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Oki T, Nagatani Y, Ishida S, Hashimoto M, Oshio Y, Hanaoka J, Uemura R, Watanabe Y. Right main pulmonary artery distensibility on dynamic ventilation CT and its association with respiratory function. Eur Radiol Exp 2024; 8:50. [PMID: 38570418 PMCID: PMC10991550 DOI: 10.1186/s41747-024-00441-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/22/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Heartbeat-based cross-sectional area (CSA) changes in the right main pulmonary artery (MPA), which reflects its distensibility associated with pulmonary hypertension, can be measured using dynamic ventilation computed tomography (DVCT) in patients with and without chronic obstructive pulmonary disease (COPD) during respiratory dynamics. We investigated the relationship between MPA distensibility (MPAD) and respiratory function and how heartbeat-based CSA is related to spirometry, mean lung density (MLD), and patient characteristics. METHODS We retrospectively analyzed DVCT performed preoperatively in 37 patients (20 female and 17 males) with lung cancer aged 70.6 ± 7.9 years (mean ± standard deviation), 18 with COPD and 19 without. MPA-CSA was separated into respiratory and heartbeat waves by discrete Fourier transformation. For the cardiac pulse-derived waves, CSA change (CSAC) and CSA change ratio (CSACR) were calculated separately during inhalation and exhalation. Spearman rank correlation was computed. RESULT In the group without COPD as well as all cases, CSACR exhalation was inversely correlated with percent residual lung volume (%RV) and RV/total lung capacity (r = -0.68, p = 0.003 and r = -0.58, p = 0.014). In contrast, in the group with COPD, CSAC inhalation was correlated with MLDmax and MLD change rate (MLDmax/MLDmin) (r = 0.54, p = 0.020 and r = 0.64, p = 0.004) as well as CSAC exhalation and CSACR exhalation. CONCLUSION In patients with insufficient exhalation, right MPAD during exhalation was decreased. Also, in COPD patients with insufficient exhalation, right MPAD was reduced during inhalation as well as exhalation, which implied that exhalation impairment is a contributing factor to pulmonary hypertension complicated with COPD. RELEVANCE STATEMENT Assessment of MPAD in different respiratory phases on DVCT has the potential to be utilized as a non-invasive assessment for pulmonary hypertension due to lung disease and/or hypoxia and elucidation of its pathogenesis. KEY POINTS • There are no previous studies analyzing all respiratory phases of right main pulmonary artery distensibility (MPAD). • Patients with exhalation impairment decreased their right MPAD. • Analysis of MPAD on dynamic ventilation computed tomography contributes to understanding the pathogenesis of pulmonary hypertension due to lung disease and/or hypoxia in patients with expiratory impairment.
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Affiliation(s)
- Tatsuya Oki
- Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan
| | - Yukihiro Nagatani
- Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan.
| | - Shota Ishida
- Department of Radiological Technology, Kyoto College of Medical Science, 1-3 Sonobecho Oyamahigashimachi Imakita, Nantan, Kyoto, 622-0041, Japan
| | - Masayuki Hashimoto
- Department of Thoracic Surgery, Takeda General Hospital, 28-1 Ishida Moriminamicho, Fushimi-Ku, Kyoto, 601-1434, Japan
- Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan
| | - Yasuhiko Oshio
- Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan
| | - Jun Hanaoka
- Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan
| | - Ryo Uemura
- Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan
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Wassipaul C, Janata-Schwatczek K, Domanovits H, Tamandl D, Prosch H, Scharitzer M, Polanec S, Schernthaner RE, Mang T, Asenbaum U, Apfaltrer P, Cacioppo F, Schuetz N, Weber M, Homolka P, Birkfellner W, Herold C, Ringl H. Ultra-low-dose CT vs. chest X-ray in non-traumatic emergency department patients - a prospective randomised crossover cohort trial. EClinicalMedicine 2023; 65:102267. [PMID: 37876998 PMCID: PMC10590727 DOI: 10.1016/j.eclinm.2023.102267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
