Quantification and visualization of relative local ventilation on dynamic chest radiographs

Abstract

Recently-developed dynamic flat-panel detector (FPD) with a large field of view is possible to obtain breathing chest radiographs, which provide respiratory kinetics information. This study was performed to investigate the ability of dynamic chest radiography using FPD to quantify relative ventilation according to respiratory physiology. We also reported the results of primary clinical study and described the possibility of clinical use of our method. Dynamic chest radiographs of 12 subjects involving abnormal subjects during respiration were obtained using a modified FPD system (30 frames in 10 seconds). Imaging was performed in three different positions (standing, and right and left decubitus positions) to change the distribution of local ventilation by changing the lung's own gravity in each area. The distance from the lung apex to the diaphragm (abbr. DLD) was measured by the edge detection technique for use as an index of respiratory phase. We measured pixel values in each lung area and calculated correlation coefficients with DLD. Differences in the pixel values between the maximum inspiratory and expiratory frame were calculated, and the trend of distribution was evaluated by two-way analysis of variance. Pixel value in each lung area was strongly associated with respiratory phase and its time variation and distribution were consistent with known properties in respiratory physiology. Dynamic chest radiography using FPD combined with our computerized methods was capable of quantifying relative amount of ventilation during respiration, and of detecting regional differences in ventilation. In the subjects with emphysema, areas with decreased respiratory changes in pixel value are consisted with the areas with air trapping. This method is expected to be a useful novel diagnostic imaging method for supporting diagnosis and follow-up of pulmonary disease, which presents with abnormalities in local ventilation.