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Quantitative CT characterization of pediatric lung development using routine clinical imaging

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Abstract

Background

The use of quantitative CT analysis in children is limited by lack of normal values of lung parenchymal attenuation. These characteristics are important because normal lung development yields significant parenchymal attenuation changes as children age.

Objective

To perform quantitative characterization of normal pediatric lung parenchymal X-ray CT attenuation under routine clinical conditions in order to establish a baseline comparison to that seen in pathological lung conditions.

Materials and methods

We conducted a retrospective query of normal CT chest examinations in children ages 0–7 years from 2004 to 2014 using standard clinical protocol. During these examinations semi-automated lung parenchymal segmentation was performed to measure lung volume and mean lung attenuation.

Results

We analyzed 42 CT examinations in 39 children, ages 3 days to 83 months (mean ± standard deviation [SD] = 42 ± 27 months). Lung volume ranged 0.10–1.72 liters (L). Mean lung attenuation was much higher in children younger than 12 months, with values as high as –380 Hounsfield units (HU) in neonates (lung volume 0.10 L). Lung volume decreased to approximately –650 HU by age 2 years (lung volume 0.47 L), with subsequently slower exponential decrease toward a relatively constant value of –860 HU as age and lung volume increased.

Conclusion

Normal lung parenchymal X-ray CT attenuation decreases with increasing lung volume and age; lung attenuation decreases rapidly in the first 2 years of age and more slowly thereafter. This change in normal lung attenuation should be taken into account as quantitative CT methods are translated to pediatric pulmonary imaging.

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Acknowledgments

Laura L. Walkup, PhD, is supported by the National Institutes of Health (NIH) grant T32 HL007752.

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Authors and Affiliations

  1. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA

    Jill M. Stein, Alan S. Brody, Robert J. Fleck & Jason C. Woods

  2. Center for Pulmonary Imaging Research, Pulmonary Medicine & Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Laura L. Walkup & Jason C. Woods

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  1. Jill M. Stein
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  2. Laura L. Walkup
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Correspondence to Jason C. Woods.

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Stein, J.M., Walkup, L.L., Brody, A.S. et al. Quantitative CT characterization of pediatric lung development using routine clinical imaging. Pediatr Radiol 46, 1804–1812 (2016). https://doi.org/10.1007/s00247-016-3686-8

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  • DOI: https://doi.org/10.1007/s00247-016-3686-8

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