Background Ultra-low-dose CT (ULDCT) examinations of the chest at only twice the radiation dose of a chest X-ray (CXR) now offer a valuable imaging alternative to CXR. This trial prospectively compares ULDCT and CXR for the detection rate of diagnoses and their clinical relevance in a low-prevalence cohort of non-traumatic emergency department patients. Methods In this prospective crossover cohort trial, 294 non-traumatic emergency department patients with a clinically indicated CXR were included between May 2nd and November 26th of 2019 (www.clinicaltrials.gov: NCT03922516). All participants received both CXR and ULDCT, and were randomized into two arms with inverse reporting order. The detection rate of CXR was calculated from 'arm CXR' (n = 147; CXR first), and of ULDCT from 'arm ULDCT' (n = 147; ULDCT first). Additional information reported by the second exam in each arm was documented. From all available clinical and imaging data, expert radiologists and emergency physicians built a compound reference standard, including radiologically undetectable diagnoses, and assigned each finding to one of five clinical relevance categories for the respective patient. Findings Detection rates for main diagnoses by CXR and ULDCT (mean effective dose: 0.22 mSv) were 9.1% (CI [5.2, 15.5]; 11/121) and 20.1% (CI [14.2, 27.7]; 27/134; P = 0.016), respectively. As an additional imaging modality, ULDCT added 9.1% (CI [5.2, 15.5]; 11/121) of main diagnoses to prior CXRs, whereas CXRs did not add a single main diagnosis (0/134; P < 0.001). Notably, ULDCT also offered higher detection rates than CXR for all other clinical relevance categories, including findings clinically irrelevant for the respective emergency department visit with 78.5% (CI [74.0, 82.5]; 278/354) vs. 16.2% (CI [12.7, 20.3]; 58/359) as a primary modality and 68.2% (CI [63.3, 72.8]; 245/359) vs. 2.5% (CI [1.3, 4.7]; 9/354) as an additional imaging modality. Interpretation In non-traumatic emergency department patients, ULDCT of the chest offered more than twice the detection rate for main diagnoses compared to CXR. Funding The Department of Biomedical Imaging and Image-guided Therapy of Medical University of Vienna received funding from Siemens Healthineers (Erlangen, Germany) to employ two research assistants for one year.
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Affiliation(s)
- Christian Wassipaul
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | | | - Hans Domanovits
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Dietmar Tamandl
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Helmut Prosch
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Martina Scharitzer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | | | - Ruediger E. Schernthaner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
- Department of Diagnostic and Interventional Radiology, Clinic Landstrasse, Vienna Healthcare Group, Austria
| | - Thomas Mang
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Ulrika Asenbaum
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Paul Apfaltrer
- Department of Radiology, Medical University of Graz, Austria
| | - Filippo Cacioppo
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Nikola Schuetz
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Michael Weber
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Peter Homolka
- Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Wolfgang Birkfellner
- Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Christian Herold
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Helmut Ringl
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
- Department of Diagnostic and Interventional Radiology, Clinic Donaustadt, Vienna Healthcare Group, Austria
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Ohno Y, Ozawa Y, Nagata H, Bando S, Cong S, Takahashi T, Oshima Y, Hamabuchi N, Matsuyama T, Ueda T, Yoshikawa T, Takenaka D, Toyama H. Area-Detector Computed Tomography for Pulmonary Functional Imaging. Diagnostics (Basel) 2023; 13:2518. [PMID: 37568881 PMCID: PMC10416899 DOI: 10.3390/diagnostics13152518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
An area-detector CT (ADCT) has a 320-detector row and can obtain isotropic volume data without helical scanning within an area of nearly 160 mm. The actual-perfusion CT data within this area can, thus, be obtained by means of continuous dynamic scanning for the qualitative or quantitative evaluation of regional perfusion within nodules, lymph nodes, or tumors. Moreover, this system can obtain CT data with not only helical but also step-and-shoot or wide-volume scanning for body CT imaging. ADCT also has the potential to use dual-energy CT and subtraction CT to enable contrast-enhanced visualization by means of not only iodine but also xenon or krypton for functional evaluations. Therefore, systems using ADCT may be able to function as a pulmonary functional imaging tool. This review is intended to help the reader understand, with study results published during the last a few decades, the basic or clinical evidence about (1) newly applied reconstruction methods for radiation dose reduction for functional ADCT, (2) morphology-based pulmonary functional imaging, (3) pulmonary perfusion evaluation, (4) ventilation assessment, and (5) biomechanical evaluation.
