Establishment of the method for chest upright CT examination and evaluation of the clinical usefulness of upright CT for chest diseases

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K16482
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Radiation science
• Research Institution: Keio University
• Principal Investigator: YAMADA Yoshitake 慶應義塾大学, 医学部(信濃町), 助教 (60383791)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: CT / computed tomography / 立位 / 座位 / 呼吸器 / 胸部 / 肺 / 循環器

Outline of Final Research Achievements

We confirmed that chest upright CT can be used in routine clinical practice.
In asymptomatic volunteer cohort, while the inspiratory volumes of the bilateral upper and lower lobes and bilateral lungs were significantly greater in the standing than in the supine position, with lower lobes showing larger changes, the right middle lobe volume did not change significantly between positions. In patients with chronic obstructive pulmonary disease (COPD), whereas the inspiratory volumes of the bilateral upper and lower lobes and bilateral lungs were significantly greater in the standing position than in the supine position, the right middle lobe volume was significantly lower in the standing position than in the supine position.
The total lung volume on upright CT in the standing position was more similar to total lung capacity on pulmonary function test than that in the supine position in both asymptomatic volunteer and COPD cohorts.

Free Research Field

放射線科学

Academic Significance and Societal Importance of the Research Achievements

現在の通常のCTは臥位で撮影するため、ヒトの日常生活の状態(立位/座位)を3次元的に画像化できていなかった。
新たな診断機器である立位CTを用いた本研究により、無症状ボランティアにおいても胸部疾患においても、立位と臥位で解剖学的構造はかなり異なることが明らかとなった。本研究結果は、特に臥位と立位で症状の異なる疾患において、未解明の病態を解明するための基礎的データになると考えられる。また、立位CTの肺体積のデータは、ヒトの日常生活の肺の状態を反映しているため、肺葉切除術予定の肺癌患者における、術後肺機能のより正確な予測に役立つ可能性があり、適切な治療法選択に役立つ可能性がある。