Non-cardiogenic Pulmonary Hypertension: Diagnosis and Etiologic Assessment using 4D Analysis of Dual energy CT Images
(Swiss National Science Foundation grant agreement 320030_146804)
Non-cardiogenic pulmonary hypertension (NCPH) is a rare and severe condition, affecting about 3 cases per 100’000 persons in the general population. It consists in an elevated pulmonary arterial pressure with secondary cardiac failure. This pathology usually affects relatively young patients, under 60. Without appropriate treatment, the outcome of the disease is poor, and almost 50% of patients will die within a 2 years period of time.
In spite of the improvement in the therapeutic options, which have fostered intensive research on this topic, the accurate identification of the NCPH by non-invasive medical imaging cause has lagged behind. Recent advances in the Computed Tomography (CT) technologies, such as dual energy CT (DECT) pulmonary angiography, opens new perspectives in the assessment of the etiological causes of NCPH. This technique allows the quantification of the pulmonary perfusion at the capillary level, by exploiting the photoelectric absorption properties of iodine contrast media at various energy levels (80 keV to 140keV). However, the current post-processing methods do only allow exploiting a limited part of the complex information that can be drawn from a DECT acquisition, usually displayed as color maps, obtained at specific levels of energy.
The goal of this research project is to obtain a comprehensive analysis of the whole information entailed in a DECT acquisition, to allow early identification of patients with PH, and to discriminate NCPH of thromboembolic origin from NCPH of other origin. This will be possible by using 4 dimensional image analysis, which consists in studying the volumetric spatial organization of the energy distribution in the lung parenchyma. Doing so will allow to obtain quantitative measures of the intensity and the texture of the parenchyma available for each level of energy, that may be specific to each etiological cause of PAH.
University Hospitals of Geneva
- Pierre-Alexandre Poletti, Emergency Radiology
- Jean-Paul Janssens, Division of Pulmonary Diseases
- Arnaud Perrier, Division of General Internal Medicine
- Alexandra Platon, Emergency Radiology