Spirometer guided chest imaging in children: It is worth the effort!
Computed tomography (CT) and magnetic resonance imaging (MRI) scans are used to assess and monitor several pediatric lung diseases. It is well recognized that lung volume at the moment of acquisition has a major impact on the appearance of lung parenchyma and airways. Importantly, the sensitivity of chest CT and MRI to detect bronchiectasis and gas trapping is highly dependent on adequate volume control during the image acquisition. This paper describes a feasible method to obtain accurate control of lung volume during chest imaging in pediatric patients with lung disease.



A procedure to obtain maximal respiratory manoeuvres with spirometry guidance during image acquisition for CT and MRI is described. This procedure requires training of the subject, an MRI compatible spirometer and close collaboration between a lung function scientist and the radiographer. A good to excellent target volume level for the inspiratory or expiratory scan can be achieved in around 90% of children. An important condition for this success rate is the training of the subject, executed prior to each chest CT or MRI, and instructions by the lung function scientist during the chest CT.



Implementing lung volume guidance with a spirometer is an important and feasible step to standardize chest imaging and to optimize the diagnostic yield of chest CT and MRI in children with lung disease. Training and the collaborative effort by a lung function scientist and radiographer is the key factor for success of this procedure. Pediatr Pulmonol. 2017;52:48-56. © 2016 Wiley Periodicals, Inc.
Department of Pediatric Pulmonology, Erasmus Medical Center, Sophia Children's Hospital, Dr. Molewaterplein 60, Room SP-3464, 3015 GJ, Rotterdam, The Netherlands.
Elizabeth
E
Salamon
Department of Pediatric Pulmonology, Erasmus Medical Center, Sophia Children's Hospital, Dr. Molewaterplein 60, Room SP-3464, 3015 GJ, Rotterdam, The Netherlands.
Sandra
S
Lever
Department of Pediatric Pulmonology, Erasmus Medical Center, Sophia Children's Hospital, Dr. Molewaterplein 60, Room SP-3464, 3015 GJ, Rotterdam, The Netherlands.|Department of Radiology, Erasmus Medical Center, Dr. Molewaterplein 60, Room SP-3464, 3015 GJ, Rotterdam, The Netherlands.
Wieying
W
Kuo
Department of Pediatric Pulmonology, Erasmus Medical Center, Sophia Children's Hospital, Dr. Molewaterplein 60, Room SP-3464, 3015 GJ, Rotterdam, The Netherlands.|Department of Radiology, Erasmus Medical Center, Dr. Molewaterplein 60, Room SP-3464, 3015 GJ, Rotterdam, The Netherlands.
Pierluigi
P
Ciet
Department of Pediatric Pulmonology, Erasmus Medical Center, Sophia Children's Hospital, Dr. Molewaterplein 60, Room SP-3464, 3015 GJ, Rotterdam, The Netherlands.|Department of Radiology, Erasmus Medical Center, Dr. Molewaterplein 60, Room SP-3464, 3015 GJ, Rotterdam, The Netherlands.
Harm A W M
HA
Tiddens
D001987:Bronchiectasis / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D045853:Exhalation; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013902:Radiography, Thoracic / Q000379:methods*; D013147:Spirometry / Q000379:methods*; D013909:Thorax; D013990:Tidal Volume; D014057:Tomography, X-Ray Computed / Q000379:methods*
computed tomography (CT); cystic fibrosis (CF); imaging; magnetic resonance imaging (MRI); pediatric; pulmonary function testing (PFT); pulmonary physiology; spirometer guidence; spirometry