The diagnostic performance of CT pulmonary angiography in the detection of chronic thromboembolic pulmonary hypertension—systematic review and meta-analysis.
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| Title: | The diagnostic performance of CT pulmonary angiography in the detection of chronic thromboembolic pulmonary hypertension—systematic review and meta-analysis. |
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| Authors: | Lambert, Lukas1 lukas.lambert@vfn.cz, Michalek, Pavel2, Burgetova, Andrea1 |
| Source: | European Radiology. Nov2022, Vol. 32 Issue 11, p7927-7935. 9p. 1 Color Photograph, 1 Black and White Photograph, 1 Diagram, 3 Charts, 3 Graphs. |
| Subjects: | Computed tomography, Pulmonary arterial hypertension, Pulmonary artery, Web of Science (Web resource), Pulmonary embolism |
| Abstract: | Objectives: To examine the diagnostic performance of CT of the pulmonary artery (CTPA) as a potential first-choice imaging modality in patients with pulmonary arterial hypertension and suspected chronic thromboembolic pulmonary hypertension (CTEPH). Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA reporting checklist. Six scientific databases and registers (PubMed, EMBASE, Scopus, Web of Science, Cochrane, ClinicalTrials.gov) were searched for studies evaluating the diagnostic performance of CTPA in suspected CTEPH in adult patients. Results were pooled separately for studies based on the evaluation of the pulmonary artery and those that relied solely on changes in parenchymal perfusion. Results: Ten single-center studies with 734 patients were eligible for pooling of the diagnostic performance of CTPA by evaluation of the pulmonary artery. The pooled sensitivity, specificity, PPV, NPV, accuracy, and diagnostic odds ratio (DOR) estimates for CTPA in the detection of CTEPH were 0.98, 0.99, 0.94, 1.00, 0.96, 0.96, and 292. Evaluation of perfusion changes yielded pooled estimates for sensitivity, specificity, PPV, NPV, accuracy, and DOR of 0.99, 0.84, 0.79, 0.98, 0.89, 0.89, and 98 across four studies with 278 patients. Scintigraphy, SPECT, digital subtraction angiography, right heart catheterization, pulmonary endarterectomy, and international guidelines were used to establish the diagnosis. Conclusion: CTPA has high sensitivity and specificity in the detection of CTEPH when the examination is evaluated by expert radiologists. Evaluation of parenchymal perfusion alone is associated with slightly lower specificity. Further research is needed to determine the diagnostic performance of CTPA in excluding CTEPH in general radiology departments. Key Points: • CT pulmonary angiography (CTPA) is recommended in the diagnostic workup of chronic thromboembolic pulmonary hypertension (CTEPH). • CTPA has high sensitivity and specificity in the detection of CTEPH when evaluated by an expert radiologist. • Evaluation of changes in parenchymal perfusion alone is associated with slightly lower specificity. • Little is known about the diagnostic performance of CTPA in the detection of CTEPH in general radiology departments. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
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| Header | DbId: egs DbLabel: Engineering Source An: 160256603 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: The diagnostic performance of CT pulmonary angiography in the detection of chronic thromboembolic pulmonary hypertension—systematic review and meta-analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Lambert%2C+Lukas%22">Lambert, Lukas</searchLink><relatesTo>1</relatesTo><i> lukas.lambert@vfn.cz</i><br /><searchLink fieldCode="AR" term="%22Michalek%2C+Pavel%22">Michalek, Pavel</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Burgetova%2C+Andrea%22">Burgetova, Andrea</searchLink><relatesTo>1</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Nov2022, Vol. 32 Issue 11, p7927-7935. 9p. 1 Color Photograph, 1 Black and White Photograph, 1 Diagram, 3 Charts, 3 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Pulmonary+arterial+hypertension%22">Pulmonary arterial hypertension</searchLink><br /><searchLink fieldCode="DE" term="%22Pulmonary+artery%22">Pulmonary artery</searchLink><br /><searchLink fieldCode="DE" term="%22Web+of+Science+%28Web+resource%29%22">Web of Science (Web resource)</searchLink><br /><searchLink fieldCode="DE" term="%22Pulmonary+embolism%22">Pulmonary embolism</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: To examine the diagnostic performance of CT of the pulmonary artery (CTPA) as a potential first-choice imaging modality in patients with pulmonary arterial hypertension and suspected chronic thromboembolic pulmonary hypertension (CTEPH). Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA reporting checklist. Six scientific databases and registers (PubMed, EMBASE, Scopus, Web of Science, Cochrane, ClinicalTrials.gov) were searched for studies evaluating the diagnostic performance of CTPA in suspected CTEPH in adult patients. Results were pooled separately for studies based on the evaluation of the pulmonary artery and those that relied solely on changes in parenchymal perfusion. Results: Ten single-center studies with 734 patients were eligible for pooling of the diagnostic performance of CTPA by evaluation of the pulmonary artery. The pooled sensitivity, specificity, PPV, NPV, accuracy, and diagnostic odds ratio (DOR) estimates for CTPA in the detection of CTEPH were 0.98, 0.99, 0.94, 1.00, 0.96, 0.96, and 292. Evaluation of perfusion changes yielded pooled estimates for sensitivity, specificity, PPV, NPV, accuracy, and DOR of 0.99, 0.84, 0.79, 0.98, 0.89, 0.89, and 98 across four studies with 278 patients. Scintigraphy, SPECT, digital subtraction angiography, right heart catheterization, pulmonary endarterectomy, and international guidelines were used to establish the diagnosis. Conclusion: CTPA has high sensitivity and specificity in the detection of CTEPH when the examination is evaluated by expert radiologists. Evaluation of parenchymal perfusion alone is associated with slightly lower specificity. Further research is needed to determine the diagnostic performance of CTPA in excluding CTEPH in general radiology departments. Key Points: • CT pulmonary angiography (CTPA) is recommended in the diagnostic workup of chronic thromboembolic pulmonary hypertension (CTEPH). • CTPA has high sensitivity and specificity in the detection of CTEPH when evaluated by an expert radiologist. • Evaluation of changes in parenchymal perfusion alone is associated with slightly lower specificity. • Little is known about the diagnostic performance of CTPA in the detection of CTEPH in general radiology departments. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-022-08804-5 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 9 StartPage: 7927 Subjects: – SubjectFull: Computed tomography Type: general – SubjectFull: Pulmonary arterial hypertension Type: general – SubjectFull: Pulmonary artery Type: general – SubjectFull: Web of Science (Web resource) Type: general – SubjectFull: Pulmonary embolism Type: general Titles: – TitleFull: The diagnostic performance of CT pulmonary angiography in the detection of chronic thromboembolic pulmonary hypertension—systematic review and meta-analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Lambert, Lukas – PersonEntity: Name: NameFull: Michalek, Pavel – PersonEntity: Name: NameFull: Burgetova, Andrea IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 11 Text: Nov2022 Type: published Y: 2022 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 32 – Type: issue Value: 11 Titles: – TitleFull: European Radiology Type: main |
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