Pulmonary ventilation imaging based on 4-dimensional computed tomography: Comparison with pulmonary function tests and SPECT ventilation images

Tokihiro Yamamoto, Sven Kabus, Cristian Lorenz, Erik Mittra, Julian C. Hong, Melody Chung, Neville Eclov, Jacqueline To, Maximilian Diehn, Billy W. Loo, Paul J. Keall

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Methods and Materials: In an institutional review board-approved prospective clinical trial, 4D-CT imaging and PFT and/or SPECT ventilation imaging were performed in thoracic cancer patients. Regional ventilation (V4DCT) was calculated by deformable image registration of 4D-CT images and quantitative analysis for regional volume change. V4DCT defect parameters were compared with the PFT measurements (forced expiratory volume in 1 second (FEV1; % predicted) and FEV1/forced vital capacity (FVC; %). V4DCT was also compared with SPECT ventilation (VSPECT) to (1) test whether V4DCT in VSPECT defect regions is significantly lower than in nondefect regions by using the 2-tailed t test; (2) to quantify the spatial overlap between V4DCT and VSPECT defect regions with Dice similarity coefficient (DSC); and (3) to test ventral-to-dorsal gradients by using the 2-tailed t test.

Purpose: 4-dimensional computed tomography (4D-CT)-based pulmonary ventilation imaging is an emerging functional imaging modality. The purpose of this study was to investigate the physiological significance of 4D-CT ventilation imaging by comparison with pulmonary function test (PFT) measurements and single-photon emission CT (SPECT) ventilation images, which are the clinical references for global and regional lung function, respectively.

Results: Of 21 patients enrolled in the study, 18 patients for whom 4D-CT and either PFT or SPECT were acquired were included in the analysis. V4DCT defect parameters were found to have significant, moderate correlations with PFT measurements. For example, V4DCTHU defect volume increased significantly with decreasing FEV1/FVC (R=-0.65, P<.01). V4DCT in VSPECT defect regions was significantly lower than in nondefect regions (mean V4DCTHU 0.049 vs 0.076, P<.01). The average DSCs for the spatial overlap with SPECT ventilation defect regions were only moderate (V4DCTHU0.39 ± 0.11). Furthermore, ventral-to-dorsal gradients of V4DCT were strong (V4DCTHU R2 = 0.69, P=.08), which was similar to VSPECT (R2 = 0.96, P<.01).

Conclusions: An 18-patient study demonstrated significant correlations between 4D-CT ventilation and PFT measurements as well as SPECT ventilation, providing evidence toward the validation of 4D-CT ventilation imaging.

Original languageEnglish (US)
Pages (from-to)414-422
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume90
Issue number2
DOIs
StatePublished - Oct 1 2014

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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