Quantitative Assessment of Postural Influence on Lung Function Using Deformable Image Registration-Based Breath-Hold...

Area of Science:

• Medical Imaging
• Pulmonary Medicine
• Biomechanical Engineering

Background:

• Pathological lung diseases like acute respiratory distress syndrome (ARDS) necessitate optimal patient positioning for ventilation.
• Assessing lung function in different positions is crucial for improving patient outcomes.
• Deformable Image Registration (DIR) offers advanced methods for analyzing lung mechanics.

Purpose of the Study:

• To determine the most beneficial body positions for patients with pathological lung diseases.
• To analyze lung ventilation and deformable vector fields (DVF) in various positions using DIR.
• To compare lung mechanics across supine, prone, and lateral decubitus positions.

Main Methods:

• Utilized DIR with the B-spline algorithm to obtain breath-hold CT ventilation imaging (BH-CTVI) in healthy volunteers.
• Acquired lung ventilation and DVF images in four body positions: supine, prone, right lateral, and left lateral.
• Analyzed Jacobian values and displacement vectors from expiration to inspiration for each lung lobe.

Main Results:

• Highly functional lung areas (Jacobian ≥ 75th percentile) were located on the ground-contacting side.
• In the supine position, abdominal displacement vectors were dorsal to ventral.
• In the prone position, lung motion was gravity-independent, with displacement vectors parallel to the ground (head to feet).

Conclusions:

• The prone position facilitates lung ventilation with minimal gravitational impact compared to other positions.
• DIR-based BH-CTVI, including DVF imaging, is essential for comprehensive lung function assessment.
• Findings suggest the prone position is optimal for patients requiring enhanced lung ventilation.