Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications

Hata, Akinori; Yamada, Yoshitake; Tanaka, Rie; Nishino, Mizuki; Hida, Tomoyuki; Hino, Takuya; Ueyama, Masashi; Yanagawa, Masahiro; Kamitani, Takeshi; Kurosaki, Atsuko; Sanada, Shigeru; Jinzaki, Masahiro; Ishigami, Kousei; Tomiyama, Noriyuki; Honda, Hiroshi; Kudoh, Shoji; Hatabu, Hiroto

doi:10.3348/kjr.2020.1136

Cited by 29 publications

(30 citation statements)

References 76 publications

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“…DCR has been used to assess average diaphragm excursion during tidal and deep breathing in healthy volunteers [ 7 , 11 ], and abnormal diaphragm dynamics in people with severe COPD [ 12 ], and pulmonary perfusion [ 13 , 14 ]. Similar correlations between BMI and diaphragm motion, as shown in this work, have been demonstrated by H ata et al [ 5 ] in healthy volunteers.…”

Section: Discussionsupporting

confidence: 91%

“…[13,14] Similar correlations between BMI and diaphragm motion, as shown in this work, have been demonstrated by Hida et al in healthy volunteers. [5] To our knowledge this is the first time DCR has been used in the investigation of hemidiaphragm dysfunction, and there remains large potential for further work in characterisation of the abnormal diaphragm, for example following surgical plication. No single imaging or spirometric technique can accurately diagnose diaphragm paralysis, and each has its own advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 95%

“…[4] It occupies the same footprint as a standard chest X-ray module and can also be used to provide plain radiographic imaging. DCR may carry advantages over traditional fluoroscopy in terms of ease of procedure and reduced radiation dose [5] and the production of quantitative data on diaphragm and chest wall motion; [6,7] due to the ease of subject positioning and the digitised results produced, DCR may have the potential for less user-dependent measurement of diaphragm motion than ultrasound imaging. DCR is licensed in the EU, US and Japan for cineradiographic thoracic imaging, and is in routine clinical use in our tertiary cardiothoracic centre for this purpose.…”

Section: Introductionmentioning

confidence: 99%

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Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study

2021

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ObjectivesDynamic chest radiography (DCR) is a novel real-time digital fluoroscopic imaging system that produces clear, wide field-of-view diagnostic images of the thorax and diaphragm in motion, alongside novel metrics on moving structures within the thoracic cavity. We describe the use of DCR in the measurement of diaphragm motion in a pilot series of cases of suspected diaphragm dysfunction.MethodsWe studied 21 patients referred for assessment of diaphragm function due to suspicious clinical symptoms or imaging (breathlessness, orthopnoea, reduced exercise tolerance, and/or an elevated hemidiaphragm on plain chest radiograph). All underwent DCR with voluntary sniff manoeuvres.ResultsParadoxical motion on sniffing was observed in 14 patients, and confirmed in 6 who also underwent fluoroscopy or ultrasound. In 4 patients, DCR showed reduced hemidiaphragm excursion but no paradoxical motion; in 3, normal bilateral diaphragm motion was demonstrated. DCR was quick to perform, well-tolerated in all cases and with no adverse events reported. DCR was achieved in around five minutes per patient, with images available to view by the clinician immediately within the clinical setting.ConclusionDCR is a rapid, well-tolerated and straightforward X-ray technique that warrants further investigation in the assessment of diaphragm dysfunction.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study

2021

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“…C ONE-BEAM X-ray imaging along with a flat-panel detector is widely used for disease diagnosis, treatment planning, and intervention guiding. It is used for direct twodimensional (2D) imaging such as fluoroscopic angiography [1] and chest radiographs [2] as well as three-dimensional (3D) volume reconstruction in cone-beam computed tomography (CBCT) [3]- [5]. In cone-beam X-ray imaging, because of the divergence of X-rays, imaged structures with different depths have different magnification factors on the X-ray detector.…”

