Open Access Highly Accessed Research article

Determination of regional lung air volume distribution at mid-tidal breathing from computed tomography: a retrospective study of normal variability and reproducibility

John Fleming1246*, Joy Conway13, Caroline Majoral4, Michael Bennett1, Georges Caillibotte4, Spyridon Montesantos4 and Ira Katz45

Author Affiliations

1 National Institute of Health Research Biomedical Research Unit in Respiratory Disease, University Hospital Southampton NHS Foundation Trust, Southampton, UK

2 Department of Medical Physics and Bioengineering, University Hospital Southampton NHS Foundation Trust, Southampton, UK

3 Faculty of Health Sciences, University of Southampton, Southampton, UK

4 Medical R&D, Air Liquide Santé International, Centre de Recherche Claude-Delorme, Les Loges-en-Josas, France

5 Department of Mechanical Engineering, Lafayette College, Easton, PA, USA

6 Department of Nuclear Medicine, Southampton General Hospital, Mail Point 26, Southampton SO166YD, UK

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BMC Medical Imaging 2014, 14:25  doi:10.1186/1471-2342-14-25

Published: 25 July 2014

Abstract

Background

Determination of regional lung air volume has several clinical applications. This study investigates the use of mid-tidal breathing CT scans to provide regional lung volume data.

Methods

Low resolution CT scans of the thorax were obtained during tidal breathing in 11 healthy control male subjects, each on two separate occasions. A 3D map of air volume was derived, and total lung volume calculated. The regional distribution of air volume from centre to periphery of the lung was analysed using a radial transform and also using one dimensional profiles in three orthogonal directions.

Results

The total air volumes for the right and left lungs were 1035 +/− 280 ml and 864 +/− 315 ml, respectively (mean and SD). The corresponding fractional air volume concentrations (FAVC) were 0.680 +/− 0.044 and 0.658 +/− 0.062. All differences between the right and left lung were highly significant (p < 0.0001). The coefficients of variation of repeated measurement of right and left lung air volumes and FAVC were 6.5% and 6.9% and 2.5% and 3.6%, respectively. FAVC correlated significantly with lung space volume (r = 0.78) (p < 0.005). FAVC increased from the centre towards the periphery of the lung. Central to peripheral ratios were significantly higher for the right (0.100 +/− 0.007 SD) than the left (0.089 +/− 0.013 SD) (p < 0.0001).

Conclusion

A technique for measuring the distribution of air volume in the lung at mid-tidal breathing is described. Mean values and reproducibility are described for healthy male control subjects. Fractional air volume concentration is shown to increase with lung size.

Keywords:
Regional lung volume measurement; Computed tomography; Reproducibility