Top

Published in:

Open Access 01-12-2023 | Cystic Fibrosis | Critical Review

Dynamic chest radiography: a state-of-the-art review

Authors: Fred Fyles, Thomas S. FitzMaurice, Ryan E. Robinson, Ram Bedi, Hassan Burhan, Martin J. Walshaw

Published in: Insights into Imaging | Issue 1/2023

Abstract

Dynamic chest radiography (DCR) is a real-time sequential high-resolution digital X-ray imaging system of the thorax in motion over the respiratory cycle, utilising pulsed image exposure and a larger field of view than fluoroscopy coupled with a low radiation dose, where post-acquisition image processing by computer algorithm automatically characterises the motion of thoracic structures. We conducted a systematic review of the literature and found 29 relevant publications describing its use in humans including the assessment of diaphragm and chest wall motion, measurement of pulmonary ventilation and perfusion, and the assessment of airway narrowing. Work is ongoing in several other areas including assessment of diaphragmatic paralysis. We assess the findings, methodology and limitations of DCR, and we discuss the current and future roles of this promising medical imaging technology.

Critical relevance statement Dynamic chest radiography provides a wealth of clinical information, but further research is required to identify its clinical niche.

Graphical abstract

Available only for authorised users

Tanaka R, Sanada S, Suzuki M, Matsui T, Uoyama Y (2002) New method of screening chest radiography with computer analysis of respiratory kinetics. Nihon Hoshasen Gijutsu Gakkai Zasshi 58(5):665–669PubMedCrossRef

Sanada S, Tanaka R, Kobayashi T, Suzuki M, Inoue H (2003) Screening chest X-ray examination with kinetic analysis using flat-panel detector. Nippon Igaku Hoshasen Gakkai Zasshi 63(9):579–581PubMed

Tanaka R, Sanada S, Kobayashi T, Suzuki M, Matsui T, Inoue H (2003) Development of breathing chest radiography: study of exposure timing. Nihon Hoshasen Gijutsu Gakkai Zasshi 59(8):984–992PubMedCrossRef

Tanaka R, Sanada S, Kobayashi T, Suzuki M, Matsui T, Matsui O (2006) Computerized methods for determining respiratory phase on dynamic chest radiographs obtained by a dynamic flat-panel detector (FPD) system. J Digit Imaging 19(1):41–51PubMedPubMedCentralCrossRef

Tanaka R, Sanada S, Fujimura M et al (2009) Pulmonary blood flow evaluation using a dynamic flat-panel detector: feasibility study with pulmonary diseases. Int J Comput Assist Radiol Surg 4(5):449–455PubMedCrossRef

Weissman C, Askanazi J, Milic-Emili J, Kinney JM (1984) Effect of respiratory apparatus on respiration. J Appl Physiol Respir Environ Exerc Physiol 57(2):475–480PubMed

Han JN, Stegen K, Cauberghs M, Van de Woestijne KP (1997) Influence of awareness of the recording of breathing on respiratory pattern in healthy humans. Eur Respir J 10(1):161–166PubMedCrossRef

Tanaka R, Sanada S, Okazaki N et al (2006) Evaluation of pulmonary function using breathing chest radiography with a dynamic flat panel detector: primary results in pulmonary diseases. Invest Radiol 41(10):735–745PubMedCrossRef

Tanaka R, Sanada S, Okazaki N et al (2008) Detectability of regional lung ventilation with flat-panel detector-based dynamic radiography. J Digit Imaging 21(1):109–120PubMedCrossRef

10.

Tanaka R, Sanada S, Fujimura M et al (2008) Development of functional chest imaging with a dynamic flat-panel detector (FPD). Radiol Phys Technol 1(2):137–143PubMedCrossRef

11.

Kawashima H, Tanaka R, Sanada S (2009) Reproducibility of dynamic chest radiography with a flat-panel detector-respiratory changes in pixel value. Nihon Hoshasen Gijutsu Gakkai Zasshi 65(6):738–744PubMedCrossRef

12.

Tanaka R, Sanada S, Fujimura M et al (2010) Development of pulmonary blood flow evaluation method with a dynamic flat-panel detector: quantitative correlation analysis with findings on perfusion scan. Radiol Phys Technol 3(1):40–45PubMedCrossRef

13.

Tsuchiya Y, Kodera Y, Tanaka R, Sanada S (2009) Quantitative kinetic analysis of lung nodules using the temporal subtraction technique in dynamic chest radiographies performed with a flat panel detector. J Digit Imaging 22(2):126–135PubMedCrossRef

14.

Tanaka R, Sanada S, Fujimura M et al (2011) Ventilatory impairment detection based on distribution of respiratory-induced changes in pixel values in dynamic chest radiography: a feasibility study. Int J Comput Assist Radiol Surg 6(1):103–110PubMedCrossRef

15.

Tanaka R, Sanada S, Sakuta K, Kawashima H (2015) Quantitative analysis of rib kinematics based on dynamic chest bone images: preliminary results. J Med Imaging (Bellingham) 2(2):024002PubMedCrossRef

16.

