Chest Dynamic-Ventilatory Digital Radiography in Chronic Obstructive or Restrictive Lung Disease

Abstract

Objective

The aim of this study was to identify the relationships between parameters obtained from dynamic-ventilatory digital radiography (DR) and ventilatory disorders.

Methods

This study comprised 273 participants with respiratory diseases who underwent spirometry and functional residual capacity measurements (104 with normal findings on spirometry as controls, 139 with an obstructive lung disorder, 30 with a restrictive lung disorder) were assessed by dynamic-ventilatory DR. Sequential chest radiography images of the patient’s slow and maximum breathing were captured at 15 frames per second by a dynamic flat-panel imaging system. The system measured the following parameters: lung area at maximum inspiration divided by height (lung area_in/height), changes in tracheal diameter due to respiratory motions, rate of tracheal narrowing, diaphragmatic motion, and rate of change in lung area due to respiratory motion. Relationships between these parameters and ventilatory disorders were analyzed.

Results

Lung area_in/height in patients with restrictive disorders showed significant decreases. Tracheal diameter change and tracheal narrowing rate in patients with obstructive disorders were significantly increased compared to both the control participants and patients with restrictive disorders. Patients with obstructive disorders and patients with restrictive disorders showed decreased diaphragmatic motion and lung area change rate. With the restrictive disorders as references, the area under the curve (AUC), sensitivity and specificity of lung area_in/height were 0.88, 0.77, and 0.88, respectively. With the obstructive disorders as references, the AUC, sensitivity and specificity of tracheal narrowing rate were 0.67, 0.53 and 0.81, respectively.

Conclusion

Dynamic-ventilatory DR shows potential as a method for the detection and evaluation of ventilatory disorders in patients with respiratory diseases.

Keywords:

• dynamic digital radiography
• pulmonary function tests
• spirometry
• COPD
• interstitial lung disease

Acknowledgments

The authors would like to thank Akinori Tsunomori and Noritsugu Matsutani for their assistance with this study. This study was supported by Konica Minolta, Inc. (Tokyo, Japan).

Disclosure

Dr Noriyuki Ohkura, Dr Rie Tanaka, Dr Isao Matsumoto, and Dr Kazuo Kasahara report grants from Konica Minolta, Inc. (Tokyo, Japan), outside the submitted work. Dr Miki Abo and Dr Munehisa Takata report non-financial support from Konica Minolta, Inc. (Tokyo, Japan), outside the submitted work. The authors report no other conflicts of interest in this work.