Dynamic chest radiography: a state-of-the-art review

• Published in: Insights into imaging 2023-06, Vol.14 (1), p.107-107, Article 107
• Main Authors: Fyles, Fred, FitzMaurice, Thomas S., Robinson, Ryan E., Bedi, Ram, Burhan, Hassan, Walshaw, Martin J.
• Format: Article
• Language: English
• Subjects: Algorithms; Chest; Critical Review; Diagnostic Radiology; Diaphragm; Diaphragm (Anatomy); Diaphragm wall; Digital imaging; Fluoroscopy; Heterogeneity; High resolution; Image acquisition; Image processing; Image resolution; Imaging; Internal Medicine; Interventional Radiology; Ionizing radiation; Literature reviews; Lung; Medical imaging; Medicine; Medicine & Public Health; Moving images; Neuroradiology; Paralysis; Radiation; Radiation dosage; Radiography; Radiography (Thoracic); Radiology; State-of-the-art reviews; Thoracic wall; Thorax; Ultrasound; Ventilation; X ray imagery; X-rays
• ISSN: 1869-4101; 1869-4101
• DOI: 10.1186/s13244-023-01451-4

Dynamic chest radiography (DCR) is a real-time sequential high-resolution digital X-ray imaging system of the thorax in motion over the respiratory cycle, utilising pulsed image exposure and a larger field of view than fluoroscopy coupled with a low radiation dose, where post-acquisition image processing by computer algorithm automatically characterises the motion of thoracic structures. We conducted a systematic review of the literature and found 29 relevant publications describing its use in humans including the assessment of diaphragm and chest wall motion, measurement of pulmonary ventilation and perfusion, and the assessment of airway narrowing. Work is ongoing in several other areas including assessment of diaphragmatic paralysis. We assess the findings, methodology and limitations of DCR, and we discuss the current and future roles of this promising medical imaging technology. Critical relevance statement Dynamic chest radiography provides a wealth of clinical information, but further research is required to identify its clinical niche. Graphical abstract Key points Dynamic chest radiography (DCR) captures high-resolution moving images of the thorax. The ionising radiation dose of DCR is low. DCR can image the diaphragm, chest wall, ventilation and perfusion. Most papers on DCR are small, with heterogeneity in study design or outcome. Large, multicentre studies with similar outcomes and healthy controls are desirable.