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Affiliation(s)
- Yoshiharu Ohno
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan;
| | - Yoshiyuki Ozawa
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Hiroyuki Nagata
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan;
| | - Shuji Bando
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Shang Cong
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Tomoki Takahashi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Takahiro Matsuyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Takeshi Yoshikawa
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi 673-0021, Hyogo, Japan
| | - Daisuke Takenaka
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi 673-0021, Hyogo, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
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Tækker M, Kristjánsdóttir B, Graumann O, Laursen CB, Pietersen PI. Diagnostic accuracy of low-dose and ultra-low-dose CT in detection of chest pathology: a systematic review. Clin Imaging 2021; 74:139-148. [PMID: 33517021 DOI: 10.1016/j.clinimag.2020.12.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/12/2020] [Accepted: 12/31/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Studies have evaluated imaging modalities with a lower radiation dose than standard-dose CT (SD-CT) for chest examination. This systematic review aimed to summarize evidence on diagnostic accuracy of these modalities - low-dose and ultra-low-dose CT (LD- and ULD-CT) - for chest pathology. METHOD Ovid-MEDLINE, Ovid-EMBASE and the Cochrane Library were systematically searched April 29th-30th, 2019 and screened by two reviewers. Studies on diagnostic accuracy were included if they defined their index tests as 'LD-CT', 'Reduced-dose CT' or 'ULD-CT' and had SD-CT as reference standard. Risk of bias was evaluated on study level using the Quality Assessment of Diagnostic Accuracy Studies-2. A narrative synthesis was conducted to compare the diagnostic accuracy measurements. RESULTS Of the 4257 studies identified, 18 were eligible for inclusion. SD-CT (3.17 ± 1.47 mSv) was used as reference standard in all studies to evaluate diagnostic accuracy of LD- (1.22 ± 0.34 mSv) and ULD-CT (0.22 ± 0.05 mSv), respectively. LD-CT had high sensitivities for detection of bronchiectasis (82-96%), honeycomb (75-100%), and varying sensitivities for nodules (63-99%) and ground glass opacities (GGO) (77-91%). ULD-CT had high sensitivities for GGO (93-100%), pneumothorax (100%), consolidations (90-100%), and varying sensitivities for nodules (60-100%) and emphysema (65-90%). CONCLUSION The included studies found LD-CT to have high diagnostic accuracy in detection of honeycombing and bronchiectasis and ULD-CT to have high diagnostic accuracy for pneumothorax, consolidations and GGO. Summarizing evidence on diagnostic accuracy of LD- and ULD-CT for other chest pathology was not possible due to varying outcome measures, lack of precision estimates and heterogeneous study design and methodology.
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Affiliation(s)
- Maria Tækker
- Research and Innovation Unit of Radiology, University of Southern Denmark, Kloevervaenget 10, entrance 112, 2nd floor, 5000 Odense C, Denmark; Department of Radiology, Odense University Hospital, Kloevervaenget 47, 5000 Odense C, Denmark.
| | - Björg Kristjánsdóttir
- Research and Innovation Unit of Radiology, University of Southern Denmark, Kloevervaenget 10, entrance 112, 2nd floor, 5000 Odense C, Denmark; Department of Radiology, Odense University Hospital, Kloevervaenget 47, 5000 Odense C, Denmark.
| | - Ole Graumann
- Research and Innovation Unit of Radiology, University of Southern Denmark, Kloevervaenget 10, entrance 112, 2nd floor, 5000 Odense C, Denmark; Department of Radiology, Odense University Hospital, Kloevervaenget 47, 5000 Odense C, Denmark.
| | - Christian B Laursen
- Department of Respiratory Medicine, Odense University Hospital, Kloevervaenget 2, entrance 87-88, 5000 Odense C, Denmark; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Pia I Pietersen
- Department of Respiratory Medicine, Odense University Hospital, Kloevervaenget 2, entrance 87-88, 5000 Odense C, Denmark; Regional Center for Technical Simulation, Odense University Hospital, Region of Southern Denmark, J. B. Winsløws Vej 4, 5000 Odense C, Denmark.
