Unenhanced computed tomography as a diagnostic tool in suspected pulmonary hypertension: a retrospective cross-sectional pilot study [version 2; peer review: 2 approved]

Bibliographic Details
Title: Unenhanced computed tomography as a diagnostic tool in suspected pulmonary hypertension: a retrospective cross-sectional pilot study [version 2; peer review: 2 approved]
Authors: Charlie Elliot, Krit Dwivedi, Dheyaa Alkanfar, Michael Sharkey, Catherine Hill, Thanos Charalampololous, Robin Condliffe, Smitha Rajaram, Andrew J. Swift, David G. Kiely, Christopher S. Johns, Ze Ming Goh, Samual Barnes, Tarik Julius
Source: Wellcome Open Research, Vol 6 (2024)
Publisher Information: Wellcome, 2024.
Publication Year: 2024
Collection: LCC:Medicine
LCC:Science
Subject Terms: Computed tomography, Pulmonary hypertension, Diagnosis, Right Ventricle, eng, Medicine, Science
More Details: Background Computed tomography pulmonary angiography (CTPA) has been proposed to be diagnostic for pulmonary hypertension (PH) in multiple studies. However, the utility of the unenhanced CT measurements diagnosing PH has not been fully assessed. This study aimed to assess the diagnostic utility and reproducibility of cardiac and great vessel parameters on unenhanced computed tomography (CT) in suspected pulmonary hypertension (PH). Methods In total, 42 patients with suspected PH who underwent unenhanced CT thorax and right heart catheterization (RHC) were included in the study. Three observers (a consultant radiologist, a specialist registrar in radiology, and a medical student) measured the parameters by using unenhanced CT. Diagnostic accuracy of the parameters was assessed by area under the receiver operating characteristic curve (AUC). Inter-observer variability between the consultant radiologist (primary observer) and the two secondary observers was determined by intra-class correlation analysis (ICC). Results Overall, 35 patients were diagnosed with PH by RHC while 7 patients were not. Main pulmonary arterial (MPA) diameter was the strongest (AUC 0.79 to 0.87) and the most reproducible great vessel parameter. ICC comparing the MPA diameter measurement of the consultant radiologist to the specialist registrar’s and the medical student’s were 0.96 and 0.92, respectively. Right atrial area was the cardiac measurement with highest accuracy and reproducibility (AUC 0.76 to 0.79; ICC 0.980, 0.950) followed by tricuspid annulus diameter (AUC 0.76 to 0.79; ICC 0.790, 0.800). Conclusions MPA diameter and right atrial areas showed high reproducibility. Diagnostic accuracies of these were within the range of acceptable to excellent, and might have clinical value. Tricuspid annular diameter was less reliable and less diagnostic and was therefore not a recommended diagnostic measurement.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2398-502X
Relation: https://wellcomeopenresearch.org/articles/6-249/v2; https://doaj.org/toc/2398-502X
DOI: 10.12688/wellcomeopenres.16853.2
Access URL: https://doaj.org/article/c382f1f9d45d497a821dab0e95892709
Accession Number: edsdoj.382f1f9d45d497a821dab0e95892709
Database: Directory of Open Access Journals
More Details
ISSN:2398502X
DOI:10.12688/wellcomeopenres.16853.2
Published in:Wellcome Open Research
Language:English