Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Four-Dimensional Thoracic CT in Free-Breathing Children

  • Hyun Woo Goo (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2018.05.19
  • Accepted : 2018.07.31
  • Published : 2019.01.01
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Abstract

In pediatric thoracic CT, respiratory motion is generally treated as a motion artifact degrading the image quality. Conversely, respiratory motion in the thorax can be used to answer important clinical questions, that cannot be assessed adequately via conventional static thoracic CT, by utilizing four-dimensional (4D) CT. However, clinical experiences of 4D thoracic CT are quite limited. In order to use 4D thoracic CT properly, imagers should understand imaging techniques, radiation dose optimization methods, and normal as well as typical abnormal imaging appearances. In this article, the imaging techniques of pediatric thoracic 4D CT are reviewed with an emphasis on radiation dose. In addition, several clinical applications of pediatric 4D thoracic CT are addressed in various thoracic functional abnormalities, including upper airway obstruction, tracheobronchomalacia, pulmonary air trapping, abnormal diaphragmatic motion, and tumor invasion. One may further explore the clinical usefulness of 4D thoracic CT in free-breathing children, which can enrich one's clinical practice.

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References

  1. Lee EY, Mason KP, Zurakowski D, Waltz DA, Ralph A, Riaz F, et al. MDCT assessment of tracheomalacia in symptomatic infants with mediastinal aortic vascular anomalies: preliminary technical experience. Pediatr Radiol 2008;38:82-88
  2. Long FR, Castile RG, Brody AS, Hogan MJ, Flucke RL, Filbrun DA, et al. Lungs in infants and young children: improved thin-section CT with a noninvasive controlled-ventilation technique--initial experience. Radiology 1999;212:588-593
  3. Goo HW, Allmendinger T. Combined electrocardiography- and respiratory-triggered CT of the lung to reduce respiratory misregistration artifacts between imaging slabs in free-breathing children: initial experience. Korean J Radiol 2017;18:860-866
  4. Goo HW. Combined prospectively electrocardiography- and respiratory-triggered sequential cardiac computed tomography in free-breathing children: success rate and image quality. Pediatr Radiol 2018;48:923-931
  5. Lin L, Bivard A, Krishnamurthy V, Levi CR, Parsons MW. Whole-brain CT perfusion to quantify acute ischemic penumbra and core. Radiology 2016;279:876-887
  6. Moorees J, Bezak E. Four dimensional CT imaging: a review of current technologies and modalities. Australas Phys Eng Sci Med 2012;35:9-23
  7. Jahani N, Choi S, Choi J, Iyer K, Hoffman EA, Lin CL. Assessment of regional ventilation and deformation using 4DCT imaging for healthy human lungs during tidal breathing. J Appl Physiol (1985) 2015;119:1064-1074
  8. Wielputz MO, Eberhardt R, Puderbach M, Weinheimer O, Kauczor HU, Heussel CP. Simultaneous assessment of airway instability and respiratory dynamics with low-dose 4D-CT in chronic obstructive pulmonary disease: a technical note. Respiration 2014;87:294-300
  9. Greenberg SB. Dynamic pulmonary CT of children. AJR Am J Roentgenol 2012;199:435-440
  10. Goo HW. Current trends in cardiac CT in children. Acta Radiol 2013;54:1055-1062
  11. Goo HW. Advanced functional thoracic imaging in children: from basic concepts to clinical applications. Pediatr Radiol 2013;43:262-268
  12. Goo HW, Drubach L, Lee EY. Imaging techniques. In: Coley BD, ed. Caffey's pediatric diagnostic imaging, 12th ed. Philadelphia, PA: Elsevier, 2013:506-518
  13. Tan JZ, Crossett M, Ditchfield M. Dynamic volumetric computed tomographic assessment of the young paediatric airway: initial experience of rapid, non-invasive, four-dimensional technique. J Med Imaging Radiat Oncol 2013;57:141-148
  14. Greenberg SB, Dyamenahalli U. Dynamic pulmonary computed tomography angiography: a new standard for evaluation of combined airway and vascular abnormalities in infants. Int J Cardiovasc Imaging 2014;30:407-414
  15. Kwong Y, Mel AO, Wheeler G, Troupis JM. Four-dimensional computed tomography (4DCT): a review of the current status and applications. J Med Imaging Radiat Oncol 2015;59:545-554
  16. Goo HW. Four-dimensional CT of the diaphragm in children: initial experience. Korean J Radiol 2018;19:111-118
  17. Goo HW. CT radiation dose optimization and estimation: an update for radiologists. Korean J Radiol 2012;13:1-11
  18. Choong CK, Pasricha SS, Li X, Briggs P, Ramdave S, Crossett M, et al. Dynamic four-dimensional computed tomography for preoperative assessment of lung cancer invasion into adjacent structures. Eur J Cardiothorac Surg 2015;47:239-243; discussion 243
  19. Goo HW. Individualized volume CT dose index determined by cross-sectional area and mean density of the body to achieve uniform image noise of contrast-enhanced pediatric chest CT obtained at variable kV levels and with combined tube current modulation. Pediatr Radiol 2011;41:839-847
  20. Goo HW. Free-breathing cine CT for the diagnosis of tracheomalacia in young children. Pediatr Radiol 2013;43:922-928
  21. Goo HW, Kim HJ. Detection of air trapping on inspiratory and expiratory phase images obtained by 0.3-second cine CT in the lungs of free-breathing young children. AJR Am J Roentgenol 2006;187:1019-1023
  22. Kipritidis J, Hofman MS, Siva S, Callahan J, Le Roux PY, Woodruff HC, et al. Estimating lung ventilation directly from 4D CT Hounsfield unit values. Med Phys 2016;43:33
  23. Chavhan GB, Babyn PS, Cohen RA, Langer JC. Multimodality imaging of the pediatric diaphragm: anatomy and pathologic conditions. Radiographics 2010;30:1797-1817
  24. Epelman M, Navarro OM, Daneman A, Miller SF. M-mode sonography of diaphragmatic motion: description of technique and experience in 278 pediatric patients. Pediatr Radiol 2005;35:661-667
  25. Akata S, Kajiwara N, Park J, Yoshimura M, Kakizaki D, Abe K, et al. Evaluation of chest wall invasion by lung cancer using respiratory dynamic MRI. J Med Imaging Radiat Oncol 2008;52:36-39
  26. Hong YJ, Hur J, Lee HJ, Kim YJ, Hong SR, Suh YJ, et al. Respiratory dynamic magnetic resonance imaging for determining aortic invasion of thoracic neoplasms. J Thorac Cardiovasc Surg 2014;148:644-650
  27. Li T, Schreibmann E, Thorndyke B, Tillman G, Boyer A, Koong A, et al. Radiation dose reduction in four-dimensional computed tomography. Med Phys 2005;32:3650-3660