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Martino R, Carry P, Stickel J, Samara O, Lee S, Selberg C. Use of the flat panel detector fluoroscope reduces radiation exposure during periacetabular osteotomy. Sci Rep 2024; 14:9475. [PMID: 38658572 PMCID: PMC11043339 DOI: 10.1038/s41598-024-58314-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
The Periacetabular Osteotomy is a technically demanding procedure that requires precise intraoperative evaluation of pelvic anatomy. Fluoroscopic images pose a radiation risk to operating room staff, scrubbed personnel, and the patient. Most commonly, a Standard Fluoroscope with an Image Intensifier is used. Our institution recently implemented the novel Fluoroscope with a Flat Panel Detector. The purpose of this study was to compare radiation dosage and accuracy between the two fluoroscopes. A retrospective review of a consecutive series of patients who underwent Periacetabular Osteotomy for symptomatic hip dysplasia was completed. The total radiation exposure dose (mGy) was recorded and compared for each case from the standard fluoroscope (n = 27) and the flat panel detector (n = 26) cohorts. Lateral center edge angle was measured and compared intraoperatively and at the six-week postoperative visit. A total of 53 patients (96% female) with a mean age and BMI of 17.84 (± 6.84) years and 22.66 (± 4.49) kg/m2 (standard fluoroscope) and 18.23 (± 4.21) years and 21.99 (± 4.00) kg/m2 (flat panel detector) were included. The standard fluoroscope averaged total radiation exposure to be 410.61(± 193.02) mGy, while the flat panel detector averaged 91.12 (± 49.64) mGy (p < 0.0001). The average difference (bias) between intraoperative and 6-week postoperative lateral center edge angle measurement was 0.36° (limits of agreement: - 3.19 to 2.47°) for the standard fluoroscope and 0.27° (limits of agreement: - 2.05 to 2.59°) for the flat panel detector cohort. Use of fluoroscopy with flat panel detector technology decreased the total radiation dose exposure intraoperatively and produced an equivalent assessment of intraoperative lateral center edge angle. Decreasing radiation exposure to young patients is imperative to reduce the risk of future comorbidities.
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Affiliation(s)
- Rachael Martino
- Children's Hospital Colorado - Orthopedics Institute, 13123 E 16th Ave, Box 060, Aurora, CO, 80045, USA
| | - Patrick Carry
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jennifer Stickel
- Children's Hospital Colorado - Orthopedics Institute, 13123 E 16th Ave, Box 060, Aurora, CO, 80045, USA
| | - Omar Samara
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sterling Lee
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Courtney Selberg
- Children's Hospital Colorado - Orthopedics Institute, 13123 E 16th Ave, Box 060, Aurora, CO, 80045, USA.
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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Cè M, Oliva G, Rabaiotti FL, Macrì L, Zollo S, Aquila A, Cellina M. Portable Dynamic Chest Radiography: Literature Review and Potential Bedside Applications. Med Sci (Basel) 2024; 12:10. [PMID: 38390860 PMCID: PMC10885043 DOI: 10.3390/medsci12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
Dynamic digital radiography (DDR) is a high-resolution radiographic imaging technique using pulsed X-ray emission to acquire a multiframe cine-loop of the target anatomical area. The first DDR technology was orthostatic chest acquisitions, but new portable equipment that can be positioned at the patient's bedside was recently released, significantly expanding its potential applications, particularly in chest examination. It provides anatomical and functional information on the motion of different anatomical structures, such as the lungs, pleura, rib cage, and trachea. Native images can be further analyzed with dedicated post-processing software to extract quantitative parameters, including diaphragm motility, automatically projected lung area and area changing rate, a colorimetric map of the signal value change related to respiration and motility, and lung perfusion. The dynamic diagnostic information along with the significant advantages of this technique in terms of portability, versatility, and cost-effectiveness represents a potential game changer for radiological diagnosis and monitoring at the patient's bedside. DDR has several applications in daily clinical practice, and in this narrative review, we will focus on chest imaging, which is the main application explored to date in the literature. However, studies are still needed to understand deeply the clinical impact of this method.
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Affiliation(s)
- Maurizio Cè
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy; (F.L.R.); (L.M.); (A.A.)
| | - Giancarlo Oliva
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, 20121 Milan, Italy; (G.O.); (M.C.)
| | - Francesca Lucrezia Rabaiotti
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy; (F.L.R.); (L.M.); (A.A.)
| | - Laura Macrì
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy; (F.L.R.); (L.M.); (A.A.)
| | - Sharon Zollo
- Konica Minolta Business Solutions Europe GmbH, Capellalaan 65, 2132 JL Hoofddorp, The Netherlands;
| | - Alessandro Aquila
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy; (F.L.R.); (L.M.); (A.A.)
| | - Michaela Cellina
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, 20121 Milan, Italy; (G.O.); (M.C.)
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Yamasaki Y, Kamitani T, Sagiyama K, Hino T, Kisanuki M, Tabata K, Isoda T, Kitamura Y, Abe K, Hosokawa K, Toyomura D, Moriyama S, Kawakubo M, Yabuuchi H, Ishigami K. Dynamic chest radiography for pulmonary vascular diseases: clinical applications and correlation with other imaging modalities. Jpn J Radiol 2024; 42:126-144. [PMID: 37626168 PMCID: PMC10811043 DOI: 10.1007/s11604-023-01483-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
Dynamic chest radiography (DCR) is a novel functional radiographic imaging technique that can be used to visualize pulmonary perfusion without using contrast media. Although it has many advantages and clinical utility, most radiologists are unfamiliar with this technique because of its novelty. This review aims to (1) explain the basic principles of lung perfusion assessment using DCR, (2) discuss the advantages of DCR over other imaging modalities, and (3) review multiple specific clinical applications of DCR for pulmonary vascular diseases and compare them with other imaging modalities.
