Ventilation from four-dimensional computed tomography: Density versus Jacobian methods

Richard Castillo, Edward Castillo, Josue Martinez, Thomas Guerrero

Research output: Contribution to journalArticlepeer-review

158 Scopus citations


Two calculation methods to produce ventilation images from four-dimensional computed tomography (4DCT) acquired without added contrast have been reported. We reported a method to obtain ventilation images using deformable image registration (DIR) and the underlying CT density information. A second method performs the ventilation image calculation from the DIR result alone, using the Jacobian determinant of the deformation field to estimate the local volume changes resulting from ventilation. For each of these two approaches, there are variations on their implementation. In this study, two implementations of the Jacobian-based methodology are evaluated, as well as a single density change-based model for calculating the physiologic specific ventilation from 4DCT. In clinical practice, 99mTc-labeled aerosol single photon emission computed tomography (SPECT) is the standard method used to obtain ventilation images in patients. In this study, the distributions of ventilation obtained from the CT-based ventilation image calculation methods are compared with those obtained from the clinical standard SPECT ventilation imaging. Seven patients with 4DCT imaging and standard 99mTc-labeled aerosol SPECT/CT ventilation imaging obtained on the same day as part of a prospective validation study were selected. The results of this work demonstrate the equivalence of the Jacobian-based methodologies for quantifying the specific ventilation on a voxel scale. Additionally, we found that both Jacobianand density-change-based methods correlate well with global measurements of the resting tidal volume. Finally, correlation with the clinical SPECT was assessed using the Dice similarity coefficient, which showed statistically higher (p-value < 10-4) correlation between density-change-based specific ventilation and the clinical reference than did either Jacobian-based implementation.

Original languageEnglish (US)
Pages (from-to)4661-4685
Number of pages25
JournalPhysics in Medicine and Biology
Issue number16
StatePublished - Aug 21 2010
Externally publishedYes

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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