Quantifying tracheobronchial tree dimensions: Methods, limitations and emerging techniques

European Respiratory Journal

Volumn 34, Issue 1, 2009, Pages 42-55

  Williamson, J P ^a,b   James, A L ^a,c   Phillips, M J ^a   Sampson, D D ^b   Hillman, D R ^a   Eastwood, P R ^a,b  

^a SIR CHARLES GAIRDNER HOSPITAL   (Australia)

^b UNIVERSITY OF WESTERN AUSTRALIA   (Australia)

^c UNIVERSITY OF WESTERN AUSTRALIA   (Australia)

Author keywords

Airway dimensions; Confocal endomicroscopy; Multidetector computed tomography; Optical coherence tomography; Videobronchoscopy

Indexed keywords

ASTHMA; BRONCHIECTASIS; BRONCHOSCOPY; CHRONIC OBSTRUCTIVE LUNG DISEASE; CLINICAL PRACTICE; COMPUTER ASSISTED TOMOGRAPHY; CONFOCAL MICROSCOPY; CYSTIC FIBROSIS; DIAGNOSTIC ACCURACY; DIAGNOSTIC IMAGING; DIAGNOSTIC VALUE; ENDOBRONCHIAL ULTRASONOGRAPHY; HUMAN; IMAGE ANALYSIS; IMAGE PROCESSING; IMAGE QUALITY; MULTIDETECTOR COMPUTED TOMOGRAPHY; NUCLEAR MAGNETIC RESONANCE IMAGING; OPTICAL COHERENCE TOMOGRAPHY; OPTICAL RESOLUTION; PRIORITY JOURNAL; REVIEW; STRUCTURE ANALYSIS; TISSUE STRUCTURE; TRACHEOBRONCHIAL TREE;

ALGORITHMS; ASTHMA; BRONCHI; BRONCHOSCOPES; BRONCHOSCOPY; CYSTIC FIBROSIS; HUMANS; MAGNETIC RESONANCE IMAGING; MICROSCOPY, CONFOCAL; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE; PULMONARY MEDICINE; RESPIRATORY SYSTEM; TOMOGRAPHY, X-RAY COMPUTED; TRACHEA;

EID: 69249085744     PISSN: 09031936     EISSN: 13993003     Source Type: Journal    
DOI: 10.1183/09031936.00020408     Document Type: Review

References (124)