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Affiliation(s)
- Yuzo Yamasaki
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Takeshi Kamitani
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Koji Sagiyama
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Takuya Hino
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Megumi Kisanuki
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
- Department of Hematology, Oncology and Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kosuke Tabata
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Takuro Isoda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yoshiyuki Kitamura
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Kohtaro Abe
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuya Hosokawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Toyomura
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shohei Moriyama
- Department of Hematology, Oncology and Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masateru Kawakubo
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hidetake Yabuuchi
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
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Raoof S, Shah M, Make B, Allaqaband H, Bowler R, Fernando S, Greenberg H, Han MK, Hogg J, Humphries S, Lee KS, Lynch D, Machnicki S, Mehta A, Mina B, Naidich D, Naidich J, Naqvi Z, Ohno Y, Regan E, Travis WD, Washko G, Braman S. Lung Imaging in COPD Part 1: Clinical Usefulness. Chest 2023; 164:69-84. [PMID: 36907372 PMCID: PMC10403625 DOI: 10.1016/j.chest.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/23/2023] [Accepted: 03/04/2023] [Indexed: 03/13/2023] Open
Abstract
COPD is a condition characterized by chronic airflow obstruction resulting from chronic bronchitis, emphysema, or both. The clinical picture is usually progressive with respiratory symptoms such as exertional dyspnea and chronic cough. For many years, spirometry was used to establish a diagnosis of COPD. Recent advancements in imaging techniques allow quantitative and qualitative analysis of the lung parenchyma as well as related airways and vascular and extrapulmonary manifestations of COPD. These imaging methods may allow prognostication of disease and shed light on the efficacy of pharmacologic and nonpharmacologic interventions. This is the first of a two-part series of articles on the usefulness of imaging methods in COPD, and it highlights useful information that clinicians can obtain from these imaging studies to make more accurate diagnosis and therapeutic decisions.
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Affiliation(s)
- Suhail Raoof
- Northwell Health, Lenox Hill Hospital, New York, NY.
| | - Manav Shah
- Northwell Health, Lenox Hill Hospital, New York, NY
| | | | | | | | | | | | | | - James Hogg
- University of British Columbia, Vancouver, BC, Canada
| | | | - Kyung Soo Lee
- Sungkyunkwan University School of Medicine, Samsung ChangWon Hospital, ChangWon, South Korea
| | | | | | | | - Bushra Mina
- Northwell Health, Lenox Hill Hospital, New York, NY
| | | | | | - Zarnab Naqvi
- Northwell Health, Lenox Hill Hospital, New York, NY
| | | | | | | | | | - Sidney Braman
- Icahn School of Medicine at Mount Sinai, New York, NY
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Wang Y, Zhao W, Guo Y, Hu W, Peng C, Li L, Wei Y, Wu Z, Xu W, Li X, Suh YD, Liu X, Huang W. Efficient X-ray luminescence imaging with ultrastable and eco-friendly copper(I)-iodide cluster microcubes. LIGHT, SCIENCE & APPLICATIONS 2023; 12:155. [PMID: 37357223 DOI: 10.1038/s41377-023-01208-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/03/2023] [Accepted: 06/11/2023] [Indexed: 06/27/2023]
Abstract
The advancement of contemporary X-ray imaging heavily depends on discovering scintillators that possess high sensitivity, robust stability, low toxicity, and a uniform size distribution. Despite significant progress in this field, the discovery of a material that satisfies all of these criteria remains a challenge. In this study, we report the synthesis of monodisperse copper(I)-iodide cluster microcubes as a new class of X-ray scintillators. The as-prepared microcubes exhibit remarkable sensitivity to X-rays and exceptional stability under moisture and X-ray exposure. The uniform size distribution and high scintillation performance of the copper(I)-iodide cluster microcubes make them suitable for the fabrication of large-area, flexible scintillating films for X-ray imaging applications in both static and dynamic settings.
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Affiliation(s)
- Yanze Wang
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Wenjing Zhao
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Yuanyuan Guo
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Wenbo Hu
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Chenxi Peng
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Lei Li
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
- Key Laboratory of Magnetic Materials Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
| | - Yuan Wei
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Zhongbin Wu
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Weidong Xu
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Xiyan Li
- Institute of Photoelectronic Thin Film Devices and Technology, Solar Energy Conversion Center, Nankai University, Tianjin, 300350, China
| | - Yung Doug Suh
- Department of Chemistry and School of Energy and Chemical Engineering, UNIST, Ulsan, 44919, Korea
| | - Xiaowang Liu
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China.
| | - Wei Huang
- Frontiers Science Centre for Flexible Electronics (FSCFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Shaanxi Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Flexible Electronics, Xi'an Key Laboratory of Biomedical Materials & Engineering, Xi'an Institute of Flexible Electronics, Institute of Flexible Electronics (IFE), Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China.
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials(IAM), Nanjing University of Posts & Telecommunications, 9 Wenyuan Road, Nanjing, 210023, China.
- Key Laboratory of Flexible Electronics (KLOFE), Institute of Advanced Materials (IAM), Nanjing Tech University (Nanjing Tech), 30 South Puzhu Road, Nanjing, 211816, China.
