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We included 41 patients (18 female; mean age 59.9\u2009\u00b1\u200918.3\u00a0years) with confirmed CTEPH who underwent CACT and CTPA within 21\u00a0days (average 5.3\u2009\u00b1\u20095.2). Two readers (R1; R2) independently evaluated datasets from both imaging techniques for mosaic perfusion patterns and presence of CTEPH-typical vascular lesions. The number of pulmonary arterial segments with typical findings was evaluated and the percentage of affected segments was calculated and categorized:\u2009&lt;\u200925%; 25\u201349%; 50\u201375%;\u2009&lt;\u200975% of all pulmonary arterial segments affected by thromboembolic vascular lesions. Inter-observer agreement was calculated for both modalities using the intraclass-correlation-coefficient (ICC). Based on consensus reading the inter-modality agreement (CACT<jats:sub>cons<\/jats:sub> vs. CTPA<jats:sub>cons<\/jats:sub>) was calculated using the ICC. Inter-observer agreement was excellent for central vascular lesions (ICC\u2009&gt;\u20090.87) and the percentage of affected segments (ICC\u2009&gt;\u20090.76) and good for the perceptibility of mosaic perfusion (ICC\u2009&gt;\u20090.6) and attribution of the pattern of mosaic perfusion (ICC\u2009&gt;\u20090.6) for both readers on CACT and CTPA. Inter-modality agreement was excellent for the perceptibility of mosaic perfusion (ICC\u2009=\u20091), the present perfusion pattern (ICC\u2009=\u20091) and central vascular lesions (ICC\u2009=\u20091). However, inter-modality agreement for the percentage of affected segments was fair (ICC\u2009=\u20090.50), with a greater proportion of identified affected segments on CACT<jats:sub>cons<\/jats:sub>. CACT demonstrates a high agreement with CTPA regarding the detection of mosaic perfusion. CACT detects a higher number of peripheral vascular lesions compared to CTPA.<\/jats:p>","DOI":"10.1038\/s41598-021-99658-2","type":"journal-article","created":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T07:03:53Z","timestamp":1633763033000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Depiction of mosaic perfusion in chronic thromboembolic pulmonary hypertension (CTEPH) on C-arm computed tomography compared to computed tomography pulmonary angiogram (CTPA)"],"prefix":"10.1038","volume":"11","author":[{"given":"Sabine K.","family":"Maschke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Werncke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia L. 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