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Imaging of Pulmonary Vascular Disease

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 10314

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Special Issue Editors

Prof. Dr. Thomas Frauenfelder

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Guest Editor

Institut für Diagnostische und Interventionelle Radiologie, Universitätsspital Zürich, Zürich, Switzerland
Interests: image processing; multimodal imaging; radiology; computed tomography; magnetic resonance imaging; diagnostic radiology; imaging; interventional radiology

Dr. Katharina Martini

E-Mail Website
Guest Editor

Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8091 Zürich, Switzerland
Interests: image processing; early detection of cancer; lung neoplasms; computed tomography; artificial intelligence

Special Issue Information

Dear Colleagues,

Pulmonary vascular disease is a broad term used for disorders causing abnormal blood flow between the heart and lungs and may concern pulmonary arteries, capillaries, and veins. Pulmonary vascular diseases include various conditions, such as primary or secondary pulmonary hypertension, acute pulmonary embolism, chronic thromboembolic diseases, pulmonary vasculitis, and hereditary diseases such as Osler syndrome.

In recent years, imaging has made significant progress. On the one hand, CT has the advantage of allowing fast image acquisition, enabling high spatial resolution with isotropic voxels. In addition, new innovations such as photon-counting CT provide new insights. Multiparametric MRI provides the accurate assessment of flow dynamics and right-heart function. Finally, other modalities such as angiography or nuclear medicine need to be addressed with regard to therapy and specific questions. The goal of this Special Issue is to provide relevant new information concerning the diagnosis and management of pulmonary vascular diseases useful for daily practice and based on the most recent available data.

This Special Issue will thus offer an up-to-date view of the advances made in the imaging of pulmonary vascular diseases and seeks to collate articles providing a comprehensive presentation of current image-related novelties.

Prof. Dr. Thomas Frauenfelder
Dr. Katharina Martini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

image processing
multimodal Imaging
radiology
computed tomography
magnetic resonance imaging
diagnostic radiology
imaging
interventional radiology

Published Papers (5 papers)

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Research

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13 pages, 2903 KiB

Open AccessArticle

Left Ventricular Fibrosis Assessment by Native T1, ECV, and LGE in Pulmonary Hypertension Patients

by John W. Cerne, Ashitha Pathrose, Roberto Sarnari, Manik Veer, Kelvin Chow, Kamal Subedi, Bradley D. Allen, Ryan J. Avery, Michael Markl and James C. Carr

Diagnostics 2023, 13(1), 71; https://doi.org/10.3390/diagnostics13010071 - 27 Dec 2022

Cited by 1 | Viewed by 1470

Abstract

Cardiac magnetic resonance imaging (MRI) is emerging as an alternative to right heart catheterization for the evaluation of pulmonary hypertension (PH) patients. The aim of this study was to compare cardiac MRI-derived left ventricle fibrosis indices between pre-capillary PH (PrePH) and isolated post-capillary PH (IpcPH) patients and assess their associations with measures of ventricle function. Global and segmental late gadolinium enhancement (LGE), longitudinal relaxation time (native T1) maps, and extracellular volume fraction (ECV) were compared among healthy controls (N = 25; 37% female; 52 ± 13 years), PH patients (N = 48; 60% female; 60 ± 14 years), and PH subgroups (PrePH: N = 29; 65% female; 55 ± 12 years, IpcPH: N = 19; 53% female; 66 ± 13 years). Cardiac cine measured ejection fraction, end diastolic, and end systolic volumes and were assessed for correlations with fibrosis. LGE mural location was qualitatively assessed on a segmental basis for all subjects. PrePH patients had elevated (apical-, mid-antero-, and mid-infero) septal left ventricle native T1 values (1080 ± 74 ms, 1077 ± 39 ms, and 1082 ± 47 ms) compared to IpcPH patients (1028 ± 53 ms, 1046 ± 36 ms, 1051 ± 44 ms) (p < 0.05). PrePH had a higher amount of insertional point LGE (69%) and LGE patterns characteristic of non-vascular fibrosis (77%) compared to IpcPH (37% and 46%, respectively) (p < 0.05; p < 0.05). Assessment of global LGE, native T1, and ECV burdens did not show a statistically significant difference between PrePH (1.9 ± 2.7%, 1056.2 ± 36.3 ms, 31.2 ± 3.7%) and IpcPH (2.7 ± 2.7%, 1042.4 ± 28.1 ms, 30.7 ± 4.7%) (p = 0.102; p = 0.229 p = 0.756). Global native T1 and ECV were higher in patients (1050.9 ± 33.8 and 31.0 ± 4.1%) than controls (28.2 ± 3.7% and 1012.9 ± 29.4 ms) (p < 0.05). Cardiac MRI-based tissue characterization may augment understanding of cardiac involvement and become a tool to facilitate PH patient classification. Full article

