Thursday, December 4 | 11:20 a.m.-11:30 a.m. | R4-STCE2-3 | Learning Center Theater 2
Noninvasive methods are lacking for detecting reduced alveolar perfusion due to emphysema in patients with chronic obstructive pulmonary disease (COPD), and in this session, researchers present a study suggesting that dynamic digital radiography (DDR) holds promise for filling the role.
In a prospective study led by presenter Masahiro Okada, MD, PhD, of Nihon University in Tokyo, Japan, researchers enrolled 40 patients with stable COPD. Participants underwent DDR, high-resolution CT (HRCT), and spirometry. The researchers generated pulmonary perfusion maps from breath-hold DDR sequences and calculated low signal area (LSA) ratios based on histogram thresholds (5%, 10%, 15%).
They used CT-derived percent low attenuation volume (%LAV) and Goddard scores as reference structural indices, as well as assessed pulmonary vessel volume and lung function parameters, including diffusing capacity of the lung for carbon monoxide (DLCO), forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC).
According to the findings, DDR-derived LSA ratios significantly correlated with Goddard scores, with the strongest correlation observed for DDR 10% LSA ratio (r = 0.672, p < 0.0001). DDR 10% LSA ratio was also positively correlated with CT-%LAV (r = 0.691) and negatively with FEV1 percentage of predicted normal value (r = -0.459) and DLCO percentage of predicted normal value (r = -0.38). An area under the curve (AUC) analysis, DDR-10% LSA ratio demonstrated good diagnostic performance for detecting FEV1 percentage of predicted normal value < 80% (AUC = 0.863) and DLCO percentage of predicted normal value < 80% (AUC = 0.794), comparable with CT-%LAV.
Ultimately, pulmonary perfusion mapping using DDR provides a noninvasive method to quantify functional impairment in emphysema, according to the researchers.
“This modality holds promise as a practical imaging biomarker for emphysema assessment and clinical decision-making in routine practice,” the group wrote.
Interested in learning about DDR? Attend this session to learn more.
