4DMedical Archives - The Imaging Wire

Regional lung function is emerging as an important factor in thoracic imaging. While chest CT is central to evaluating lung disease, anatomy (structure) alone does not always explain the full clinical challenge. Fortunately, a new generation of CT-based software tools brings regional lung function into the workflow radiologists use every day – chest CT.

Patients with dyspnea, COPD, emphysema, interstitial lung disease, or pulmonary vascular questions can often have symptoms that are difficult to reconcile with structural findings alone.

Radiologists and clinicians assemble the broader clinical picture from multiple sources: CT findings, pulmonary function tests, and nuclear medicine ventilation/perfusion (V/Q) exams.

Each offers useful information, but each has limits. Pulmonary function tests provide global measures rather than regional detail, while V/Q imaging depends on radiotracer availability, department hours, and nuclear medicine resources.

One example of an emerging technology that provides radiologists with deeper, functional pulmonary detail is CT:VQ from 4DMedical.

CT:VQ, operating in a Software as a Service (SaaS) mode, uses paired inspiratory and expiratory non-contrast chest CT scans to generate regional ventilation and perfusion maps – along with quantitative outputs designed for radiology workflow.

This approach brings functional lung information closer to the CT reading room without requiring injected contrast or radiotracers for the CT:VQ analysis.

It also builds on a modality that is widely available and often operational around the clock.

Adding regional ventilation and perfusion information to CT could help address common thoracic imaging questions…

Which regions are ventilating well, and which are not?
Is perfusion preserved in areas that look abnormal on CT?
Do symptoms align with regional functional impairment?
Which lung regions may be most important to preserve before intervention?

The non-contrast approach has compelling clinical advantages…

Contrast can trigger renal screening, prior reaction history, IV access challenges, workflow delays, and patient anxiety.
Avoiding contrast can simplify the pathway for many patients.

CT-based functional imaging is not a replacement for legacy lung function assessments. But it brings quantitative tools that can make routine studies more clinically actionable.

The Takeaway

Technology brings radiologists new opportunities. Chest CT can reveal far more than what the lungs look like. With tools such as CT:VQ, CT can show regional patterns of lung ventilation and perfusion – adding functional context to a radiologist’s toolkit.

More information about CT:VQ and non-contrast functional lung imaging is available at ctvq.com.

Radiology has adopted seven mainstream modalities over its 127 years, and 4DMedical is determined to create the eighth imaging modality with its new XV Scanner.

The XV Scanner would be the first dedicated lung imaging system, giving radiologists four-dimensional and color-coded visibility into patients’ lung airflow and blood flow, and potentially a new way to assess lung diseases.

The XV Scanner integrates fluoroscopy with advanced analytics software, producing qualitative and quantitative 4D lung function metrics
It simultaneously acquires images from different angles, then measures lung tissue motion, and calculates ventilation at each breathing stage and every lung location
XV scans take 5 seconds to perform and deliver less radiation than a typical chest X-ray

4DMedical’s XV technology is also backed by a growing number of positive clinical studies, solid post-IPO funding, and an impressive expansion across Australian imaging giant I-Med Radiology’s 250 locations.

Although the XV Scanner hardware is still forthcoming, 4DMedical will initially launch XV software that can be installed on existing fluoroscopy systems (FDA cleared for ventilation, later adding perfusion) and will also support existing CTs in the future.

Software-only might prove to be a logical starting point, providing 4DMedical with a low-friction way to demonstrate XV’s impact on patient care and test whether this impact is great enough to entice imaging departments to add a whole new scanner to their fleets.

The Takeaway

Creating medical imaging’s eighth mainstream modality might be among the most ambitious goals you’ll hear at RSNA 2022, but if the XV Scanner proves to be much better than existing lung imaging techniques, radiology might have to make room for one more.

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