1. Hurter T, Hanrath P. Endobronchial sonography: feasibility and preliminary results. Thorax 1992; 47: 565-567.
2. Weibel E, Gomez D. Architecture of the human lung. Use of quantitative methods establishes fundamental relations between size and number of lung structures. Science 1962; 137: 577-585.
3. Boyden EA. A synthesis of the prevailing patterns of the bronchopulmonary segments in the light of their variations. Chest 1949; 15: 657-668.
4. Ikeda S. Atlas of Flexible Bronchofiberoscopy. Tokyo, Igaku-Shoin, 1974; pp. 58-71.
5. Jackson CL, Huber JF. Correlated applied anatomy of the bronchial tree and lungs with a system of nomenclature. Chest 1943; 9: 319-326.
6. Tschirren J, McLennan G, Palagyi K, et al. Matching and anatomical labeling of human airway tree. IEEE Trans Med Imaging 2005; 24: 1540-1547.
7. James AL, Wenzel S. Clinical relevance of airway remodelling in airway diseases. Eur Respir J 2007; 30: 134-155.
8. Dame Carroll JR, Chandra A, Jones AS, et al. Airway dimensions measured from micro-computed tomography and high-resolution computed tomography. Eur Respir J 2006; 28: 712-720.
9. Berger P, Perot V, Desbarats P, et al. Airway wall thickness in cigarette smokers: quantitative thin-section CT assessment. Radiology 2005; 235: 1055-1064.
10. Kalender WA, Rienmuller R, Seissler W, et al. Measurement of pulmonary parenchymal attenuation - use of spirometric gating with quantitative CT. Radiology 1990; 175: 265-268.
11. James AL, Pare PD, Hogg JC. Effects of lung volume, bronchoconstriction, and cigarette smoke on morphometric airway dimensions. J Appl Physiol 1988; 64: 913-919.
12. Hogg JC, Macklem PT, Thurlbeck WM. Site and nature of airway obstruction in chronic obstructive lung disease. N Engl J Med 1968; 278: 1355-1360.
13. James AL, Pare PD, Hogg JC. The mechanics of airway narrowing in asthma. Am Rev Respir Dis 1989; 139: 242-246.
14. Yanai M, Sekizawa K, Ohrui T, et al. Site of airway obstruction in pulmonary disease: direct measurement of intrabronchial pressure. J Appl Physiol 1992; 72: 1016-1023.
15. Long FR, Williams RS, Castile RG. Structural airway abnormalities in infants and young children with cystic fibrosis. J Pediatr 2004; 144: 154-161.
16. Todo G, Herman PG. High-resolution computed tomography of the pig lung. Invest Radiol 1986; 21: 689-696.
17. King GG, Muller NL, Pare PD. Evaluation of airways in obstructive pulmonary disease using high-resolution computed tomography. Am J Respir Crit Care Med 1999; 159: 992-1004.
18. King GG, Muller NL, Whittall KP, et al. An analysis algorithm for measuring airway lumen and wall areas from high-resolution computed tomographic data. Am J Respir Crit Care Med 2000; 161: 574-580.
19. McNamara AE, Muller NL, Okazawa M, et al. Airway narrowing in excised canine lungs measured by high-resolution computed tomography. J Appl Physiol 1992; 73: 307-316.
20. Nakano Y, Muro S, Sakai H, et al. Computed tomographic measurements of airway dimensions and emphysema in smokers. Correlation with lung function. Am J Respir Crit Care Med 2000; 162: 1102-1108.
21. Nakano Y, Wong JC, de Jong PA, et al. The prediction of small airway dimensions using computed tomography. Am J Respir Crit Care Med 2005; 171: 142-146.
22. Palagyi K, Tschirren J, Hoffman EA, et al. Quantitative analysis of pulmonary airway tree structures. Comput Biol Med 2006; 36: 974-996.
23. Tschirren J, Hoffman EA, McLennan G, et al. Intrathoracic airway trees: segmentation and airway morphology analysis from low-dose CT scans. IEEE Trans Med Imaging 2005; 24: 1529-1539.
24. Bankier AA, Fleischmann D, Mallek R, et al. Bronchial wall thickness: appropriate window settings for thin-section CT and radiologic-anatomic correlation. Radiology 1996; 199: 831-836.
25. Niimi A, Matsumoto H, Amitani R, et al. Airway wall thickness in asthma assessed by computed tomography. Relation to clinical indices. Am J Respir Crit Care Med 2000; 162: 1518-1523.
26. Seneterre E, Paganin F, Bruel JM, et al. Measurement of the internal size of bronchi using high resolution computed tomography (HRCT). Eur Respir J 1994; 7: 596-600.