(This article belongs to the Special Issue Imaging of Pulmonary Vascular Disease)

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10 pages, 1373 KiB

Open AccessArticle

Impact of Photon Counting Detector CT Derived Virtual Monoenergetic Images on the Diagnosis of Pulmonary Embolism

by Tetyana Yalynska, Malgorzata Polacin, Thomas Frauenfelder and Katharina Martini

Diagnostics 2022, 12(11), 2715; https://doi.org/10.3390/diagnostics12112715 - 07 Nov 2022

Cited by 10 | Viewed by 1258

Abstract

Purpose: To assess the impact of virtual-monoenergetic-image (VMI) energies on the diagnosis of pulmonary embolism (PE) in photon-counting-detector computed-tomography (PCD-CT). Methods: Eighty patients (median age 60.4 years) with suspected PE were retrospectively included. Scans were performed on PCD-CT in the multi-energy mode at 120 kV. VMIs from 40–70 keV in 10 keV intervals were reconstructed. CT-attenuation was measured in the pulmonary trunk and the main branches of the pulmonary artery. Signal-to-noise (SNR) ratio was calculated. Two radiologists evaluated subjective-image-quality (noise, vessel-attenuation and sharpness; five-point-Likert-scale, non-diagnostic–excellent), the presence of hardening artefacts and presence/visibility of PE. Results: Signal was highest at the lowest evaluated VMI (40 keV; 1053.50 HU); image noise was lowest at the highest VMI (70 keV; 15.60 HU). Highest SNR was achieved at the lowest VMI (p < 0.05). Inter-reader-agreement for subjective analysis was fair to excellent (k = 0.373–1.000; p < 0.001). Scores for vessel-attenuation and sharpness were highest at 40 keV (both:5, range 4/3–5; k = 1.000); scores for image-noise were highest at 70 keV (4, range 3–5). The highest number of hardening artifacts were reported at 40 keV (n = 22; 28%). PE-visualization was rated best at 50 keV (4.7; range 4–5) and decreased with increasing VMI-energy (r = −0.558; p < 0.001). Conclusions: While SNR was best at 40 keV, subjective PE visibility was rated highest at 50 keV, potentially owing to the lower image noise and hardening artefacts. Full article

(This article belongs to the Special Issue Imaging of Pulmonary Vascular Disease)

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11 pages, 5961 KiB

Open AccessArticle

Solitary Pulmonary Capillary Hemangioma: CT and PET-CT Features with Clinicopathologic Correlation

by Min Ju Kim, Wonju Hong, Tae Jung Kim, Joungho Han, Yoon-La Choi, Joon Young Choi, Sang Min Lee and Sung Ho Hwang

Diagnostics 2022, 12(11), 2618; https://doi.org/10.3390/diagnostics12112618 - 28 Oct 2022

