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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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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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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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