27. Webb WR, Gamsu G, Wall SD, et al. CT of a bronchial phantom. Factors affecting appearance and size measurements. Invest Radiol 1984; 19: 394-398.
28. Brown RH, Herold CJ, Hirshman CA, et al. In vivo measurements of airway reactivity using high-resolution computed tomography. Am Rev Respir Dis 1991; 144: 208-212.
29. McNittGray MF, Goldin JG, Johnson TD, et al. Development and testing of image-processing methods for the quantitative assessment of airway hyperresponsiveness from high-resolution CT images. J Comput Assist Tomogr 1997; 21: 939-947.
30. Amirav I, Kramer SS, Grunstein MM, et al. Assessment of methacholine-induced airway constriction by ultrafast high-resolution computed tomography. J Appl Physiol 1993; 75: 2239-2250.
31. Montaudon M, Berger P, de Dietrich G, et al. Assessment of airways with three-dimensional quantitative thin-section CT: in vitro and in vivo validation. Radiology 2007; 242: 563-572.
32. Reinhardt JM, D'Souza ND, Hoffman EA. Accurate measurement of intrathoracic airways. IEEE Trans Med Imaging 1997; 16: 820-827.
33. Saba OI, Hoffman EA, Reinhardt JM. Maximizing quantitative accuracy of lung airway lumen and wall measures obtained from X-ray CT imaging. J Appl Physiol 2003; 95: 1063-1075.
34. de Jong PA, Muller NL, Pare PD, et al. Computed tomographic imaging of the airways: relationship to structure and function. Eur Respir J 2005; 26: 140-152.
35. Nakano Y, Muller NL, King GG, et al. Quantitative assessment of airway remodeling using high-resolution CT. Chest 2002; 122: 271S-275S.
36. Venkatraman R, Raman R, Raman B, et al. Fully automated system for three-dimensional bronchial morphology analysis using volumetric multidetector computed tomography of the chest. J Digit Imaging 2006; 19: 132-139.
37. Bushberg JT, Seibert JA, Leidholdt EM Jr, et al., The Essential Physics of Medical Imaging. 2nd Edn. Philadelphia, Lippincott Williams and Wilkins, 2002; pp. 371-372.
38. Okazawa M, Muller N, McNamara AE, et al. Human airway narrowing measured using high resolution computed tomography. Am J Respir Crit Care Med 1996; 154: 1557-1562.
39. Wood SA, Zerhouni EA, Hoford JD, et al. Measurement of three-dimensional lung tree structures by using computed tomography. J Appl Physiol 1995; 79: 1687-1697.
40. Tschirren J, Hoffman EA, McLennan G, et al. Segmentation and quantitative analysis of intrathoracic airway trees from computed tomography images. Proc Am Thorac Soc 2005; 2: 484-487.
41. Graham SM, McLennan G, Funk GF, et al. Preoperative assessment of obstruction with computed tomography image analysis. Am J Otolaryngol 2000; 21: 263-270.
42. Di Simone MP, Mattioli S, D'Ovidio F, et al. Three-dimensional CT imaging and virtual endoscopy for the placement of self-expandable stents in oesophageal and tracheobronchial neoplastic stenoses. Eur J Cardiothorac Surg 2003; 23: 106-108.
43. Zwischenberger JB, Wittich GR, van Sonnenberg E, et al. Airway simulation to guide stent placement for tracheobronchial obstruction in lung cancer. Ann Thorac Surg 1997; 64: 1619-1625.
44. Hoppe H, Dinkel HP, Walder B, et al. Grading airway stenosis down to the segmental level using virtual bronchoscopy. Chest 2004; 125: 704-711.
45. Shitrit D, Valdsislav P, Grubstein A, et al. Accuracy of virtual bronchoscopy for grading tracheobronchial stenosis: correlation with pulmonary function test and fiberoptic bronchoscopy. Chest 2005; 128: 3545-3550.
46. Heyer CM, Nuesslein TG, Jung D, et al. Tracheobronchial anomalies and stenoses: detection with low-dose multidetector CT with virtual tracheobronchoscopy - comparison with flexible tracheobronchoscopy. Radiology 2007; 242: 542-549.
47. Hoppe H, Walder B, Sonnenschein M, et al. Multidetector CT virtual bronchoscopy to grade tracheobronchial stenosis. AJR Am J Roentgenol 2002; 178: 1195-1200.
48. Maniatis PN, Triantopoulou CC, Tsalafoutas IA, et al. Virtual bronchoscopy versus thin section computed-tomography in evaluation of moderate and low grade stenoses: receiver operating characteristic curve analysis. Acta Radiol 2006; 47: 48-57.
49. Burke AJ, Vining DJ, McGuirt WF, et al. Evaluation of airway obstruction using virtual endoscopy. Laryngoscope 2000; 110: 23-29.
