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Novel Lung Ventilation Imaging with Single Energy CT After Single Inhalation of Xenon: Comparison with SPECT Ventilation Images

M Negahdar

M Negahdar1*, T Yamamoto2 , D Shultz3 , L Gable4 , X Shan5 , E Mittra6 , M Diehn7 , B Loo8 , P Maxim9 , (1) Stanford University School of Medicine, Stanford, CA, (2) UC Davis School of Medicine, Sacramento, CA, (3) Stanford University, Stanford, CA, (4) Stanford University, Stanford, CA, (5) Stanford University, Stanford, CA, (6) Stanford University, Stanford, CA, (7) Stanford University, Palo Alto, CA, (8) Stanford University, Stanford, CA, (9) Stanford University, Stanford, CA


TU-A-12A-2 Tuesday 7:30AM - 9:30AM Room: 12A

Purpose: We propose a novel lung functional imaging method to determine the spatial distribution of xenon (Xe) gas in a single inhalation as a measure of regional ventilation. We compare Xe-CT ventilation to single-photon emission CT (SPECT) ventilation, which is the current clinical reference. Regional lung ventilation information may be useful for the diagnosis and monitoring of pulmonary diseases such as COPD, radiotherapy planning, and assessing the progression of toxicity after radiation therapy.

Methods: In an IRB-approved clinical study, Xe-CT and SPECT ventilation scans were acquired for three patients including one patient with severe emphysema and two lung cancer patients treated with radiotherapy. For Xe-CT, we acquired two breath-hold single energy CT images of the entire lung with inspiration of 100% O2 and a mixture of 70% Xe and 30% O2, respectively. A video biofeedback system was used to achieve reproducible breath-holds. We used deformable image registration to align the breath-hold images with each other to accurately subtract them, producing a map of the distribution of Xe as a surrogate of lung ventilation. We divided each lung into twelve parts and correlated the Hounsfield unit (HU) enhancement at each part with the SPECT ventilation count of the corresponding part of the lung.

Results: The mean of the Pearson linear correlation coefficient values between the Xe-CT and ventilation SPECT count for all three patients were 0.62 (p<0.01). The Xe-CT image had a higher resolution than SPECT, and did not show central airway deposition artifacts that were present in the SPECT image.

Conclusion: We developed a rapid, safe, clinically practical, and potentially widely accessible method for regional lung functional imaging. We demonstrated strong correlations between the Xe-CT ventilation image and SPECT ventilation image as the clinical reference. This ongoing study will investigate more patients to confirm this finding.

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