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FitzMaurice TS, McCann C, Nazareth D, Hawkes S, Shaw M, McNamara PS, Walshaw M. Feasibility of dynamic chest radiography to calculate lung volumes in adult people with cystic fibrosis: a pilot study. BMJ Open Respir Res 2023; 10:e001309. [PMID: 37147023 PMCID: PMC10163553 DOI: 10.1136/bmjresp-2022-001309] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 04/21/2023] [Indexed: 05/07/2023] Open
Abstract
INTRODUCTION Dynamic chest radiography (DCR) is a novel, low-dose, real-time digital imaging system where software identifies moving thoracic structures and can automatically calculate lung areas. In an observational, prospective, non-controlled, single-centre pilot study, we compared it with whole-body plethysmography (WBP) in the measurement of lung volume subdivisions in people with cystic fibrosis (pwCF). METHODS Lung volume subdivisions were estimated by DCR using projected lung area (PLA) during deep inspiration, tidal breathing and full expiration, and compared with same-day WBP in 20 adult pwCF attending routine review. Linear regression models to predict lung volumes from PLA were developed. RESULTS Total lung area (PLA at maximum inspiration) correlated with total lung capacity (TLC) (r=0.78, p<0.001), functional residual lung area with functional residual capacity (FRC) (r=0.91, p<0.001), residual lung area with residual volume (RV) (r=0.82, p=0.001) and inspiratory lung area with inspiratory capacity (r=0.72, p=0.001). Despite the small sample size, accurate models were developed for predicting TLC, RV and FRC. CONCLUSION DCR is a promising new technology that can be used to estimate lung volume subdivisions. Plausible correlations between plethysmographic lung volumes and DCR lung areas were identified. Further studies are needed to build on this exploratory work in both pwCF and individuals without CF. TRIAL REGISTRATION NUMBER ISRCTN64994816.
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Affiliation(s)
- Thomas Simon FitzMaurice
- Department of Respiratory Medicine, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Caroline McCann
- Department of Radiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Dilip Nazareth
- Department of Respiratory Medicine, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Scott Hawkes
- Department of Pulmonary Physiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Matthew Shaw
- Research Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Paul Stephen McNamara
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Department of Child Health (University of Liverpool), Institute in the Park, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
| | - Martin Walshaw
- Department of Respiratory Medicine, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
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Watanabe T, Suzuki E, Yoshii N, Tsuchida H, Yobita S, Uchiyama S, Iguchi K, Nakamura M, Endo T, Tanahashi M. Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis. J Thorac Dis 2023; 15:1096-1105. [PMID: 37065574 PMCID: PMC10089839 DOI: 10.21037/jtd-22-1226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023]
Abstract
Background To plan a surgical approach and predict the operative time or bleeding volume, it is important to determine the presence of pleural adhesions before surgery. Dynamic chest radiography (DCR) is a new modality that can dynamically capture X-rays, and we assessed the utility of DCR for detecting pleural adhesions preoperatively. Methods The subjects of this study were those who underwent DCR before surgery from January 2020 to May 2022. The preoperative evaluation was performed by three imaging analysis modes, and pleural adhesion was defined as the that spreading to more than 20% of the thoracic cavity and/or taking more than 5 minutes to dissect. Results Of the 120 total patients, DCR was performed properly for 119 (99.2%). Accurate preoperative evaluations of pleural adhesions were confirmed in 101 patients (84.9%), with a sensitivity of 64.5%, specificity of 91.0%, positive predictive value of 74.1%, and negative predictive value of 88.0%. Conclusions DCR was very easy to perform in all preoperative patients with all manner of thoracic disease. We demonstrated the utility of DCR, showing its high specificity and negative predictive value. DCR has the potential to become a common preoperative examination for detecting pleural adhesions with further improvements in software programs.
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Affiliation(s)
| | - Eriko Suzuki
- Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Naoko Yoshii
- Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | | | - Shogo Yobita
- Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Suiha Uchiyama
- Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Kensuke Iguchi
- Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Minori Nakamura
- Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Takumi Endo
- Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan
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Kim H, Jin KN, Yoo SJ, Lee CH, Lee SM, Hong H, Witanto JN, Yoon SH. Deep Learning for Estimating Lung Capacity on Chest Radiographs Predicts Survival in Idiopathic Pulmonary Fibrosis. Radiology 2023; 306:e220292. [PMID: 36283113 DOI: 10.1148/radiol.220292] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Total lung capacity (TLC) has been estimated with use of chest radiographs based on time-consuming methods, such as planimetric techniques and manual measurements. Purpose To develop a deep learning-based, multidimensional model capable of estimating TLC from chest radiographs and demographic variables and validate its technical performance and clinical utility with use of multicenter retrospective data sets. Materials and Methods A deep learning model was pretrained with use of 50 000 consecutive chest CT scans performed between January 2015 and June 2017. The model was fine-tuned on 3523 pairs of posteroanterior chest radiographs and plethysmographic TLC measurements from consecutive patients who underwent pulmonary function testing on the same day. The model was tested with multicenter retrospective data sets from two tertiary care centers and one community hospital, including (a) an external test set 1 (n = 207) and external test set 2 (n = 216) for technical performance and (b) patients with idiopathic pulmonary fibrosis (n = 217) for clinical utility. Technical performance was evaluated with use of various agreement measures, and clinical utility was assessed in terms of the prognostic value for overall survival with use of multivariable Cox regression. Results The mean absolute difference and within-subject SD between observed and estimated TLC were 0.69 L and 0.73 L, respectively, in the external test set 1 (161 men; median age, 70 years [IQR: 61-76 years]) and 0.52 L and 0.53 L in the external test set 2 (113 men; median age, 63 years [IQR: 51-70 years]). In patients with idiopathic pulmonary fibrosis (145 men; median age, 67 years [IQR: 61-73 years]), greater estimated TLC percentage was associated with lower mortality risk (adjusted hazard ratio, 0.97 per percent; 95% CI: 0.95, 0.98; P < .001). Conclusion A fully automatic, deep learning-based model estimated total lung capacity from chest radiographs, and the model predicted survival in idiopathic pulmonary fibrosis. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Sorkness in this issue.
