1107. Advanced Imaging Biomarkers to Uncover the Association Between D-dimer Levels and Actual Thrombus Size in Acute Pulmonary Embolism
Authors * Denotes Presenting Author
  1. Jennifer Gotta; Goethe University Hospital Frankfurt
  2. Leon Grünewald; Goethe University Hospital Frankfurt
  3. Thomas Vogl; Goethe University Hospital Frankfurt
  4. Vitali Koch *; Goethe University Hospital Frankfurt
The emergence of new generation computed tomography (CT) and radiomics has brought about new possibilities in diagnostic evaluation. There is growing evidence supporting the integration of quantitative imaging biomarkers in clinical decision-making. This study aimed to examine the correlation between D-dimer levels and thrombus size in acute pulmonary embolism (PE) combining dual-energy CT (DECT) and radiomics for volumetric analysis.

Materials and Methods:
The study was conducted including 136 participants who underwent pulmonary artery CT angiography from January 2015 to March 2022. Of these, 93 participants were diagnosed with central PE and 16 with peripheral PE, where 27 served as a control group. Statistical analyses, such as Spearman rank correlation coefficient, Mann-Whitney analysis, and Wilcoxon signed-rank test, were employed for data comparisons. Receiver operating characteristics analysis was utilized to evaluate the association between volumetric, laboratory data, and adverse outcomes.

In the central PE group, we observed a significant correlation between thrombus volumetrics and D-dimer levels (<em>p</em> = 0.0037), as well as between thrombus volumetrics and hospitalization at the Intermediate Care Unit (IMC) (<em>p</em> = 0.0001). In contrast, no statistically significant differences were identified in thrombus sizes between patients who experienced complications and those who had a favorable course (<em>p</em> = 0.3162). Likewise, there was no significant disparity in D-dimer levels between patients with complications and those without.

In conclusion, the study results suggest that D-dimer levels are positively correlated with the pulmonary embolic burden in patients with central PE. Furthermore, thrombus volumetrics can serve as an indicator of potential complications and outcomes in patients with acute PE. Therefore, thrombus volumetrics, rather than D-dimers, could be used as an additional marker for assessing the severity of embolic disease.