Measurement of pulmonary parenchymal attenuation: use of spirometric gating with quantitative CT

A new approach to reproducible measurement of lung attenuation and structure by means of respiratory-gated computed tomography (CT) was developed. The patient breathes through a microcomputer-controlled pocket spirometer during the complete CT examination, starting with a measurement of the vital capacity. At a user-selected respiratory level, the CT scan is triggered and air flow is inhibited mechanically. To exclude operator-related reproducibility errors, evaluation is based on semiautomated algorithms that isolate lung parenchyma by fast contour tracing. In a study on one volunteer, measurement of lung attenuation changed by a factor of about 2.6 (-895 to -730 HU) as a function of inspirational status. Reproducibility on the order of 5% or better can be achieved only with tight spirometric control of respiration.