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. 2023 Nov;16(11):1469-1484.
doi: 10.1016/j.jcmg.2023.06.023. Epub 2023 Aug 23.

Noninvasive Imaging Methods for Quantification of Pulmonary Edema and Congestion: A Systematic Review

Thomas Lindow  1 , Scott Quadrelli  2 , Martin Ugander  3
Affiliations
Free article

Noninvasive Imaging Methods for Quantification of Pulmonary Edema and Congestion: A Systematic Review

Thomas Lindow et al. JACC Cardiovasc Imaging. 2023 Nov.
Free article

Abstract

Quantification of pulmonary edema and congestion is important to guide diagnosis and risk stratification, and to objectively evaluate new therapies in heart failure. Herein, we review the validation, diagnostic performance, and clinical utility of noninvasive imaging modalities in this setting, including chest x-ray, lung ultrasound (LUS), computed tomography (CT), nuclear medicine imaging methods (positron emission tomography [PET], single photon emission CT), and magnetic resonance imaging (MRI). LUS is a clinically useful bedside modality, and fully quantitative methods (CT, MRI, PET) are likely to be important contributors to a more accurate and precise evaluation of new heart failure therapies and for clinical use in conjunction with cardiac imaging. There are only a limited number of studies evaluating pulmonary congestion during stress. Taken together, noninvasive imaging of pulmonary congestion provides utility for both clinical and research assessment, and continued refinement of methodologic accuracy, validation, and workflow has the potential to increase broader clinical adoption.

Keywords: extravascular lung water; grading; lung water; pulmonary edema; review.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Lindow is supported by the Swedish Heart Lung Foundation (20200553), Swedish Cardiac Society, Royal Swedish Academy of Sciences (LM2019-0013), Women and Health Foundation, Region Kronoberg (8301), Swedish Heart and Lung Association, Swedish Association of Clinical Physiology, and Scandinavian Society of Clinical Physiology and Nuclear Medicine. This review was supported in part by grants to Dr Ugander from the University of Sydney, New South Wales Health, and Heart Research Australia. All of the authors are affiliated with the University of Sydney or Karolinska Institute, and both institutions have research and developments agreements with Siemens for cardiac magnetic resonance. Siemens had no role in the conceptualization, design, data collection, analysis, decision to publish, or preparation of the manuscript.

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