Dynamic-Ventilatory Digital Radiography in Air Flow Limitation: A Change in Lung Area Reflects Air Trapping

Noriyuki Ohkura*, Kazuo Kasahara, Satoshi Watanabe, Johsuke Hara, Miki Abo, Takashi Sone, Hideharu Kimura, Munehisa Takata, Masaya Tamura, Isao Matsumoto, Yusuke Nakade, Shigeru Sanada, Rie Tanaka

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objective: The aim of this study was to determine the utility of dynamic-ventilatory digital radiography (DR) for pulmonary function assessment in patients with airflow limitation. Methods: One hundred and eighteen patients with airflow limitation (72 patients with lung cancer before surgery, 35 patients with chronic obstructive pulmonary disease [COPD], 6 patients with asthma, and 5 patients with asthma-COPD overlap syndrome) were assessed with dynamic-ventilatory DR. The patients were instructed to inhale and exhale slowly and maximally. Sequential chest X-ray images were captured in 15 frames per second using a dynamic flat-panel imaging system. The relationship between the lung area and the rate of change in the lung area due to respiratory motion with respect to pulmonary function was analyzed. Results: The rate of change in the lung area from maximum inspiration to maximum expiration (Rs ratio) was associated with the RV/TLC ratio (r = 0.48, p < 0.01) and the percentage of the predicted FEV1 (r = -0.33, p < 0.01) in patients with airflow limitations. The Rs ratio also decreased in an FEV1-dependent manner. Conclusion: The rate of change in the lung area due to respiratory motion evaluated with dynamic DR reflects air trapping. Dynamic DR is a potential tool for the comprehensive assessment of pulmonary function in patients with COPD.

Original languageEnglish (US)
Pages (from-to)382-388
Number of pages7
JournalRespiration
Volume99
Issue number5
DOIs
StatePublished - May 1 2020

Keywords

  • Air flow limitation
  • Chronic obstructive pulmonary disease
  • Digital radiography
  • Lung area changes
  • Pulmonary function

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Ohkura, N., Kasahara, K., Watanabe, S., Hara, J., Abo, M., Sone, T., Kimura, H., Takata, M., Tamura, M., Matsumoto, I., Nakade, Y., Sanada, S., & Tanaka, R. (2020). Dynamic-Ventilatory Digital Radiography in Air Flow Limitation: A Change in Lung Area Reflects Air Trapping. Respiration, 99(5), 382-388. https://doi.org/10.1159/000506881