Why the study?
While CTPA is diagnostic for pulmonary hypertension, the utility and reproducibility of unenhanced CT measurements diagnosing PH have not been fully assessed.
Does unenhanced CT thorax provide accurate and reproducible diagnostic measurements for suspected pulmonary hypertension compared to right heart catheterization?
Does unenhanced CT thorax provide accurate and reproducible diagnostic measurements for suspected pulmonary hypertension compared to right heart catheterization?
Unenhanced CT thorax measurements, specifically main pulmonary artery diameter and right atrial area, offer reproducible and acceptable-to-excellent diagnostic accuracy for suspected pulmonary hypertension.
I need the paper’s actual key finding before writing the implication. Searching the study now.Opening the paper to extract the key finding and results.Should not yet change diagnostic pathways; leaves open whether unenhanced CT can triage suspected PH when contrast is unavailable.
<ns3:p> <ns3:bold>Background:</ns3:bold> 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). </ns3:p> <ns3:p> <ns3:bold>Methods:</ns3:bold> In total, <ns3:bold/> 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). </ns3:p> <ns3:p> <ns3:bold>Results:</ns3:bold> Overall, <ns3:bold/> 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). </ns3:p> <ns3:p> <ns3:bold>Conclusions:</ns3:bold> 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. </ns3:p>
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Goh et al. (2021) studied this question.
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