Continuous quantitative measurement of the proximal airway dimensions and lung density on four-dimensional dynamic-ventilation CT in smokers.
OBJECTIVE
Four-dimensional dynamic-ventilation computed tomography (CT) imaging demonstrates continuous movement of the airways and lungs, which cannot be depicted with conventional CT. We aimed to investigate continuous changes in lung density and airway dimensions and to assess the correlation with spirometric values in smokers.


METHODS
This retrospective study was approved by the Institutional Review Board, and informed consent was waived. Twenty-one smokers including six patients with COPD underwent four-dimensional dynamic-ventilation CT during free breathing (160 mm in length). The mean lung density (MLD) of the scanned lung and luminal areas (Ai) of fixed points in the trachea and the right proximal bronchi (main bronchus, upper bronchus, bronchus intermedius, and lower bronchus) were continuously measured. Concordance between the time curve of the MLD and that of the airway Ai values was expressed by cross-correlation coefficients. The associations between these quantitative measurements and the forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) values were assessed by Spearman's rank correlation analysis.


RESULTS
On the time curve for the MLD, the Δ-MLD1.05 values between the peak inspiratory frame to the later third frame (1.05 seconds later) were strongly correlated with the FEV1/FVC (ρ=0.76, P<0.0001). The cross-correlation coefficients between the airway Ai and MLD values were significantly correlated with the FEV1/FVC (ρ=-0.56 to -0.66, P<0.01), except for the right upper bronchus. This suggested that the synchrony between the airway and lung movement was lost in patients with severe airflow limitation.


CONCLUSIONS
Respiratory changes in the MLD and synchrony between the airway Ai and the MLD measured with dynamic-ventilation CT were correlated with patient's spirometric values.
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan.
Tsuneo
T
Yamashiro
Department of Radiology, Ohara General Hospital, Fukushima-shi, Fukushima, Japan.
Hiroshi
H
Moriya
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan.
Maho
M
Tsubakimoto
Department of Radiology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Shin
S
Matsuoka
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan.
Sadayuki
S
Murayama
D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D012189:Retrospective Studies; D012907:Smoking / Q000503:physiopathology; D013147:Spirometry; D014057:Tomography, X-Ray Computed / Q000379:methods; D014132:Trachea / Q000000981:diagnostic imaging* / Q000473:pathology*
airflow limitation; chronic obstructive pulmonary disease; computed tomography; emphysema; mean lung density