{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T13:44:18Z","timestamp":1782395058870,"version":"3.54.5"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>In chronic thromboembolic pulmonary hypertension (CTEPH), assessment of severity requires right heart catheterization (RHC) through cardiac index (CI). Previous studies have shown that dual-energy CT allows a quantitative assessment of the lung perfusion blood volume (PBV). Therefore, the objective was to evaluate the quantitative PBV as a marker of severity in CTEPH. In the present study, thirty-three patients with CTEPH (22 women, 68.2 \u00b1 14.8 years) were included from May 2017 to September 2021. Mean quantitative PBV was 7.6% \u00b1 3.1 and correlated with CI (r = 0.519, p = 0.002). Mean qualitative PBV was 41.1 \u00b1 13.4 and did not correlate with CI. Quantitative PBV AUC values were 0.795 (95% CI: 0.637\u20130.953, p = 0.013) for a CI \u2265 2 L\/min\/m2 and 0.752 (95% CI: 0.575\u20130.929, p = 0.020) for a CI \u2265 2.5 L\/min\/m2. In conclusion, quantitative lung PBV outperformed qualitative PBV for its correlation with the cardiac index and may be used as a non-invasive marker of severity in CTPEH patients.<\/jats:p>","DOI":"10.3390\/diagnostics13040769","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T05:57:52Z","timestamp":1676872672000},"page":"769","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Lung Dual-Energy CT Perfusion Blood Volume as a Marker of Severity in Chronic Thromboembolic Pulmonary Hypertension"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0314-4010","authenticated-orcid":false,"given":"Salim A.","family":"Si-Mohamed","sequence":"first","affiliation":[{"name":"Radiology Department, Louis Pradel Hospital, 59 Boulevard Pinel, 69500 Bron, France"},{"name":"INSA-Lyon, University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9a","family":"Zumbihl","sequence":"additional","affiliation":[{"name":"Radiology Department, Louis Pradel Hospital, 59 Boulevard Pinel, 69500 Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5894-4491","authenticated-orcid":false,"given":"S\u00e9gol\u00e8ne","family":"Turquier","sequence":"additional","affiliation":[{"name":"National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, 69677 Lyon, France"},{"name":"UMR 754, INRAE, Claude Bernard University Lyon, 69007 Lyon, France"},{"name":"ERN-LUNG, 69500 Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Boccalini","sequence":"additional","affiliation":[{"name":"Radiology Department, Louis Pradel Hospital, 59 Boulevard Pinel, 69500 Bron, France"},{"name":"INSA-Lyon, University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Francois","family":"Mornex","sequence":"additional","affiliation":[{"name":"National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, 69677 Lyon, France"},{"name":"UMR 754, INRAE, Claude Bernard University Lyon, 69007 Lyon, France"},{"name":"ERN-LUNG, 69500 Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Douek","sequence":"additional","affiliation":[{"name":"Radiology Department, Louis Pradel Hospital, 59 Boulevard Pinel, 69500 Bron, France"},{"name":"INSA-Lyon, University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5591-0955","authenticated-orcid":false,"given":"Vincent","family":"Cottin","sequence":"additional","affiliation":[{"name":"National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, 69677 Lyon, France"},{"name":"UMR 754, INRAE, Claude Bernard University Lyon, 69007 Lyon, France"},{"name":"ERN-LUNG, 69500 Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loic","family":"Boussel","sequence":"additional","affiliation":[{"name":"Radiology Department, Louis Pradel Hospital, 59 Boulevard Pinel, 69500 Bron, France"},{"name":"INSA-Lyon, University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1161\/CIRCULATIONAHA.110.015008","article-title":"Chronic Thromboembolic Pulmonary Hypertension (CTEPH): Results from an International Prospective Registry","volume":"124","author":"Delcroix","year":"2011","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1378\/chest.130.1.172","article-title":"Incidence of Chronic Thromboembolic Pulmonary Hypertension After a First Episode of Pulmonary Embolism","volume":"130","author":"Becattini","year":"2006","journal-title":"Chest"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1056\/NEJMoa032274","article-title":"Incidence of Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism","volume":"8","author":"Pengo","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1801913","DOI":"10.1183\/13993003.01913-2018","article-title":"Haemodynamic definitions and updated clinical classification of pulmonary hypertension","volume":"53","author":"Simonneau","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1801915","DOI":"10.1183\/13993003.01915-2018","article-title":"Chronic thromboembolic pulmonary hypertension","volume":"53","author":"Kim","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1801887","DOI":"10.1183\/13993003.01887-2018","article-title":"Pathology and pathobiology of pulmonary hypertension: State of the art and research perspectives","volume":"53","author":"Humbert","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1183\/09031936.00169113","article-title":"Microvascular disease in chronic thromboembolic pulmonary hypertension: A role for pulmonary veins and systemic vasculature","volume":"44","author":"Ghigna","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"160112","DOI":"10.1183\/16000617.0112-2016","article-title":"The pathophysiology of chronic thromboembolic pulmonary hypertension","volume":"26","author":"Simonneau","year":"2017","journal-title":"Eur. Respir. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1183\/13993003.01032-2015","article-title":"2015 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"46","author":"Humbert","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2002828","DOI":"10.1183\/13993003.02828-2020","article-title":"ERS statement on chronic thromboembolic pulmonary hypertension","volume":"57","author":"Delcroix","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1148\/radiol.2020203108","article-title":"Imaging of Pulmonary Hypertension in Adults: A Position Paper from the Fleischner Society","volume":"298","author":"Ryerson","year":"2021","journal-title":"Radiology"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Greffier, J., Villani, N., Defez, D., Dabli, D., and Si-Mohamed, S. (2022). Spectral CT imaging: Technical principles of dual-energy CT and multi-energy photon-counting CT. Diagn. Interv. Imaging, S2211-5684(22)00221-2.","DOI":"10.1016\/j.diii.2022.11.003"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1148\/radiol.12112789","article-title":"Pulmonary Perfused Blood Volume with Dual-Energy CT as Surrogate for Pulmonary Perfusion Assessed with Dynamic Multidetector CT","volume":"267","author":"Fuld","year":"2013","journal-title":"Radiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.ejrad.2015.11.035","article-title":"Chronic thromboembolic pulmonary hypertension: Comparison of dual-energy computed tomography and single photon emission computed tomography in canines","volume":"85","author":"Tang","year":"2015","journal-title":"Eur. J. