Korean Journal of Radiology

  • 제21권6호
  • /
  • Pages.756-763
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  • 2020
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Optimal Attenuation Threshold for Quantifying CT Pulmonary Vascular Volume Ratio

  • Hyun Woo Goo (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Sang Hyub Park (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • 투고 : 2019.10.21
  • 심사 : 2020.01.21
  • 발행 : 2020.06.01
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초록

Objective: To evaluate the effects of attenuation threshold on CT pulmonary vascular volume ratios in children and young adults with congenital heart disease, and to suggest an optimal attenuation threshold. Materials and Methods: CT percentages of right pulmonary vascular volume were compared and correlated with percentages calculated from nuclear medicine right lung perfusion in 52 patients with congenital heart disease. The selected patients had undergone electrocardiography-synchronized cardiothoracic CT and lung perfusion scintigraphy within a 1-year interval, but not interim surgical or transcatheter intervention. The percentages of CT right pulmonary vascular volumes were calculated with fixed (80-600 Hounsfield units [HU]) and adaptive thresholds (average pulmonary artery enhancement [PAavg] divided by 2.50, 2.00, 1.75, 1.63, 1.50, and 1.25). The optimal threshold exhibited the smallest mean difference, the lowest p-value in statistically significant paired comparisons, and the highest Pearson correlation coefficient. Results: The PAavg value was 529.5 ± 164.8 HU (range, 250.1-956.6 HU). Results showed that fixed thresholds in the range of 320-400 HU, and adaptive thresholds of PAavg/1.75-1.50 were optimal for quantifying CT pulmonary vascular volume ratios. The optimal thresholds demonstrated a small mean difference of ≤ 5%, no significant difference (> 0.2 for fixed thresholds, and > 0.5 for adaptive thresholds), and a high correlation coefficient (0.93 for fixed thresholds, and 0.91 for adaptive thresholds). Conclusion: The optimal fixed and adaptive thresholds for quantifying CT pulmonary vascular volume ratios appeared equally useful. However, when considering a wide range of PAavg, application of optimal adaptive thresholds may be more suitable than fixed thresholds in actual clinical practice.

