title: Dynamic Volume Computed Tomography Imaging of the Upper Airway in Obstructive Sleep Apnea.
abstract: OBJECTIVE
  To describe a dynamic three-dimensional (3D) computed tomography (CT) technique for the upper airway and compare the required radiation dose to that used for common clinical studies of a similar anatomical area, such as for subjects undergoing routine clinical facial CT.
  
  
  METHODS
  Dynamic upper-airway CT was performed on eight subjects with persistent obstructive sleep apnea, four of whom were undergoing magnetic resonance imaging and an additional four subjects who had a contraindication to magnetic resonance imaging. This Health Insurance Portability and Accountability Act-compliant study was approved by our institutional review board, and informed consent was obtained. The control subjects (n = 41) for comparison of radiation dose were obtained from a retrospective review of the clinical picture-archiving computer system to identify 10 age-matched patients per age-based control group undergoing facial CT.
  
  
  RESULTS
  Dynamic 3D CT can be performed with an effective radiation dose of less than 0.38 mSv, a dose that is less than or comparable to that used for clinical facial CT. The resulting data- set is a uniquely complete, dynamic 3D volume of the upper airway through a full respiratory cycle that can be processed for clinical and modeling analyses.
  
  
  CONCLUSIONS
  A dynamic 3D CT technique of the upper airway is described that can be performed with a clinically reasonable radiation dose and sets a benchmark for future use.
authors: Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Robert J
authors: RJ
authors: Fleck
authors: Division of Pediatric Otolaryngology - Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati School of Medicine, Cincinnati, OH.
authors: Stacey L
authors: SL
authors: Ishman
authors: Division of Pediatric Otolaryngology - Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati School of Medicine, Cincinnati, OH.
authors: Sally R
authors: SR
authors: Shott
authors: Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati School of Medicine, Cincinnati, OH.|Department of Aerospace Engineering and Engineering Mechanics, CEAS, University of Cincinnati, Cincinnati, OH.
authors: Ephraim J
authors: EJ
authors: Gutmark
authors: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Keith B
authors: KB
authors: McConnell
authors: Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Mohamed
authors: M
authors: Mahmoud
authors: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Goutham
authors: G
authors: Mylavarapu
authors: Department of Aerospace Engineering and Engineering Mechanics, CEAS, University of Cincinnati, Cincinnati, OH.
authors: Dhananjay R
authors: DR
authors: Subramaniam
authors: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Rhonda
authors: R
authors: Szczesniak
authors: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH.
authors: Raouf S
authors: RS
authors: Amin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D017286:Polysomnography; D011446:Prospective Studies; D012137:Respiratory System / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Down syndrome; four-dimensional computed tomography; obstructive volumetric computed tomography; radiation dosage; sleep apnea; sleep-disordered breathing