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Affiliation(s)
- Hyungjin Kim
- From the Department of Radiology (H.K., S.H.Y.), Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.H.L., S.M.L.), and Medical Research Collaborating Center (H.H.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (H.K., K.N.J., S.H.Y.); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea (K.N.J.); Department of Radiology, Hanyang University Medical Center, Seoul, Korea (S.J.Y.); and MEDICAL IP, Seoul, Korea (J.N.W., S.H.Y.)
| | - Kwang Nam Jin
- From the Department of Radiology (H.K., S.H.Y.), Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.H.L., S.M.L.), and Medical Research Collaborating Center (H.H.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (H.K., K.N.J., S.H.Y.); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea (K.N.J.); Department of Radiology, Hanyang University Medical Center, Seoul, Korea (S.J.Y.); and MEDICAL IP, Seoul, Korea (J.N.W., S.H.Y.)
| | - Seung-Jin Yoo
- From the Department of Radiology (H.K., S.H.Y.), Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.H.L., S.M.L.), and Medical Research Collaborating Center (H.H.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (H.K., K.N.J., S.H.Y.); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea (K.N.J.); Department of Radiology, Hanyang University Medical Center, Seoul, Korea (S.J.Y.); and MEDICAL IP, Seoul, Korea (J.N.W., S.H.Y.)
| | - Chang Hoon Lee
- From the Department of Radiology (H.K., S.H.Y.), Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.H.L., S.M.L.), and Medical Research Collaborating Center (H.H.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (H.K., K.N.J., S.H.Y.); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea (K.N.J.); Department of Radiology, Hanyang University Medical Center, Seoul, Korea (S.J.Y.); and MEDICAL IP, Seoul, Korea (J.N.W., S.H.Y.)
| | - Sang-Min Lee
- From the Department of Radiology (H.K., S.H.Y.), Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.H.L., S.M.L.), and Medical Research Collaborating Center (H.H.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (H.K., K.N.J., S.H.Y.); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea (K.N.J.); Department of Radiology, Hanyang University Medical Center, Seoul, Korea (S.J.Y.); and MEDICAL IP, Seoul, Korea (J.N.W., S.H.Y.)
| | - Hyunsook Hong
- From the Department of Radiology (H.K., S.H.Y.), Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.H.L., S.M.L.), and Medical Research Collaborating Center (H.H.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (H.K., K.N.J., S.H.Y.); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea (K.N.J.); Department of Radiology, Hanyang University Medical Center, Seoul, Korea (S.J.Y.); and MEDICAL IP, Seoul, Korea (J.N.W., S.H.Y.)
| | - Joseph Nathanael Witanto
- From the Department of Radiology (H.K., S.H.Y.), Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.H.L., S.M.L.), and Medical Research Collaborating Center (H.H.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (H.K., K.N.J., S.H.Y.); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea (K.N.J.); Department of Radiology, Hanyang University Medical Center, Seoul, Korea (S.J.Y.); and MEDICAL IP, Seoul, Korea (J.N.W., S.H.Y.)
| | - Soon Ho Yoon
- From the Department of Radiology (H.K., S.H.Y.), Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.H.L., S.M.L.), and Medical Research Collaborating Center (H.H.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (H.K., K.N.J., S.H.Y.); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea (K.N.J.); Department of Radiology, Hanyang University Medical Center, Seoul, Korea (S.J.Y.); and MEDICAL IP, Seoul, Korea (J.N.W., S.H.Y.)
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Dose Reduction and Image Quality Optimization of Pediatric Chest Radiography Using a Tungsten Filter. Bioengineering (Basel) 2022; 9:bioengineering9100583. [PMID: 36290551 PMCID: PMC9598093 DOI: 10.3390/bioengineering9100583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/23/2022] Open
Abstract
The use of diagnostic radiology in pediatric patients has increased, and various positive effects have been reported, including methods to reduce radiation doses in children. Research has been conducted to preserve image quality while reducing exposure and doses in pediatric patients. This study aimed to measure four different filters to identify an optimized filter for pediatric patients. The experiment was conducted using four types of filters, including aluminum, copper, molybdenum, and tungsten. The optimal filter thickness was verified using a histogram to visually evaluate the spectrum by filter thickness, effective dose on a pediatric phantom, entrance skin dose, organ absorbed dose using the PC-based Monte Carlo (PCXMC) program version 2.0 simulation, figure of merit (FOM), and image quality. As a result of measuring the spectrum according to the tube voltage and the four types of filters, dose reduction and contrast improvement effects were obtained with a 0.05 mm tungsten filter. Additionally, effective entrance skin and organ absorbed dose decreased with the said filter. The aluminum, copper, and molybdenum filters demonstrated that the effective dose scarcely decreased even when the thickness was increased; meanwhile, the effective dose decreased when the tungsten filter was 0.05 mm. The FOM with a 0.05 mm tungsten increased by 91% in the lung field and 39% in the mediastinal field. The entrance skin and organ absorbed dose in pediatric patients can be reduced by removing low-energy photons that fail in image formation using a tungsten filter.
