Pulmonary Disease Assessment Research Articles

Cryoprobe biopsy versus mechanical biopsies in pulmonary diagnostics.

Biopsy tools have been essential in improving the diagnostic accuracy of bronchoscopic procedures. Of these tools, cryobiopsy has emerged as a promising technique for diagnosing thoracic diseases. This review summarizes the existing data comparing cryobiopsies to other mechanical biopsy methods for sampling endobronchial, parenchymal, and mediastinal targets. Initially adopted for managing airway stenoses, the use of cryoprobes has expanded to diagnosing endobronchial lesions, parenchymal opacities, and mediastinal lymph node pathologies. Studies have demonstrated that cryobiopsy offers a higher diagnostic yield than forceps biopsy alone. By leveraging the Joule-Thomson effect to freeze and collect larger tissue samples compared to traditional methods, cryobiopsy improves diagnostic accuracy and helps in better characterizing the nature of the lesions. While the risk of complications, such as pneumothorax and hemorrhage are comparable to, or higher than traditional biopsy methods, cryobiopsy's enhanced diagnostic capabilities make it a valuable tool in the assessment of pulmonary disease. Compared with other mechanical biopsy techniques, cryoprobe biopsies significantly enhance the diagnostic yield for endobronchial lesions, interstitial lung disease, pulmonary nodules, and mediastinal lymph nodes.

Sequence comparison of spoiled gradient echo and balanced steady-state free precession for pulmonary free-breathing proton MRI in patients and healthy volunteers: Correspondence, repeatability, and validation with dynamic contrast-enhanced MRI.

Phase-resolved functional lung (PREFUL) MRI is a proton-based, contrast agent-free technique derived from the Fourier decomposition approach to measure regional ventilation and perfusion dynamics during free-breathing. Besides the necessity of extensive PREFUL postprocessing, the utilized MRI sequence must fulfill specific requirements. This study investigates the impact of sequence selection on PREFUL-MRI-derived functional parameters by comparing the standard spoiled gradient echo (SPGRE) sequence with a lung-optimized balanced steady-state free precession (bSSFP) sequence, thereby facilitating PREFULs clinical application in pulmonary disease assessment. This study comprised a prospective dataset of healthy volunteers and a retrospective dataset of patients with suspected chronic thromboembolic pulmonary hypertension. Both cohorts underwent PREFUL-MRI with both sequences to assess the correspondence of PREFUL ventilation and perfusion parameters (A). Additionally, healthy subjects were scanned a second time to evaluate repeatability (B), whereas patients received dynamic contrast-enhanced (DCE)-MRI, considered the perfusion gold standard for comparison with PREFUL-MRI (C). Signal-to-noise ratio (SNR), calculated from the unprocessed images, was compared alongside median differences of PREFUL-MRI-derived parameters using a paired Wilcoxon signed rank test. Further evaluations included calculation of the Pearson correlation, intraclass-correlation coefficient for repeatability assessment, and spatial overlap (SO) for regional comparison of PREFUL-MRI and DCE-MRI. bSSFP showed a clear SNR advantage over SPGRE (median: 23 vs. 9, p< 0.001). (A) Despite significant differences, parameter values were strongly correlated (r≥0.75). After thresholding, binary maps showed high healthy overlap across both cohorts (SOHealthy > 86%) and high defect overlap in the patient cohort (SODefect≥48%). (B) bSSFP demonstrated slightly higher repeatability across most parameters. (C) Both sequences demonstrated comparable correspondence to DCE-MRI, with SPGRE excelling in absolute quantification and bSSFP in spatial agreement. Although bSSFP showed superior SNR results, both sequences displayed spatial defect concordance and highly correlated PREFUL parameters with deviations regarding repeatability and alignment with DCE-MRI.

High-Resolution Computer Tomography Image Features of Lungs for Patients with Type 2 Diabetes under the Faster-Region Recurrent Convolutional Neural Network Algorithm.

