ArticleCurrent medical imaging2025
Improving Diagnostic Accuracy in Acute Pulmonary Embolism: Insights from Spectral Dual-energy CT.
Article in Current medical imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aims to evaluate the clinical efficacy of spectral dual-energy detector computed tomography (SDCT) and its associated parameters in diagnosing acute pulmonary embolism (APE).
methodsRetrospective analysis of imaging data from 86 APE-diagnosed patients using SDCT was conducted. Virtual monoenergetic images (VMIs) at 40, 70, and 100 KeV, Iodine concentration (IC) maps, Electron Cloud Density Map (ECDM), Effective atomic number (Z-eff) maps, and Hounsfield unit attenuation plots (VMI slope) were reconstructed from pulmonary artery phase CT images. The subtraction (SUB) and ratios of VMIs were calculated, and two experienced radiologists evaluated the patients. The Mann-Whitney U test assessed the parameter ability to differentiate between normal and obstructed lung fields and detect emboli in the pulmonary artery. Receiver Operating Characteristic Curves (ROC) were generated for performance evaluation.
resultsSignificant differences (p<0.001) in 40KeV, Ratio, SUB, and Z-eff were found between normal and embolized lung fields. Logistic regression demonstrated good detection performance for Z-eff (AUC=0.986), SUB (AUC=0.975), and IC (AUC=0.974). Parameters such as 40KeV (AUC=0.990), 70KeV (AUC=0.980), 100KeV (AUC=0.962), SUB (AUC=0.990), Z-eff (AUC=0.999), and IC (AUC=1.000) exhibited good detection capabilities for identifying emboli in the pulmonary artery.
conclusionSDCT facilitates the identification of diseased lung fields and localization of emboli in the pulmonary artery, thereby improving diagnostic efficiency in APE.
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