50. Gilkeson RC, Ciancibello LM, Hejal RB, et al. Tracheobronchomalacia: dynamic airway evaluation with multidetector CT. AJR Am J Roentgenol 2001; 176: 205-210.
51. Zhang J, Hasegawa I, Feller-Kopman D, et al. 2003 AUR Memorial Award. Dynamic expiratory volumetric CT imaging of the central airways: comparison of standard-dose and low-dose techniques. Acad Radiol 2003; 10: 719-724.
52. Baroni RH, Feller-Kopman D, Nishino M, et al. Tracheobronchomalacia: comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse. Radiology 2005: 235; 635-641.
53. Carden KA, Boiselle PM, Waltz DA, et al. Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest 2005; 127: 984-1005.
54. Dumon JF. A dedicated tracheobronchial stent. Chest 1990; 97: 328-332.
55. Clarke DB. Palliative intubation of the trachea and main bronchi. J Thorac Cardiovasc Surg 1980; 80: 736-741.
56. Orlowski TM. Palliative intubation of the tracheobronchial tree. J Thorac Cardiovasc Surg 1987; 94: 343-348.
57. Ferretti GR, Kocier M, Calaque O, et al. Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy. Eur Radiol 2003; 13: 1172-1178.
58. Wadsworth SJ, Juniper MC, Benson MK, et al. Fatal complication of an expandable metallic bronchial stent. Br J Radiol 1999; 72: 706-708.
59. Dorffel WV, Fietze I, Hentschel D, et al. A new bronchoscopic method to measure airway size. Eur Respir J 1999; 14: 783-788.
60. McFawn PK, Forkert L, Fisher JT. A new method to perform quantitative measurement of bronchoscopic images. Eur Respir J 2001; 18: 817-826.
61. Doolin EJ, Strande LL. Calibration of endoscopic images. Ann Otol Rhinol Laryngol 1995; 104: 19-23.
62. Santos MC, Strande L, Doolin EJ. Airway measurement using morphometric analysis. Ann Otol Rhinol Laryngol 1995; 104: 835-838.
63. Masters IB, Eastburn MM, Francis PW, et al. Quantification of the magnification and distortion effects of a pediatric flexible videobronchoscope. Respir Res 2005; 6: 16.
64. Forkert L, Watanabe H, Sutherland K, et al. Quantitative videobronchoscopy: a new technique to assess airway caliber. Am J Respir Crit Care Med 1996; 154: 1794-1803.
65. Riff EJ, Mitra S, Baker MC. Pediatric fiberoptic video bronchoscopy: the use of computer interfacing. Comput Biol Med 1993; 23: 345-347.
66. Helferty JP, Zhang C, McLennan G, et al. Videoendoscopic distortion correction and its application to virtual guidance of endoscopy. IEEE Trans Med Imaging 2001; 20: 605-617.
67. Mitchell HW, Sparrow MP. Video-imaging of lumen narrowing; muscle shortening and flow responsiveness in isolated bronchial segments of the pig. Eur Respir J 1994; 7: 1317-1325.
68. Czaja P, Soja J, Grzanka P, et al. Assessment of airway caliber in quantitative videobronchoscopy. Respiration 2007; 74: 432-438.
69. Masters IB, Eastburn MM, Wootton R, et al. A new method for objective identification and measurement of airway lumen in paediatric flexible videobronchoscopy. Thorax 2005; 60: 652-658.
70. Rasband WS. ImageJ. Bethesda, US National Institutes of Health. http://rsb.info.nih.gov/ij/
71. Masters IB, Zimmerman PV, Chang AB. Longitudinal quantification of growth and changes in primary tracheobronchomalacia sites in children. Pediatr Pulmonol 2007; 42: 906-913.
72. Suter M, McLennan G, Reinhardt JM, et al. Macro-optical color assessment of the pulmonary airways with subsequent three-dimensional multidetector-X-ray-computed-tomography assisted display. J Biomed Opt 2005; 10: 051703.
73. Suter M, Reinhardt JM, McLennan G. Integrated CT/bronchoscopy in the central airways: Preliminary results. Acad Radiol 2008; 15: 786-798.
74. Sheppard CJR, Shotton DM. Confocal Laser Scanning Microscopy. Oxford, Bios Scientific, 1997.
75. Flusberg BA, Cocker ED, Piyawattanametha W, et al. Fiber-optic fluorescence imaging. Nat Methods 2005; 2: 941-950.
76. Thiberville L, Moreno-Swirc S, Vercauteren T, et al. In vivo imaging of the bronchial wall microstructure using fibered confocal fluorescence microscopy. Am J Respir Crit Care Med 2007; 175: 22-31.
77. Vercauteren T, Perchant A, Malandain G, et al. Robust mosaicing with correction of motion distortions and tissue deformations for in vivo fibered microscopy. Med Image Anal 2006; 10: 673-692.
