Dynamic chest radiography with a flat-panel detector (FPD): Ventilation-perfusion study

Pulmonary ventilation and blood flow are reflected in dynamic chest radiographs as changes in X-ray translucency, i.e., pixel values. This study was performed to investigate the feasibility of ventilation-perfusion (V/Q) study based on the changes in pixel value. Sequential chest radiographs of a patient with ventilation-perfusion mismatch were obtained during respiration using a dynamic flat-panel detector (FPD) system. The lung area was recognized and average pixel value was measured in each area, tracking and deforming the region of interest. Inter-frame differences were then calculated, and the absolute values were summed in each respiratory phase. The results were visualized as ventilation, blood flow, V/Q ratio distribution map and compared to distribution of radioactive counts on ventilation and perfusion scintigrams. In the results, abnormalities were appeared as a reduction of changes in pixel values, and a correlation was observed between the distribution of changes in pixel value and those of radioactivity counts (Ventilation; r=0.78, Perfusion; r=0.77). V/Q mismatch was also indicated as mismatch of changes in pixel value, and a correlation with V/Q calculated by radioactivity counts (r=0.78). These results indicated that the present method is potentially useful for V/Q study as an additional examination in conventional chest radiography.