Dynamic chest radiography: clinical validation of ventilation and perfusion metrics derived from changes in radiographic lung density compared to nuclear medicine imaging

Tanaka, Rie; Matsumoto, Isao; Tamura, Masaya; Takata, Munehisa; Yoshida, Shuhei; Saito, Daisuke; Tanaka, Yusuke; Inoue, Dai; Ohkura, Noriyuki; Kondo, Kazuo

doi:10.21037/qims-20-1217

Cited by 13 publications

(12 citation statements)

References 39 publications

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“…DCR can provide information on several points, such as pulmonary ventilation, diaphragm movement, and lung circulation (9)(10)(11). It is expected to be clinically applied in various fields, and some reports have already been published, describing DCR as useful for evaluating chronic obstructive pulmonary disease and cystic fibrosis patients (1,2,(12)(13)(14), in the clinical application of ventilation and perfusion (15,16), and for diagnosing pulmonary hypertension (5). However, there have been few reports of its surgical application, and the ones in existence are only case reports of surgery for pleural tumor (6).…”

Section: Discussionmentioning

confidence: 99%

Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis

Watanabe¹,

Suzuki²,

Yoshii³

et al. 2023

J Thorac Dis

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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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Section: Discussionmentioning

confidence: 99%

Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis

Watanabe¹,

Suzuki²,

Yoshii³

et al. 2023

J Thorac Dis

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“…Dynamic chest radiography analysis has the advantages of not requiring a contrast agent, and its radiation exposure is comparable with that of conventional chest radiography. 8 Therefore, it may be more useful for patients with contraindication to contrast agents or for pregnant women. However, it has limitations, in that the sensitivity and specificity are unknown because this method is relatively new.…”

Section: Discussionmentioning

confidence: 99%

Successful visualization of pulmonary embolism using fluoroscopic video analysis in a patient with iodine contrast allergy: a case report

Hijikata¹,

Sakurai²,

Takahashi³

et al. 2022

European Heart Journal - Case Reports

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Background Contrast-enhanced computed tomography (CT) is commonly used to diagnose pulmonary embolism (PE). However, a history of iodine contrast allergy presents a dilemma in the management of patients with PE. As an alternative approach, X-ray fluoroscopic video analysis has been recently reported to be useful in diagnosing PE. Case summary A 78-year-old man with dyspnea of 1-month duration visited our hospital. His oxygen saturation was 89% and echocardiography demonstrated right heart strain. We could not perform contrast-enhanced CT because the patient had a history of contrast allergy and refused to undergo premedicated contrast CT with anti-histamine and/or corticosteroid. Therefore, a video analysis of pulmonary circulation using dynamic chest X-ray (DCR) was performed. The reconstructed pseudo-color video showed defects of pulmonary circulation in both lung areas. We diagnosed PE and began anticoagulant therapy. Multiple segmental defects were also observed in pulmonary perfusion scintigraphy on day 3, which confirmed the diagnosis of PE. He was discharged on day 9, and improvement of the pulmonary circulation as assessed with DCR was observed. He had no symptoms at the last follow-up visit at 1 year after discharge. Conclusion We describe the successful visualization of PE using DCR in a patient with iodine contrast allergy.

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“…Dynamic chest radiography (DCR) is a flat-panel detector (FPD)-based functional X-ray imaging method that can be performed with a total entrance surface dose comparable to that of conventional radiography [1]. DCR allows for the evaluation of lung function based on changes in lung density due to respiration and chest wall invasion based on lung cancer movement [2,3]. Because bone shadows can degrade dynamic image analysis, there is a growing need for bone suppression (BS) techniques for multidirectional dynamic chest images.…”

Section: Introductionmentioning

confidence: 99%

Bone suppression technique for multidirectional dynamic chest radiography: a virtual imaging trial

Goshima

Tanaka

Segars

et al. 2023

Medical Imaging 2023: Physics of Medical Imaging

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Prediction of pleural invasion in lung cancer is crucial in planning appropriate operating procedures and can be assessed using dynamic chest radiography (DCR). However, this assessment is negatively affected by rib shadows in conventional images. The purpose of this study was to develop a deep learning-based bone suppression technique for DCR in various projection directions. Twenty breathing XCAT phantoms with lung tumors and a pair of phantoms consisting only of bone structures were generated. The XCAT phantoms were virtually projected from six directions, resulting in 54000 multidirectional chest X-ray images and were used for training a pix2pix model to estimate bone images from original images. Bone suppression (BS) images were created by subtracting the bone images from the original images and then evaluated based on the peak signal to noise ratio (PSNR), structural similarity index measure (SSIM), and Fréchet Video Distance (FVD). Clinical cases were processed using the trained model as well. Furthermore, lung tumors on the original and BS images were tracked using OpenCV template matching, and the tracking accuracy was compared. The PSNR, SSIM, and FVD were 0.9966, 52.20 and 136.9, respectively. In the visual evaluation, we confirmed the effect of BS without temporal fluctuation of pixel values in both the resulting images of the XCAT phantom and real patients. Furthermore, precise tracking of the targeted tumor was achieved on the resulting BS images even in oblique directions, without any interruption from the rib shadows. These results indicate that our proposed method can effectively reduce bone shadows as well as temporal variations in the effect of bone suppression.

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Dynamic chest radiography: clinical validation of ventilation and perfusion metrics derived from changes in radiographic lung density compared to nuclear medicine imaging

Cited by 13 publications

References 39 publications

Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis

Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis

Successful visualization of pulmonary embolism using fluoroscopic video analysis in a patient with iodine contrast allergy: a case report

Bone suppression technique for multidirectional dynamic chest radiography: a virtual imaging trial

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