Pilot Study for comparative assessment of Dual-energy CT and SPECT-CT V/Q scanning for lung perfusion evaluation in infants.

OBJECTIVE: To evaluate clinical applications of Dual-Energy CT (DECT) in pediatric-specific lung diseases and compare ventilation and perfusion findings with those from single-photon emission CT (SPECT-CT) V/Q.

METHODS: All patients at our institution who underwent exams using both techniques within a 3-month period were included in this study. Two readers independently described findings for DECT, and two other readers independently analyzed the SPECT-CT V/Q scan data. All findings were compared between readers and disagreements were reassessed and resolved by consensus. Inter- modality agreements are described throughout this paper.

RESULTS: Eight patients were included for evaluation. The median age for DECT scanning was 3.5 months (IQR=2). Five of these patients were scanned for both DECT and SPECT-CT V/Q studies the same day, and three had a time gap of 7, 65, and 94 days between studies. The most common indications were chronic lung disease (5/8; 63%) and pulmonary hypertension (6/8; 75%). DECT and SPECT-CT V/Q identified perfusion abnormalities in concordant lobes in most patients (7/8; 88%). In one case, atelectasis limited DECT perfusion assessment. Three patients ultimately underwent lobectomy with corresponding perfusion abnormalities identified by all reviewers on both DECT and SPECT-CT V/Q in all resected lobes.

CONCLUSION: DECT is a feasible technique that could be considered as an alternative for SPECT-CT V/Q for lung perfusion evaluation in infants. This article is protected by copyright. All rights reserved.