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Projected Lung Area using dynamic X-ray (DXR) with a flat-panel detector system and automated tracking in patients with Chronic Obstructive Pulmonary Disease (COPD). Eur J Radiol 2022; 157:110546. [DOI: 10.1016/j.ejrad.2022.110546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022]
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Kitamura K, Takayama K, Yamazaki R, Ueda Y, Nishiki S. A new method for assessing lung tumor motion in radiotherapy using dynamic chest radiography. J Appl Clin Med Phys 2022; 23:e13736. [PMID: 35930373 PMCID: PMC9588259 DOI: 10.1002/acm2.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 05/17/2022] [Accepted: 07/07/2022] [Indexed: 11/15/2022] Open
Abstract
Dynamic chest radiography (DCR) is a recent advanced modality to acquire dynamic and functional images. We developed a new method using DCR and the free analysis software, Kinovea, to assess lung tumor motion. This study aimed to demonstrate the usefulness of our method. Phantom and clinical studies were performed. In the phantom study, dynamic images of a moving lead sphere were acquired using DCR, and the motion of the phantom was tracked using Kinovea in a DCR video. The amplitude of phantom motion was measured and compared with a predetermined baseline amplitude. In a clinical study, DCR and respiratory‐gated four‐dimensional computed tomography (4D‐CT) were performed on 15 patients who underwent stereotactic body radiation therapy for lung tumors. The amplitudes of tumor motion in DCR and 4D‐CT were measured in the superior‐inferior (SI), left‐right (LR), and anterior‐posterior (AP) directions, and the square root of the sum of squares (SRSS) of the amplitude was calculated in all directions. Spearman's rank correlation and the Wilcoxon signed‐rank test were performed to determine the correlations of the amplitudes of tumor motion obtained using DCR and 4D‐CT. In the phantom study, the absolute mean error between the measured and predetermined amplitudes was 0.60 mm (range: 0.061.53 mm). In the clinical study, the amplitudes of tumor motion obtained using DCR correlated significantly with those of 4D‐CT in the SI and LR directions, as did the SRSS values. The median amplitudes for DCR were significantly higher than those for 4D‐CT in all (SI, LR, and AP) directions, as were the SRSS values. Our proposed method based on DCR and Kinovea is useful for assessing lung tumor motion, visually and quantitatively. Therefore, DCR has potential as a new modality for evaluating lung tumor motion in radiotherapy.
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Affiliation(s)
| | - Kenji Takayama
- Department of Radiation Oncology, Tenri Hospital, Tenri, Japan
| | - Ryo Yamazaki
- Department of Radiology, Tenri Hospital, Tenri, Japan
| | - Yukihiro Ueda
- Department of Radiology, Tenri Hospital, Tenri, Japan
| | - Shigeo Nishiki
- Japanese Society of Radiological Technology, Shimogyo-ku, Japan
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12
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Yamasaki Y, Hosokawa K, Abe K, Ishigami K. Dynamic Chest Radiography of Acute Pulmonary Thromboembolism. Radiol Cardiothorac Imaging 2022; 4:e220086. [PMID: 36059380 PMCID: PMC9434978 DOI: 10.1148/ryct.220086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/31/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
Supplemental material is available for this article.
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13
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FitzMaurice TS, McCann C, Nazareth DS, McNamara PS, Walshaw MJ. Use of Dynamic Chest Radiography to Assess Treatment of Pulmonary Exacerbations in Cystic Fibrosis. Radiology 2022; 303:675-681. [PMID: 35289662 DOI: 10.1148/radiol.212641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background Although spirometry is an important marker in the management of pulmonary exacerbations in cystic fibrosis (CF), it is a forced maneuver and can generate aerosol. Therefore, it may be difficult to perform in some individuals. Dynamic chest radiography (DCR) provides real-time information regarding pulmonary dynamics alongside fluoroscopic-style thoracic imaging. Purpose To assess the effect of pulmonary exacerbation treatment by using both spirometry and DCR and assess the clinical utility of DCR in participants with CF experiencing pulmonary exacerbations. Materials and Methods In this prospective, observational, single-center pilot study, spirometry and DCR were performed before and after treatment of pulmonary exacerbations in participants with CF between December 2019 and August 2020. Spirometry measured forced expiratory volume in 1 second (FEV1) and forced vital capacity. DCR helped to measure projected lung area (PLA), hemidiaphragm midpoint position, and speed during tidal and deep breathing. Data were analyzed by using the paired t test or Wilcoxon signed-rank test. Correlation was assessed by using the Spearman rank correlation coefficient. Results Twenty participants with CF (mean age, 25 years ± 7 [standard deviation]; 14 women) were evaluated. Spirometry showed that percentage predicted FEV1 improved from a median of 44% (interquartile range [IQR], 17%) before treatment to 55% (IQR, 16%) after treatment (P = .004). DCR showed improvement in median deep breathing excursion for left and right hemidiaphragms (from 18 [IQR, 11] to 25 [IQR, 16] mm [P = .03] and from 13 [IQR, 6] to 19 [IQR, 14] mm [P = .03], respectively) and in median expiratory speed following deep breathing for left and right hemidiaphragms (from 7 [IQR, 2] to 11 [IQR, 5] mm/sec [P = .004] and 6 [IQR, 3] to 9 [IQR, 6] mm/sec [P = .004], respectively). PLA rate of change during full expiration and change in PLA during tidal breathing improved (from a mean of 42 cm2/sec ± 16 to 56 cm2/sec ± 24 [P = .03] and from a mean of 29 cm2 ± 14 to 35 cm2 ± 10 [P = .03], respectively). Conclusion Dynamic chest radiography demonstrated improvement in diaphragm speed and range of chest wall movement during respiration aftere treatment for pulmonary exacerbations in cystic fibrosis and showed potential as a tool to investigate the effect of pulmonary exacerbations on lung mechanics. Clinical trials registration no. NCT01234567 Published under a CC BY 4.0 license. Online supplemental material is available for this article.