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Nagatani Y, Hashimoto M, Oshio Y, Sato S, Hanaoka J, Fukunaga K, Uemura R, Yoshigoe M, Nitta N, Usio N, Tsukagoshi S, Kimoto T, Yamashiro T, Moriya H, Murata K, Watanabe Y. Preoperative assessment of localized pleural adhesion: Utility of software-assisted analysis on dynamic-ventilation computed tomography. Eur J Radiol 2020; 133:109347. [PMID: 33166835 DOI: 10.1016/j.ejrad.2020.109347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/29/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the usefulness of software analysis using dynamic-ventilation CT for localized pleural adhesion (LPA). MATERIALS AND METHODS Fifty-one patients scheduled to undergo surgery underwent both dynamic-ventilation CT and static chest CT as preoperative assessments. Five observers independently evaluated the presence and severity of LPA on a three-point scale (non, mild, and severe LPA) for 9 pleural regions (upper, middle, and lower pleural aspects on ventral, lateral, and dorsal areas) on the chest CT by three different methods by observing images from: static high-resolution CT (static image); dynamic-ventilation CT (movie image), and dynamic-ventilation CT while referring to the adhesion map (movie image with color map), which was created using research software to visualize movement differences between the lung surface and chest wall. The presence and severity of LPA was confirmed by intraoperative thoracoscopic findings. Parameters of diagnostic accuracy for LPA presence and severity were assessed among the three methods using Wilcoxon signed rank test in total and for each of the three pleural aspects. RESULTS Mild and severe LPA were confirmed in 14 and 8 patients. Movie image with color map had higher sensitivity (56.9 ± 10.7 %) and negative predictive value (NPV) (91.4 ± 1.7 %) in LPA detection than both movie image and static image. Additionally, for severe LPA, detection sensitivity was the highest with movie image with color map (82.5 ± 6.1 %), followed by movie image (58.8 ± 17.0 %) and static image (38.8 ± 13.9 %). For LPA severity, movie image with color map was similar to movie image and superior to static image in accuracy as well as underestimation and overestimation, with a mean value of 80.2 %. CONCLUSION Software-assisted dynamic-ventilation CT may be a useful novel imaging approach to improve the detection performance of LPA.
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Affiliation(s)
- Yukihiro Nagatani
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan.
| | - Masayuki Hashimoto
- Department of Thoracic Surgery, Kyoto Medical Center, Kyoto, Kyoto, 612-8555, Japan; Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan
| | - Yasuhiko Oshio
- Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan
| | - Shigetaka Sato
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Jun Hanaoka
- Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan
| | - Kentaro Fukunaga
- Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan
| | - Ryo Uemura
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Makoto Yoshigoe
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Norihisa Nitta
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Noritoshi Usio
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Shinsuke Tsukagoshi
- CT System Division, Canon Medical Systems, Otawara, Tochigi, 324-8550, Japan
| | - Tatsuya Kimoto
- Department of Radio Center for Medical Research and Development, Canon Medical Systems, Otawara, Tochigi, 324-8550, Japan
| | - Tsuneo Yamashiro
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, 903-0215, Japan
| | - Hiroshi Moriya
- Department of Radiology, Ohara General Hospital, Fukushima, Fukushima, 960-8611, Japan
| | - Kiyoshi Murata
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
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Kubo T, Ohno Kishimoto A, Togashi K. Efficiency and reproducibility in pulmonary nodule detection in simulated dose reduction lung CT images. Eur J Radiol Open 2019; 6:113-118. [PMID: 30899771 PMCID: PMC6412012 DOI: 10.1016/j.ejro.2019.02.001] [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: 12/10/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the reproducibility and productivity of reduced dose chest computed tomography (CT) using a nodule detection task. Materials and methods Eighty-eight consecutive non-contrast CT examinations were performed using an automatic exposure system with a reference standard deviation of 8.5. Simulated raw data of a reduced dose scan (standard deviation at 21 and 29) were generated with a dose simulator. Original and simulated raw data were reconstructed to series of 7-mm-thick images (Original, Simulation A, Simulation B). In the first part of the reading experiment, three readers independently interpreted these images (88 cases × 3 series) and recorded the size, type, and location of the pulmonary nodules. The reading time for every case was recorded. In the second part of the experiment, the repeated interpretation of standard dose images was performed by two readers. Concordance or discordance of nodule detection between the first and the repeated reading result was assessed. Results A statistically significant difference in the detected nodule counts for lesions less than 5 mm by one reader was observed in simulation B images. Discordance of the interpretation result was found only in ground-glass nodules larger than 5 mm detected by one reader in simulation B images. There was no statistically significant difference in the reading time among the three image types. Conclusion Simulated standard deviation 21 images can reproduce the image interpretation result of original images, whereas simulated standard deviation 29 images may compromise the accuracy of nodule assessment. The effect on the reading time was not observed with dose reduction simulation.