Yamada Y, Ueyama M, Abe T et al (2017) Time-resolved quantitative analysis of the diaphragms during tidal breathing in a standing position using dynamic chest radiography with a flat panel detector system (“dynamic X-ray phrenicography”): initial experience in 172 volunteers. Acad Radiol 24(4):393–400PubMedCrossRef

17.

Tanaka R, Matsuda H, Sanada S (2017) Time-series analysis of lung texture on bone-suppressed dynamic chest radiograph for the evaluation of pulmonary function: a preliminary study: SPIE

18.

Yamada Y, Ueyama M, Abe T et al (2017) Difference in diaphragmatic motion during tidal breathing in a standing position between COPD patients and normal subjects: time-resolved quantitative evaluation using dynamic chest radiography with flat panel detector system (“dynamic X-ray phrenicography”). Eur J Radiol 87:76–82PubMedCrossRef

19.

Yamada Y, Ueyama M, Abe T et al (2017) 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 92:37–44PubMedCrossRef

20.

Hida T, Yamada Y, Ueyama M et al (2019) Time-resolved quantitative evaluation of diaphragmatic motion during forced breathing in a health screening cohort in a standing position: dynamic chest phrenicography. Eur J Radiol 113:59–65PubMedCrossRef

21.

Hida T, Yamada Y, Ueyama M et al (2019) Decreased and slower diaphragmatic motion during forced breathing in severe COPD patients: time-resolved quantitative analysis using dynamic chest radiography with a flat panel detector system. Eur J Radiol 112:28–36PubMedCrossRef

22.

Kitahara Y, Tanaka R, Roth HR, Oda H, Mori K, Kasahara K et al (eds) (2019) Lung segmentation based on a deep learning approach for dynamic chest radiography. Medical Imaging 2019: Computer-Aided Diagnosis; 01 Mar 2019

23.

Hanaoka J, Yoden M, Hayashi K et al (2021) Dynamic perfusion digital radiography for predicting pulmonary function after lung cancer resection. World J Surg Oncol 19(1):43PubMedPubMedCentralCrossRef

24.

Hino T, Hata A, Hida T et al (2020) Projected lung areas using dynamic X-ray (DXR). Eur J Radiol Open 7:100263PubMedPubMedCentralCrossRef

25.

Ohkura N, Kasahara K, Watanabe S et al (2020) Dynamic-ventilatory digital radiography in air flow limitation: a change in lung area reflects air trapping. Respiration 99(5):382–388PubMedCrossRef

26.

Tanaka R, Matsumoto I, Tamura M et al (2020) Comparison of dynamic flat-panel detector-based chest radiography with nuclear medicine ventilation–perfusion imaging for the evaluation of pulmonary function: a clinical validation study. Med Phys 47(10):4800–4809PubMedCrossRef

27.

Watase S, Sonoda A, Matsutani N et al (2020) Evaluation of intrathoracic tracheal narrowing in patients with obstructive ventilatory impairment using dynamic chest radiography: a preliminary study. Eur J Radiol 129:109141PubMedCrossRef

28.

Yamamoto S, Hasebe T, Tomita K et al (2020) Pulmonary perfusion by chest digital dynamic radiography: comparison between breath-holding and deep-breathing acquisition. J Appl Clin Med Phys 21(11):247–255PubMedPubMedCentralCrossRef

29.

FitzMaurice TS, McCann C, Nazareth D, Shaw M, McNamara PS, Walshaw MJ (2022) Measuring the effect of elexacaftor/tezacaftor/ivacaftor combination therapy on the respiratory pump in people with CF using dynamic chest radiography. J Cyst Fibros 21:1036–1041PubMedCrossRef

30.

FitzMaurice TS, McCann C, Nazareth DS, Walshaw MJ (2022) Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study. ERJ Open Res 8(1):00343–02021PubMedPubMedCentralCrossRef

31.

Ohkura N, Tanaka R, Watanabe S et al (2021) Chest dynamic-ventilatory digital radiography in chronic obstructive or restrictive lung disease. Int J Chron Obstruct Pulmon Dis 16:1393–1399PubMedPubMedCentralCrossRef

32.

Tanaka R, Matsumoto I, Tamura M et al (2021) Dynamic chest radiography: clinical validation of ventilation and perfusion metrics derived from changes in radiographic lung density compared to nuclear medicine imaging. Quant Imaging Med Surg 11(9):4016–4027PubMedPubMedCentralCrossRef

33.

Ueyama M, Hashimoto S, Takeda A et al (2021) Prediction of forced vital capacity with dynamic chest radiography in interstitial lung disease. Eur J Radiol 142:109866PubMedCrossRef

34.

FitzMaurice TS, McCann C, Nazareth DS, McNamara PS, Walshaw MJ (2022) Use of dynamic chest radiography to assess treatment of pulmonary exacerbations in cystic fibrosis. Radiology 212641

35.