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Affiliation(s)
- Thomas Simon FitzMaurice
- From the Adult CF Unit (T.S.F., D.S.N., M.J.W.) and Department of Radiology (C.M.), Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK; Institute of Life Course and Medical Sciences (T.S.F., P.S.M.) and Institute of Infection and Global Health (D.S.N., M.J.W.), University of Liverpool, Liverpool, UK; and Institute in the Park (University of Liverpool), Alder Hey Children's Hospital, Liverpool, UK (P.S.M.)
| | - Caroline McCann
- From the Adult CF Unit (T.S.F., D.S.N., M.J.W.) and Department of Radiology (C.M.), Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK; Institute of Life Course and Medical Sciences (T.S.F., P.S.M.) and Institute of Infection and Global Health (D.S.N., M.J.W.), University of Liverpool, Liverpool, UK; and Institute in the Park (University of Liverpool), Alder Hey Children's Hospital, Liverpool, UK (P.S.M.)
| | - Dilip S Nazareth
- From the Adult CF Unit (T.S.F., D.S.N., M.J.W.) and Department of Radiology (C.M.), Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK; Institute of Life Course and Medical Sciences (T.S.F., P.S.M.) and Institute of Infection and Global Health (D.S.N., M.J.W.), University of Liverpool, Liverpool, UK; and Institute in the Park (University of Liverpool), Alder Hey Children's Hospital, Liverpool, UK (P.S.M.)
| | - Paul S McNamara
- From the Adult CF Unit (T.S.F., D.S.N., M.J.W.) and Department of Radiology (C.M.), Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK; Institute of Life Course and Medical Sciences (T.S.F., P.S.M.) and Institute of Infection and Global Health (D.S.N., M.J.W.), University of Liverpool, Liverpool, UK; and Institute in the Park (University of Liverpool), Alder Hey Children's Hospital, Liverpool, UK (P.S.M.)
| | - Martin J Walshaw
- From the Adult CF Unit (T.S.F., D.S.N., M.J.W.) and Department of Radiology (C.M.), Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK; Institute of Life Course and Medical Sciences (T.S.F., P.S.M.) and Institute of Infection and Global Health (D.S.N., M.J.W.), University of Liverpool, Liverpool, UK; and Institute in the Park (University of Liverpool), Alder Hey Children's Hospital, Liverpool, UK (P.S.M.)
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Hino T, Tsunomori A, Hata A, Hida T, Yamada Y, Ueyama M, Yoneyama T, Kurosaki A, Kamitani T, Ishigami K, Fukumoto T, Kudoh S, Hatabu H. Vector-field dynamic x-ray (VF-DXR) using optical flow method in patients with chronic obstructive pulmonary disease. Eur Radiol Exp 2022; 6:4. [PMID: 35099604 PMCID: PMC8802288 DOI: 10.1186/s41747-021-00254-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/20/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We assessed the difference in lung motion during inspiration/expiration between chronic obstructive pulmonary disease (COPD) patients and healthy volunteers using vector-field dynamic x-ray (VF-DXR) with optical flow method (OFM). METHODS We enrolled 36 COPD patients and 47 healthy volunteers, classified according to pulmonary function into: normal, COPD mild, and COPD severe. Contrast gradient was obtained from sequential dynamic x-ray (DXR) and converted to motion vector using OFM. VF-DXR images were created by projection of the vertical component of lung motion vectors onto DXR images. The maximum magnitude of lung motion vectors in tidal inspiration/expiration, forced inspiration/expiration were selected and defined as lung motion velocity (LMV). Correlations between LMV with demographics and pulmonary function and differences in LMV between COPD patients and healthy volunteers were investigated. RESULTS Negative correlations were confirmed between LMV and % forced expiratory volume in one second (%FEV1) in the tidal inspiration in the right lung (Spearman's rank correlation coefficient, rs = -0.47, p < 0.001) and the left lung (rs = -0.32, p = 0.033). A positive correlation between LMV and %FEV1 in the tidal expiration was observed only in the right lung (rs = 0.25, p = 0.024). LMVs among normal, COPD mild and COPD severe groups were different in the tidal respiration. COPD mild group showed a significantly larger magnitude of LMV compared with the normal group. CONCLUSIONS In the tidal inspiration, the lung parenchyma moved faster in COPD patients compared with healthy volunteers. VF-DXR was feasible for the assessment of lung parenchyma using LMV.
