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Head-to-Head Comparison of Dual-Source and Split-Beam Filter Multi-Energy CT versus SPECT/CT for Assessing Lobar Lung
Quirin D Strotzer1, Stefanie Heidemanns1, Vinzenz Mayr1
1From the Institute of Radiology (Q.D.S., V.M., R.S., S.M., C.S., O.W.H.) and Department of Nuclear Medicine (S.H., D.S., J.G., D.H.), University of Regensburg Medical Center, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany; and Departments of Pulmonology (S.B.) and Radiology (O.W.H.), Donaustauf Hospital, Donaustauf, Germany.
Purpose:
To evaluate dual-source and split-beam filter multi-energy chest CT in assessing pulmonary perfusion on a lobar level in patients with lung emphysema, using perfusion SPECT as the reference standard.
Materials And Methods:
Patients with emphysema evaluated for lung volume reduction therapy between May 2016 and February 2021 were retrospectively included. All patients underwent SPECT and either dual-source or split-beam filter (SBF) multi-energy CT. To calculate the fractional lobar lung perfusion (FLLP), SPECT acquisitions were co-registered with chest CT scans (hereafter, SPECT/CT) and semi-manually segmented. For multi-energy CT scans, lung lobes were automatically segmented using a U-Net model. Segmentations were manually verified. The FLLP was derived from iodine maps computed from the multi-energy data. Statistical analysis included Pearson and intraclass correlation coefficients and Bland-Altman analysis.
Results:
Fifty-nine patients (30 male, 29 female; 31 underwent dual-source CT, 28 underwent SBF CT; mean age for all patients, 67 years ± 8 [SD]) were included. Both multi-energy methods significantly correlated with the SPECT/CT acquisitions for all individual lobes (P < .001). Pearson correlation concerning all lobes combined was significantly better for dual-source (r = 0.88) than for SBF multi-energy CT (r = 0.78; P = .006). On the level of single lobes, Pearson correlation coefficient differed for the right upper lobe only (dual-source CT, r = 0.88; SBF CT, r = 0.58; P = .008).
Conclusion:
Dual-source and SBF multi-energy CT accurately assessed lung perfusion on a lobar level in patients with emphysema compared with SPECT/CT. The overall correlation was higher for dual-source multi-energy CT.Keywords: Chronic Obstructive Pulmonary Disease, Comparative Studies, Computer Applications, CT Spectral Imaging, Image Postprocessing, Lung, Pulmonary Perfusion© RSNA, 2023.
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