Hart D, Hillier MC, Shrimpton PC (2012) Doses to patients from radiographic and fluoroscopic X-ray imaging procedures in the UK: 2010 review (HPA-CRCE-034)

36.

Moloney F, Kavanagh RG, Ronan NJ et al (2021) Ultra-low-dose thoracic CT with model-based iterative reconstruction (MBIR) in cystic fibrosis patients undergoing treatment with cystic fibrosis transmembrane conductance regulators (CFTR). Clin Radiol 76(5):393CrossRef

37.

Wall BF, Haylock R, Jansen JTM, Hillier MC, Hart D, Shrimpton PC (2011) Radiation risks from medical X-ray examinations as a function of the age and sex of the patient (HPA-CRCE-028)

38.

Boussuges A, Finance J, Chaumet G, Brégeon F (2021) Diaphragmatic motion recorded by M-mode ultrasonography: limits of normality. ERJ Open Res 7(1):00714–02020PubMedPubMedCentralCrossRef

39.

Fitzmaurice T (2021) A study comparing ultrasound versus X-rays to diagnose paralysed diaphragm muscles ISRCTN Registry: ISRCTN Registry. Available from: https://www.isrctn.com/ISRCTN31111675

40.

Motamedi-Fakhr S, Wilson RC, Iles R (2016) Tidal breathing patterns derived from structured light plethysmography in COPD patients compared with healthy subjects. Med Devices (Auckl) 10:1–9PubMedPubMedCentral

41.

Pratt PC, Klugh GA (1967) A method for the determination of total lung capacity from posteroanterior and lateral chest roentgenograms. Am Rev Respir Dis 96(3):548–552PubMed

42.

Tanaka R, Sanada S, Tsujioka K, Matsui T, Takata T, Matsui O (2008) Development of a cardiac evaluation method using a dynamic flat-panel detector (FPD) system: a feasibility study using a cardiac motion phantom. Radiol Phys Technol 1(1):27–32PubMedCrossRef

43.

Miyatake H, Asada K, Tabata T, Eguchi Y, Matsutani N, Nakagawa Y (2021) Novel pulmonary circulation imaging using dynamic chest radiography for acute pulmonary embolism. Circ J 85(4):400PubMedCrossRef

44.

Hoshino S, Miyatake H, Maruo Y (2021) Using dynamic digital radiography to assess pulmonary circulation imaging in a patient with congenital heart disease. Int J Cardiovasc Imaging. https://doi.org/10.1007/s10554-021-02517-4CrossRefPubMed

45.

Yamasaki Y, Moriyama S, Tatsumoto R, Abe K, Ishigami K (2022) Chronic thromboembolic pulmonary hypertension after acute pulmonary thromboembolism revealed by dynamic chest radiography. Eur Heart J Cardiovasc Imaging 23(6):e264–e265PubMedPubMedCentralCrossRef

46.

Yamasaki Y, Ishigami K (2021) Dynamic chest radiography of pulmonary arteriovenous malformation. Radiology 300(2):285PubMedCrossRef

47.

Leong P, Bardin PG, Lau KK (2013) What’s in a name? Expiratory tracheal narrowing in adults explained. Clin Radiol 68(12):1268–1275PubMedCrossRef

48.

Mitropoulos A, Song W-J, Almaghlouth F, Kemp S, Polkey M, Hull JH (2021) Detection and diagnosis of large airway collapse: a systematic review. ERJ Open Res 7(3):00055–02021PubMedPubMedCentralCrossRef

49.

Rajendran K, Petersilka M, Henning A et al (2021) First clinical photon-counting detector CT system: technical evaluation. Radiology 303(1):130–138PubMedCrossRef

50.

Kim Y, Kim YK, Lee BE et al (2015) Ultra-low-dose CT of the thorax using iterative reconstruction: evaluation of image quality and radiation dose reduction. AJR Am J Roentgenol 204(6):1197–1202PubMedCrossRef

Title: Dynamic chest radiography: a state-of-the-art review
Authors: Fred Fyles
Thomas S. FitzMaurice
Ryan E. Robinson
Ram Bedi
Hassan Burhan
Martin J. Walshaw
Publication date: 01-12-2023
Publisher: Springer Vienna
Keywords: Cystic Fibrosis
Cystic Fibrosis
Chronic Obstructive Lung Disease
Published in: Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-023-01451-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dynamic chest radiography: a state-of-the-art review

Abstract

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Graphical abstract

Please log in to get access to this content

Other articles of this Issue 1/2023

CheckList for EvaluAtion of Radiomics research (CLEAR): a step-by-step reporting guideline for authors and reviewers endorsed by ESR and EuSoMII

Imaging of hepatocellular carcinoma recurrence after liver transplantation

Chyluria: non-enhanced MR lymphography

Predictive models and early postoperative recurrence evaluation for hepatocellular carcinoma based on gadoxetic acid-enhanced MR imaging

Complications of cochlear implants with MRI scans in different body regions: type, frequency and impact

Correlation analysis of MR elastography and Ki-67 expression in intrahepatic cholangiocarcinoma