Evidence map›Paper›PMID 33102639›Full record

ArticleEuropean journal of radiology open2020

Improving Contrast Enhancement in Pulmonary CTA: The value of breathing maneuvers.

P Manava, M Galster, M Schoen, J Ficker, M M Lell, R Adamus, M Bruch

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of radiology open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

P ManavaDepartment of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany.
M GalsterDepartment of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany.
M SchoenDepartment of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany.
J FickerDepartment of Pulmonology, Klinikum Nuernberg, Paracelsus Medical University, Germany.
M M LellDepartment of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany.
R AdamusInstitute of Radiology, Friedrich-Alexander University, Erlangen-Nuremberg (FAU), Erlangen, Germany.
M BruchDepartment of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany.
Paracelsus Medizinische Privatuniversität · DEFriedrich-Alexander-Universität Erlangen-Nürnberg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate contrast dynamics and artifacts associated with different breathing maneuvers during pulmonary computed tomography angiography (pCTA) in a prospective randomized clinical trial.

methodThree different breathing maneuvers (inspiration, expiration, Mueller) were randomly assigned to 146 patients receiving pCTA for suspected pulmonary embolism (PE). Contrast enhancement of central and peripheral arteries and imaging quality of lung parenchyma were compared and analyzed. Results were compared by using the analysis of variances (ANOVA) and Kruskal-Wallis-Test.

resultsMean enhancement in the pulmonary trunk was highest during breath-hold in inspiration (293 HU, range 195-460 HU) compared to Mueller (259 HU, range 136-429 HU, p = 0022) and expiration (267 HU, range 115-376 HU). This was similar for the right pulmonary artery (inspiration 289 HU, range 173-454 HU; Mueller 250 HU, range 119-378 HU; p = 0.007; expiration 257 HU, range 114-366 HU; p = 0.032) and left pulmonary artery (inspiration 280.3 HU, range 170-462 HU; Mueller 245 HU, range 111-371 HU; p = 0.016; expiration 252 HU, range 110-371 HU).Delineation of peripheral arteries was significantly better in inspiration vs Mueller (p = 0.006) and expiration (p = 0.049). Assessment of the lung parenchyma was significantly better in inspiration vs Mueller (p = 0.013) or expiration (p < 0.001).

conclusionsResting inspiratory position achieved the highest enhancement levels in central and peripheral pulmonary arteries and best image quality of the pulmonary parenchyma in comparison to other breathing maneuvers. It is necessary to train the maneuver prior to the examination in order to avoid deep inspiration with the risk of suboptimal opacification of the pulmonary arteries.

Indexed as

ANOVA, analysis of variancesBreathingComputed tomography angiographyContrast densityGCP, good clinical practiceICC, intraclass correlation coefficientIDR, iodine delivery rateImage qualityIRB, institutional review boardIVC, inferior vena cavaMPR, multiplanar reformationspCTA, pulmonary computed tomography angiographyPE, pulmonary embolismPulmonary arteriesPulmonary embolismROI, region of interestSVC, superior vena cava

Identifiers

PMID33102639
PMCPMC7578205
OpenAlexW3094359534

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.