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Robust quantification of CT‐ventilation biomarker techniques and repeatability in a porcine model.
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- Author(s): Flakus, Mattison J.; Wuschner, Antonia E.; Wallat, Eric M.; Shao, Wei; Meudt, Jen; Shanmuganayagam, Dhanansayan; Christensen, Gary E.; Reinhardt, Joseph M.; Bayouth, John E.
- Source:
Medical Physics; Oct2023, Vol. 50 Issue 10, p6366-6378, 13p- Subject Terms:
- Source:
- Additional Information
- Abstract: Background: Biomarkers estimating local lung ventilation have been derived from computed tomography (CT) imaging using various image acquisition and post‐processing techniques. CT‐ventilation biomarkers have potential clinical use in functional avoidance radiation therapy (RT), in which RT treatment plans are optimized to reduce dose delivered to highly ventilated lung. Widespread clinical implementation of CT‐ventilation biomarkers necessitates understanding of biomarker repeatability. Performing imaging within a highly controlled experimental design enables quantification of error associated with remaining variables. Purpose: To characterize CT‐ventilation biomarker repeatability and dependence on image acquisition and post‐processing methodology in anesthetized and mechanically ventilated pigs. Methods: Five mechanically ventilated Wisconsin Miniature Swine (WMS) received multiple consecutive four‐dimensional CT (4DCT) and maximum inhale and exhale breath‐hold CT (BH‐CT) scans on five dates to generate CT‐ventilation biomarkers. Breathing maneuvers were controlled with an average tidal volume difference <200 cc. As surrogates for ventilation, multiple local expansion ratios (LERs) were calculated from the acquired CT scans using Jacobian‐based post‐processing techniques. LER2$LER_2$ measured local expansion between an image pair using either inhale and exhale BH‐CT images or two 4DCT breathing phase images. LERN$LER_N$ measured the maximum local expansion across the 4DCT breathing phase images. Breathing maneuver consistency, intra‐ and interday biomarker repeatability, image acquisition and post‐processing technique dependence were quantitatively analyzed. Results: Biomarkers showed strong agreement with voxel‐wise Spearman correlation ρ>0.9$\rho > 0.9$ for intraday repeatability and ρ>0.8$\rho > 0.8$ for all other comparisons, including between image acquisition techniques. Intra‐ and interday repeatability were significantly different (p < 0.01). LER2 and LERN post‐processing did not significantly affect intraday repeatability. Conclusions: 4DCT and BH‐CT ventilation biomarkers derived from consecutive scans show strong agreement in controlled experiments with nonhuman subjects. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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