Aims and objectives
Amiodarone is an iodinated benzofuran derivative,
class III antiarrhythmic agent used to suppress tachyarrhythmias.
Pulmonary toxicity is among the most serious adverse effects of amiodarone.
The diagnosis of amiodarone induced lung injury (AILD) is made by excluding alternative diagnoses and makes use of CT imaging. Since amiodarone is an iodine-containing compound,
lung parenchymal lesions that show high attenuation on CT are helpful in suggesting AILD.
dual-energy CT (DECT) is particularly sensitive for the detection of iodine due to its high atomic number. Furthermore,
Methods and materials
Following IRB approval,
83 patients (mean age 76 range 58-95; male 48/58%) with suspected AILD,
treated with ≥200 mg/d of amiodarone for ≥4 months,
underwent clinically indicated DECT (Siemens SomatomFlash Scanner) in DE mode (100 and Sn140SkV) without IV contrast material.
Two radiologists with experience in DECT evaluated the CT studies independently.
Lung parenchymal disease and liver amiodarone iodine deposition were identified using dedicated DE post-processing application (Syngo.DualEnergy,
AILD probability was assessed on a 3-point probability scale (low,
According to DECT,
30% and 23% of the exams showed low,
intermediate and high AILD probability respectively with high ICC among radiologists (r = .983) .
Based on the clinical assessments,
19% and 14% of patients had low intermediate and high AILD probability respectively,
with moderate ICC (r = .798) among pulmonologists.
ICC between DECT and clinical diagnoses was moderate (r = .608).
Out of the 83 examined patients: 2 patients had severe breathing artifacts and were excluded; 22(27%) patients had...
This preliminary work suggests that DECT,
based on lung and liver amiodarone deposition identification,
may allow a high degree of agreement for AILD diagnosis among radiologists.
The correlation registered between radiological and clinical diagnoses was moderate.
Further research is warranted for the determination of gold standard diagnostic procedures for AILD.
Naama R Bogot,
Shaare Zedek Medical Center,
Department of Radiology,
12 Beit St
This work was supported by the Hebrew University Joint Fund
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