Bronchial wall thickness: appropriate window settings for thin-section CT and radiologic-anatomic correlation.

Bankier, Alexander A.; Fleischmann, Dominik; Mallek, R.; Windisch, Alfred; Winkelbauer, F.; Kontrus, Manfred; Havelec, L; Herold, Christian; Hübsch, P

doi:10.1148/radiology.199.3.8638013

Cited by 84 publications

(43 citation statements)

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“…However, this process is not only very labor intensive and subject to large inter-and intraobserver error (10)(11)(12), but is also extremely dependent on the display parameters of the CT image. Investigators showed that the airway could only be accurately measured using a CT window level of 2450 HU and a window width of 1,000 to 1,400 HU (10)(11)(12)(13). While these images allow one to measure airways, they are not suitable for clinical uses, and since a printed version of the CT scan was the most common version of the CT images at that time, these images were rarely produced.…”

Section: Airway Analysismentioning

confidence: 99%

Quantitative Computed Tomography Assessment of Airway Wall Dimensions: Current Status and Potential Applications for Phenotyping Chronic Obstructive Pulmonary Disease

Coxson

2008

Proceedings of the American Thoracic Society

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Airway remodeling is extremely important in the pathophysiology of chronic obstructive pulmonary disease (COPD). Since the site and nature of airflow obstruction was described by Hogg, Thurlbeck, and Macklem, investigators have been looking for methods to noninvasively measure the airway wall dimensions in subjects with and at risk for COPD. The advent and proliferation of computed tomography (CT) initially allowed investigators to quantify changes in lung parenchymal structure in subjects with emphysema, and more recently attention has turned to the measurement of airway wall dimensions. Unfortunately, while the lung density is relatively easy to quantify, reliable airway measurements have proven to be more difficult to obtain. However, recent advances in CT technology and new computer algorithms have changed the way investigators have measured airways using CT, and it is now hoped that many of the early issues surrounding airway measurements can be resolved. The measurement of airway wall dimensions is important because it is well known that chronic airflow limitation can be caused by a combination of airway and parenchymal changes. The phenotypic expression of these different subtypes of COPD is vital because a therapy designed to modulate the inflammation in airways may be contraindicated in subjects with the emphysema phenotype and visa versa. Therefore, these new imaging techniques are very likely to play a front-line role in the study of COPD and will, hopefully, allow clinicians to phenotype individuals, thereby personalizing their treatment.

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Section: Airway Analysismentioning

confidence: 99%

Quantitative Computed Tomography Assessment of Airway Wall Dimensions: Current Status and Potential Applications for Phenotyping Chronic Obstructive Pulmonary Disease

Coxson

2008

Proceedings of the American Thoracic Society

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“…In the initial studies in which airway dimensions were measured using CT, the investigators relied on manual tracing of the airway images [11][12][13][14][15]. These techniques are extremely time consuming and prone to error.…”

Section: Quantitative Assessment Of Larger Airwaysmentioning

confidence: 99%

Computed tomographic imaging of the airways: relationship to structure and function

Jong

Müller²,

Paré³

et al. 2005

Eur Respir J

157

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Alterations in the structure of the airways, collectively termed airway remodelling, contribute to airflow obstruction in a variety of chronic lung diseases. While histology has provided valuable insights into the structure of airway wall remodelling, this technique is invasive and does not allow the longitudinal analysis of airway wall dimensions. Technical advances in computed tomography allow the assessment of airway wall dimensions, and are ideally suited for the noninvasive investigation of the pathogenesis of airway wall remodelling and the evaluation of new therapeutic interventions. The aim of this article is to review the use of computed tomography in the investigation of airway structure and function in health and disease.

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“…Several groups have investigated optimal window settings for quantitative airway measurements [19,[24][25][26][27]. While most studies in phantoms have shown that window level and not width determines the accuracy with which the airway lumen [19,27] and wall area [25] are measured, BANKIER et al [24], using inflation-fixed cadaveric lungs, found window width rather than level affected this accuracy. This suggests that phantom studies may not reflect in vivo conditions in which partial volume averaging plays an important role.…”

Section: Limits Of Ct Resolutionmentioning

confidence: 99%

“…As CT slices are two-dimensional images representing three-dimensional data it follows that, when airways are imaged at angles other than 90u, more wall area, derived from the z axis, is incorporated into the x and y dimensions leading to an apparent increase in wall thickness and decrease in lumen area ( fig. 2) [24]. Thinner slices and more orthogonal airway scanning therefore lessen the degree of partial voluming averaging [9,27].…”

Section: Measuring Airway Dimensions From Ct Datamentioning

confidence: 99%

Quantifying tracheobronchial tree dimensions: methods, limitations and emerging techniques

Williamson¹,

James²,

Phillips³

et al. 2009

Eur Respir J

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The ability to measure airway dimensions is important for clinicians, interventional bronchoscopists and researchers in order to accurately quantify structural abnormalities and track their changes over time or in response to treatment.Most quantitative airway measurements are based on X-ray computed tomography and, more recently, on multidetector computed tomography. Quantitative bronchoscopic techniques have also been developed, although these are less widely employed. Emerging techniques, including magnetic resonance imaging, endoscopic optical coherence tomography, endobronchial ultrasound and confocal endomicroscopy, provide new research tools with potential clinical applications.An understanding of issues related to the acquisition, processing and analysis of images, and how such issues impact on imaging the tracheobronchial tree, is essential in order to assess measurement accuracy and to make effective use of the newer methods. This article contributes to this understanding by providing a comprehensive review of current and emerging techniques for quantifying airway dimensions.KEYWORDS: Airway dimensions, confocal endomicroscopy, multidetector computed tomography, optical coherence tomography, videobronchoscopy A dvances over the past 20 yrs in medical imaging and bronchoscopy have heralded an era of unprecedented access to quantitative information on tracheobronchial structure and, increasingly, function. The expanding scope of technical advances challenges the ability of clinicians and researchers to keep abreast of recent developments and emerging techniques. Computed tomography (CT) and, to a lesser extent, bronchoscopy are the two imaging tools that have contributed most to our understanding of the airway in vivo and are used on a daily basis by clinicians in the management of airway diseases. Newer techniques, such as magnetic resonance imaging, optical coherence tomography, fibreoptic confocal endomicroscopy and endobronchial ultrasound, offer fresh insights into the way we view and quantify the airway.Over the coming years, the clinical applications of these newer techniques will be defined. As with endobronchial ultrasound, which has been adopted by interventional bronchoscopists in a little over a decade from its first reported use [1], it is likely that smoking-related lung diseases, such as bronchogenic cancer and chronic obstructive pulmonary disease (COPD), will drive the rapid development of new endoscopic imaging modalities and maintain the current pace of technical improvements of existing techniques, in particular CT. Initial applications of these techniques may focus on screening and surveillance of endobronchial malignancies and the use of real-time airway measurements during interventional procedures to deploy endobronchial stents. In these settings, accurate real-time quantitative imaging is advantageous.

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Bronchial wall thickness: appropriate window settings for thin-section CT and radiologic-anatomic correlation.

Cited by 84 publications

References 0 publications

Quantitative Computed Tomography Assessment of Airway Wall Dimensions: Current Status and Potential Applications for Phenotyping Chronic Obstructive Pulmonary Disease

Quantitative Computed Tomography Assessment of Airway Wall Dimensions: Current Status and Potential Applications for Phenotyping Chronic Obstructive Pulmonary Disease

Computed tomographic imaging of the airways: relationship to structure and function

Quantifying tracheobronchial tree dimensions: methods, limitations and emerging techniques

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