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참고문헌

  1. Hayabuchi Y, Mori K, Kitagawa T, Inoue M, Kagami S. Accurate quantification of pulmonary artery diameter in patients with cyanotic congenital heart disease using multidetector-row computed tomography. Am Heart J 2007;154:783-788 
  2. Shi K, Yang ZG, Xu HY, Zhao SX, Liu X, Guo YK. Dual-source computed tomography for evaluating pulmonary artery in pediatric patients with cyanotic congenital heart disease: comparison with transthoracic echocardiography. Eur J Radiol 2016;85:187-192 
  3. Pruckmayer M, Zacherl S, Salzer-Muhar U, Schlemmer M, Leitha T. Scintigraphic assessment of pulmonary and whole-body blood flow patterns after surgical intervention in congenital heart disease. J Nucl Med 1999;40:1477-1483 
  4. Sabiniewicz R, Romanowicz G, Bandurski T, Chojnicki M, Alszewicz-Baranowska J, Erecin'ski J, et al. Lung perfusion scintigraphy in the diagnosis of peripheral pulmonary stenosis in patients after repair of Fallot tetralogy. Nucl Med Rev Cent East Eur 2002;5:11-13 
  5. Goo HW, Park SH. Pulmonary vascular volume ratio measured by cardiac computed tomography in children and young adults with congenital heart disease: comparison with lung perfusion scintigraphy. Pediatr Radiol 2017;47:1580-1587 
  6. Goo HW. Computed tomography pulmonary vascular volume ratio in children and young adults with congenital heart disease: the effect of cardiac phase. Pediatr Radiol 2018;48:915-922 
  7. Goo HW. Computed tomography pulmonary vascular volume ratio can be used to evaluate the effectiveness of pulmonary angioplasty in peripheral pulmonary artery stenosis. Korean J Radiol 2019;20:1422-1430 
  8. Koch K, Oellig F, Oberholzer K, Bender P, Kunz P, Mildenberger P, et al. Assessment of right ventricular function by 16-detector-row CT: comparison with magnetic resonance imaging. Eur Radiol 2005;15:312-318 
  9. Goo HW, Yang DH, Hong SJ, Yu J, Kim BJ, Seo JB, et al. Xenon ventilation CT using dual-source and dual-energy technique in children with bronchiolitis obliterans: correlation of xenon and CT density values with pulmonary function test results. Pediatr Radiol 2010;40:1490-1497 
  10. Goo HW, Park SH. Semiautomatic three-dimensional CT ventricular volumetry in patients with congenital heart disease: agreement between two methods with different user interaction. Int J Cardiovasc Imaging 2015;31:223-232 
  11. Scholten ET, Jacobs C, van Ginneken B, van Riel S, Vliegenthart R, Oudkerk M, et al. Detection and quantification of the solid component in pulmonary subsolid nodules by semiautomatic segmentation. Eur Radiol 2015;25:488-496 
  12. Yanagawa N, Kawata N, Matsuura Y, Sugiura T, Suzuki T, Kasai H, et al. Effect of threshold on the correlation between airflow obstruction and low attenuation volume in smokers assessed by inspiratory and expiratory MDCT. Acta Radiol 2015;56:438-446 
  13. Lee SM, Seo JB, Lee SM, Kim N, Oh SY, Oh YM. Optimal threshold of subtraction method for quantification of air-trapping on coregistered CT in COPD patients. Eur Radiol 2016;26:2184-2192 
  14. Bettinger N, Khalique OK, Krepp JM, Hamid NB, Bae DJ, Pulerwitz TC, et al. Practical determination of aortic valve calcium volume score on contrast-enhanced computed tomography prior to transcatheter aortic valve replacement and impact on paravalvular regurgitation: elucidating optimal threshold cutoffs. J Cardiovasc Comput Tomogr 2017;11:302-308 
  15. Goo HW, Allmendinger T. Combined electrocardiography- and respiratory-triggered CT of the lung to reduce respiratory misregistration artifacts between imaging slabs in free-breathing children: initial experience. Korean J Radiol 2017;18:860-866 
  16. Goo HW. Combined prospectively electrocardiography- and respiratory-triggered sequential cardiac computed tomography in free-breathing children: success rate and image quality. Pediatr Radiol 2018;48:923-931 
  17. Goo HW, Suh DS. Tube current reduction in pediatric non-ECG-gated heart CT by combined tube current modulation. Pediatr Radiol 2006;36:344-351 
  18. Goo HW. State-of-the-art CT imaging techniques for congenital heart disease. Korean J Radiol 2010;11:4-18 
  19. Goo HW. Individualized volume CT dose index determined by cross-sectional area and mean density of the body to achieve uniform image noise of contrast-enhanced pediatric chest CT obtained at variable kV levels and with combined tube current modulation. Pediatr Radiol 2011;41:839-847 
  20. Tricarico F, Hlavacek AM, Schoepf UJ, Ebersberger U, Nance JW Jr, Vliegenthart R, et al. Cardiovascular CT angiography in neonates and children: image quality and potential for radiation dose reduction with iterative image reconstruction techniques. Eur Radiol 2013;23:1306-1315 
  21. Goo HW. Is it better to enter a volume CT dose index value before or after scan range adjustment for radiation dose optimization of pediatric cardiothoracic CT with tube current modulation? Korean J Radiol 2018;19:692-703 
  22. Goo HW. Comparison of chest pain protocols for electrocardiography-gated dual-source cardiothoracic CT in children and adults: the effect of tube current saturation on radiation dose reduction. Korean J Radiol 2018;19:23-31 
  23. Hong SH, Goo HW, Maeda E, Choo KS, Tsai IC; Asian Society of Cardiovascular Imaging Congenital Heart Disease Study Group. User-friendly vendor-specific guideline for pediatric cardiothoracic computed tomography provided by the Asian Society of Cardiovascular Imaging Congenital Heart Disease Study Group: part 1. Imaging techniques. Korean J Radiol 2019;20:190-204 
  24. Goo HW. Haemodynamic findings on cardiac CT in children with congenital heart disease. Pediatr Radiol 2011;41:250-261 
  25. Park S, Lee SM, Kim N, Seo JB, Shin H. Automatic reconstruction of the arterial and venous trees on volumetric chest CT. Med Phys 2013;40:071906 
  26. Goo HW. Semiautomatic three-dimensional threshold-based cardiac computed tomography ventricular volumetry in repaired tetralogy of Fallot: comparison with cardiac magnetic resonance imaging. Korean J Radiol 2019;20:102-113 
  27. Goo HW. Myocardial delayed-enhancement CT: initial experience in children and young adults. Pediatr Radiol 2017;47:1452-1462 
  28. Goo HW. Advanced functional thoracic imaging in children: from basic concepts to clinical applications. Pediatr Radiol 2013;43:262-268