The objective of this study was to adopt the high-resolution computed tomography (HRCT) technology based on the faster-region recurrent convolutional neural network (Faster-RCNN) algorithm to evaluate the lung infection in patients with type 2 diabetes, so as to analyze the application value of imaging features in the assessment of pulmonary disease in type 2 diabetes. In this study, 176 patients with type 2 diabetes were selected as the research objects, and they were divided into different groups based on gender, course of disease, age, glycosylated hemoglobin level (HbA1c), 2 h C peptide (2 h C-P) after meal, fasting C peptide (FC-P), and complications. The research objects were performed with HRCT scan, and the Faster-RCNN algorithm model was built to obtain the imaging features. The relationships between HRCT imaging features and 2 h C-P, FC-P, HbA1c, gender, course of disease, age, and complications were analyzed comprehensively. The results showed that there were no significant differences in HRCT scores between male and female patients, patients of various ages, and patients with different HbA1c contents (P > 0.05). As the course of disease and complications increased, HRCT scores of patients increased obviously (P < 0.05). The HRCT score decreased dramatically with the increase in the contents of 2 h C-P and FC-P after the meal (P < 0.05). In addition, the results of the Spearman rank correlation analysis showed that the course of disease and complications were positively correlated with the HRCT scores, while the 2 h C-P and FC-P levels after meal were negatively correlated with the HRCT scores. The receiver operating curve (ROC) showed that the accuracy, specificity, and sensitivity of HRCT imaging based on Faster-RCNN algorithm were 90.12%, 90.43%, and 83.64%, respectively, in diagnosing lung infection of patients with type 2 diabetes. In summary, the HRCT imaging features based on the Faster-RCNN algorithm can provide effective reference information for the diagnosis and condition assessment of lung infection in patients with type 2 diabetes.

Assessment of Pulmonary Vascular Disease: Pulmonary Vascular Resistance, Exercise Hemodynamics, and Ventriculovascular Coupling.

Assessment of Pulmonary Vascular Disease: Pulmonary Vascular Resistance, Exercise Hemodynamics, and Ventriculovascular Coupling.

"Current place of impulse oscillometry in the assessment of pulmonary diseases."

In 1956, a diagnostic tool using the forced oscillation technique (FOT) was developed to examine respiratory functions. A modification of this method is impulse oscillometry (IOS). In the latter, a loudspeaker delivers to the respiratory system a regular, square pressure wave at a constant frequency from which all other individual frequencies are derived using spectral analysis. The usefulness of IOS has been examined in relation to COPD, asthma, interstitial lung diseases, obstructive sleep apnea, and other conditions. The greatest advantage, most notable in children, is the ability to monitor the course of a disease and to assess the response to therapy in a simple way, i.e., minimal requirements for the cooperation of the patient, rapid and reproducible measurements. The IOS shows similar or even higher sensitivity than spirometry in detecting small airways dysfunction (SAD). The most well-known result observed in peripheral airways disease (PAD) is the frequency dependence of resistance. Importantly, the abnormal resistance at a specific frequency may occur with normal spirometry in those with early PAD. Moreover, IOS is particularly useful if the patient cannot perform effort dependent exhalation. Despite its advantages, the technique is still poorly found in official worldwide recommendations. Nonetheless, considering the promising results of many studies, an increase in interest in IOS is expected, and it could soon be on par with standard pulmonary function tests. The aim of this work is to present the basics, current views, and various aspects of IOS. To carry out our analysis, we searched for relevant publications on PubMed, Web of Science. Original and review articles were selected and discussed.

Lung T1 mapping magnetic resonance imaging in the assessment of pulmonary disease in children with cystic fibrosis: a pilot study.

Assessment tools for early cystic fibrosis (CF) lung disease are limited. Detecting early pulmonary disease is crucial to increasing life expectancy by starting interventions to slow the progression of the pulmonary disease with the many treatment options available. To compare the utility of lung T1-mapping MRI with ultrashort echo time (UTE) MRI in children with cystic fibrosis in detecting early stage lung disease and monitoring pulmonary exacerbations. We performed a prospective study in 16 children between September 2017 and January 2018. In Phase 1, we compared five CF patients with normal spirometry (mean 11.2years) to five age- and gender-matched healthy volunteers. In Phase 2, we longitudinally evaluated six CF patients (median 11years) in acute pulmonary exacerbation. All children had non-contrast lung T1-mapping and UTE MRI and spirometry testing. We compared the mean normalized T1 value and percentage lung volume without T1 value in CF patients and healthy subjects in Phase 1 and during treatment in Phase 2. We also performed cystic fibrosis MRI scoring. We evaluated differences in continuous variables using standard statistical tests. In Phase 1, mean normalized T1 values of the lung were significantly lower in CF patients in comparison to healthy controls (P=0.02) except in the right lower lobe (P=0.29). The percentage lung volume without T1 value was also significantly higher in CF patients (P=0.006). UTE MRI showed no significant differences between CF patients and healthy volunteers (P=0.11). In Phase 2, excluding one outlier case who developed systemic disease in the course of treatment, the whole-lung T1 value increased (P=0.001) and perfusion scoring improved (P=0.02) following therapy. We observed no other significant changes in the MRI scoring. Lung T1-mapping MRI can detect early regional pulmonary CF disease in children and might be helpful in the assessment of acute pulmonary exacerbations.

