Evidence map›Paper›PMID 41902931›Full record

ArticlePediatric radiology2026

Dynamic digital radiography as a minimally invasive alternative to perfusion scintigraphy for assessing pulmonary blood flow in children: a prospective study.

Kiyotaka Go, Kentaro Suzuki, Kazuto Ueda, Yoshihito Morimoto, Hidenori Yamamoto, Toshihiko Suzuki, Yoshie Fukasawa, Yukako Muramatsu, Naoki Ohashi, Yoshiaki Sato and 2 more

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Article in Pediatric radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Kiyotaka GoDepartment of Pediatric Cardiology, Children՚s Heart Center, Nagoya University Hospital, Nagoya, Japan. kiyotakago@hotmail.co.jp.
Kentaro SuzukiDepartment of Pediatric Cardiology, Children՚s Heart Center, Nagoya University Hospital, Nagoya, Japan.
Kazuto UedaDivision of Neonatology, Center for Maternal Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Yoshihito MorimotoDepartment of Pediatric Cardiology, Children՚s Heart Center, Nagoya University Hospital, Nagoya, Japan.
Hidenori YamamotoDepartment of Pediatric Cardiology, Children՚s Heart Center, Nagoya University Hospital, Nagoya, Japan.
Toshihiko SuzukiDivision of Neonatology, Center for Maternal Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Yoshie FukasawaDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yukako MuramatsuDivision of Neonatology, Center for Maternal Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Naoki OhashiDepartment of Pediatric Cardiology, Children՚s Heart Center, Nagoya University Hospital, Nagoya, Japan.
Yoshiaki SatoDivision of Neonatology, Center for Maternal Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Yoshiyuki TakahashiDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Taichi KatoDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn congenital diaphragmatic hernia, postoperative right-left asymmetry of pulmonary perfusion affects outcome. Although pulmonary perfusion scintigraphy (PPS) is widely used to assess pulmonary perfusion, it requires the use of radionuclides and peripheral venous access. In contrast, dynamic digital radiography (DDR) visualizes and analyzes pulmonary perfusion by extracting subtle changes in X-ray attenuation from sequential images acquired using a pulsed X-ray generator and a flat-panel detector.

objectiveThis study aimed to evaluate the accuracy of DDR for assessing pulmonary perfusion in children and verify the associated radiation dose. MATERIALS AND

methodsConsecutive congenital diaphragmatic hernia survivors aged 5-7 years scheduled for routine PPS between January 2024 and June 2025 underwent DDR on the same day. The images were analyzed using a dedicated workstation. For each modality, we calculated the blood-flow ratio in the affected lung and assessed the agreement using Pearson correlation and Bland-Altman analysis. Effective doses were also compared.

resultsThirteen children (median age, 6.07 years; 10 left-sided diaphragmatic hernia) were included in the study. DDR-derived blood-flow ratio strongly correlated with PPS (r=0.977, P<0.01), with absolute inter-method blood-flow ratio differences <5%. Neither fixed nor proportional bias was observed. The median effective dose for DDR was 0.16 mSv-significantly lower than that for PPS (2.09 mSv). The blood-flow ratio calculated using DDR correlated well with the scintigraphy results.

conclusionDDR could serve as a minimally invasive, low-dose alternative to PPS for the evaluation of pulmonary perfusion. Future validation in a broader pediatric population is warranted.

Indexed as

Hernias, Diaphragmatic, CongenitalPerfusion ImagingPulmonary CirculationRadiographic Image EnhancementChildChild, PreschoolFemaleHumansMaleProspective StudiesRadiation DosageReproducibility of ResultsBlood-flow ratioCongenital diaphragmatic herniaDynamic digital radiographyPediatricPulmonary perfusionPulmonary perfusion scintigraphy

Identifiers

PMID41902931

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