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Affiliation(s)
- Takeshi Kubo
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Ayami Ohno Kishimoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Nagatani Y, Hashimoto M, Nitta N, Oshio Y, Yamashiro T, Sato S, Tsukagoshi S, Moriya H, Kimoto T, Igarashi T, Ushio N, Sonoda A, Otani H, Hanaoka J, Murata K. Continuous quantitative measurement of the main bronchial dimensions and lung density in the lateral position by four-dimensional dynamic-ventilation CT in smokers and COPD patients. Int J Chron Obstruct Pulmon Dis 2018; 13:3845-3856. [PMID: 30568436 PMCID: PMC6267741 DOI: 10.2147/copd.s178836] [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] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to measure changes in lung density and airway dimension in smokers in the lateral position using four-dimensional dynamic-ventilation computed tomography (CT) during free breathing and to evaluate their correlations with spirometric values. Materials and methods Preoperative pleural adhesion assessments included dynamic-ventilation CT of 42 smokers (including 22 patients with COPD) in the lateral position, with the unoperated lung beneath (dependent lung). The scanned lungs' mean lung density (MLD) and the bilateral main bronchi's luminal areas (Ai) were measured automatically (13-18 continuous image frames, 0.35 seconds/frame). Calculations included cross-correlation coefficients (CCCs) between the MLD and Ai time curves, and correlations between the quantitative measurements and spirometric values were evaluated by using Spearman's rank coefficient. Results The ΔMLD1.05 (from the peak inspiration frame to the third expiratory frame, 1.05 seconds later) in the nondependent lung negatively correlated with FEV1/FVC (r=-0.417, P<0.01), suggesting that large expiratory movement of the nondependent lung would compensate limited expiratory movement of the dependent lung due to COPD. The ΔAi1.05 negatively correlated with the FEV1/FVC predicted in both the lungs (r=-0.465 and -0.311, P<0.05), suggesting that early expiratory collapses of the main bronchi indicate severe airflow limitation. The CCC correlated with FEV1/FVC in the dependent lung (r=-0.474, P<0.01), suggesting that reduced synchrony between the proximal airway and lung occurs in patients with severe airflow limitation. Conclusion In COPD patients, in the lateral position, the following abnormal dynamic-ventilation CT findings are associated with airflow limitation: enhanced complementary ventilation in the nondependent lung, early expiratory airway collapses, and reduced synchrony between airway and lung movements in the dependent lung.
