title: Dual Energy CT lung perfusion imaging--correlation with SPECT/CT.
abstract: OBJECTIVE
  Aims were (1) to determine the diagnostic accuracy of Dual Energy CT (DECT) in the detection of perfusion defects and (2) to evaluate the potential of DECT to improve the sensitivity for PE.
  
  
  METHODS
  15 patients underwent Dual Energy pulmonary CT angiography (DE CTPA) and a combination of lung perfusion SPECT/CT and ventilation scintigraphy. CTPA and DE iodine distribution maps as well as perfusion SPECT/CT and inhalation scintigrams were reviewed for pulmonary embolism (PE) diagnosis. DECT and SPECT perfusion images were assessed regarding localization and extent of perfusion defects. Diagnostic accuracy of DE iodine (perfusion) maps was determined with reference to SPECT/CT. Diagnostic accuracies for PE detection of DECT and of SPECT/CT with ventilation scintigraphy were calculated with reference to the consensus reading of all modalities.
  
  
  RESULTS
  DE CTPA had a sensitivity/specificity of 100%/100% for acute PE, while the combination of SPECT/CT and ventilation scintigraphy had a sensitivity/specificity of 85.7%/87.5%. For perfusion defects, DECT iodine maps had a sensitivity/specificity of 76.7% and 98.2%.
  
  
  CONCLUSIONS
  DECT is able to identify pulmonary perfusion defects with good accuracy. This technique may potentially enhance the diagnostic accuracy in the assessment of PE.
authors.affiliation: Department of Clinical Radiology, Ludwig Maximilians University, Klinikum Grosshadern, Marchioninistr 15, D-81377 München, Germany. sven.thieme@med.lmu.de
authors.forename: S F
authors.initials: SF
authors.lastname: Thieme
authors.forename: V
authors.initials: V
authors.lastname: Graute
authors.forename: K
authors.initials: K
authors.lastname: Nikolaou
authors.forename: D
authors.initials: D
authors.lastname: Maxien
authors.forename: M F
authors.initials: MF
authors.lastname: Reiser
authors.forename: M
authors.initials: M
authors.lastname: Hacker
authors.forename: T R C
authors.initials: TR
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D011655:Pulmonary Embolism / Q000175:diagnosis*; D012123:Pulmonary Ventilation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013382:Subtraction Technique; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*