Semi-Quantitative Analysis of Lung Perfusion SPECT/CT for Evaluation of Response to Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension

• Published in: Nuclear medicine and molecular imaging 2024, 58(5), , pp.291-299
• Main Authors: Han, Shin Ae, Han, Sangwon, Lee, Jinho, Kang, Do-Yoon, Lee, Jae Seung, Kim, Dae-Hee, Park, Duk-Woo, Song, Jong‑Min, Ryu, Jin-Sook, Moon, Dae Hyuk
• Format: Article
• Language: English
• Subjects: Cardiology; Imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original Article; Orthopedics; Radiology; 방사선과학
• ISSN: 1869-3474; 1869-3482
• DOI: 10.1007/s13139-024-00858-1

Purpose We aimed to investigate the response to balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) using semi-quantitative analysis of lung perfusion SPECT/CT. Methods This is a single-center retrospective study of patients with CTEPH who underwent BPA and pre- and post-BPA lung perfusion SPECT/CT between 2015 and 2022. Segmental defects on SPECT/CT were visually assessed and semi-quantitatively scored as 1 (large defect) or 0.5 (moderate defect) in accordance with modified PIOPED II criteria. The perfusion defect score was defined as (Σ segmental defect scores/18) × 100 (%). Associations between perfusion defect score and hemodynamic or functional parameters including WHO functional class, six-minute walking distance (6MWD), serum B-type natriuretic peptide (BNP), mean arterial pulmonary pressure (mPAP), pulmonary vascular resistance (PVR), and tricuspid regurgitation pressure gradient (TRPG) on echocardiography were statistically analyzed. Results A total of 24 consecutive patients were included. The perfusion defect score significantly improved after BPA (median 58.3% vs. 47.2%, P