Fast and automatic segmentation of pulmonary lobes from chest CT using a progressive dense V-network

ABSTRACT Automatic, reliable lobe segmentation is crucial to the diagnosis, assessment, and quantification of pulmonary diseases. Existing pulmonary lobe segmentation techniques are prohibitively slow, undesirably rely on prior (airway/vessel) segmentation, and/or require user interactions for optimal results. We introduce a reliable, fast, and fully automated lung lobe segmentation method based on a Progressive Dense V-Network (PDV-Net). The proposed method can segment lung lobes in one forward pass of the network, with an average runtime of 2 seconds using a single Nvidia Titan XP GPU. An extensive robustness analysis of our method demonstrates reliable lobe segmentation of both healthy and pathological lungs in CT images acquired by scanners from different vendors, across various CT scan protocols and acquisition parameters.

Can smoking duration alone replace pack-years to predict the risk of smoking-related oncogenic mutations in non-small cell lung cancer (NSCLC)?

e20017 Background: P has widely been used for the risk assessment of lung cancer and chronic obstructive pulmonary disease (COPD). We previously reported that mutations in KRAS, TP53, and EGFR were also associated with P from a prospective multicenter molecular epidemiology study (JME study; Kawaguchi T, J Clin Oncol 2016). Recently, D alone has been reported to provide stronger risk estimates of COPD than P. Here, we show the comparison of these two indices in predicting the risk of smoking-related oncogenic mutations in NSCLC, utilizing the database from the JME study including detailed smoking information and the mutational profile by next generation sequencing. Methods: In 439 ever- and 437 never-smokers, the frequency of mutations in KRAS, TP53 and EGFR were 9.4, 26.8 and 42.5%, respectively, and smoking-related cytosine to adenine base substitution (C &gt; A) was observed in 12.7 % of cases. AUC values (area under the ROC curves) for logistic regression determined from P and D to predict the mutations or C &gt; A change were compared, considering gender, age, stage and histology as covariates. Results: The median of P and D were 43 (1-189) and 41 (years, 1-65) in smokers, respectively. The AUC values in EGFR and KRAS were numerically higher than others, suggesting stronger association with smoking. There was no significant difference in AUC values between P and D in TP53, EGFR and C &gt; A, and P was a significantly better estimate of KRAS mutations (table). Conclusions: P remains the standard method to evaluate the risk of oncogenic mutations in NSCLC. D, however, warrants further investigation as a simpler alternative to P.[Table: see text]

New combined assessment of chronic obstructive pulmonary disease : Utilization, pitfalls, and association with spirometry.

New combined assessment of chronic obstructive pulmonary disease : Utilization, pitfalls, and association with spirometry.

Chronic obstructive pulmonary disease and ultrasonographic assessment of quadriceps muscle

Chronic obstructive pulmonary disease and ultrasonographic assessment of quadriceps muscle

Pay attention to the assessment and pulmonary rehabilitation of chronic obstructive pulmonary disease

The assessment runs through the diagnosis, treatment and prognosis of chronic obstructive pulmonary disease (COPD). Though there are various methods of assessments, many physicians diagnose patients and prescribe medicine homogeneously according to the lung function or clinical manifestations. Therefore, it is necessary to summarize the measurements of COPD, making it be better known to clinic physicians. On the basis of these measurements, physicians can choose the suitable therapeutic schemes to treat COPD patients. In recent years, pulmonary rehabilitation is growing up gradually, which is one of treatment methods for COPD. To popularize knowledge and form complete treatments of pulmonary rehabilitation is still a long way to go, because of unbalanced development, unpopular and monotherapy in China. In order to benefit patients and improve the patients' life quality, we need to promote actively, intensify constantly and practice the pulmonary rehabilitation one by one. Key words: Pulmonary disease, chronic obstructive; Rehabilitation; Editorial

