Dual-energy CT angiography for detection of pulmonary emboli: Incremental benefit of iodine maps Journal Article


Authors: Weidman, E. K.; Plodkowski, A. J.; Halpenny, D. F.; Hayes, S. A.; Perez-Johnston, R.; Zheng, J.; Moskowitz, C.; Ginsberg, M. S.
Article Title: Dual-energy CT angiography for detection of pulmonary emboli: Incremental benefit of iodine maps
Abstract: Purpose To determine if there is added benefit of using iodine maps from dual-energy (DE) CT in addition to conventional CT angiography images to diagnose pulmonary embolism (PE). Materials and Methods In this retrospective analysis, 1144 consecutive dual-energy CT angiography examinations performed from January through September 2014 at an oncologic referral center to evaluate for PE were reviewed. The 1144 examinations included 1035 patients (mean age, 58.7 years; range, 15-99 years). First, the location, level, and type (occlusive vs nonocclusive) of PEs on conventional CT angiograms were recorded. Iodine maps were then reviewed for defects suggestive of PE. Last, CT angiograms were rereviewed to detect additional PEs suggested by the iodine map. Consensus reviews were performed for examinations with PEs. The confidence interval of percentages was calculated by using the Clopper-Pearson method. Results On 147 of 1144 (12.8%) CT angiograms, a total of 372 PEs were detected at initial review. After review of the DE CT iodine map, 27 additional PEs were found on 26 of 1144 CT angiograms (2.3%; 95% confidence interval [CI]: 1.5%, 3.3%). Of the 27 additional PEs, six (22.2%) were segmental, 21 (77.8%) were subsegmental, 24 (88.9%) were occlusive, and three (11.1%) were nonocclusive. Eleven of 1144 (1.0%; 95% CI: 0.5%, 1.7%) CT angiograms had a new diagnosis of PE after review of the DE CT iodine maps. Conclusion Dual-energy CT iodine maps show a small incremental benefit for the detection of occlusive segmental and subsegmental pulmonary emboli. © RSNA, 2018.
Journal Title: Radiology
Volume: 289
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2018-11-01
Start Page: 546
End Page: 553
Language: English
DOI: 10.1148/radiol.2018180594
PUBMED: 30204073
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 November 2018 -- Source: Scopus
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MSK Authors
  1. Junting Zheng
    131 Zheng
  2. Michelle S Ginsberg
    158 Ginsberg
  3. Chaya S. Moskowitz
    173 Moskowitz
  4. Sara Anne Hayes
    19 Hayes