Cited by 2 | Viewed by 1426

Abstract

The aim of this study was to evaluate the CT and PET-CT features of solitary pulmonary capillary hemangioma (SPCH) with clinicopathologic correlations. This retrospective study included 17 patients with histologically proven SPCH from four tertiary institutions. The clinical, pathological and imaging findings of SPCH were reviewed. The CT features assessed included lesion location, size, density, contour, margin, enhancement, presence of air bronchogram, perivascular lucency and pleural retraction, and ¹⁸F-fluorodeoxyglucose uptake on PET-CT. Changes in the size during the follow-up period were also evaluated. Imaging features were correlated with the clinicopathologic findings. The mean age of the patients was 47 years (range 30–60 years). All SPCHs were incidentally detected during screening CT examinations (n = 13, 76%) or during cancer work-up (n = 4, 24%). Most SPCHs appeared as part-solid nodules (n = 15, 88%), the remaining appeared as a pure ground-glass nodule or a pure solid nodule, respectively. Most had smooth contours (n = 16, 94%), while one had a lobulated contour. Nine SPCHs (53%) showed ill-defined margins. Air bronchogram was present in ten (59%) SPCHs, and perivascular lucency in two (12%). All SPCHs exhibited hypoattenuation on contrast-enhanced CT and hypometabolism on PET-CT. During the follow-up period (mean 14.8 ± 17.7 months), the lesions showed no change in size or density in ten SPCHs (59%), decreased or fluctuation in size and density in three (18%). SPCH is often incidentally detected in young and middle-aged adults, commonly as an ill-defined part-solid nodule that may accompany air bronchogram, perivascular lucency, and fluctuation in size or density on CT and hypometabolism on PET-CT. Full article

(This article belongs to the Special Issue Imaging of Pulmonary Vascular Disease)

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Review

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19 pages, 13668 KiB

Open AccessReview

Pulmonary Hypertension in Chronic Lung Diseases: What Role Do Radiologists Play?

by Adele Valentini, Paola Franchi, Giuseppe Cicchetti, Gaia Messana, Greta Chiffi, Cecilia Strappa, Lucio Calandriello, Annemilia del Ciello, Alessandra Farchione, Lorenzo Preda and Anna Rita Larici

Diagnostics 2023, 13(9), 1607; https://doi.org/10.3390/diagnostics13091607 - 01 May 2023

Cited by 1 | Viewed by 3151

Abstract

Pulmonary hypertension (PH) is a pathophysiological disorder, defined by a mean pulmonary arterial pressure (mPAP) > 20 mmHg at rest, as assessed by right heart catheterization (RHC). PH is not a specific disease, as it may be observed in multiple clinical conditions and may complicate a variety of thoracic diseases. Conditions associated with the risk of developing PH are categorized into five different groups, according to similar clinical presentations, pathological findings, hemodynamic characteristics, and treatment strategy. Most chronic lung diseases that may be complicated by PH belong to group 3 (interstitial lung diseases, chronic obstructive pulmonary disease, combined pulmonary fibrosis, and emphysema) and are associated with the lowest overall survival among all groups. However, some of the chronic pulmonary diseases may develop PH with unclear/multifactorial mechanisms and are included in group 5 PH (sarcoidosis, pulmonary Langerhans’ cell histiocytosis, and neurofibromatosis type 1). This paper focuses on PH associated with chronic lung diseases, in which radiological imaging—particularly computed tomography (CT)—plays a crucial role in diagnosis and classification. Radiologists should become familiar with the hemodynamical, physiological, and radiological aspects of PH and chronic lung diseases in patients at risk of developing PH, whose prognosis and treatment depend on the underlying disease. Full article

(This article belongs to the Special Issue Imaging of Pulmonary Vascular Disease)

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13 pages, 2741 KiB

Open AccessReview

Behçet’s Disease: A Radiological Review of Vascular and Parenchymal Pulmonary Involvement

by Caterina Giannessi, Olga Smorchkova, Diletta Cozzi, Giulia Zantonelli, Elena Bertelli, Chiara Moroni, Edoardo Cavigli and Vittorio Miele

Diagnostics 2022, 12(11), 2868; https://doi.org/10.3390/diagnostics12112868 - 19 Nov 2022

Cited by 7 | Viewed by 2136

Abstract

Behcet’s disease (BD) is a chronic systemic inflammatory disorder characterized by underlying chronic vasculitis of both large- and small-caliber vessels. Thoracic involvement in BD can occur with various types of manifestations, which can be detected with contrast-enhanced MSCT scanning. In addition, MR can be useful in diagnosis. Characteristic features are aneurysms of the pulmonary arteries that can cause severe hemoptysis and SVC thrombosis that manifests as SVC syndrome. Other manifestations are aortic and bronchial artery aneurysms, alveolar hemorrhage, pulmonary infarction, and rarely pleural effusion. Achieving the right diagnosis of these manifestations is important for setting the correct therapy and improving the patient’s outcome. Full article

(This article belongs to the Special Issue Imaging of Pulmonary Vascular Disease)

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