PREVALENCE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN PATIENTS WITH CORONARY HEART DISEASE AND ARTERIAL HYPERTENSION

The prevalence of chronic obstructive pulmonary disease among patients with cardio-vascular diseases is higher than in general population. At the same time the one of problems of internal medicine is a timely diagnostics of chronic obstructive pulmonary disease. The aim of the work was the study of prevalence of chronic obstructive pulmonary disease among patients with cardio-vascular diseases, especially arterial hypertension and coronary heart disease. Materials and methods. The retrospective analysis of statistical cards of patients, who were on stationary treatment at therapeutic departments, was carried out to estimate the prevalence of combination of chronic obstructive pulmonary disease with arterial hypertension. The target examination of 136 patients was realized for revelation of chronic obstructive pulmonary disease. All patients were interrogated by the original modified questionnaire of assessment of short breath by medical research council (mMRC), test for assessment of chronic obstructive pulmonary disease (CAT) and underwent spirography with bronchodilatation test. Results. It was established, that 10,2 % of patients had the combination of chronic obstructive pulmonary disease with arterial hypertension. Among persons, who were on treatment as to the stable coronary heart disease and had not obstructive disease of respiratory organs in anamnesis, in 26,4 % the chronic obstructive pulmonary disease was diagnosed for the first time.

The use of reversibility percent in spirometric assessment of chronic obstructive pulmonary diseases for the detrimental effect of 3rd generation beta-blockers

Background: For clinicians who work in respiratory medicine, the use of beta-blockers (BBs) has, for a long time, posed a dilemma because of the potential risk of bronchospasm and neutralization of the effectiveness of β-2 agonists. Aims and Objectives: To observe the effect of nebivolol on clinical and spirometric parameters on patients with stable chronic obstructive pulmonary disease (COPD) and the effect of the reversibility magnitude on the nebivolol detrimental effects. Materials and Methods: A total of 32 patients with age above 40 years regardless their smoking state from both genders were included in the study at College of Medicine, Babylon University from February 2014 to September 2016. The study was approved by Institutional Review Board. The study included the patients who were diagnosed as COPD. Patients were divided into two groups depending on the reversibility test in spirometric assessment. Results: There were significant differences between means of forced expiratory flow (FEF), forced expiratory volume in 1 second (FEV1) and COPD assessment test (CAT) score before and after using of 3rd generation BB for all patients with COPD and patients with high reversibility percent while for patients with low reversibility percent were significant differences between means of FEF, while there were no significant differences between means of FEV1 and CAT score. Conclusion: The reversibility percent can be used as an indicator for the adverse effect of BB on COPD patients.

Impact of pulmonary disease on patient-reported outcomes and patient-performed functional testing in systemic lupus erythematosus.

This study examines the effect of pulmonary disease on patient-reported outcomes (PROs) and patient-performed outcome (PPO) in systemic lupus erythematosus (SLE) patients at a single tertiary referral center. Pulmonary function tests (PFTs), chest imaging, SLE-related damage, and disease activity were examined in 110 SLE patients. Presence was noted of abnormal PFTs, pleural disease, pulmonary hypertension (PH), pulmonary infarction, interstitial lung disease (ILD), and shrinking lung syndrome (SLS). PROs included the Medical Outcome Short Form-36 Health Survey, Pittsburgh Sleep Quality Index, Fatigue Severity Scale, Borg Dyspnea Scale, patient dyspnea and cough. The PPO of interest was the six-minute walk test (6MWT). Relationships amongst PROs, 6MWT, and pulmonary disease were studied. Pulmonary disease was present in 62 (56%) of 110 subjects: 54 (49%) abnormal PFT, 13 (12%) pleural disease, 12 (11%) ILD, 11 (10%) SLS and five (5%) PH. Dyspnea was the only PRO found to be significantly associated with pulmonary disease (P = 0.0004). Participants with pulmonary disease compared to those without had significantly reduced distance (P = 0.00015, 95% CI for mean 39-125 m) and predicted distance (P = 0.00001, 10%-26%) on 6MWT. Pulmonary disease is common in SLE and adversely impacts 6MWT distance and dyspnea without apparent influence on other PROs. The 6MWT may be a promising tool in the assessment of pulmonary disease in SLE.

