Xenon-enhanced CT using subtraction CT: Basic and preliminary clinical studies for comparison of its efficacy with that of dual-energy CT and ventilation SPECT/CT to assess regional ventilation and pulmonary functional loss in smokers

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• 作者：Yoshiharu Ohno ; MD PhD^a ; ^b ; ^{yosirad@kobe-u.ac.jp} ; ^{yosirad@med.kobe-u.ac.jp} ; ^{yoshiharuohno@aol.jp} ; Takeshi Yoshikawa ; MD PhD^a ; ^b ; Daisuke Takenaka ; MD^c ; Yasuko Fujisawa ; BS^d ; Naoki Sugihara ; MEng^d ; Yuji Kishida ; MD^e ; Shinichiro Seki ; MD PhD^e ; Hisanobu Koyama ; MD PhD^e ; Kazuro Sugimura ; MD^e
• 关键词：Lung ; CT ; SPECT ; Ventilation ; COPD
• 刊名：European Journal of Radiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：86
• 期：Complete
• 页码：41-51
• 全文大小：2317 K
• 卷排序：86

文摘

To prospectively and directly compare the capability for assessments of regional ventilation and pulmonary functional loss in smokers of xenon-ventilation CT obtained with the dual-energy CT (DE-CT) and subtraction CT (Sub-CT)Materials and methodsTwenty-three consecutive smokers (15 men and 8 women, mean age: 69.7 ± 8.7 years) underwent prospective unenhanced and xenon-enhanced CTs, the latter by Sub-CT and DE-CT methods, ventilation SPECT and pulmonary function tests. Sub-CT was generated from unenhanced and xenon-enhanced CT, and all co-registered SPECT/CT data were produced from SPECT and unenhanced CT data. For each method, regional ventilation was assessed by using a 11-point scoring system on a per-lobe basis. To determine the functional lung volume by each method, it was also calculated for individual sublets with a previously reported method. To determine inter-observer agreement for each method, ventilation defect assessment was evaluated by using the χ2 test with weighted kappa statistics. For evaluation of the efficacy of each method for pulmonary functional loss assessment, functional lung volume was correlated with%FEV1.ResultsEach inter-observer agreement was rated as substantial (Sub-CT: κ = 0.69, p < 0.0001; DE-CT: κ = 0.64, p < 0.0001; SPECT/CT: κ = 0.64, p < 0.0001). Functional lung volume for each method showed significant to good correlation with%FEV1 (Sub-CT: r = 0.72, p = 0.0001; DE-CT: r = 0.74, p < 0.0001; SPECT/CT: r = 0.66, p = 0.0006).ConclusionXenon-enhanced CT obtained by Sub-CT can be considered at least as efficacious as that obtained by DE-CT and SPECT/CT for assessment of ventilation abnormality and pulmonary functional loss in smokers.