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Affiliation(s)
- Takuya Hino
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
| | - Akinori Tsunomori
- R&D Promotion Division, Healthcare Business Headquarters, Konica Minolta, Inc., 2970 Ishikawa-machi, Hachioji-shi, Tokyo, Japan
| | - Akinori Hata
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
- Department of Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Tomoyuki Hida
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Yoshitake Yamada
- Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Masako Ueyama
- Department of Health Care, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan
| | - Tsutomu Yoneyama
- R&D Promotion Division, Healthcare Business Headquarters, Konica Minolta, Inc., 2970 Ishikawa-machi, Hachioji-shi, Tokyo, Japan
| | - Atsuko Kurosaki
- Department of Diagnostic Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan
| | - Takeshi Kamitani
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Takenori Fukumoto
- R&D Promotion Division, Healthcare Business Headquarters, Konica Minolta, Inc., 2970 Ishikawa-machi, Hachioji-shi, Tokyo, Japan
| | - Shoji Kudoh
- Japan Anti-Tuberculosis Association, 1-3-12 Kanda-Misakicho, Chiyoda-ku, Tokyo, Japan
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
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15
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Hatabu H, Madore B. Dark-Field Chest Radiography in the Detection of Emphysema. Radiology 2022; 303:128-129. [PMID: 35014909 DOI: 10.1148/radiol.212910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hiroto Hatabu
- From the Center for Pulmonary Functional Imaging (H.H.) and Department of Radiology (H.H., B.M.), Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Bruno Madore
- From the Center for Pulmonary Functional Imaging (H.H.) and Department of Radiology (H.H., B.M.), Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
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16
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FitzMaurice TS, McCann C, Nazareth DS, Walshaw MJ. Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study. ERJ Open Res 2021; 8:00343-2021. [PMID: 35211619 PMCID: PMC8862633 DOI: 10.1183/23120541.00343-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives Dynamic chest radiography (DCR) is a novel real-time digital fluoroscopic imaging system that produces clear, wide field-of-view diagnostic images of the thorax and diaphragm in motion, alongside novel metrics on moving structures within the thoracic cavity. We describe the use of DCR in the measurement of diaphragm motion in a pilot series of cases of suspected diaphragm dysfunction. Methods We studied 21 patients referred for assessment of diaphragm function due to suspicious clinical symptoms or imaging (breathlessness, orthopnoea, reduced exercise tolerance and/or an elevated hemidiaphragm on plain chest radiograph). All underwent DCR with voluntary sniff manoeuvres. Results Paradoxical motion on sniffing was observed in 14 patients, and confirmed in six who also underwent fluoroscopy or ultrasound. In four patients, DCR showed reduced hemidiaphragm excursion, but no paradoxical motion; in three, normal bilateral diaphragm motion was demonstrated. DCR was quick to perform, and well tolerated in all cases and with no adverse events reported. DCR was achieved in ∼5 min per patient, with images available to view by the clinician immediately within the clinical setting. Conclusion DCR is a rapid, well-tolerated and straightforward chest radiography technique that warrants further investigation in the assessment of diaphragm dysfunction. Dynamic chest radiography is a rapid, well-tolerated and straightforward chest radiography technique that warrants further investigation in the assessment of diaphragm dysfunctionhttps://bit.ly/3HFriWk
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Tanaka R, Kasahara K, Ohkura N, Matsumoto I, Tamura M, Takata M, Inoue D, Izumozaki A, Horii J, Matsuura Y, Sanada S. [Paradigm Shift in Respiratory Diagnosis: Current Status and Future Prospects of Dynamic Chest Radiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:1279-1287. [PMID: 34803108 DOI: 10.6009/jjrt.2021_jsrt_77.11.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dynamic chest radiography (DCR) is a flat-panel detector (FPD) -based functional X-ray imaging, which is performed as an additional examination in chest radiography. The large field of view of FPDs permits real-time observation of motion/kinetic findings on the entire lungs, right and left diaphragm, ribs, and chest wall; heart wall motions; respiratory changes in lung density; and diameter of the intrathoracic trachea. Since the dynamic FPDs had been developed in the early 2000s, we focused on the potential of dynamic FPDs for functional X-ray imaging and have launched a research project for the development of an imaging protocol and digital image-processing techniques for the DCR. The quantitative analysis of motion/kinetic findings is helpful for a better understanding of pulmonary function, because the interpretation of dynamic chest radiographs is challenging and time-consuming for radiologists, pulmonologists, and surgeons. Recent clinical studies have demonstrated the usefulness of DCR combined with the digital image processing techniques for the evaluation of pulmonary function and circulation. Especially, there is a major concern in color-mapping images based on dynamic changes in radiographic lung density, where pulmonary impairments can be detected as color defects, even without the use of contrast media or radioactive medicine. Dynamic chest radiography is now commercially available for the use in general X-ray room and therefore can be deployed as a simple and rapid means of functional imaging in both routine and emergency medicine. This review article describes the current status and future prospects of DCR, which might bring a paradigm shift in respiratory diagnosis.
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Affiliation(s)
- Rie Tanaka
- College of Medical, Pharmaceutical & Health Sciences, Kanazawa University
| | - Kazuo Kasahara
- Department of Respiratory Medicine, Kanazawa University Hospital
| | - Noriyuki Ohkura
- Department of Respiratory Medicine, Kanazawa University Hospital
| | | | | | | | - Dai Inoue
- Department of Radiology, Kanazawa University Hospital
| | | | - Junsei Horii
- Division of Radiology, Kanazawa University Hospital
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18
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Gassert FT, Urban T, Frank M, Willer K, Noichl W, Buchberger P, Schick R, Koehler T, von Berg J, Fingerle AA, Sauter AP, Makowski MR, Pfeiffer D, Pfeiffer F. X-ray Dark-Field Chest Imaging: Qualitative and Quantitative Results in Healthy Humans. Radiology 2021; 301:389-395. [PMID: 34427464 DOI: 10.1148/radiol.2021210963] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background X-ray dark-field radiography takes advantage of the wave properties of x-rays, with a relatively high signal in the lungs due to the many air-tissue interfaces in the alveoli. Purpose To describe the qualitative and quantitative characteristics of x-ray dark-field images in healthy human subjects. Materials and Methods Between October 2018 and January 2020, patients of legal age who underwent chest CT as part of their diagnostic work-up were screened for study participation. Inclusion criteria were a normal chest CT scan, the ability to consent, and the ability to stand upright without help. Exclusion criteria were pregnancy, serious medical conditions, and changes in the lung tissue, such as those due to cancer, pleural effusion, atelectasis, emphysema, infiltrates, ground-glass opacities, or pneumothorax. Images of study participants were obtained by using a clinical x-ray dark-field prototype, recently constructed and commissioned at the authors' institution, to simultaneously acquire both attenuation-based and dark-field thorax radiographs. Each subject's total dark-field signal was correlated with his or her lung volume, and the dark-field coefficient was correlated with age, sex, weight, and height. Results Overall, 40 subjects were included in this study (average age, 62 years ± 13 [standard deviation]; 26 men, 14 women). Normal human lungs have high signal, while the surrounding osseous structures and soft tissue have very low and no signal, respectively. The average dark-field signal was 2.5 m-1 ± 0.4 of examined lung tissue. There was a correlation between the total dark-field signal and the lung volume (r = 0.61, P < .001). No difference was found between men and women (P = .78). Also, age (r = -0.18, P = .26), weight (r = 0.24, P = .13), and height (r = 0.01, P = .96) did not influence dark-field signal. Conclusion This study introduces qualitative and quantitative values for x-ray dark-field imaging in healthy human subjects. The quantitative x-ray dark-field coefficient is independent from demographic subject parameters, emphasizing its potential in diagnostic assessment of the lung. ©RSNA, 2021 See also the editorial by Hatabu and Madore in this issue.
