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Lobar-Level Lung Ventilation Analysis Using 4DCT and Deformable Image Registration

K Du

K Du1*, T Patton2 , J Reinhardt3 , G Christensen4 , B Zhao4 , S Gerard3 , Y Pan4 , J Bayouth1 , (1) Department of Human Oncology, University of Wisconsin Hopspital and Clinics, Madison, WI, (2) Department of Medical Physics, University of Wisconsin, Madison, WI, (3) Department of Biomedical Engineering, The University of Iowa, Iowa City, IA, (4) Department of Electrical and Computer Engineering, The University of Iowa, Iowa City, IA


SU-E-J-90 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: To assess regional changes in human lung ventilation and mechanics using four-dimensional computed tomography (4DCT) and deformable image registration. This work extends our prior analysis of the entire lung to a lobe-based analysis.

Methods: 4DCT images acquired from 20 patients prior to radiation therapy (RT) were used for this analysis. Jacobian ventilation and motion maps were computed from the displacement field after deformable image registration between the end of expiration breathing phase and the end of inspiration breathing phase. The lobes were manually segmented on the reference phase by a medical physicist expert. The voxel-by-voxel ventilation and motion magnitude for all subjects were grouped by lobes and plotted into cumulative voxel frequency curves respectively. In addition, to eliminate the effect of different breathing efforts across subjects, we applied the inter-subject equivalent lung volume (ELV) method on a subset of the cohort and reevaluated the lobar ventilation.

Results: 95% of voxels in the lung are expanding during inspiration. However, some local regions of lung tissue show far more expansion than others. The greatest expansion with respiration occurs within the lower lobes; between exhale and inhale the median expansion in lower lobes is approximately 15%, while the median expansion in upper lobes is 10%. This appears to be driven by a subset of lung tissues within the lobe that have greater expansion; twice the number of voxels in the lower lobes (20%) expand by > 30% when compared to the upper lobes (10%).

Conclusion: Lung ventilation and motion show significant difference on the lobar level. There are different lobar fractions of driving voxels that contribute to the major expansion of the lung.

Funding Support, Disclosures, and Conflict of Interest: This work was supported by NIH grant CA166703

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