Comparison of computed tomography and thoracic radiography findings for the assessment of pulmonary diseases in dogs

Akciger hastaliklarinin tanisinda radyografik muayene siklikla kullanilan bir yontemdir; ancak kesin tani icin yetersiz kalmaktadir. Bu calismada ileri goruntuleme yontemi olan bilgisayarli tomografi, veteriner amacli kullanilmistir. Calismada, bahsi gecen iki goruntuleme yonteminin akciger hastaliklarinda birbirlerine olan ustunlugu karsilastirilmistir. Solunum sikayeti ile klinige basvuran cesitli irk, yas ve cinsiyetteki 20 kopek calismaya dahil edilmistir. Hastalara ait anamnez bilgileri alinip klinik muayeneleri yapildiktan sonra, radyografik muayene ve bunu takiben bilgisayarli tomografi ile inceleme yapilmistir. On iki hastaya pulmoner nodul, kitle ya da kalsifiye odak, dort hastaya ploral efuzyon ve pnomotoraks, iki hastaya pulmoner odem ve iki hastaya trakeal kollaps ve megaozofagus tanisi hem radyografik hem de BT muayenesi sonucunda konulmustur. Sonuc olarak, radyografi akciger hastaliklarinda oncul tani konulmasi amaciyla ilk goruntuleme yontemi olarak kullanilabilir. Bilgisayarli tomografide kesit goruntu elde edilebilmesi sonucunda, kesin taniya giden yolda radyografiye olan ustunlugu ortaya konmustur

Relationship between chronic obstructive pulmonary disease (COPD) assessment test score and prognostic factors of COPD patients

Objective To observe the correlation between chronic obstructive pulmonary disease(COPD)assessment test (CAT)score and prognostic factors,so as to investigate the value of CAT score in predicting the prognosis of COPD. Methods A total of 81patients with newly diagnosed COPD in our hospital during Jul.2011to Sep.2012,without using inhaled corticosteroid(ICS)/long-actingβ2agonist(LABA)or long-acting antimuscarinic agent(LAMA),were divided into group A (low risk,less symptoms),B (low risk,more symptoms),C (high risk,less symptoms)and D (high risk,more symptoms)groups according to Global Initiative for Chronic Obstructive Lung Disease(GOLD,2011edition),and the patients were given ICS/LABA or ICS/LABA+LAMA treatment for 3months.The CAT score,age,smoking quantity,pulmonary function indices,body mass index (BMI),6-min walking distance (6MWD),modified medical British research council (mMRC)dyspnea scale,and the times of acute exacerbation of COPD (AECOPD)in previous one year were collected before and after treatment.The clinical characteristics analysis and correlation analysis were performed.Results The average age of the 81COPD patients was (66.27±8.52)years,with 88.89% being males and 85.19% having smoking history.The proportions of group A,B,C and D were 8.64%,30.86%,4.94%and 55.56% before treatment,respectively.The values of the forced expiratory volume in one second (FEV1),predicted amount as a percentage of FEV1(FEV1%Pred),forced vital capacity(FVC),predicted amount as a percentage of FVC (FVC%Pred),peak expiratory flow (PEF),predicted amount as a percentage of PEF(PEF%Pred),and 6MWD in CAT score≥10groups were significantly less than those in CAT score10 group(P0.05).The above parameters were not significantly different between patients with CAT score being 10-20,20- 30and≥30groups.mMRC scale and times of AECOPD in CAT score≥20groups were significantly higher than those in CAT score10group(P0.05).No significant difference in FEV1/FVC was found in different CAT score groups.The CAT score was significantly correlated with mMRC scale(pre-treatment r2=0.417,P0.001;post-treatment r2=0.19,P0.001), 6MWD (pre-treatment r2=0.320,P0.001;post-treatment r2=0.19,P0.001),pre-treatment FEV1(r2=0.177,P= 0.001 5),FEV1%Pred(r2=0.125,P=0.002),PEF(r2=0.164,P=0.002 4),PEF%Pred(r2=0.129,P=0.007 6),FVC (r2=0.098,P=0.021),FVC%Pred(r2=0.094,P=0.024),FEV1/FVC(r2=0.101,P=0.005 7),and AECOPD number (r2=0.059,P=0.028);and not correlated with the quantity of smoking (r2=0.041,P=0.083),BMI(r2=0.00,P= 0.89),and post-treatment FEV1(r2=0.01,P=0.22)or FEV1%Pred(r2=0.003,P=0.09).Conclusion COPD is prone to occur in the male smokers,with the highest proportion found in group D.CAT score has a good correlation with pre-and post -treatment mMRC scale and exercise capacity,suggesting it has a potential for predicting prognosis of COPD.