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Affiliation(s)
- Yukihiro Nagatani
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Masayuki Hashimoto
- Department of Surgery, Division of General Thoracic Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Norihisa Nitta
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Yasuhiko Oshio
- Department of Surgery, Division of General Thoracic Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Tsuneo Yamashiro
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan,
| | - Shigetaka Sato
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | | | - Hiroshi Moriya
- Department of Radiology, Ohara General Hospital, Fukushima, Fukushima 960-8611, Japan
| | - Tatsuya Kimoto
- Healthcare IT Development Center, Canon Medical Systems, Otawara, Tochigi 324-8550, Japan
| | - Tomoyuki Igarashi
- Department of Surgery, Division of General Thoracic Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Noritoshi Ushio
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Akinaga Sonoda
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Hideji Otani
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Jun Hanaoka
- Department of Surgery, Division of General Thoracic Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Kiyoshi Murata
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
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Nagatani Y, Takahashi M, Ikeda M, Nitta N, Miyata K, Hanaoka J, Nakano Y, Matsuo S, Hamada Y, Sonoda A, Otani H, Ushio N, Ohta S, Murakami Y, Kaneko C, Inoue A, Kida T, Murata K. Sub-solid nodule detectability in seven observers of seventy-nine clinical cases: comparison between ultra-low-dose chest digital tomosynthesis with iterative reconstruction and chest radiography by receiver-operating characteristics analysis. Eur J Radiol 2018; 107:166-174. [DOI: 10.1016/j.ejrad.2018.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/30/2018] [Accepted: 08/09/2018] [Indexed: 12/16/2022]
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Nagatani Y, Moriya H, Noma S, Sato S, Tsukagoshi S, Yamashiro T, Koyama M, Tomiyama N, Ono Y, Murayama S, Murata K, Koyama M, Narumi Y, Yanagawa M, Honda O, Tomiyama N, Ohno Y, Sugimura K, Sakuma K, Moriya H, Tada A, Kanazawa S, Sakai F, Nishimoto Y, Noma S, Tsuchiya N, Tsubakimoto M, Yamashiro T, Murayama S, Sato S, Nagatani Y, Nitta N, Murata K. Association of Focal Radiation Dose Adjusted on Cross Sections with Subsolid Nodule Visibility and Quantification on Computed Tomography Images Using AIDR 3D: Comparison Among Scanning at 84, 42, and 7 mAs. Acad Radiol 2018; 25:1156-1166. [PMID: 29735355 DOI: 10.1016/j.acra.2018.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 12/17/2022]
Abstract
RATIONALE AND OBJECTIVES The objectives of this study were to compare the visibility and quantification of subsolid nodules (SSNs) on computed tomography (CT) using adaptive iterative dose reduction using three-dimensional processing between 7 and 42 mAs and to assess the association of size-specific dose estimate (SSDE) with relative measured value change between 7 and 84 mAs (RMVC7-84) and relative measured value change between 42 and 84 mAs (RMVC42-84). MATERIALS AND METHODS As a Japanese multicenter research project (Area-detector Computed Tomography for the Investigation of Thoracic Diseases [ACTIve] study), 50 subjects underwent chest CT with 120 kV, 0.35 second per location and three tube currents: 240 mA (84 mAs), 120 mA (42 mAs), and 20 mA (7 mAs). Axial CT images were reconstructed using adaptive iterative dose reduction using three-dimensional processing. SSN visibility was assessed with three grades (1, obscure, to 3, definitely visible) using CT at 84 mAs as reference standard and compared between 7 and 42 mAs using t test. Dimension, mean CT density, and particular SSDE to the nodular center of 71 SSNs and volume of 58 SSNs (diameter >5 mm) were measured. Measured values (MVs) were compared using Wilcoxon signed-rank tests among CTs at three doses. Pearson correlation analyses were performed to assess the association of SSDE with RMVC7-84: 100 × (MV at 7 mAs - MV at 84 mAs)/MV at 84 mAs and RMVC42-84. RESULTS SSN visibilities were similar between 7 and 42 mAs (2.76 ± 0.45 vs 2.78 ± 0.40) (P = .67). For larger SSNs (>8 mm), MVs were similar among CTs at three doses (P > .05). For smaller SSNs (<8 mm), dimensions and volumes on CT at 7 mAs were larger and the mean CT density was smaller than 42 and 84 mAs, and SSDE had mild negative correlations with RMVC7-84 (P < .05). CONCLUSIONS Comparable quantification was demonstrated irrespective of doses for larger SSNs. For smaller SSNs, nodular exaggerating effect associated with decreased SSDE on CT at 7 mAs compared to 84 mAs could result in comparable visibilities to CT at 42 mAs.
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Hashimoto M, Nagatani Y, Oshio Y, Nitta N, Yamashiro T, Tsukagoshi S, Ushio N, Mayumi M, Kimoto T, Igarashi T, Yoshigoe M, Iwai K, Tanaka K, Sato S, Sonoda A, Otani H, Murata K, Hanaoka J. Preoperative assessment of pleural adhesion by Four-Dimensional Ultra-Low-Dose Computed Tomography (4D-ULDCT) with Adaptive Iterative Dose Reduction using Three-Dimensional processing (AIDR-3D). Eur J Radiol 2018; 98:179-186. [DOI: 10.1016/j.ejrad.2017.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/19/2017] [Accepted: 11/17/2017] [Indexed: 11/29/2022]
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