Diagnosis of Chronic Thromboembolic Pulmonary Hypertension Using Quantitative Lung Perfusion Parameters Extracted From Dual-energy Computed Tomography Images

Purpose: To evaluate quantified iodine mapping parameters in dual-energy computed tomography in normal patients versus those with chronic thromboembolic pulmonary hypertension (CTEPH) with and without pulmonary thromboembolism. Materials and Methods: Using automatically quantified iodine mapping in dual-energy computed tomography, we evaluated lung relative average enhancement, standard deviation (SD), and the SD/lung relative average enhancement ratio. We compared the values for these parameters in normal patients versus those with CTEPH. We also performed a receiver operating characteristic curve analysis to determine the diagnostic cutoffs for the parameters. Results: Patients constituted 41 patients (10 male [24.4%] and 31 female [75.6%]; mean age [SD]: 70.0 y [13.3]) with CTEPH and 237 (92 male [38.8%] and 145 female [61.2%]; mean age [SD]: 65.9 y [15.9]) normal patients. We found significant differences in lung relative average enhancement (34.9±6.3 vs. 26.9±6.3; P<0.0001), SD (11.6±1.9 vs. 14.7±3.3; P<0.001), and the SD/lung relative average enhancement ratio (33.7±5.0 vs. 55.7±10.4; P