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Quantitative analysis of changes in lung density by dynamic chest radiography in association with CT values: a virtual imaging study and initial clinical corroboration

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Abstract

Dynamic chest radiography (DCR) identifies pulmonary impairments as decreased changes in radiographic lung density during respiration (Δpixel values), but not as scaled/standardized computed tomography (CT) values. Quantitative analysis correlated with CT values is beneficial for a better understanding of Δpixel values in DCR-based assessment of pulmonary function. The present study aimed to correlate Δpixel values from DCR with changes in CT values during respiration (ΔCT values) through a computer-based phantom study. A total of 20 four-dimensional computational phantoms during forced breathing were created to simulate both CT and projection images of the same virtual patients. The Δpixel and ΔCT values of the lung fields were correlated on a regression line, and the inclination was statistically evaluated to determine whether there were significant differences among physical types, sex, and breathing methods. The resulting conversion expression was also assessed in the DCR images of 37 patients. The resulting Δpixel values for 30/37 (81%) real patients, 6/7 (86%) normal controls, and 24/30 (80%) chronic obstructive pulmonary disorder patients were within the range of ΔCT values ± standard deviation (SD) reported in a previous study. In addition, no significant differences were detected for each condition of thoracic breathing, suggesting that the same regression line inclination values measured across the entire lung can be used for the conversion of Δpixel values, providing a quantitative analysis that can be correlated with ΔCT values. The developed conversion expression may be helpful for improving the understanding of respiratory changes using radiographic lung densities from DCR-based assessments of pulmonary function.

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Acknowledgements

The authors sincerely thank the staff from the departments of respiratory medicine, thoracic surgery, and radiology at Kanazawa University Hospital for providing the data described above.

Funding

The devices used in our clinical study were also provided by Konica Minolta, Inc., Tokyo, Japan. This work was supported in part by Grants-in-Aid from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) KAKENHI (#16K10271, 19K12841), the Shimadzu Corporation for Science and Technology, and the Tateishi Science and Technology Foundation.

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Authors and Affiliations

  1. Clinical Radiology Service Unit, Kyoto University Hospital, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Teruyo Sugiura

  2. College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan

    Teruyo Sugiura & Rie Tanaka

  3. Carl E Ravin Advanced Imaging Labs, Department of Radiology, Duke University, Durham, NC, 27705, USA

    Ehsan Samei, William Paul Segars & Ehsan Abadi

  4. Department of Respiratory Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan

    Kazuo Kasahara & Noriyuki Ohkura

  5. Department of Thoracic Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan

    Masaya Tamura & Isao Matsumoto

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  1. Teruyo Sugiura
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  2. Rie Tanaka
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  3. Ehsan Samei
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  9. Isao Matsumoto
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Corresponding authors

Correspondence to Teruyo Sugiura or Rie Tanaka.

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Conflict of interest

Our institution has received a research grant from Konica Minolta, Inc., Tokyo, Japan.

Informed consent

The present study was approved by the institutional review board of Kanazawa University (registration number 1729). Written informed consent was obtained from all the participants.

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Sugiura, T., Tanaka, R., Samei, E. et al. Quantitative analysis of changes in lung density by dynamic chest radiography in association with CT values: a virtual imaging study and initial clinical corroboration. Radiol Phys Technol 15, 45–53 (2022). https://doi.org/10.1007/s12194-021-00648-w

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  • DOI: https://doi.org/10.1007/s12194-021-00648-w

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