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Quantitative CT characterization of pediatric lung development using routine clinical imaging
Jill M Stein1, Laura L Walkup2, Alan S Brody1
1Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA.
Insights
Quantitative CT analysis in children requires normal lung parenchymal X-ray CT attenuation values. This study establishes pediatric lung attenuation norms, showing a rapid decrease in the first two years of life.
Area of Science:
- Pediatric Radiology
- Pulmonary Imaging
- Quantitative CT Analysis
Background:
- Quantitative CT analysis in children is hindered by a lack of established normal values for lung parenchymal attenuation.
- Normal lung development significantly alters parenchymal attenuation with age, necessitating age-specific reference data.
Purpose of the Study:
- To quantitatively characterize normal pediatric lung parenchymal X-ray CT attenuation.
- To establish a baseline for comparison with pathological lung conditions in children.
- To provide reference data for routine clinical CT examinations.
Main Methods:
- Retrospective analysis of normal CT chest examinations in children aged 0-7 years (2004-2014).
- Utilized standard clinical protocols and semi-automated lung parenchymal segmentation.
- Measured lung volume and mean lung attenuation.
Main Results:
- Analyzed 42 CT scans from 39 children (3 days to 83 months).
- Mean lung attenuation was higher in infants (<12 months), reaching -380 HU in neonates.
- Attenuation decreased to -650 HU by age 2 years, then slowed to a plateau of -860 HU.
Conclusions:
- Normal lung parenchymal X-ray CT attenuation decreases with increasing lung volume and age.
- Attenuation decreases rapidly in the first two years, then more slowly.
- These findings are crucial for the accurate application of quantitative CT in pediatric pulmonary imaging.
Background:
The use of quantitative CT analysis in children is limited by lack of normal values of lung parenchymal attenuation. These characteristics are important because normal lung development yields significant parenchymal attenuation changes as children age.
Objective:
To perform quantitative characterization of normal pediatric lung parenchymal X-ray CT attenuation under routine clinical conditions in order to establish a baseline comparison to that seen in pathological lung conditions.
Materials And Methods:
We conducted a retrospective query of normal CT chest examinations in children ages 0-7 years from 2004 to 2014 using standard clinical protocol. During these examinations semi-automated lung parenchymal segmentation was performed to measure lung volume and mean lung attenuation.
Results:
We analyzed 42 CT examinations in 39 children, ages 3 days to 83 months (mean ± standard deviation [SD] = 42 ± 27 months). Lung volume ranged 0.10-1.72 liters (L). Mean lung attenuation was much higher in children younger than 12 months, with values as high as -380 Hounsfield units (HU) in neonates (lung volume 0.10 L). Lung volume decreased to approximately -650 HU by age 2 years (lung volume 0.47 L), with subsequently slower exponential decrease toward a relatively constant value of -860 HU as age and lung volume increased.
Conclusion:
Normal lung parenchymal X-ray CT attenuation decreases with increasing lung volume and age; lung attenuation decreases rapidly in the first 2 years of age and more slowly thereafter. This change in normal lung attenuation should be taken into account as quantitative CT methods are translated to pediatric pulmonary imaging.
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