Section: Introductionmentioning

confidence: 99%

Learning Perspective Deformation in X-Ray Transmission Imaging

Huang¹,

Maier²,

Fietkau³

et al. 2022

Preprint

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In cone-beam X-ray transmission imaging, due to the divergence of X-rays, imaged structures with different depths have different magnification factors on an X-ray detector, which results in perspective deformation. Perspective deformation causes difficulty in direct, accurate geometric assessments of anatomical structures. In this work, in order to reduce perspective deformation in X-ray images acquired from regular cone-beam computed tomography (CBCT) systems, we investigate on learning perspective deformation, i.e., converting perspective (cone-beam) projections into orthogonal (parallel-beam) projections. Directly converting a single perspective projection image into an orthogonal projection image is extremely challenging due to the lack of depth information. Therefore, we propose to utilize one additional perspective projection, a complementary (180 • ) or orthogonal (90 • ) view, to provide a certain degree of depth information. Furthermore, learning perspective deformation in different spatial domains, i.e. in Cartesian, polar, and log-polar coordinates, is investigated. Our proposed method is evaluated on numerical spherical bead phantoms as well as patients' chest and head X-ray data. The experiments on numerical bead phantom data demonstrate that learning perspective deformation in polar coordinates has significant advantages over learning in Cartesian coordinates, as root-mean-square error (RMSE) decreases from 5.31 to 1.40, while learning in log-polar coordinates has no further considerable improvement (RMSE = 1.85). In addition, using a complementary view (RMSE = 1.40) is better than an orthogonal view (RMSE = 3.87). The experiments on patients' chest and head data demonstrate that learning perspective deformation using dual complementary views is also applicable in anatomical X-ray data, allowing accurate cardiothoracic ratio measurements in chest X-ray images and cephalometric analysis in synthetic cephalograms from cone-beam X-ray projections. Our proof-of-concept experiments indicate that learning perspective deformation has the potential to empower conventional CBCT systems with more applications, e.g. chest X-ray imaging, which typically require specialized X-ray devices.

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“…Among pulmonary function testing, radiologic imaging is an important diagnostic pillar, with plain radiography being the most used imaging modality, as it is widely available, of low cost, and exposes the patient to a comparably low dose of radiation (2). Since the discovery of x-rays by W.C. Röntgen in 1895 (3), medical radiography has been further developed and optimized for chest imaging (4,5), including more recent techniques focusing on functional lung imaging (6). However, early stage diseases may sometimes be difficult to detect with plain radi-ography due to overlapping anatomy.…”

mentioning

confidence: 99%

X-ray Dark-Field Chest Imaging: Qualitative and Quantitative Results in Healthy Humans

et al. 2021

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Background: X-ray dark-field radiography takes advantage of the wave properties of x-rays, with a relatively high signal in the lungs due to the many air-tissue interfaces in the alveoli.Purpose: To describe the qualitative and quantitative characteristics of x-ray dark-field images in healthy human subjects. Materials and Methods:Between October 2018 and January 2020, patients of legal age who underwent chest CT as part of their diagnostic work-up were screened for study participation. Inclusion criteria were a normal chest CT scan, the ability to consent, and the ability to stand upright without help. Exclusion criteria were pregnancy, serious medical conditions, and changes in the lung tissue, such as those due to cancer, pleural effusion, atelectasis, emphysema, infiltrates, ground-glass opacities, or pneumothorax. Images of study participants were obtained by using a clinical x-ray dark-field prototype, recently constructed and commissioned at the authors' institution, to simultaneously acquire both attenuation-based and dark-field thorax radiographs. Each subject's total dark-field signal was correlated with his or her lung volume, and the dark-field coefficient was correlated with age, sex, weight, and height.Results: Overall, 40 subjects were included in this study (average age, 62 years 6 13 [standard deviation]; 26 men, 14 women). Normal human lungs have high signal, while the surrounding osseous structures and soft tissue have very low and no signal, respectively. The average dark-field signal was 2.5 m 21 6 0.4 of examined lung tissue. There was a correlation between the total dark-field signal and the lung volume (r = 0.61, P , .001). No difference was found between men and women (P = .78). Also, age (r = -0.18, P = .26), weight (r = 0.24, P = .13), and height (r = 0.01, P = .96) did not influence dark-field signal. Conclusion:This study introduces qualitative and quantitative values for x-ray dark-field imaging in healthy human subjects. The quantitative x-ray dark-field coefficient is independent from demographic subject parameters, emphasizing its potential in diagnostic assessment of the lung.

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Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications

Cited by 29 publications

References 76 publications

Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study

Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study

Learning Perspective Deformation in X-Ray Transmission Imaging

X-ray Dark-Field Chest Imaging: Qualitative and Quantitative Results in Healthy Humans

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