title: Dual-energy CT lung ventilation/perfusion imaging for diagnosing pulmonary embolism.
abstract: OBJECTIVE
  To evaluate the feasibility and findings of combined dual-energy computed tomography (DECT) lung ventilation/perfusion imaging in patients with suspected pulmonary embolism (PE).
  
  
  METHODS
  This study was institutional review board-approved and written informed consent was obtained from each patient. Thirty-two subjects (aged 11-61 years) underwent combined xenon-enhanced ventilation and iodine-enhanced perfusion DECT. Ventilation, perfusion and morphological information were visually interpreted. Ventilation/perfusion information was classified as mismatch (differing patterns) or match (concordant patterns). Adverse reactions and radiation doses were recorded for each subject.
  
  
  RESULTS
  Of 32 patients undergoing xenon-enhanced DECT, six patients reported adverse reactions (shortness of breath, n = 2; mild dizziness, n = 3; limb numbness, n = 1). Twenty-eight of 32 patients could be included into the data analysis. PE was detected in 10/28 patients. PE-related ventilation/perfusion mismatch was found in 17 lung lobes in 8/10 patients and matched ventilation/perfusion was detected in 2 patients. Eighteen patients had no PE. In this group, there was no case of a ventilation/perfusion mismatch. Matched ventilation/perfusion impairment was seen in one patient. The overall radiation dose from two DECT acquisitions was 4.8 ± 1.4 mSv (range 2.7-7.5 mSv).
  
  
  CONCLUSIONS
  DECT lung ventilation/perfusion imaging is feasible and can visualise ventilation/perfusion match or mismatch in patients with suspected PE.
  
  
  CONCLUSIONS
  • Combined dual-energy CT lung ventilation/perfusion imaging is feasible. • Combined dual-energy CT ventilation/perfusion imaging provides lung morphological and functional information. • Dual-energy CT can demonstrate ventilation/perfusion mismatch in patients with pulmonary embolism.
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China.
authors.forename: Long Jiang
authors.initials: LJ
authors.lastname: Zhang
authors.forename: Chang Sheng
authors.initials: CS
authors.lastname: Zhou
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
authors.forename: Hui Xue
authors.initials: HX
authors.lastname: Sheng
authors.forename: Sheng Yong
authors.initials: SY
authors.lastname: Wu
authors.forename: Aleksander W
authors.initials: AW
authors.lastname: Krazinski
authors.forename: Justin R
authors.initials: JR
authors.lastname: Silverman
authors.forename: Felix G
authors.initials: FG
authors.lastname: Meinel
authors.forename: Yan E
authors.initials: YE
authors.lastname: Zhao
authors.forename: Zong Jun
authors.initials: ZJ
authors.lastname: Zhang
authors.forename: Guang Ming
authors.initials: GM
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014692:Ventilation-Perfusion Ratio; D055815:Young Adult