Utility and validity of dynamic chest radiography in cystic fibrosis (dynamic CF): an observational, non-controlled, non-randomised, single-centre, prospective study

FitzMaurice, Thomas Simon; McNamara, Paul; Nazareth, D.; McCann, Caroline; Bedi, Robinder P.; Shaw, Matthew; Walshaw, Martin

doi:10.1136/bmjresp-2020-000569

Cited by 5 publications

(5 citation statements)

References 25 publications

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“…DCR can provide information on several points, such as pulmonary ventilation, diaphragm movement, and lung circulation (9)(10)(11). It is expected to be clinically applied in various fields, and some reports have already been published, describing DCR as useful for evaluating chronic obstructive pulmonary disease and cystic fibrosis patients (1,2,(12)(13)(14), in the clinical application of ventilation and perfusion (15,16), and for diagnosing pulmonary hypertension (5). However, there have been few reports of its surgical application, and the ones in existence are only case reports of surgery for pleural tumor (6).…”

Section: Discussionmentioning

confidence: 99%

Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis

Watanabe¹,

Suzuki²,

Yoshii³

et al. 2023

J Thorac Dis

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Background: To plan a surgical approach and predict the operative time or bleeding volume, it is important to determine the presence of pleural adhesions before surgery. Dynamic chest radiography (DCR)is a new modality that can dynamically capture X-rays, and we assessed the utility of DCR for detecting pleural adhesions preoperatively. Methods:The subjects of this study were those who underwent DCR before surgery from January 2020 to May 2022. The preoperative evaluation was performed by three imaging analysis modes, and pleural adhesion was defined as the that spreading to more than 20% of the thoracic cavity and/or taking more than 5 minutes to dissect.Results: Of the 120 total patients, DCR was performed properly for 119 (99.2%). Accurate preoperative evaluations of pleural adhesions were confirmed in 101 patients (84.9%), with a sensitivity of 64.5%, specificity of 91.0%, positive predictive value of 74.1%, and negative predictive value of 88.0%.Conclusions: DCR was very easy to perform in all preoperative patients with all manner of thoracic disease. We demonstrated the utility of DCR, showing its high specificity and negative predictive value.DCR has the potential to become a common preoperative examination for detecting pleural adhesions with further improvements in software programs.

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Section: Discussionmentioning

confidence: 99%

Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis

Watanabe¹,

Suzuki²,

Yoshii³

et al. 2023

J Thorac Dis

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“…Dynamic chest radiography (DCR) is a novel imaging technology that makes use of a high-sensitivity flat panel detector with a large field of view to obtain successive radiographs (up to 15 images per second) thereby providing real-time images of the moving chest over 10–20 s [25 ▪ ]. In addition to providing structural information on the lungs, it can provide functional information on lung compliance and breathing patterns.…”

Section: Reviewmentioning

confidence: 99%

“…It can also calculate lung volumes by acquiring both PA and lateral projections. It has a relatively low radiation dose, with an average ED of 0.125 mSv [25 ▪ ]. DCR therefore offers a potential alternative means of assessing both pulmonary structure and function in CF.…”

Section: Reviewmentioning

confidence: 99%

“…Potential roles for DCR in CF might be as an adjunct tool in surveillance imaging and in functional assessment during exacerbations. This is currently being evaluated in a prospective observational study at the Liverpool Heart and Chest Hospital adult CF unit [25 ▪ ], which aims to establish if DCR correlates with PFTs and whole-body plethysmography.…”

Section: Reviewmentioning

confidence: 99%

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The evolving role of radiological imaging in cystic fibrosis

Crowley¹,

Connor²,

Ciet³

et al. 2021

Current Opinion in Pulmonary Medicine

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Purpose of reviewRadiological imaging has a crucial role in pulmonary evaluation in cystic fibrosis (CF), having been shown to be more sensitive than pulmonary function testing at detecting structural lung changes. The present review summarizes the latest published information on established and evolving pulmonary imaging techniques for assessing people with this potentially life-limiting disorder. Recent findingsChest computed tomography (CT) has taken over the predominant role of chest radiography in many centres for the initial assessment and surveillance of CF lung disease. However, several emerging techniques offer a promising means of pulmonary imaging using less ionizing radiation. This is of particular importance given these patients tend to require repeated imaging throughout their lives from a young age. Such techniques include ultra-low-dose CT, tomosynthesis, dynamic radiography and magnetic resonance imaging. In addition, deep-learning algorithms are anticipated to improve diagnostic accuracy.

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“…DCR provides a large amount of functional information on rib and diaphragm motion, cardiac motion, pulmonary ventilation, and perfusion. Several studies have reported potential clinical use for DCR (21)(22)(23)(24)(25)(26)(27)(28), focusing on motion analysis of lung structures. Notably, pulmonary ventilation and perfusion are reflected as time changes in radiographic lung density on DCR images.…”

Section: Introductionmentioning

confidence: 99%

Dynamic chest radiography: clinical validation of ventilation and perfusion metrics derived from changes in radiographic lung density compared to nuclear medicine imaging

Tanaka¹,

Matsumoto²,

Tamura³

et al. 2021

Quant Imaging Med Surg

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Background: Dynamic chest radiography (DCR) is a type of non-contrast-enhanced functional lung imaging with a dynamic flat-panel detector (FPD). This study aimed to assess the clinical significance of ventilation and perfusion metrics derived from changes in radiographic lung density on DCR in comparison to nuclear medicine imaging-derived metrics.Methods: DCR images of 42 lung cancer patients were sequentially obtained during respiration using a dynamic FPD imaging system. For each subdivided lung region, the maximum change in the averaged pixel value (Δ max ), i.e., lung density, due to respiration and cardiac function was calculated, and the percentage of Δ max relative to the total of all lung regions (Δ max %) was computed for ventilation and perfusion, respectively.The Δ max % was compared to the accumulation of radioactive agents such as Tc-99m gas and Tc-99m macroaggregated albumin (radioactive agents%) on ventilation and perfusion scans in the subdivided lung regions, by Spearman's correlation coefficient (r) and the Dice similarity coefficients (DSC). To facilitate visual evaluation, Δ max % was visualized as a color scaling, where larger Δ max values were indicated by higher color intensities.Results: We found a moderate correlation between Δ max % and radioactive agents% on ventilation and perfusion scans, with perfusion metrics (r=0.57, P<0.001) showing a higher correlation than ventilation metrics (r=0.53, P<0.001). We also found a good or strong correlation (r≥0.5) in 80.9% (34/42) of patients for perfusion metrics (r=0.60±0.16) and in 52.4% (22/42) of patients for ventilation metrics (r=0.53±0.16).DSC indicated a moderate correlation for both metrics. Decreased pulmonary function was observed in the form of reduced color intensities on color-mapping images.Conclusions: DCR-derived ventilation and perfusion metrics correlated reasonably well with nuclear medicine imaging findings in lung subdivisions, suggesting that DCR could provide useful information on pulmonary function without the use of radioactive contrast agents.

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Utility and validity of dynamic chest radiography in cystic fibrosis (dynamic CF): an observational, non-controlled, non-randomised, single-centre, prospective study

Cited by 5 publications

References 25 publications

Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis

Preoperative detection of pleural adhesions using dynamic chest radiography: prospective analysis

The evolving role of radiological imaging in cystic fibrosis

Dynamic chest radiography: clinical validation of ventilation and perfusion metrics derived from changes in radiographic lung density compared to nuclear medicine imaging

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