Evaluation of the Relationship Between Pulmonary Perfusion Via Chest Digital Dynamic Radiography System and Diffusing...

Non-invasive, visual, and quantitative in vivo evaluation of pulmonary blood flow is helpful in assessing gas exchange at the alveolar level. A chest digital dynamic radiography system (CDDR) has the potential to visually and quantitatively express pulmonary haemodynamics using temporal changes in radiographic transparency synchronised with the heartbeat. The lung-diffusing capacity (DLCO) test involves membranous factors comprising the alveolar membrane, interstitium, and vascular walls. Additionally, DLCO includes pulmonary blood flow factors defined by pulmonary capillary blood flow and haemoglobin levels. In individuals lacking an alveolar septum, interstitial abnormalities or anaemia leading to changes in DLCO may reflect changes in the pulmonary blood flow. Here, we investigated the usefulness of CDDR in evaluating pulmonary blood flow by comparing it with DLCO.For pulmonary blood flow, we extracted and visualised signal changes in the lung field synchronised with heart rate during CDDR imaging and created a maximum intensity projection (MIP). The DLCO was measured using the single-breath method. Among the patients who underwent CDDR, 10 with FEV/FVC (FEV1.0%) > 70% and 16 with COPD (FEV1.0% < 70%) without noticeable interstitial changes were included, with a cutoff = 70%/predicted value. MIP was compared as a pulmonary blood flow evaluation method in the DLCO≥70% group (control group: n = 15) and the DLCO<70% group (decreased DLCO group: n = 11). The mean and median values of MIP in the reduced group were lower than those in the control group (p < 0.05).Pulmonary blood flow evaluated using CDDR may be able to assess pulmonary circulatory disturbances visually and quantitatively, as indicated by decreased pulmonary diffusion capacity in patients with negligible pulmonary interstitial changes and anaemia.