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首页> 外文期刊>Academic radiology >A Feasibility Study of Single-inhalation, Single-energy Xenon-enhanced CT for High-resolution Imaging of Regional Lung Ventilation in Humans
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A Feasibility Study of Single-inhalation, Single-energy Xenon-enhanced CT for High-resolution Imaging of Regional Lung Ventilation in Humans

机译：单吸入，单能氙增强CT的可行性研究人类区域肺通风的高分辨率成像

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Rationale and ObjectivesThe objective of this study was to assess the feasibility of single-inhalation xenon-enhanced computed tomography (XeCT) to provide clinically practical, high-resolution pulmonary ventilation imaging to clinics with access to only a single-energy computed tomography scanner, and to reduce the subject's overall exposure to xenon by utilizing a higher (70%) concentration for a much shorter time than has been employed in prior studies. Materials and MethodsWe conducted an institutional review board-approved prospective feasibility study of XeCT for 15 patients undergoing thoracic radiotherapy. For XeCT, we acquired two breath-hold single-energy computed tomography images of the entire lung with a single inhalation each of 100% oxygen and a mixture of 70% xenon and 30% oxygen, respectively. A video biofeedback system for coached patient breathing was used to achieve reproducible breath holds. We assessed the technical success of XeCT acquisition and side effects. We then used deformable image registration to align the breath-hold images with each other to accurately subtract them, producing a map of lung xenon distribution. Additionally, we acquired ventilation single-photon emission computed tomography-computed tomography (V-SPECT-CT) images for 11 of the 15 patients. For a comparative analysis, we partitioned each lung into 12 sectors, calculated the xenon concentration from the Hounsfield unit enhancement in each sector, and then correlated this with the corresponding V-SPECT-CT counts. ResultsXeCT scans were tolerated well overall, with a mild (grade 1) dizziness as the only side effect in 5 of the 15 patients. Technical failures in five patients occurred because of inaccurate breathing synchronization with xenon gas delivery, leaving seven patients analyzable for XeCT and single-photon emission computed tomography correlation. Sector-wise correlations were strong (Spearman coefficient >0.75, Pearson coefficient >0.65,Pvalue <.002) for two patients for whom ventilation deficits were visibly pronounced in both scans. Correlations were nonsignificant for the remaining five who had more homogeneous XeCT ventilation maps, as well as strong V-SPECT-CT imaging artifacts attributable to airway deposition of the aerosolized imaging agent. Qualitatively, XeCT demonstrated higher resolution and no central airway deposition artifacts compared to V-SPECT-CT. ConclusionsIn this pilot study, single-breath XeCT ventilation imaging was generally feasible for patients undergoing thoracic radiotherapy, using an imaging protocol that is clinically practical and potentially widely available. In the future, the xenon delivery failures can be addressed by straightforward technical improvements to the patient biofeedback coaching system.
机译：理由和ObjectivesThe目标本研究的是评估单吸入氙增强CT（XeCT）的可行性，以提供临床上实用的，高分辨率的肺部换气成像到诊所访问仅一个单能计算机断层摄影扫描仪和通过利用较高（70％）的浓度比已先前的研究已采用更短的时间向被检者的整体曝光减少氙。材料和MethodsWe进行XeCT的机构审查委员会批准的前瞻性可行性研究报告15例接受胸部放疗。对于XeCT，我们获取整个肺两个屏气单能计算机断层摄影图像与在单次吸入每100％的氧气和70％氙和30％的氧，的混合物组成。对于执教病人呼吸视频生物反馈系统来实现可重复呼吸持有。我们评估XeCT采集和副作用的技术上的成功。然后，我们使用变形图像配准，以彼此对准的屏气图像准确地相减，从而产生一个地图肺氙分布。此外，我们获得的通风单光子发射计算机断层扫描计算机断层摄影术（V-SPECT-CT）图像的15名患者的11。用于比较分析，我们分配每个肺成12个扇区，计算从每个扇区中的Hounsfield单位增强的氙浓度，然后与相应的V-SPECT-CT计数相关此。 ResultsXeCT扫描，耐受良好的整体，用温和的（1级）头晕如在15名患者的5的唯一副作用。 5例技术故障的发生是因为氙气输送不准确的呼吸同步的，剩下的7名病人可分析为XeCT和单光子发射计算机断层相关。扇区方式相关性是较强的，用于人通风赤字在两个扫描可见地显着的两名患者（斯皮尔曼系数> 0.75，Pearson相关系数> 0.65，P值<0.002）。相关性是不显着的对其余五个谁了更均匀的XeCT通风地图，以及强V-SPECT-CT成像伪影归因于雾化成像剂的气道沉积。定性地，XeCT表现出较高的分辨率并且与V-SPECT-CT没有中心气道沉积伪影。 ConclusionsIn此初步研究中，单次呼吸XeCT通气显像普遍用于进行胸部放疗的患者可行的，利用成像协议，是在临床上实际的和潜在广泛使用。在未来，氙递送失败可以通过简单的技术改进与患者生物反馈训练系统来解决。

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