Abstract
Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure greater than 20 mmHg and classified into five different groups sharing similar pathophysiologic mechanisms, haemodynamic characteristics, and therapeutic management. Radiologists play a key role in the multidisciplinary assessment and management of PH. A working group was formed from within the Fleischner Society based on expertise in the imaging and/or management of patients with PH, as well as experience with methodologies of systematic reviews. The working group identified key questions focusing on the utility of CT, MRI, and nuclear medicine in the evaluation of PH: a) Is noninvasive imaging capable of identifying PH? b) What is the role of imaging in establishing the cause of PH? c) How does imaging determine the severity and complications of PH? d) How should imaging be used to assess chronic thromboembolic PH before treatment? e) Should imaging be performed after treatment of PH? This systematic review and position paper highlights the key role of imaging in the recognition, work-up, treatment planning, and follow-up of PH.
Abstract
From the Fleischner Society: This systematic review and position paper highlights the key role of imaging in the recognition, work-up, treatment planning, and follow-up of pulmonary hypertension in adults https://bit.ly/343kgbN
Footnotes
Author contributions: Guarantors of integrity of entire study, M. Remy-Jardin, Y. Ohno, M. Humbert; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, all authors; clinical studies, L.R. Goodman, G.D. Rubin; statistical analysis, C.J. Ryerson, P.O. Alderson, L.R. Goodman, P. Thistlethwaite; and manuscript editing, all authors.
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Support statement: M. Humbert is supported by the Investissement d'Avenir program managed by the French National Research Agency under the grant contract ANR-18-RHUS-0006 (DESTINATION 2024).
Conflict of interest: M. Remy-Jardin received payment for lectures including service on speakers’ bureaus from Siemens Healthineers, Boehringer Ingelheim, Roche, and MSD, outside the submitted work.
Conflict of interest: C.J. Ryerson disclosed no relevant relationships.
Conflict of interest: M.L. Schiebler disclosed no relevant relationships.
Conflict of interest: A.N.C. Leung disclosed no relevant relationships.
Conflict of interest: J.M. Wild disclosed no relevant relationships.
Conflict of interest: M.M. Hoeper is board member and consultant for Acceleron, Actelion, Bayer, Janssen, MSD, and Pfizer, received payment for lectures including service on speakers bureaus from Acceleron, Actelion, Bayer, Janssen, MSD, and Pfizer, outside the submitted work.
Conflict of interest: P.O. Alderson disclosed no relevant relationships.
Conflict of interest: L.R. Goodman disclosed no relevant relationships.
Conflict of interest: J. Mayo received payment for lectures including service on speakers’ bureaus from Siemens Healthineers Canada, outside the submitted work.
Conflict of interest: L.B. Haramati disclosed no relevant relationships.
Conflict of interest: Y. Ohno received research grant from Canon Medical Systems, during the conduct of the study; has grants/grants pending with Bayer Pharma, outside the submitted work; received grants-in-aid for scientific research from the Japanese Ministry of Education, Culture, Sports, Science and Technology; received research grant from Smoking Research Foundation; received research grant from Daiichi Sankyo.
Conflict of interest: P. Thistlethwaite disclosed no relevant relationships.
Conflict of interest: E.J.R. van Beek is board member of Aidence, Imbio, and QCTIS, is a consultant for InHealth and Mentholatum, outside the submitted work; is owner and founder of QCTIS; author and spouse are directors.
Conflict of interest: S.L. Knight disclosed no relevant relationships.
Conflict of interest: D.A. Lynch is a consultant for Parexel Imaging, Boehringer Ingelheim, Veracyte, Daiichi Sankyo, and AstraZeneca, received payment for lectures including service on speakers bureaus from Boehringer Ingelheim, outside the submitted work.
Conflict of interest: G.D. Rubin disclosed no relevant relationships.
Conflict of interest: M. Humbert is a board member and consultant for Acceleron, Actelion, Bayer, GSK, and Merck; has grants/grants pending with Acceleron, Actelion, and Bayer; received payment for lectures including service on speakers bureaus from Actelion, Bayer, GSK, and Merck, outside the submitted work.
- Received July 15, 2020.
- Accepted October 28, 2020.
- © 2021 European Respiratory Society and RSNA. This article is a simultaneous joint publication in the European Respiratory Journal and Radiology. The articles are identical except for stylistic changes in keeping with each journal's style. Either version may be used in citing this article.