1 Post Graduate Student, Department of Radiology, Chettinad Medical College and Research Institute, Chennai, Tamil Nadu, India. Email: mullaiganesh7@gmail.com
2 Senior Resident, Department of Radiology, ACS Medical College and Hospital, Chennai, Tamil Nadu, India. Email: kssanthanalakshmi04@gmail.com | ORCID: 0009-0000-3267-0461
3* Senior Resident, Department of Radiology, Chettinad Medical College and Research Institute, Chennai, Tamil Nadu, India (Corresponding Author). Email: Sathyanarenhere@gmail.com | ORCID: 0009-0000-9292-4857
Background
Computed tomography pulmonary angiography (CTPA) is the gold standard investigation for diagnosing pulmonary embolism (PE). Maximum Intensity Projection (MIP) is an advanced post-processing technique that may enhance the delineation of segmental and subsegmental pulmonary arteries without additional radiation exposure or patient morbidity.
Objective
To assess the diagnostic efficacy of MIP technique in delineating segmental and subsegmental pulmonary arteries in patients with suspected PE, and to compare outcomes with standard Multiplanar Reconstruction (MPR).
Methods
Thirty patients referred for CTPA with suspected PE were prospectively included. Images were reconstructed using both MIP and MPR techniques. Quantitative analysis assessed the proportion of analyzable segmental and subsegmental arteries in each lung. Subjective image quality was evaluated using a 4-point Likert scale. Statistical comparisons were performed using the chi-square test and Mann-Whitney U test.
Results
The mean age of patients is 54.1 ± 19.9 years. In the right lung, 66.7% of branches were analyzable with MIP which is only 53.3% with MPR. In the left lung, 60.0% were analyzable with MIP which is 33.3% with MPR (p = 0.038). Overall combined analyzability was significantly higher with MIP (63.3% vs 43.3%; p = 0.028; RR = 1.46). Subjective image quality assessed by Likert scoring was significantly better with MIP (median 3 [IQR 3–3]) compared to MPR (median 2 [IQR 1–2]; p < 0.001).
Conclusion
MIP technique is considered to have better diagnostic efficacy in delineating segmental and subsegmental pulmonary arteries compared to standard MPR, with particular advantage in the left lung. Its integration into routine CTPA reporting is recommended.
Keywords: Pulmonary embolism; Maximum Intensity Projection; CT pulmonary angiography; Multiplanar reconstruction; Image quality; Vascular delineation
How to cite this article: Sundararajan MG, Santhana Lakshmi KS, Sathyanarayanan. Role of Maximum Intensity Projection Technique in Delineating Segmental and Subsegmental Branches of Pulmonary Artery Compared to Multiplanar Recont Technique in Evaluating Pulmonary Embolism. Int J Drug Deliv Technol. 2026;16(4): 232-237. DOI: 10.25258/ijddt.16.4.26
Source of support: Nil.
Conflict of interest: None