Open AccessEvaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon
Author(s) -
Hiroyuki Kyoyama,
Yusuke Hirata,
Satoshi Kikuchi,
Kosuke Sakai,
Yuriko Saito,
Shintaro Mikami,
Gaku Moriyama,
Hisami Yanagita,
Wataru Watanabe,
Katharina Otani,
N. Honda,
Kazutsugu Uematsu
Publication year - 2017
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000005937
Subject(s) - xenon , medicine , hounsfield scale , nuclear medicine , copd , ventilation (architecture) , pulmonary function testing , lung volumes , radiology , lung , attenuation , dual energy , computed tomography , chemistry , optics , mechanical engineering , physics , organic chemistry , engineering , bone mineral , osteoporosis
Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation. We sought to evaluate whether xenon-enhanced CT using a single-breath-hold technique correlates with pulmonary function testing (PFT) results. Twenty-six patients, including 11 chronic obstructive pulmonary disease (COPD) patients, underwent xenon-enhanced CT and PFT. Three of the COPD patients underwent xenon-enhanced CT before and after bronchodilator treatment. Images from xenon-CT were obtained by dual-source CT during a breath-hold after a single vital-capacity inspiration of a xenon–oxygen gas mixture. Image postprocessing by 3-material decomposition generated conventional CT and xenon-enhanced images. Low-attenuation areas on xenon images matched low-attenuation areas on conventional CT in 21 cases but matched normal-attenuation areas in 5 cases. Volumes of Hounsfield unit (HU) histograms of xenon images correlated moderately and highly with vital capacity (VC) and total lung capacity (TLC), respectively ( r = 0.68 and 0.85). Means and modes of histograms weakly correlated with VC ( r = 0.39 and 0.38), moderately with forced expiratory volume in 1 second (FEV 1 ) ( r = 0.59 and 0.56), weakly with the ratio of FEV 1 to FVC ( r = 0.46 and 0.42), and moderately with the ratio of FEV 1 to its predicted value ( r = 0.64 and 0.60). Mode and volume of histograms increased in 2 COPD patients after the improvement of FEV 1 with bronchodilators. Inhalation of xenon gas caused no adverse effects. Xenon-enhanced CT using a single-breath-hold technique depicted functional abnormalities not detectable on thin-slice CT. Mode, mean, and volume of HU histograms of xenon images reflected pulmonary function. Xenon images obtained with xenon-enhanced CT using a single-breath-hold technique can qualitatively depict pulmonary ventilation. A larger study comprising only COPD patients should be conducted, as xenon-enhanced CT is expected to be a promising technique for the management of COPD.