CT-derived pulmonary artery-to-vein volume difference improves risk stratification in acute PE

A new CT-based biomarker, pulmonary artery-to-vein volume difference (PAVVD), had an AUC of 0.89 for identifying high-risk PE, outperforming traditional CTPA parameters, with NPV 0.94. It was most beneficial when clot burden was low (Qanadli score <50%).

• A crossover effect was seen: PAVVD performed better when Qanadli score was <50%, while clot volume was superior when Qanadli score ≥50%.
• Chronic pulmonary disease and log(1+clot volume) were independently correlated with PAVVD.
• PAVVD was automatically quantified using a commercial AI software; no external or prospective validation was reported.

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