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/s00330-013-2975-y","article-title":"Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: Diagnostic accuracy and concordance with radionuclide scintigraphy","volume":"24","author":"Dournes","year":"2013","journal-title":"Eur. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.diii.2020.02.006","article-title":"Head-to-head comparison of lung perfusion with dual-energy CT and SPECT-CT","volume":"101","author":"Tylski","year":"2020","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1148\/rg.2016150081","article-title":"Dual-Energy CT: Spectrum of Thoracic Abnormalities","volume":"36","author":"Otrakji","year":"2016","journal-title":"Radiographics"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.ejrad.2013.11.005","article-title":"Value of monoenergetic low-kV dual energy CT datasets for improved image quality of CT pulmonary angiography","volume":"83","author":"Apfaltrer","year":"2014","journal-title":"Eur. J. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1148\/radiol.2018180594","article-title":"Dual-Energy CT Angiography for Detection of Pulmonary Emboli: Incremental Benefit of Iodine Maps","volume":"289","author":"Weidman","year":"2018","journal-title":"Radiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5100","DOI":"10.1007\/s00330-018-5467-2","article-title":"Dual-energy CT (DECT) lung perfusion in pulmonary hypertension: Concordance rate with V\/Q scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH)","volume":"28","author":"Masy","year":"2018","journal-title":"Eur. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1007\/s10554-020-01911-8","article-title":"Dual-energy CT angiography in suspected pulmonary embolism: Influence of injection protocols on image quality and perfused blood volume","volume":"36","author":"Kosmala","year":"2020","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1800248","DOI":"10.1183\/13993003.00248-2018","article-title":"Risk assessment in medically treated chronic thromboembolic pulmonary hypertension patients","volume":"52","author":"Delcroix","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1802004","DOI":"10.1183\/13993003.02004-2018","article-title":"Risk assessment in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension","volume":"53","author":"Humbert","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"524","DOI":"10.2214\/AJR.10.4842","article-title":"Dual-energy CT angiography for assessment of regional pulmonary perfusion in patients with chronic thromboembolic pulmonary hypertension: Initial experience","volume":"196","author":"Hoey","year":"2011","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1016\/j.ejrad.2016.06.010","article-title":"Dual-energy CT to estimate clinical severity of chronic thromboembolic pulmonary hypertension: Comparison with invasive right heart catheterization","volume":"85","author":"Takagi","year":"2016","journal-title":"Eur. J. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1055\/s-0033-1350412","article-title":"Automated Quantification of Pulmonary Perfused Blood Volume by Dual-Energy CTPA in Chronic Thromboembolic Pulmonary Hypertension","volume":"186","author":"Meinel","year":"2013","journal-title":"Rofo"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1097\/RCT.0000000000001052","article-title":"Assessment of Severity in Chronic Thromboembolic Pulmonary Hypertension by Quantitative Parameters of Dual-Energy Computed Tomography","volume":"44","author":"Tsutsumi","year":"2020","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.ejrad.2010.04.018","article-title":"Dual-energy CT angiography of chronic thromboembolic disease: Can it help recognize links between the severity of pulmonary arterial obstruction and perfusion defects?","volume":"79","author":"Renard","year":"2011","journal-title":"Eur. J. Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1136\/hrt.78.2.171","article-title":"Comparison of bronchopulmonary collaterals and collateral blood flow in patients with chronic thromboembolic and primary pulmonary hypertension","volume":"78","author":"Endrys","year":"1997","journal-title":"Heart"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/RTI.0000000000000250","article-title":"Clinical Significance of Late Phase of Lung Perfusion Blood Volume (Lung Perfusion Blood Volume) Quantified by Dual-Energy Computed Tomography in Patients with Pulmonary Thromboembolism","volume":"32","author":"Koike","year":"2017","journal-title":"J. Thorac. Imag."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2002608","DOI":"10.1183\/13993003.02608-2020","article-title":"In vivo demonstration of pulmonary microvascular involvement in COVID-19 using dual-energy computed tomography","volume":"56","author":"Chebib","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.21037\/qims-21-229","article-title":"Detection of patients with chronic thromboembolic pulmonary hypertension by volumetric iodine quantification in the lung\u2014a case control study","volume":"12","author":"Kroeger","year":"2022","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2535","DOI":"10.1007\/s00330-019-06607-9","article-title":"Quantitative lobar pulmonary perfusion assessment on dual-energy CT pulmonary angiography: Applications in pulmonary embolism","volume":"30","author":"Singh","year":"2020","journal-title":"Eur. Radiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/4\/769\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:39:48Z","timestamp":1760121588000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/4\/769"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,17]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["diagnostics13040769"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13040769","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,17]]}}}