A Pilot Trial on Pulmonary Emphysema Quantification and Perfusion Mapping in a Single-Step Using Contrast-Enhanced Dual-Energy Computed Tomography

Lee, Choong Wook; Seo, Joon Beom; Lee, Young‐Joo; Chae, Eun Jin; Kim, Namkug; Lee, Hyun Joo; Hwang, Hye Jeon; Lim, Chaehun

doi:10.1097/rli.0b013e318228359a

Cited by 36 publications

(16 citation statements)

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“…It also appears to be promising for the evaluation of patients with obstructive airway disease [ 16 17 18 ]. Recently, the degree of decrease of perfusion in lung PBV has been shown to be correlated with the severity of emphysema [ 13 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Quantification of Lung Perfusion Blood Volume by Dual-Energy CT in Patients With and Without Chronic Obstructive Pulmonary Disease

Koike¹,

Sueyoshi²,

Sakamoto³

et al. 2015

Journal of the Belgian Society of Radiology

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Purpose: In chronic obstructive pulmonary disease (COPD), pulmonary vascular alteration is one of the characteristic features. Recently, software has been used for the quantification of lung iodine perfusion blood volume (iPBV) using dual-energy CT, allowing objective evaluation. The purpose of this study was to evaluate the quantification of lung PBV with and without COPD.Materials and Methods: This study was approved by the Institutional Review Board. Sixty-two subjects who had undergone a respiratory function test within one month underwent dual-energy CT angiography. The subjects were divided into two groups: with (n = 14) and without (n = 48) COPD. We evaluated the quantification of lung iPBV in the early phase and late phase using Syngo softwarepost contrast. Associations between lung iPBV and respiratory function (forced expiratory volume in 1 second/forced vital capacity; FEV1/FVC) and the percentage area of emphysema (%LAA-950) were also evaluated.Results: In the early phase, lung iPBV values were 20.1 ± 5.5 and 30.6 ± 7.6 Hounsfield Unit (HU) in those with and without COPD, respectively, with a significant difference between them (p < 0.0001). In the late phase, the values were 12.3 ± 3.7 and 15.3 ± 4.6 HU, respectively, with no significant difference (p = 0.051). However, this could be noticed as a trend. In the early phase, there was a weak significant correlation between lung iPBV value and FEV1/FVC (R = 0.26, p = 0.047). There were significant and moderate negative correlations between lung iPBV value and %LAA-950 in early and late phases (R = −0.57, p = 0.0002; R = −0.45, p = 0.005, respectively).Conclusions: Quantification of lung iPBV reflects reduced pulmonary perfusion in patients with COPD. It may be useful for objective evaluation of the pulmonary blood flow in patients with COPD.

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Section: Discussionmentioning

confidence: 99%

Quantification of Lung Perfusion Blood Volume by Dual-Energy CT in Patients With and Without Chronic Obstructive Pulmonary Disease

Koike¹,

Sueyoshi²,

Sakamoto³

et al. 2015

Journal of the Belgian Society of Radiology

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“…The GE Advantage Workstation™ has advanced lung analysis modules, while the TeraRecon Aquarius workstation includes lung nodule tracking and analysis functions. In addition, some academic labs in South Korea and Netherlands have developed in-house software for lung specific workstations (47-55). …”

Section: Organ-specific Diagnostic Worktationsmentioning

confidence: 99%

“…In the former, xenon ventilation (76, 77) and iodine perfusion (47) using dual-energy CT have been evaluated (Fig. 4).…”

Section: Functional Molecular and Quantitative Imagingmentioning

confidence: 99%

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An Engineering View on Megatrends in Radiology: Digitization to Quantitative Tools of Medicine

Kim

Choi

et al. 2013

Korean J Radiol

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Within six months of the discovery of X-ray in 1895, the technology was used to scan the interior of the human body, paving the way for many innovations in the field of medicine, including an ultrasound device in 1950, a CT scanner in 1972, and MRI in 1980. More recent decades have witnessed developments such as digital imaging using a picture archiving and communication system, computer-aided detection/diagnosis, organ-specific workstations, and molecular, functional, and quantitative imaging. One of the latest technical breakthrough in the field of radiology has been imaging genomics and robotic interventions for biopsy and theragnosis. This review provides an engineering perspective on these developments and several other megatrends in radiology.

