Quantitative CT characterization of normal lung anatomy: In relation to locations and gender and study of various lung volume estimation
Keywords:
Mean lung attenuation, Lung volume estimation, Ellipsoid formulaAbstract
Background: Mean lung parenchymal attenuation (MLA) may show gender differences and vary in different locations. Lung volume estimations play an important role in lung transplantation workout. In the current study, we focus on quantitative measurement of lung volume using different estimations obtained through calculated formulae from CT images and Chest Radiograph. This study could help to generate data for future references, particularly for Malaysia or Southeast Asia.
Objective: To study the MLA in relation to the location, patient’s position and gender differences, in order to find the correlation of various lung volume estimation methods.
Materials and Methods: This was a retrospective cross-sectional study. A total of 62 patients’ CT images were selected and measurements of MLA were analyzed at lung apex, main carinal level (MCL), and base level (BL). At MCL and BL, the MLA was measured in three regions which were anterior, middle and posterior regions. A total lung volume of 26 from the 62 study subjects was also estimated using the predictive equation (method i), estimation from the frontal chest radiograph (method ii), ellipsoid formula using measurement from CT images (method iii) and semi auto-segmentation and volumetric calculation (method iv).
Results: MLA of the right lungs range from -860±9.52 to -787.66±14.8 HU. MLA of the left lungs range from -845.60±10.0 to -789.66±14.0 HU. MLA at middle MCL is lower than apex and middle BL bilaterally (p<0.05). Male subjects have lower lung attenuation with several areas showing a statistically significant difference (p<0.05). The four lung volume estimations show moderate to strong linear correlation (r = 0.565 – 0.899).
Conclusion: Variation of MLA among MCL, apex and BL could be related to better chest expansion at MCL. Theposterior part of the lungs shows a higher value of MLA and this is related to the supine position during scanning that results in a lesser degree of chest expansion at the posterior part and gravity influence. Lung volume estimation is possible using demographic data, a chest radiograph or the ellipsoid formula.
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