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Updated: Jun 2, 2026
Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
Published on: April 12, 2024
Detection of pulmonary embolism using 64-slice multidetector-row computed tomography: accuracy and reproducibility on
Jung Im Jung1, Ki Jun Kim, Myong Im Ahn
1Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Korea. jijung@catholic.ac.kr
Background:
Direct comparison of different image reconstruction parameters to detect pulmonary embolism (PE) using 64-slice multidetector-row computed tomography (MDCT) is absent and the most accurate image reconstruction parameters have not yet been proven.
Purpose:
To compare different image reconstruction parameters for detecting PE using 64-slice MDCT in patients suspected of having an acute PE.
Material And Methods:
Forty patients who underwent pulmonary CT angiography with 64-slice MDCT for a suspected PE were included. Different image reconstruction parameters were used for each patient: axial and coronal images with slice thicknesses of 0.625 mm, 1.3 mm, and 2.5 mm and axial maximum intensity projection (MIP) images with slab thicknesses of 1.3 mm, 2.5 mm, and 5 mm. Four experienced radiologists reviewed the images. The diagnosis of a PE was based on consensus review of axial 0.625 mm slice thickness images by two chest radiologists with allowing multiplanar reconstruction. Accuracy and reproducibility (kappa value) were evaluated.
Results:
In 15 of 40 patients, a PE was diagnosed. For detecting lobar PEs, axial images with a slice thickness of 1.25 mm and all coronal re-formatted images showed comparable results to axial images with a slice thickness of 0.625 mm. For detecting segmental PEs, axial images with a slice thickness of 1.25 mm and coronal images with a slice thickness of 0.625 mm re-formatted images showed comparable results to axial images of a slice thickness of 0.625 mm. For detecting subsegmental PEs, axial images with a slice thickness of 0.625 mm showed the highest sensitivity. Better reproducibility was obtained when the thinner slice thickness reconstructions were in axial and coronal images. However, reproducibility of MIP images with slab thicknesses of 2.5 mm and 5 mm was similar for detecting segmental and subsegmental PEs.
Conclusion:
Thin-slice reconstruction of less than 1 mm is mandatory for visualization of PE at the subsegmental level.
Insights
Detecting pulmonary embolism (PE) with 64-slice MDCT requires thin-slice reconstructions. Thin-slice axial and coronal images offer better visualization and reproducibility for PE detection, especially at the subsegmental level.
Area of Science:
- Radiology
- Medical Imaging
Background:
- Pulmonary embolism (PE) detection using 64-slice multidetector-row computed tomography (MDCT) lacks direct comparison of reconstruction parameters.
- Optimal image reconstruction parameters for PE detection remain unproven.
Purpose of the Study:
- To compare various image reconstruction parameters for detecting PE in patients with suspected acute PE using 64-slice MDCT.
- To determine the most accurate parameters for PE diagnosis.
Main Methods:
- Forty patients with suspected PE underwent pulmonary CT angiography with 64-slice MDCT.
- Axial and coronal images (0.625mm, 1.3mm, 2.5mm slices) and axial MIP images (1.3mm, 2.5mm, 5mm slabs) were reconstructed.
- Radiologists evaluated accuracy and reproducibility, with consensus on 0.625mm axial images as the gold standard.
Main Results:
- PE was diagnosed in 15 out of 40 patients.
- Axial 1.25mm and all coronal images showed comparable results to 0.625mm axial images for lobar PE.
- Thin-slice axial and coronal reconstructions (≤1.25mm) improved reproducibility for PE detection, particularly for subsegmental PE.
Conclusions:
- Thin-slice reconstruction (<1mm) is essential for visualizing subsegmental pulmonary embolism.
- Optimized reconstruction parameters enhance the accuracy and reproducibility of PE detection via MDCT.
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