Difference in the craniocaudal gradient of the maximum pixel value change rate between chronic obstructive pulmonary disease patients and normal subjects using sub-mGy dynamic chest radiography with a flat panel detector system

Yoshitake Yamada; Masako Ueyama; Takehiko Abe; Tetsuro Araki; Takayuki Abe; Mizuki Nishino; Masahiro Jinzaki; Hiroto Hatabu; Shoji Kudoh

doi:10.1016/j.ejrad.2017.04.016

Difference in the craniocaudal gradient of the maximum pixel value change rate between chronic obstructive pulmonary disease patients and normal subjects using sub-mGy dynamic chest radiography with a flat panel detector system

Eur J Radiol. 2017 Jul:92:37-44. doi: 10.1016/j.ejrad.2017.04.016. Epub 2017 Apr 27.

Authors

Yoshitake Yamada¹, Masako Ueyama², Takehiko Abe³, Tetsuro Araki⁴, Takayuki Abe⁵, Mizuki Nishino⁶, Masahiro Jinzaki⁷, Hiroto Hatabu⁸, Shoji Kudoh⁹

Affiliations

¹ Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan. Electronic address: yamada@rad.med.keio.ac.jp.
² Department of Health Care, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Japan. Electronic address: ueyamam@fukujuji.org.
³ Department of Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Japan. Electronic address: takehikoabe@hotmail.com.
⁴ Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: TARAKI@partners.org.
⁵ Department of Preventive Medicine and Public Health, Biostatistics Unit at Clinical and Translational Research Center, Keio University School of Medicine, Tokyo, Japan. Electronic address: abe.t@keio.jp.
⁶ Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: Mizuki_Nishino11@dfci.harvard.edu.
⁷ Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan. Electronic address: jinzaki@rad.med.keio.ac.jp.
⁸ Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: hhatabu@partners.org.
⁹ Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Japan. Electronic address: skudoh@jatahq.org.

PMID: 28624018
DOI: 10.1016/j.ejrad.2017.04.016

Abstract

Objectives: To compare the craniocaudal gradients of the maximum pixel value change rate (MPCR) during tidal breathing between chronic obstructive pulmonary disease (COPD) patients and normal subjects using dynamic chest radiography.

Materials and methods: This prospective study was approved by the institutional review board and all participants provided written informed consent. Forty-three COPD patients (mean age, 71.6±8.7 years) and 47 normal subjects (non-smoker healthy volunteers) (mean age, 54.8±9.8 years) underwent sequential chest radiographs during tidal breathing in a standing position using dynamic chest radiography with a flat panel detector system. We evaluated the craniocaudal gradient of MPCR. The results were analyzed using an unpaired t-test and the Tukey-Kramer method.

Results: The craniocaudal gradients of MPCR in COPD patients were significantly lower than those in normal subjects (right inspiratory phase, 75.5±48.1 vs. 108.9±42.0s^-1cm^-1, P<0.001; right expiratory phase, 66.4±40.6 vs. 89.8±31.6s^-1cm^-1, P=0.003; left inspiratory phase, 75.5±48.2 vs. 108.2±47.2s^-1cm^-1, P=0.002; left expiratory phase, 60.9±38.2 vs. 84.3±29.5s^-1cm^-1, P=0.002). No significant differences in height, weight, or BMI were observed between COPD and normal groups. In the sub-analysis, the gradients in severe COPD patients (global initiative for chronic obstructive lung disease [GOLD] 3 or 4, n=26) were significantly lower than those in mild COPD patients (GOLD 1 or 2, n=17) for both right and left inspiratory/expiratory phases (all P≤0.005).

Conclusions: A decrease of the craniocaudal gradient of MPCR was observed in COPD patients. The craniocaudal gradient was lower in severe COPD patients than in mild COPD patients.

Keywords: Lung; Respiration; Thorax; Ventilation; X-ray.

MeSH terms

Aged, 80 and over
Exhalation
Female
Humans
Male
Posture
Prospective Studies
Pulmonary Disease, Chronic Obstructive / diagnostic imaging*
Radiography / methods*
Respiration