Pediatric Radiology

, Volume 40, Issue 10, pp 1663–1669 | Cite as

Volume-monitored chest CT: a simplified method for obtaining motion-free images near full inspiratory and end expiratory lung volumes

  • Kathryn S. Mueller
  • Frederick R. Long
  • Robert L. Flucke
  • Robert G. Castile
Original Article

Abstract

Background

Lung inflation and respiratory motion during chest CT affect diagnostic accuracy and reproducibility.

Objective

To describe a simple volume-monitored (VM) method for performing reproducible, motion-free full inspiratory and end expiratory chest CT examinations in children.

Materials and methods

Fifty-two children with cystic fibrosis (mean age 8.8 ± 2.2 years) underwent pulmonary function tests and inspiratory and expiratory VM-CT scans (1.25-mm slices, 80–120 kVp, 16–40 mAs) according to an IRB-approved protocol. The VM-CT technique utilizes instruction from a respiratory therapist, a portable spirometer and real-time documentation of lung volume on a computer. CT image quality was evaluated for achievement of targeted lung-volume levels and for respiratory motion.

Results

Children achieved 95% of vital capacity during full inspiratory imaging. For end expiratory scans, 92% were at or below the child’s end expiratory level. Two expiratory exams were judged to be at suboptimal volumes. Two inspiratory (4%) and three expiratory (6%) exams showed respiratory motion. Overall, 94% of scans were performed at optimal volumes without respiratory motion.

Conclusion

The VM-CT technique is a simple, feasible method in children as young as 4 years to achieve reproducible high-quality full inspiratory and end expiratory lung CT images.

Keywords

High-resolution CT Imaging techniques Cystic fibrosis Children 

Notes

Acknowledgment

The study was funded by the Cystic Fibrosis Foundation.

Supplementary material

ESM 1

(MP4 4121 kb)

ESM 2

(M4V 28940 kb)

References

  1. 1.
    Long FR, Williams RS, Adler BH et al (2005) Comparison of quiet breathing and controlled ventilation in the high-resolution CT assessment of airway disease in infants with cystic fibrosis. Pediatr Radiol 35:1075–1080CrossRefPubMedGoogle Scholar
  2. 2.
    Bankier AA, O'Donnell CR, Boiselle PM (2008) Quality initiatives. Respiratory instructions for CT examinations of the lungs: a hands-on guide. Radiographics 28:919–931CrossRefPubMedGoogle Scholar
  3. 3.
    Long FR, Castile RG, Brody AS et al (1999) Lungs in infants and young children: improved thin-section CT with a noninvasive controlled-ventilation technique—initial experience. Radiology 212:588–593PubMedGoogle Scholar
  4. 4.
    Thomas KE, Wang B (2008) Age-specific effective doses for pediatric MSCT examinations at a large children’s hospital using DLP conversion coefficients: a simple estimation method. Pediatr Radiol 38:645–656CrossRefPubMedGoogle Scholar
  5. 5.
    Zapletal A, Paul T, Samanek M (1977) Significance of contemporary methods of lung function testing for the detection of airway obstruction in children and adolescents (author’s transl). Z Erkr Atmungsorgane 149:343–371PubMedGoogle Scholar
  6. 6.
    Stanojevic SA, Wade A, Cole TJ et al (2009) Spirometry centile charts for young Caucasian children: the Asthma UK Collaborative Initiative. Am J Respir Crit Care Med 180:547–552CrossRefPubMedGoogle Scholar
  7. 7.
    Castile R, Mead J, Jackson A et al (1982) Effects of posture on flow-volume curve configuration in normal humans. J Appl Physiol 52:1175–1183Google Scholar
  8. 8.
    Robinson TE, Leung AN, Moss RB et al (1999) Standardized high-resolution CT of the lung using a spirometer- triggered electron beam CT scanner. AJR 172:1636–1638PubMedGoogle Scholar
  9. 9.
    Raschle NM, Lee M, Buechler R et al (2009) Making MR imaging child’s play—pediatric neuroimaging protocol guidelines and procedure. J Vis Exp 30; pii: 1309. doi: 10.3791/1309
  10. 10.
    Vilozni DO, Efrati O, Hakim F et al (2009) FRC measurements using body plethysmography in young children. Pediatr Pulmonol 44:885–891CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Kathryn S. Mueller
    • 1
  • Frederick R. Long
    • 2
  • Robert L. Flucke
    • 3
  • Robert G. Castile
    • 4
  1. 1.The Ohio State University College of MedicineColumbusUSA
  2. 2.The Children’s Radiological InstituteNationwide Children’s HospitalColumbusUSA
  3. 3.Department of Pulmonary MedicineNationwide Children’s HospitalColumbusUSA
  4. 4.Center for Perinatal ResearchThe Research Institute at Nationwide Children’s HospitalColumbusUSA

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