Comparison of Photon-Counting CT and V/Q SPECT for Assessing Lobar Perfusion in Chronic Thromboembolic Pulmonary Hypertension
By
Matthias M. V. Moeskes
Thorsten Derlin
Anna M. Hunkemöller
Cornelia Schäfer-Prokop
Norman Kornemann
Jan W. Eckstein
Bernhard Meyer
Jens Vogel-Claussen
Frank K. Wacker
Hoen-oh Shin
April 24, 2026
Clinical Scorecard: Comparison of Photon-Counting CT and V/Q SPECT for Assessing Lobar Perfusion in Chronic Thromboembolic Pulmonary Hypertension
At a Glance
Category Detail
Condition Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Key Mechanisms Multimodal diagnostic strategy including imaging techniques like V/Q-SPECT and PCCT. Target Population Patients with suspected or confirmed CTEPH. Care Setting Single-centre, interdisciplinary clinical collaboration.
Key Highlights
V/Q-SPECT is the first-line imaging modality for CTEPH with high sensitivity and specificity. PCCT offers superior image quality and detailed perfusion assessment compared to conventional methods. PCCT can evaluate pulmonary perfusion, ventilation, vascular anatomy, and parenchymal morphology in one exam. Quantitative lobar perfusion assessment is crucial for treatment planning in CTEPH. Guideline-Based Recommendations
Diagnosis
Utilize V/Q-SPECT for initial detection of chronic thromboembolic disease. Management
Consider PCCT for detailed perfusion assessment and treatment planning. Monitoring & Follow-up
Assess perfusion defects longitudinally to guide treatment response. Risks
Be aware of limitations in V/Q-SPECT, including underestimation of non-occlusive lesions. Patient & Prescribing Data
23 patients with suspected or confirmed CTEPH.
PCCT-derived PBV maps show strong agreement with V/Q-SPECT and can inform surgical planning.
Clinical Best Practices
Implement a multimodal diagnostic approach for CTEPH. Use PCCT for enhanced imaging capabilities in perfusion assessment. Ensure interdisciplinary collaboration for optimal patient management. References
