and Q DECT imaging and significantly correlate with PFT results in COPD patients. Assessing disease patterns using conventional computed tomography images may not provide correct evaluation of regional V and Q in COPD patients with emphysema.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>26685105</pmid><doi>10.1097/RLI.0000000000000239</doi><tpages>10</tpages></addata></record> |
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| subjects | Aged Contrast Media - administration & dosage Feasibility Studies Humans Image Enhancement - methods Iodine - administration & dosage Male Middle Aged Pulmonary Disease, Chronic Obstructive - diagnostic imaging Pulmonary Disease, Chronic Obstructive - physiopathology Pulmonary Ventilation Respiratory Function Tests - methods Tomography, X-Ray Computed - methods Xenon - administration & dosage |
| title | Assessment of Regional Xenon Ventilation, Perfusion, and Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography in Chronic Obstructive Pulmonary Disease Patients |
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