78. Sampson DD, Hillman TR. Optical coherence tomography. In: Palumbo G, Pratesi R, eds. Lasers and Current Optical Techniques in Biology. Cambridge, Royal Society of Chemistry, 2004; pp. 481-571.
79. Fujimoto JG, Boppart SA, Tearney GJ, et al. High resolution in vivo intra-arterial imaging with optical coherence tomography. Heart 1999; 82: 128-133.
80. Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science 1991; 254: 1178-1181.
81. Drexler W, Fujimoto JG. Optical coherence tomography in ophthalmology. J Biomed Opt 2007; 12: 041201.
82. Chen J, Lee L. Clinical applications and new developments of optical coherence tomography: an evidence-based review. Clin Exp Optom 2007; 90: 317-335.
83. Evans JA, Poneros JM, Bouma BE, et al. Optical coherence tomography to identify intramucosal carcinoma and high-grade dysplasia in Barrett's esophagus. Clin Gastroenterol Hepatol 2006; 4: 38-43.
84. Bhindi R, Munir SM, Channon KM. Optical coherence tomography in the setting of an acute anterior myocardial infarction. Circulation 2007; 116: e366-e367.
85. Brezinski ME. Optical coherence tomography for identifying unstable coronary plaque. Int J Cardiol 2006; 107: 154-165.
86. Kubo T, Imanishi T, Takarada S, et al. Assessment of culprit lesion morphology in acute myocardial infarction: ability of optical coherence tomography compared with intravascular ultrasound and coronary angioscopy. J Am Coll Cardiol 2007; 50: 933-939.
87. Yun SH, Tearney GJ, Vakoc BJ, et al. Comprehensive volumetric optical microscopy in vivo. Nat Med 2006; 12: 1429-1433.
88. Han SG, El-Abbadi NH, Hanna N, et al. Evaluation of tracheal imaging by optical coherence tomography. Respiration 2005; 72: 537-541.
89. Hanna N, Saltzman D, Mukai D, et al. Two-dimensional and 3-dimensional optical coherence tomographic imaging of the airway, lung, and pleura. J Thorac Cardiovasc Surg 2005; 129: 615-622.
90. Whiteman SC, Yang Y, van Pittius DG, et al. Optical coherence tomography: real-time imaging of bronchial airways microstructure and detection of inflammatory/neoplastic morphologic changes. Clin Cancer Res 2006; 12: 813-818.
91. Coxson HO, Quiney B, Sin DD, et al. Airway wall thickness assessed using computed tomography and optical coherence tomography. Am J Respir Crit Care Med 2008; 177: 1201-1206.
92. Armstrong JJ, Leigh MS, Walton ID, et al. In vivo size and shape measurement of the human upper airway using endoscopic longrange optical coherence tomography.OptExpress 2003; 11: 1817-1826.
93. Leigh MS, Armstrong JJ, Paduch A, et al. Anatomical optical coherence tomography for long-term, portable, quantitative endoscopy. IEEE Trans Biomed Eng 2008; 55: 1438-1446.
94. Armstrong JJ, Leigh MS, Sampson DD, et al. Quantitative upper airway imaging with anatomic optical coherence tomography. Am J Respir Crit Care Med 2006; 173: 226-233.
95. Walsh JH, Leigh MS, Paduch A, et al. Effect of body posture on pharyngeal shape and size in adults with and without obstructive sleep apnoea. Sleep 2008; 31: 1543-1549.
96. Walsh JH, Leigh MS, Paduch A, et al. Evaluation of pharyngeal shape and size using anatomical optical coherence tomography in individuals with and without obstructive sleep apnoea. J Sleep Res 2008; 17: 230-238.
97. McLaughlin RA, Williamson JP, Phillips MJ, et al. Applying anatomical optical coherence tomography to quantitative 3D imaging of the lower airway. Opt Express 2008; 16: 17521-17529.
98. Bailey DL. Imaging the airways in 2006. J Aerosol Med 2006; 19: 1-7.
99. Yablonskiy DA, Sukstanskii AL, Leawoods JC, et al. Quantitative in vivo assessment of lung microstructure at the alveolar level with hyperpolarized He-3 diffusion MRI. Proc Natl Acad Sci USA 2002; 99: 3111-3116.
100. Tooker AC, Hong KS, McKinstry EL, et al. Distal airways in humans: dynamic hyperpolarized He-3 MR imaging - feasibility. Radiology 2003; 227: 575-579.
101. Lewis TA, Tzeng YS, McKinstry EL, et al. Quantification of airway diameters and 3D airway tree rendering from dynamic hyperpolarized He-3 magnetic resonance imaging. Magn Reson Med 2005; 53: 474-478.
