Development of functional chest imaging with a dynamic flat-panel detector (FPD).

Dynamic FPD permits the acquisition of distortion-free radiographs with a large field of view and high image quality. In the present study, we investigated the feasibility of functional imaging for evaluating the pulmonary sequential blood distribution with an FPD, based on changes in pixel values during cardiac pumping. Dynamic chest radiographs of seven normal subjects were obtained in the expiratory phase by use of an FPD system. We measured the average pixel value in each region of interest that was located manually in the heart and lung areas. Subsequently, inter-frame differences and differences from a minimum-intensity projection image, which was created from one cardiac cycle, were calculated. These difference values were then superimposed on dynamic chest radiographs in the form of a color display, and sequential blood distribution images and a blood distribution map were created. The results were compared to typical data on normal cardiac physiology. The clinical effectiveness of our method was evaluated in a patient who had abnormal pulmonary blood flow. In normal cases, there was a strong correlation between the cardiac cycle and changes in pixel value. Sequential blood distribution images showed a normal pattern at determined by the physiology of pulmonary blood flow, with a symmetric distribution and no blood flow defects throughout the entire lung region. These findings indicated that pulmonary blood flow was reflected on dynamic chest radiographs. In an abnormal case, a defect in blood flow was shown as defective in color in a blood distribution map. The present method has the potential for evaluation of local blood flow as an optional application in general chest radiography.