Intraprocedural Angiographic Lung Perfusion: A Novel Application for Real-Time Integration Into a Fluoroscopic Platform
6 affiliations
- 1The Heart Center, Nationwide Children’s Hospital, Columbus, Ohio
- 2Pediatric Cardiology, Northern Light-Eastern Maine Medical Center, Bangor, Maine
- 3Center for Biostatistics, The Ohio State University, Wexner Medical Center, Columbus, Ohio
- 4Biostatistics Resource, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
- 5Canon Medical Systems USA, Tustin, California
- 6Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota
Abstract
Background: Assessment of differential lung perfusion is currently limited to periprocedural lung perfusion scans (LPS) or magnetic resonance imaging (MRI), which do not enable for real-time decision making. This study demonstrates the development and evaluation of a novel angiographic lung perfusion (ALP) technique in patients with congenital heart disease.
Methods: The ALP technique was used to analyze differential branch pulmonary artery (PA) flow in retrospectively identified PA angiograms with corresponding LPS or MRI. Intraclass correlation coefficient and agreement were assessed. Two mathematical models were tested (area under curve and slope) at 2 time points (second peak and average).
Results: Twenty-five angiograms were analyzed. The most common cardiac anatomy was tetralogy of Fallot, and most common indication for catheterization was unilateral branch PA stenosis. The slope-based methods demonstrated high intraclass correlation coefficients with LPS/MRI (ICC, 0.84-0.86), indicating good reliability (ranging moderate-to-excellent), whereas Bland-Altman analysis showed low overall bias.
Conclusions: This ALP quantification application enables accurate lung perfusion assessment with potential for real-time integration into a fluoroscopic platform. This method provides a potential method for quantifying clinically meaningful intraprocedural information, particularly in assessing relative changes in differential perfusion before and after PA interventions. Further prospective studies are needed to confirm accuracy and clinical utility in broader populations.
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BibTeX
@article{salavitabar2026intraprocedural,
title = {{Intraprocedural Angiographic Lung Perfusion: A Novel Application for Real-Time Integration Into a Fluoroscopic Platform}},
author = {Arash Salavitabar and Daniel Gruenstein and Chance Alvarado and Andrew Kuhls-Gilcrist and Gurumurthy Hiremath},
journal = {Journal of the Society for Cardiovascular Angiography \& Interventions},
year = {2026},
month = aug,
doi = {10.1016/j.jscai.2026.105617},
url = {https://doi.org/10.1016/j.jscai.2026.105617},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Intraprocedural Angiographic Lung Perfusion: A Novel Application for Real-Time Integration Into a Fluoroscopic Platform
AU - Arash Salavitabar
AU - Daniel Gruenstein
AU - Chance Alvarado
AU - Andrew Kuhls-Gilcrist
AU - Gurumurthy Hiremath
PY - 2026
DA - 2026/08/20
JO - Journal of the Society for Cardiovascular Angiography & Interventions
DO - 10.1016/j.jscai.2026.105617
UR - https://doi.org/10.1016/j.jscai.2026.105617
AB - Background: Assessment of differential lung perfusion is currently limited to periprocedural lung perfusion scans (LPS) or magnetic resonance imaging (MRI), which do not enable for real-time decision making. This study demonstrates the development and evaluation of a novel angiographic lung perfusion (ALP) technique in patients with congenital heart disease. Methods: The ALP technique was used to analyze differential branch pulmonary artery (PA) flow in retrospectively identified PA angiograms with corresponding LPS or MRI. Intraclass correlation coefficient and agreement were assessed. Two mathematical models were tested (area under curve and slope) at 2 time points (second peak and average). Results: Twenty-five angiograms were analyzed. The most common cardiac anatomy was tetralogy of Fallot, and most common indication for catheterization was unilateral branch PA stenosis. The slope-based methods demonstrated high intraclass correlation coefficients with LPS/MRI (ICC, 0.84-0.86), indicating good reliability (ranging moderate-to-excellent), whereas Bland-Altman analysis showed low overall bias. Conclusions: This ALP quantification application enables accurate lung perfusion assessment with potential for real-time integration into a fluoroscopic platform. This method provides a potential method for quantifying clinically meaningful intraprocedural information, particularly in assessing relative changes in differential perfusion before and after PA interventions. Further prospective studies are needed to confirm accuracy and clinical utility in broader populations.
SN - 2772-9303
ER -