102. Lakhal K, Delplace X, Cottier JP, et al. The feasibility of ultrasound to assess subglottic diameter. Anesth Analg 2007; 104: 611-614.
103. Silverstein FE, Martin RW, Kimmey MB, et al. Experimental evaluation of an endoscopic ultrasound probe - in vitro and in vivo canine studies. Gastroenterology 1989; 96: 1058-1062.
104. Shaw TJ, Wakely SL, Peebles CR, et al. Endobronchial ultrasound to assess airway wall thickening: validation in vitro and in vivo. Eur Respir J 2004; 23: 813-817.
105. de Jong PA, Ottink MD, Robben SGF, et al. Pulmonary disease assessment in cystic fibrosis: comparison of CT scoring systems and value of bronchial and arterial dimension measurements. Radiology 2004; 231: 434-439.
106. Helbich TH, Heinz-Peer G, Fleischmann D, et al. Evolution of CT findings in patients with cystic fibrosis. Am J Roentgenol 1999; 173: 81-88.
107. de Jong PA, Nakano Y, Lequin MH, et al. Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis. Eur Respir J 2004; 23: 93-97.
108. Brody AS, Klein JS, Molina PL, et al. High-resolution computed tomography in young patients with cystic fibrosis: distribution of abnormalities and correlation with pulmonary function tests. J Pediatr 2004; 145: 32-38.
109. de Gonzalez AB, Kim KP, Samet JM. Radiation-induced cancer risk from annual computed tomography for patients with cystic fibrosis. Am J Respir Crit Care Med 2007; 176: 970-973.
110. de Jong PA, Mayo JR, Golmohammadi K, et al. Estimation of cancer mortality associated with repetitive computed tomography scanning. Am J Respir Crit Care Med 2006; 173: 199-203.
111. de Jong PA, Nakano Y, Lequin MH, et al. Dose reduction for CT in children with cystic fibrosis: is it feasible to reduce the number of images per scan? Pediatr Radiol 2006; 36: 50-53.
112. Jimenez S, Jimenez JR, Crespo M, et al. Computed tomography in children with cystic fibrosis: a new way to reduce radiation dose. Arch Dis Child 2006; 91: 388-390.
113. Tiddens H, de Jong PA. Update on the application of chest computed tomography scanning to cystic fibrosis. Curr Opin Pulm Med 2006; 12: 433-439.
114. Fain SB, Gonzalez-Fernandez G, Peterson ET, et al. Evaluation of structure-function relationships in asthma using multidetector CT and hyperpolarized He-3 MRI. Acad Radiol 2008; 15: 753-762.
115. Gono H, Fujimoto K, Kawakami S, et al. Evaluation of airway wall thickness and air trapping by HRCT in asymptomatic asthma. Eur Respir J 2003; 22: 965-971.
116. Ueda T, Niimi A, Matsumoto H, et al. Role of small airways in asthma: investigation using high-resolution computed tomography. J Allergy Clin Immunol 2006; 118: 1019-1025.
117. Hogg JC, Chu F, Utokaparch S, et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 2004; 350: 2645-2653.
118. Jeffery PK. Structural and inflammatory changes in COPD: a comparison with asthma. Thorax 1998; 53: 129-136.
119. Kitaguchi Y, Fujimoto K, Kubo K, et al. Characteristics of COPD phenotypes classified according to the findings of HRCT. Respir Med 2006; 100: 1742-1752.
120. Hoffman EA, Simon BA, McLennan G. State of the art. A structural and functional assessment of the lung via multidetector-row computed tomography: phenotyping chronic obstructive pulmonary disease. Proc Am Thorac Soc 2006; 3: 519-532.
121. Orlandi I, Moroni C, Camiciottoli G, et al. Chronic obstructive pulmonary disease: thin-section CT measurement of airway wall thickness and lung attenuation. Radiology 2005; 234: 604-610.
122. Arakawa A, Yamashita Y, Nakayama Y, et al. Assessment of lung volumes in pulmonary emphysema using multidetector helical CT: comparison with pulmonary function tests. Comput Med Imaging Graph 2001; 25: 399-404.
123. Kauczor HU, Hast J, Heussel CP, et al. CT attenuation of paired HRCT scans obtained at full inspiratory/expiratory position: comparison with pulmonary function tests. Eur Radiol 2002; 12: 2757-2763.
124. Zaporozhan J, Ley S, Eberhardt R, et al. Paired inspiratory/ expiratory volumetric thin-slice CT scan for emphysema analysis - comparison of different quantitative evaluations and pulmonary function test. Chest 2005; 128: 3212-3220.