ArticleEuropean radiology2022
Prediction of chronic thromboembolic pulmonary hypertension with standardised evaluation of initial computed tomography pulmonary angiography performed for suspected acute pulmonary embolism.
Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 43 citations in OpenAlex.
- Post-pulmonary embolism cardiac impairment and chronic thromboembolic pulmonary hypertension after ultrasound-assisted catheter-directed thrombolysis for acute pulmonary embolism.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Elevated tricuspid peak systolic gradient with enlarged right ventricle present during acute episode of pulmonary embolism predict subsequent chronic thromboembolic pulmonary hypertension.Thrombosis journal · 2025Article
- A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism.Scientific reports · 2025Article
- Article
- The promise and limitations of artificial intelligence in CTPA-based pulmonary embolism detection.Frontiers in medicine · 2025Review
- Cost-effectiveness of follow-up algorithms for chronic thromboembolic pulmonary hypertension in pulmonary embolism survivors.ERJ open research · 2025Article
- Imaging in chronic thromboembolic pulmonary disease: Current practice and advances.International journal of cardiology. Congenital heart disease · 2024Review
- CT Imaging Findings of Pulmonary Artery Stenosis: A Pictorial Review.Diagnostics (Basel, Switzerland) · 2024Review
- Pulmonary perfusion defects or residual vascular obstruction and persistent symptoms after pulmonary embolism: a systematic review and meta-analysis.ERJ open research · 2024Article
- Investigation in image quality and immediate patient safety using pre-dual-flow injection for low-contrast dose spectral pulmonary artery CT angiography.European journal of radiology open · 2024Article
- Even non-expert radiologists report chronic thromboembolic pulmonary hypertension (CTEPH) on CT pulmonary angiography with high sensitivity and almost perfect agreement.European radiology · 2024Article
- Article
- Pulmonary Embolism (PE) to Chronic Thromboembolic Pulmonary Disease (CTEPD): Findings from a Survey of UK Physicians.Advances in respiratory medicine · 2024Article
- Automated quantification of the pulmonary vasculature in pulmonary embolism and chronic thromboembolic pulmonary hypertension.Pulmonary circulation · 2023Article
- Pulmonary thromboembolic events in COVID-19-A systematic literature review.Pulmonary circulation · 2022Review
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Authors and funding
15 authors at 6 institutions in 3 countries.
Funding
Abstract
objectivesCloser reading of computed tomography pulmonary angiography (CTPA) scans of patients presenting with acute pulmonary embolism (PE) may identify those at high risk of developing chronic thromboembolic pulmonary hypertension (CTEPH). We aimed to validate the predictive value of six radiological predictors that were previously proposed.
methodsThree hundred forty-one patients with acute PE were prospectively followed for development of CTEPH in six European hospitals. Index CTPAs were analysed post hoc by expert chest radiologists blinded to the final diagnosis. The accuracy of the predictors using a predefined threshold for 'high risk' (≥ 3 predictors) and the expert overall judgment on the presence of CTEPH were assessed.
resultsCTEPH was confirmed in nine patients (2.6%) during 2-year follow-up. Any sign of chronic thrombi was already present in 74/341 patients (22%) on the index CTPA, which was associated with CTEPH (OR 7.8, 95%CI 1.9-32); 37 patients (11%) had ≥ 3 of 6 radiological predictors, of whom 4 (11%) were diagnosed with CTEPH (sensitivity 44%, 95%CI 14-79; specificity 90%, 95%CI 86-93). Expert judgment raised suspicion of CTEPH in 27 patients, which was confirmed in 8 (30%; sensitivity 89%, 95%CI 52-100; specificity 94%, 95%CI 91-97).
conclusionsThe presence of ≥ 3 of 6 predefined radiological predictors was highly specific for a future CTEPH diagnosis, comparable to overall expert judgment, while the latter was associated with higher sensitivity. Dedicated CTPA reading for signs of CTEPH may therefore help in early detection of CTEPH after PE, although in our cohort this strategy would not have detected all cases. KEY POINTS: • Three expert chest radiologists re-assessed CTPA scans performed at the moment of acute pulmonary embolism diagnosis and observed a high prevalence of chronic thrombi and signs of pulmonary hypertension. • On these index scans, the presence of ≥ 3 of 6 predefined radiological predictors was highly specific for a future diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH), comparable to overall expert judgment. • Dedicated CTPA reading for signs of CTEPH may help in early detection of CTEPH after acute pulmonary embolism.
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