Purpose: To evaluate dual-source and split-beam filter multi-energy chest CT in assessing pulmonary perfusion on a lobar level in patients with lung emphysema, using perfusion SPECT as the reference standard.
Materials and Methods: Patients with emphysema evaluated for lung volume reduction therapy between May 2016 and February 2021 were retrospectively included. All patients underwent SPECT and either dual-source or split-beam filter (SBF) multi-energy CT. To calculate the fractional lobar lung perfusion (FLLP), SPECT acquisitions were co-registered with chest CT scans (hereafter, SPECT/CT) and semi-manually segmented. For multi-energy CT scans, lung lobes were automatically segmented using a U-Net model. Segmentations were manually verified. The FLLP was derived from iodine maps computed from the multi-energy data. Statistical analysis included Pearson and intraclass correlation coefficients and Bland-Altman analysis.
Results: Fifty-nine patients (30 male, 29 female; 31 underwent dual-source CT, 28 underwent SBF CT; mean age for all patients, 67 years ± 8 [SD]) were included. Both multi-energy methods significantly correlated with the SPECT/CT acquisitions for all individual lobes ( P < .001). Pearson correlation concerning all lobes combined was significantly better for dual-source ( r = 0.88) than for SBF multi-energy CT ( r = 0.78; P = .006). On the level of single lobes, Pearson correlation coefficient differed for the right upper lobe only (dual-source CT, r = 0.88; SBF CT, r = 0.58; P = .008).
Conclusion: Dual-source and SBF multi-energy CT accurately assessed lung perfusion on a lobar level in patients with emphysema compared with SPECT/CT. The overall correlation was higher for dual-source multi-energy CT. Keywords: Chronic Obstructive Pulmonary Disease, Comparative Studies, Computer Applications, CT Spectral Imaging, Image Postprocessing, Lung, Pulmonary Perfusion© RSNA, 2023.
Competing Interests: Disclosures of conflicts of interest: Q.D.S. Introduction to Research for International Young Academics (IRIYA) Travel Grant from RSNA (flights and shared accommodation). S.H. No relevant relationships. V.M. No relevant relationships. R.S. No relevant relationships. S.M. No relevant relationships. D.S. No relevant relationships. S.B. No relevant relationships. J.G. No relevant relationships. D.H. No relevant relationships. C.S. No relevant relationships. O.W.H. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Boehringer-Ingelheim Roche.
(© 2023 by the Radiological Society of North America, Inc.)