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“…The procedures for dynamically following wash-in kinetics of xenon gas requires complex CT scanning methodologies that are difficult to transfer to clinical settings 17 . The development of dual-energy CT (DECT) 19-21 has offered the possibility of imaging regional ventilation throughout the whole lung, albeit via a breath hold technique 15,19,22 . Because little has been done to explore the quantitative measures obtained via the emerging static dual-energy CT methods of imaging the lung with xenon gas and because little has been done to evaluate optimal dual-energy xenon-CT imaging protocols to minimize the gravitational effects of the very dense xenon gas, we have undertaken, here, to explore xenon-CT imaging of regional ventilation by comparing and optimizing methodological approaches.…”

Section: Introductionmentioning

confidence: 99%

Optimization of Dual-Energy Xenon–Computed Tomography for Quantitative Assessment of Regional Pulmonary Ventilation

Fuld

Halaweish²,

Newell³

et al. 2013

Investigative Radiology

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Objective Dual-energy X-ray computed tomography (DECT) offers visualization of the airways and quantitation of regional pulmonary ventilation using a single breath of inhaled xenon gas. In this study we seek to optimize scanning protocols for DECT xenon gas ventilation imaging of the airways and lung parenchyma and to characterize the quantitative nature of the developed protocols through a series of test-object and animal studies. Materials and Methods The Institutional Animal Care and Use Committee approved all animal studies reported here. A range of xenon-oxygen gas mixtures (0, 20, 25, 33, 50, 66, 100%; balance oxygen) were scanned in syringes and balloon test-objects to optimize the delivered gas mixture for assessment of regional ventilation while allowing for the development of improved three-material decomposition calibration parameters. Additionally, to alleviate gravitational effects on xenon gas distribution, we replaced a portion of the oxygen in the xenon/oxygen gas mixture with helium and compared gas distributions in a rapid-prototyped human central-airway test-object. Additional syringe tests were performed to determine if the introduction of helium had any effect on xenon quantitation. Xenon gas mixtures were delivered to anesthetized swine in order to assess airway and lung parenchymal opacification while evaluating various DECT scan acquisition settings. Results Attenuation curves for xenon were obtained from the syringe test objects and were used to develop improved three-material decomposition parameters (HU enhancement per percent xenon: Within the chest phantom: 2.25 at 80kVp, 1.7 at 100 kVp, and 0.76 at 140 kVp with tin filtration; In open air: 2.5 at 80kVp, 1.95 at 100 kVp, and 0.81 at 140 kVp with tin filtration). The addition of helium improved the distribution of xenon gas to the gravitationally non-dependent portion of the airway tree test-object, while not affecting quantitation of xenon in the three-material decomposition DECT. 40%Xe/40%He/20%O2 provided good signal-to-noise, greater than the Rose Criterion (SNR > 5), while avoiding gravitational effects of similar concentrations of xenon in a 60%O2 mixture. 80/140-kVp (tin-filtered) provided improved SNR compared with 100/140-kVp in a swine with an equivalent thoracic transverse density to a human subject with body mass index of 33. Airways were brighter in the 80/140 kVp scan (80/140Sn, 31.6%; 100/140Sn, 25.1%) with considerably lower noise (80/140Sn, CV of 0.140; 100/140Sn, CV of 0.216). Conclusion In order to provide a truly quantitative measure of regional lung function with xenon-DECT, the basic protocols and parameter calibrations needed to be better understood and quantified. It is critically important to understand the fundamentals of new techniques in order to allow for proper implementation and interpretation of their results prior to wide spread usage. With the use of an in house derived xenon calibration curve for three-material decomposition rather than the scanner supplied calibration and a xenon/helium/oxyge...

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A Pilot Trial on Pulmonary Emphysema Quantification and Perfusion Mapping in a Single-Step Using Contrast-Enhanced Dual-Energy Computed Tomography

Cited by 36 publications

References 24 publications

Quantification of Lung Perfusion Blood Volume by Dual-Energy CT in Patients With and Without Chronic Obstructive Pulmonary Disease

Quantification of Lung Perfusion Blood Volume by Dual-Energy CT in Patients With and Without Chronic Obstructive Pulmonary Disease

An Engineering View on Megatrends in Radiology: Digitization to Quantitative Tools of Medicine

Optimization of Dual-Energy Xenon–Computed Tomography for Quantitative Assessment of Regional Pulmonary Ventilation

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