Airway Imaging

  • Claus P. HeusselEmail author


The development of cross-sectional and bronchoscopic technique making advantage of optical and ultrasound imaging technology as well as therapeutic interventional options has had considerable impact on the management of pulmonary diseases. While interventional pulmonology is mainly limited to the central half of the tracheobronchial system, CT and even more MRI are limited to the central tracheobronchial structure. However, cross-sectional imaging provides information distally to a stenosis, e.g., the relation of a lesion to the adjacent anatomy, and allows for detailed evaluation of the parenchyma. This includes the whole lung from apex to bases, while bronchoscopy is limited to a certain point of view. Furthermore, CT and MRI provide the possibility for functional judgment of parenchyma and bronchi in terms of perfusion, ventilation, collapsibility, and others, while endoscopy is capable for real-time imaging during continuous respiration including the option for manipulation, biopsy, and even treatment. A wide range of synergies of radiological and advanced interventional endoscopic procedures in patients with both central and peripheral airway disease is the result of this concept.


Virtual Bronchoscopy Global Quantification Bronchial Wall Thickness Bronchial Disease Expiratory Breath Hold 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Dr. rer. nat. Oliver Weinheimer for the development of the fully automatic analyzing YACTA software and the processing of so many CT data sets (Figs. 8.7 and 8.8).

Miss Melanie Segovic for the analysis of many CT data sets in adequate quality and the reliable data management together with Carola de Silva.

Suggested Reading

  1. 1.
    Amdo T, Godoy MC, Ost D, Naidich DP. Imaging–bronchoscopic correlations for interventional pulmonology. Radiol Clin North Am. 2009;47(2):271–87. doi: 10.1016/j.rcl.2008.11.005.PubMedCrossRefGoogle Scholar
  2. 2.
    Naidich DP, Gruden JF, McGuinness G, et al. Volumetric (helical/spiral) CT (VCT) of the airways. J Thorac Imaging. 1997;12:11–28.PubMedCrossRefGoogle Scholar
  3. 3.
    Grenier PA, BeigelmanAubry C, Fetita C, et al. Multidetector-row CT of the airways. Semin Roentgenol. 2003;38:146–57.PubMedCrossRefGoogle Scholar
  4. 4.
    Heussel CP, Kappes J, Hantusch R, Hartlieb S, Weinheimer O, Kauczor HU, Eberhardt R. Contrast enhanced CT-scans are not comparable to non-enhanced scans in emphysema quantification. Eur J Radiol. 2009;74(3):473–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Ederle JR, Heussel CP, Hast J, Fischer B, Van Beek EJ, Ley S, Thelen M, Kauczor HU. Evaluation of changes in central airway dimensions, lung area and mean lung density at paired inspiratory/expiratory high-resolution computed tomography. Eur Radiol. 2003;13(11):2454–61.PubMedCrossRefGoogle Scholar
  6. 6.
    Fleiter T, Merkle EM, Aschoff AJ, et al. Comparison of real-time virtual and fiberoptic bronchoscopy in patients with bronchial carcinoma: opportunities and limitations. Am J Roentgenol. 1997;169:1591–5.CrossRefGoogle Scholar
  7. 7.
    Finkelstein SE, Schrump DS, Nguyen DM, et al. Comparative evaluation of super high-resolution CT scan and virtual bronchoscopy for the detection of tracheobronchial malignancies. Chest. 2003;124:1834–40.PubMedCrossRefGoogle Scholar
  8. 8.
    Eberhardt R, Kahn N, Gompelmann D, Schumann M, Heussel CP, Herth FJF. LungPoint®: a new approach to peripheral lesions. J Thoracic Oncol. 2010;5:1559–63.CrossRefGoogle Scholar
  9. 9.
    Eberhardt R, Anantham D, Herth F, Feller-Kopman D, Ernst A. Electromagnetic navigation diagnostic bronchoscopy in peripheral lung lesions. Chest. 2007;131:1800–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Heussel CP, Ley S, Biedermann A, Rist A, Gast KK, Schreiber W, Kauczor H-U. Respiratory lumenal change of pharynx and trachea in normal subjects and COPD patients: assessment by cine-MRI. Eur Radiol. 2004;14:2188–97.PubMedCrossRefGoogle Scholar
  11. 11.
    Boiselle PM, Ernst A. State-of-the-art imaging of the central airways. Respiration. 2003;70:383–94.PubMedCrossRefGoogle Scholar
  12. 12.
    Sciurba FC, Ernst A, Herth FJ, Strange C, Criner GJ, Marquette CH, Kovitz KL, Chiacchierini RP, Goldin J, McLennan G. VENT Study Research Group: a randomized study of endobronchial valves for advanced emphysema. N Engl J Med. 2010;363:1233–44.PubMedCrossRefGoogle Scholar
  13. 13.
    Sanchez PG, Kucharczuk JC, Su S, Kaiser LR, Cooper JD. National Emphysema Treatment Trial redux: accentuating the positive. J Thorac Cardiovasc Surg. 2010;140:564–72.PubMedCrossRefGoogle Scholar
  14. 14.
    Nakano Y, Muro S, Sakai H, Hirai T, Chin K, Tsukino M, Nishimura K, Itoh H, Paré PD, Hogg JC, Mishima M. Computed tomographic measurements of airway dimensions and emphysema in smokers. Am J Respir Crit Care Med. 2000;162:1102–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Weinheimer O, Achenbach T, Bletz C, Duber C, Kauczor H-U, Heussel CP. About objective 3D analysis of airway geometry in computerized tomography. Trans Med Imaging. 2008;27:64–74.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional Radiology with Nuclear MedicineThoraxklinik at University Hospital HeidelbergHeidelbergGermany

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