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Projected lung areas using dynamic X-ray (DXR).

Takuya Hino1, Akinori Hata1, Tomoyuki Hida2

  • 1Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA.

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Summary

Dynamic X-ray (DXR) can accurately measure projected lung area (PLA), showing a significant correlation with vital capacity (VC) and forced expiratory volume in one second (FEV1). This suggests DXR may be a viable alternative for pulmonary function testing.

Keywords:
%FEV1, percent predicted FEV1%VC, percent vital capacityBMI, body mass indexCOPD, chronic obstructive pulmonary diseaseChest radiographDXR, dynamic X-rayFEV1%, forced expiratory volume percent in one second divided by FVCFEV1, forced expiratory volume in one secondFPD, flat-panel detectorFVC, forced vital capacityHealth screening cohortIPF, idiopathic pulmonary fibrosisPA, posteroanteriorPFTs, pulmonary function testsPLA, projected lung areaProjected lung areaPulmonary functionTLC, total lung capacityTV, tidal volumeVC, vital capacitydynamic X-ray

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Area of Science:

  • Radiology and Imaging
  • Pulmonary Medicine
  • Medical Diagnostics

Background:

  • Dynamic X-ray (DXR) offers multi-phase breath imaging with reduced radiation compared to CT.
  • DXR allows precise selection of end-inspiratory and end-expiratory phases.

Purpose of the Study:

  • To determine the correlation between projected lung area (PLA) measured by DXR and standard pulmonary function tests.
  • Investigate DXR's utility in assessing lung capacity and airflow.

Main Methods:

  • 162 healthy volunteers underwent DXR (PA and lateral views) and pulmonary function tests.
  • Lung outlines were manually contoured, and PLA was automatically calculated.
  • Statistical analysis correlated PLA with pulmonary function and demographic data.

Main Results:

  • PLA correlated significantly with physical characteristics (height, weight, BMI) and pulmonary functions (vital capacity - VC, forced expiratory volume in one second - FEV1).
  • Moderate correlations were observed between VC/FEV1 and PA view PLAs during forced inspiration (VC: r=0.65-0.69; FEV1: r=0.54-0.59).
  • Multivariate analysis identified BMI, sex, and VC as independent correlation factors.

Conclusions:

  • Projected lung area (PLA) measured by DXR demonstrates a statistically significant correlation with pulmonary function metrics.
  • DXR shows potential as an alternative method for pulmonary function testing, especially for patients requiring contact inhibition, such as those with COVID-19.