Assessment and management of chronic obstructive pulmonary disease in the emergency department and beyond

Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) are common, can result in emergency department presentation and often result in hospitalization. After confirming the diagnosis and treating comorbidities, management of severe AECOPD includes bronchodilators, systemic corticosteroids, antibiotics, noninvasive ventilation and, occasionally, endotracheal intubation. Once discharged, delayed follow-up and suboptimal management often occurs. Antibiotics, systemic corticosteroids and optimization of nonpharmacological interventions (e.g., smoking cessation, immunization and pulmonary rehabilitation) are important discharge considerations. Improving linkages to primary providers who adhere to management involving a pharmacological and nonpharmacological evidence-based treatment plan is critical to preventing future AECOPDs, reducing healthcare utilization and maintaining the quality of life of patients following an AECOPD.

Imaging lung microstructure in mice with hyperpolarized 3 He diffusion MRI

Quantitative measurement of lung microstructure is of great significance in assessment of pulmonary disease, particularly in the earliest stages. The technique for MRI-based 3He lung morphometry was previously developed and validated for human lungs, and was recently extended to ex vivo mouse lungs. The technique yields accurate, quantitative information about the microstructure and geometry of acinar airways. In this study, the 3He lung morphometry technique is successfully implemented for in vivo studies of mice. Results indicate excellent agreement between in vivo morphometry via 3He MRI and microscopic morphometry after sacrifice. This opens up new avenues for application of the technique as a precise, noninvasive, in vivo biomarker of changes in lung microstructure, within various mouse models of lung disease.

Breast: The Forgotten Organ

HomeRadiologyVol. 233, No. 3 PreviousNext Letters to the EditorBreast: The Forgotten OrganEric N. C. MilneEric N. C. MilneAuthor AffiliationsImaging Diagnostic Systems, 6531 NW 18th Court, Plantation, FL 33313. e-mail: [email protected]Eric N. C. MilnePublished Online:Dec 1 2004https://doi.org/10.1148/radiol.2333040846MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In References 1 Brenner DJ. Radiation risks potentially associated with low-dose CT screening of adult smokers for lung cancer. Radiology 2004; 231:440-445. Link, Google Scholar2 Lee CI, Haims AH, Monico EP, Brink JA, Forman HP. Diagnostic CT scans: assessment of patient, physician, and radiologist awareness of radiation dose and possible risks. Radiology 2004; 231:393-398. Link, Google Scholar3 de Jong PA, Ottink MD, Robben SG, et al. Pulmonary disease assessment in cystic fibrosis: comparison of CT scoring systems and value of bronchial and arterial dimension measurements. Radiology 2004; 231:434-439. Link, Google ScholarArticle HistoryPublished in print: Dec 2004 FiguresReferencesRelatedDetailsCited ByClinical Radiology, Vol. 63, No. 3American Journal of Roentgenology, Vol. 186, No. 6Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 233, No. 3 Metrics Altmetric Score PDF download

Spirometric Pulmonary Function in Healthy Preschool Children.

The purpose of this study was to evaluate spirometric lung function in normal children ages 3 to 6 yr. Spirometric measurements were obtained at nursery and daycare centers by experienced pediatric pulmonary function technicians. Of 307 children recruited, 259 fulfilled our criteria as normal. Of these, 82.6% (214) were able to perform technically acceptable and reproducible maneuvers during a testing session limited to 15 min. The regression model with log-transformed parameters of pulmonary function and height had the best correlations. After accounting for height in the model, other physical traits and health questionnaire items did not contribute significantly. PEFR, FVC, FEV1, and FEF25-75 all increased with increasing height; correlation coefficients were 0.73, 0.93, 0.92, and 0.67, respectively. The group mean coefficients of variation for replicate measurements of PEFR, FVC, FEV1, and FEF25-75 were 7.8%, 2.5%, 2.7%, and 8.3%, respectively. There was a significant decrease in the ratio FEV1/FVC with increasing height; the mean predicted FEV1/FVC was 0.97 at 90 cm height and 0.89 at 125 cm height. In conclusion, reproducible spirometry can be obtained in the majority of preschool children and has the potential to improve our assessment and management of pulmonary disease.