Yoshiharu Ohno MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Bayer AG Research grant, DAIICHI SANKYO Group Research grant, Eisai Co, Ltd

Yumiko Onishi MD, Presenter: Nothing to Disclose

Keiko Matsumoto MD, Abstract Co-Author: Nothing to Disclose

Hisanobu Koyama MD, Abstract Co-Author: Nothing to Disclose

Nobukazu Aoyama BS, Abstract Co-Author: Nothing to Disclose

Daisuke Takenaka MD, Abstract Co-Author: Nothing to Disclose

Sumiaki Matsumoto MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation

Takeshi Yoshikawa MD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV

Munenobu Nogami MD, PhD, Abstract Co-Author: Nothing to Disclose

Kenya Murase PhD, Abstract Co-Author: Nothing to Disclose

Kazuro Sugimura MD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Mitsubishi Corporation Research grant, Bayer AG Research grant, Eisai Co, Ltd Research grant, DAIICHI SANKYO Group Research Consultant, Shionogi & Co, Ltd

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To determine the capability for quantitative disease extent assessment and patient outcome prediction of dynamic perfusion MRI in patients with acute pulmonary thromboembolism (APTE).

25 consecutive APTE patients underwent contrast-enhanced MDCT, dynamic perfusion MRI, lung scan, angiography, treatment and follow-up examination. All perfusion MRIs were performed by using 3D spoiled gradient echo sequence (TR 2.7ms/ TE 0.6 ms/ Flip angle 40) using a 1.5 T scanner. From the signal intensity-time curves, pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) maps were generated on a pixel-by-pixel basis. From all perfusion parameter maps, each segmental perfusion parameter was determined by ROI measurement. To determine the most accurate dynamic perfusion parameter for diagnosis of lung segment affected by APTE and its feasible threshold value, ROC analyses were performed. Then, the most feasible threshold value was adapted and calculated PTE index as the ratio between total lung volume and lung volume affected by APTE for evaluation of disease severity. Mean PTE indexes were compared between death (n=5) and survival (n=20) groups by Student’s t-test. To evaluate the capability of dynamic perfusion MRI for prediction of patient outcome (death or survival), the feasible threshold value of PTE index for distinguishing death from survival was determined by ROC-based positive test. Finally, sensitivity, specificity and accuracy of PE index for distinguishing death from survival groups was compared with clinical outcome.

PBF (Az=0.98, p<0.05) was significantly more accurate parameter than MTT (Az=0.88) and PBV (Az=0.81). When adapted 80ml/100ml/min as feasible threshold value for diagnosis of segmental APTE, mean PTE index of death group was significantly higher than that of survival group (p<0.05). In addition, ROC-based positive test determined 0.5 as the feasible threshold value for distinguishing death from survival groups, sensitivity, specificity and accuracy of PTE index were 80 %, 95 % and 92 %, respectively.

Quantitative assessment of perfusion MRI is useful for disease extent assessment and prediction of patient outcome in acute PTE patients.

Quantitatively assessed dynamic perfusion MR imaging has potential for disease extent assessment and prediction of patients’ outcome in acute pulmonary thromboembolism patients.

Ohno, Y, Onishi, Y, Matsumoto, K, Koyama, H, Aoyama, N, Takenaka, D, Matsumoto, S, Yoshikawa, T, Nogami, M, Murase, K, Sugimura, K, et al, 0, Dynamic MR Perfusion Imaging: Capability for Quantitative Assessment of  Disease Extent and Prediction of Patient Outcome in Patients with Acute Pulmonary Thromboembolism.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8007885.html