Dynamic Chest Radiography: A New Perspective in Pulmonary Function Assessment

Dynamic chest radiography (DCR) is an emerging functional X-ray imaging technique utilizing flat-panel detectors to capture time-resolved radiographic sequences of the entire thorax. By analyzing subtle respiration and cardiac-induced pixel value fluctuations, DCR enables noninvasive, quantitative assessment of pulmonary ventilation, perfusion, and diaphragmatic kinetics without contrast agents. Key applications include evaluating regional ventilation heterogeneity in obstructive diseases (e.g., chronic obstructive pulmonary disease, asthma), detecting perfusion defects in pulmonary embolism, quantifying diaphragmatic dysfunction, and assessing pleural adhesions or lung motion abnormalities. DCR offers high diagnostic performance, portability, low radiation dose, and flexibility in patient positioning. This technique represents a significant advance in functional pulmonary imaging, providing a safe and accessible tool for precision assessment in diverse clinical settings, including critical care. This article elucidates the mechanisms and analytical methodologies of DCR, and comprehensively reviews its clinical applications in respiratory physiology and pathophysiology.