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Dual-energy CT-based iodine quantification for differentiating pulmonary artery sarcoma from pulmonary thromboembolism: a pilot study

 Suyon Chang  ;  Jin Hur  ;  Dong Jin Im  ;  Young Joo Suh  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Young Jin Kim  ;  Byoung Wook Choi 
 EUROPEAN RADIOLOGY, Vol.26(9) : 3162-3170, 2016 
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OBJECTIVES: The purpose of this study was to determine whether dual-energy computed tomography (DECT) angiography could differentiate pulmonary thromboembolism (PTE) from pulmonary artery sarcoma (PAS).

METHODS: We prospectively enrolled 19 patients that had a filling defect in the main pulmonary artery on DECT. Six patients who had PAS and underwent DECT were retrospectively enrolled for comparison. Pathological results or follow-up CT after anticoagulation therapy were used to make the final diagnosis. Two investigators measured the following parameters at the filling defect in the main pulmonary artery: CT attenuation density [Hounsfield units (HU)], iodine-related HU (IHU) and iodine concentration (IC, mg/ml).

RESULTS: From a total of 25 patients (M:F?=?10:15; mean age, 65 years old), 19 were categorised into the PTE group and six were categorised into the PAS group. The mean HU values were not significantly different between the PTE and PAS groups (45.5?±?15.9 vs 47.1?±?9.2 HU; P?=?0.776). However, the mean IHU and IC values of the lesions were significantly different between the PTE and PAS groups (10.6?±?7.2 vs 27.9?±?9.1 HU; P?=?0.004, and 0.61?±?0.39 vs 1.49?±?0.57; P?=?0.001).

CONCLUSIONS: DECT angiography using a quantitative analytic methodology can be used to differentiate PTE and PAS.

KEY POINTS: ? DECT can be useful for differentiation of PAS and PTE. ? With quantitative analysis, DECT offers tissue characterisation by detecting lesion parameter increases. ? The patients without predisposing factors for PTE can be candidates for DECT.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Im, Dong Jin(임동진) ORCID logo https://orcid.org/0000-0001-8139-5646
Chang, Su Yon(장수연)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
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