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Ohno Y, Seo JB, Parraga G, Lee KS, Gefter WB, Fain SB, Schiebler ML, Hatabu H. Pulmonary Functional Imaging: Part 1-State-of-the-Art Technical and Physiologic Underpinnings. Radiology 2021; 299:508-523. [PMID: 33825513 DOI: 10.1148/radiol.2021203711] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Over the past few decades, pulmonary imaging technologies have advanced from chest radiography and nuclear medicine methods to high-spatial-resolution or low-dose chest CT and MRI. It is currently possible to identify and measure pulmonary pathologic changes before these are obvious even to patients or depicted on conventional morphologic images. Here, key technological advances are described, including multiparametric CT image processing methods, inhaled hyperpolarized and fluorinated gas MRI, and four-dimensional free-breathing CT and MRI methods to measure regional ventilation, perfusion, gas exchange, and biomechanics. The basic anatomic and physiologic underpinnings of these pulmonary functional imaging techniques are explained. In addition, advances in image analysis and computational and artificial intelligence (machine learning) methods pertinent to functional lung imaging are discussed. The clinical applications of pulmonary functional imaging, including both the opportunities and challenges for clinical translation and deployment, will be discussed in part 2 of this review. Given the technical advances in these sophisticated imaging methods and the wealth of information they can provide, it is anticipated that pulmonary functional imaging will be increasingly used in the care of patients with lung disease. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Yoshiharu Ohno
- From the Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Medicine, Robarts Research Institute, and Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Departments of Medical Physics and Radiology (S.B.F., M.L.S.), UW-Madison School of Medicine and Public Health, Madison, Wis; and Center for Pulmonary Functional Imaging, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Joon Beom Seo
- From the Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Medicine, Robarts Research Institute, and Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Departments of Medical Physics and Radiology (S.B.F., M.L.S.), UW-Madison School of Medicine and Public Health, Madison, Wis; and Center for Pulmonary Functional Imaging, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Grace Parraga
- From the Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Medicine, Robarts Research Institute, and Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Departments of Medical Physics and Radiology (S.B.F., M.L.S.), UW-Madison School of Medicine and Public Health, Madison, Wis; and Center for Pulmonary Functional Imaging, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Kyung Soo Lee
- From the Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Medicine, Robarts Research Institute, and Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Departments of Medical Physics and Radiology (S.B.F., M.L.S.), UW-Madison School of Medicine and Public Health, Madison, Wis; and Center for Pulmonary Functional Imaging, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Warren B Gefter
- From the Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Medicine, Robarts Research Institute, and Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Departments of Medical Physics and Radiology (S.B.F., M.L.S.), UW-Madison School of Medicine and Public Health, Madison, Wis; and Center for Pulmonary Functional Imaging, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Sean B Fain
- From the Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Medicine, Robarts Research Institute, and Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Departments of Medical Physics and Radiology (S.B.F., M.L.S.), UW-Madison School of Medicine and Public Health, Madison, Wis; and Center for Pulmonary Functional Imaging, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Mark L Schiebler
- From the Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Medicine, Robarts Research Institute, and Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Departments of Medical Physics and Radiology (S.B.F., M.L.S.), UW-Madison School of Medicine and Public Health, Madison, Wis; and Center for Pulmonary Functional Imaging, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Hiroto Hatabu
- From the Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Medicine, Robarts Research Institute, and Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Departments of Medical Physics and Radiology (S.B.F., M.L.S.), UW-Madison School of Medicine and Public Health, Madison, Wis; and Center for Pulmonary Functional Imaging, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
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