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Affiliation(s)
- Florian T Gassert
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Theresa Urban
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Manuela Frank
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Konstantin Willer
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Wolfgang Noichl
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Philipp Buchberger
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Rafael Schick
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Thomas Koehler
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Jens von Berg
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Alexander A Fingerle
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Andreas P Sauter
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Marcus R Makowski
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Daniela Pfeiffer
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
| | - Franz Pfeiffer
- From the Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstr 22, 81675 Munich, Germany (F.T.G., A.A.F., A.P.S., M.R.M., D.P., F.P.); Department of Physics and Munich School of BioEngineering, Technical University of Munich, Garching, Germany (T.U., M.F., K.W., W.N., P.B., R.S., F.P.); and Philips Research, Hamburg, Germany (T.K., J.v.B.)
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19
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Hatabu H, Madore B. Dark-Field Chest X-ray Imaging: An Evolving Technique in the Century-Old History of Chest X-ray Imaging. Radiology 2021; 301:396-397. [PMID: 34427468 DOI: 10.1148/radiol.2021211603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hiroto Hatabu
- From the Center for Pulmonary Functional Imaging (H.H.) and Department of Radiology (H.H., B.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, 75 Francis St, Boston, MA 02215
| | - Bruno Madore
- From the Center for Pulmonary Functional Imaging (H.H.) and Department of Radiology (H.H., B.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, 75 Francis St, Boston, MA 02215
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20
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Yamasaki Y, Kamitani T, Abe K, Hosokawa K, Sagiyama K, Hida T, Matsuura Y, Kitamura Y, Maruoka Y, Isoda T, Baba S, Yoshikawa H, Kuramoto T, Yabuuchi H, Ishigami K. Diagnosis of Pulmonary Hypertension Using Dynamic Chest Radiography. Am J Respir Crit Care Med 2021; 204:1336-1337. [PMID: 34102086 DOI: 10.1164/rccm.202102-0387im] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yuzo Yamasaki
- Kyushu University, 12923, Clinical Radiology, Fukuoka, Japan;
| | | | - Kohtaro Abe
- Kyushu University Faculty of Medicine Graduate School of Medical Science, 38305, Departments of Advanced Cardiovascular Regulation and Therapeutics, Fukuoka, Japan
| | - Kazuya Hosokawa
- Kyushu University Hospital, 145181, Cardiovascular medicine, Fukuoka, Japan
| | - Koji Sagiyama
- Kyushu University, 12923, Clinical Radiology, Fukuoka, Japan
| | - Tomoyuki Hida
- Kyushu University, 12923, Clinical Radiology, Fukuoka, Japan
| | - Yuko Matsuura
- Kyushu University, 12923, Clinical Radiology, Fukuoka, Japan
| | | | | | - Takuro Isoda
- Kyushu University, 12923, Clinical radiology, Fukuoka, Japan
| | | | - Hideki Yoshikawa
- Kyushu University Hospital, 145181, Medical Technology, Fukuoka, Japan
| | - Taku Kuramoto
- Kyushu University Hospital, 145181, Medical Technology, Fukuoka, Japan
| | | | - Kousei Ishigami
- Kyushu University, 12923, Clinical Radiology, Fukuoka, Japan
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21
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Shibuya Y, Machida H, Yoshiike S, Suda K, Tanaka R, Fujiwara M, Yokoyama K, Kondo H. Pulmonary artery aneurysm diagnosed by dynamic digital chest radiography. Ann Thorac Surg 2021; 113:e87-e90. [PMID: 34022216 DOI: 10.1016/j.athoracsur.2021.04.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/27/2021] [Indexed: 11/01/2022]
Abstract
Pulmonary artery aneurysms (PAAs) are rare, but clinically important because their rupture can cause sudden death. We present the first case of an asymptomatic patient with an unruptured PAA that was successfully diagnosed by dynamic digital chest radiography (DDCR) and was treated surgically. DDCR is a state-of-the-art temporally resolved radiographic technique that offers high-quality fluoroscopy-like images at a low radiation dose. Although noncontrast chest computed tomography (CT) revealed only a nonspecific nodule, DDCR delineated this lesion as a pulsatile nodule synchronized with cardiac pulsations, establishing the diagnosis of PAA. This diagnosis was confirmed by CT pulmonary angiography and surgery.
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Affiliation(s)
- Yukimi Shibuya
- Department of Thoracic and Thyroid Surgery, Faculty of Medicine, Kyorin University.
| | | | - Shinya Yoshiike
- Department of Pathology, Faculty of Medicine, Kyorin University
| | - Kazuharu Suda
- Department of Thoracic and Thyroid Surgery, Faculty of Medicine, Kyorin University
| | - Ryota Tanaka
- Department of Thoracic and Thyroid Surgery, Faculty of Medicine, Kyorin University
| | | | | | - Haruhiko Kondo
- Department of Thoracic and Thyroid Surgery, Faculty of Medicine, Kyorin University
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