Imaging of pulmonary hypertension in adults: a position paper from the Fleischner Society

Martine Remy-Jardin^{1

2}, Christopher J Ryerson³, Mark L Schiebler⁴, Ann N C Leung⁵, James M Wild⁶, Marius M Hoeper⁷, Philip O Alderson⁸, Lawrence R Goodman⁹, John Mayo¹⁰, Linda B Haramati¹¹, Yoshiharu Ohno¹², Patricia Thistlethwaite¹³, Edwin J R van Beek¹⁴, Shandra Lee Knight¹⁵, David A Lynch¹⁶, Geoffrey D Rubin¹⁷, Marc Humbert^{18

19}

Affiliations

¹ Dept of Thoracic Imaging, Hôpital Calmette, Boulevard Jules Leclercq, Lille, France.
² Chair of the Fleischner Society writing committee of the position paper for imaging of pulmonary hypertension.
³ Dept of Medicine, University of British Columbia and Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada.
⁴ Dept of Radiology, UW-Madison School of Medicine and Public Health, Madison, WI, USA.
⁵ Dept of Radiology, Stanford University Medical Center, Stanford, CA, USA.
⁶ Division of Imaging, Dept of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
⁷ Dept of Respiratory Medicine, Hannover Medical School and German Centre of Lung Research (DZL), Hannover, Germany.
⁸ Dept of Radiology, Saint Louis University School of Medicine, St Louis, MO, USA.
⁹ Dept of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
¹⁰ Dept of Radiology, Vancouver General Hospital, Vancouver, BC, Canada.
¹¹ Dept of Radiology and Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
¹² Dept of Radiology, Fujita Health University School of Medicine, Toyoake, Japan.
¹³ Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, CA, USA.
¹⁴ Edinburgh Imaging, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK.
¹⁵ Dept of Library and Knowledge Services, National Jewish Health, Denver, CO, USA.
¹⁶ Dept of Radiology, National Jewish Health, Denver, CO, USA.
¹⁷ Dept of Radiology, Duke University School of Medicine, Durham, NC, USA.
¹⁸ Université Paris Saclay, Inserm UMR S999, Dept of Pneumology, AP-HP, Pulmonary Hypertension Reference Center, Hôpital de Bicêtre, Le Kremlin Bicêtre, France.
¹⁹ Co-Chair of the Fleischner Society writing committee of the position paper for imaging of pulmonary hypertension.

PMID: 33402372
DOI: 10.1183/13993003.04455-2020

Free article

Imaging of pulmonary hypertension in adults: a position paper from the Fleischner Society

Martine Remy-Jardin et al. Eur Respir J. 2021.

Free article

. 2021 Jan 5;57(1):2004455.

doi: 10.1183/13993003.04455-2020. Print 2021 Jan.

Authors

Affiliations

¹ Dept of Thoracic Imaging, Hôpital Calmette, Boulevard Jules Leclercq, Lille, France.
² Chair of the Fleischner Society writing committee of the position paper for imaging of pulmonary hypertension.
³ Dept of Medicine, University of British Columbia and Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada.
⁴ Dept of Radiology, UW-Madison School of Medicine and Public Health, Madison, WI, USA.
⁵ Dept of Radiology, Stanford University Medical Center, Stanford, CA, USA.
⁶ Division of Imaging, Dept of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
⁷ Dept of Respiratory Medicine, Hannover Medical School and German Centre of Lung Research (DZL), Hannover, Germany.
⁸ Dept of Radiology, Saint Louis University School of Medicine, St Louis, MO, USA.
⁹ Dept of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
¹⁰ Dept of Radiology, Vancouver General Hospital, Vancouver, BC, Canada.
¹¹ Dept of Radiology and Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
¹² Dept of Radiology, Fujita Health University School of Medicine, Toyoake, Japan.
¹³ Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, CA, USA.
¹⁴ Edinburgh Imaging, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK.
¹⁵ Dept of Library and Knowledge Services, National Jewish Health, Denver, CO, USA.
¹⁶ Dept of Radiology, National Jewish Health, Denver, CO, USA.
¹⁷ Dept of Radiology, Duke University School of Medicine, Durham, NC, USA.
¹⁸ Université Paris Saclay, Inserm UMR S999, Dept of Pneumology, AP-HP, Pulmonary Hypertension Reference Center, Hôpital de Bicêtre, Le Kremlin Bicêtre, France.
¹⁹ Co-Chair of the Fleischner Society writing committee of the position paper for imaging of pulmonary hypertension.

PMID: 33402372
DOI: 10.1183/13993003.04455-2020

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.

© 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.

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Conflict of interest statement

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.

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Imaging of pulmonary hypertension in adults: a position paper from the Fleischner Society

Affiliations

Imaging of pulmonary hypertension in adults: a position paper from the Fleischner Society

Authors

Affiliations

Abstract

Conflict of interest statement

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MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

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Medical