title: Non-ECG-gated CT pulmonary angiography and the prediction of right ventricular dysfunction in patients suspected of pulmonary embolism.
abstract: OBJECTIVE
  Right ventricular dysfunction (RVD) is an important prognostic factor of 30-day mortality in patients with acute pulmonary embolism (PE). The aim of our study was to evaluate whether non-electrocardiogram (ECG)-gated cardiovascular parameters attained during computed tomography pulmonary angiography (CTPA) could predict RVD in patients suspected of PE using ECG-gated cardiac CT angiography as reference.
  
  
  METHODS
  Consecutive patients suspected of PE were referred to a ventilation/perfusion single-photon emission tomography (V/Q-SPECT) as first-line imaging procedure. Patients had a V/Q-SPECT/CT, a CTPA and an ECG-gated cardiac CT angiography performed the same day.
  
  
  RESULTS
  A total of 71 patients were available for analysis. Seventeen patients (24%) had RVD. The non-ECG-gated dimensions of left and right ventricle and the major vessels were correlated with ECG-gated cardiac dimensions. The size of the pulmonary trunk could identify patients with RVD: AUC (0·67, 95% confidence intervals (CIs) 0·52-0·82) as seen in the ROC curve (P<0·05). With a cut-off value of the pulmonary trunk of 29 mm, the sensitivity and specificity were 70·6% and 55·5%, respectively. The positive predictive and negative predictive values for detection of RVD were 59·1% and 85·7%, respectively.
  
  
  CONCLUSIONS
  In the present study, we demonstrated correlation between ECG-gated cardiac dimensions and non-ECG-gated cardiovascular parameters, however with only moderate diagnostic accuracies. We demonstrated that the dimension of the pulmonary trunk might be of value in detection of patients with RVD. We suggest further studies on the potential value of non-ECG-gated cardiac dimensions in patients suspected of PE.
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.|Cluster for Molecular Imaging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Gutte
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Jann
authors.initials: J
authors.lastname: Mortensen
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.|Cluster for Molecular Imaging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mette Louise
authors.initials: ML
authors.lastname: Mørk
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.|Cluster for Molecular Imaging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ulrik Sloth
authors.initials: US
authors.lastname: Kristoffersen
authors.affiliation: Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Claus Verner
authors.initials: CV
authors.lastname: Jensen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Frederiksberg Hospital, Frederiksberg, Denmark.|Unit for Functional Imaging, Hvidovre Hospital, Hvidovre, Denmark.
authors.forename: Claus Leth
authors.initials: CL
authors.lastname: Petersen
authors.affiliation: Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: von der Recke
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.|Cluster for Molecular Imaging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjaer
mesh_terms: D019540:Area Under Curve; D055424:Cardiac-Gated Imaging Techniques; D000072226:Computed Tomography Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D055420:Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012372:ROC Curve; D015203:Reproducibility of Results; D000072098:Single Photon Emission Computed Tomography Computed Tomography; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016278:Ventricular Function, Right
keywords: CT pulmonary angiography; ECG gated CT; SPECT/CT; pulmonary embolism; right ventricle dysfunction