Hye Jeon Hwang MD, Presenter: Nothing to Disclose

Joon Beom Seo MD, PhD, Abstract Co-Author: Nothing to Disclose

Sang Min Lee MD, Abstract Co-Author: Nothing to Disclose

Sang Young Oh MD, Abstract Co-Author: Nothing to Disclose

Namkug Kim PhD, Abstract Co-Author: Stockholder, Coreline Soft, Inc

Taekjin Jang, Abstract Co-Author: Nothing to Disclose

Jae Seung Lee, Abstract Co-Author: Nothing to Disclose

Sei Won Lee, Abstract Co-Author: Nothing to Disclose

Yeon-Mok Oh MD, PhD, Abstract Co-Author: Nothing to Disclose

To assessthe feasibility of combined xenon-enhanced ventilation (V) and iodine-enhanced perfusion (Q) dual-energy CT (DECT) for the evaluation of regional V and Q status in COPD.

Fifty-two male patients with COPD (mean age 67.9) were prospectively enrolled. Combined V and Q DECT imaging was performed. Virtual noncontrast image, V map, and Q (pulmonary blood volume) map were anatomically co-registered with deformable registration and evaluated with in-house software. After the normalization of the V and Q values of each pixel, V/Qratio map and VQmin map, which is a map of smaller value between V and Q in each pixel, were additionally generated. For visual analysis, regional V, Q, and V/Qratio pattern was determined as decreased, normal and increased, in combination of the regional disease patterns including emphysema, bronchial wall thickening and normal at each segment. Mean V, Q, V/Qratio, VQmin values and standard deviation of V/Qratio (V/Qsd) of each patient were quantified and compared with PFT parameters, such as FEV1, FEV1/FVC, and DLco with Pearson correlation test.

At visual analysis, while segments with normal parenchyma showed matched V/Qratio pattern, segment with bronchial wall thickening commonly showed mismatched pattern. There was no dominant V/Qratio pattern at emphysema area. At quantitative analysis, mean V, Q, V/Qratio, VQmin values showed significant positive correlation with PFT parameters (r = 0.290 ~ 0.815, p < 0.05). V/Qsd showed significant negative correlation with PFT parameters (r = - 0.439 ~ - 0.736, p < 0.001). VQmin values showed the best correlation with PFT (r = 0.483 ~ 0.815, p < 0.001).

Visual and quantitative assessment of regional V, Q, V/Qratio, VQmin is feasible with combined V and Q DECT imaging, with significant correlation with PFT results in COPD patients. Assessment of disease pattern at conventional CT images may not represent regional V, Q and V-Q mismatch.

Regional structural abnormities, ventilation and perfusion status can be assessed simultaneously with combined xenon-enhanced ventilation and iodine-enhanced perfusion DECT.

Hwang, H, Seo, J, Lee, S, Oh, S, Kim, N, Jang, T, Lee, J, Lee, S, Oh, Y, Assessment of Regional Xenon-ventilation, Perfusion and Ventilation-perfusion Mismatch Using Dual-energy Computed Tomography in COPD Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016775.html