ArticleJournal of applied clinical medical physics2026
Investigating the impact of key algorithm parameters and patient-specific factors on the accuracy of CT ventilation imaging.
Article in Journal of applied clinical medical physics, 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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Abstract
backgroundComputed Tomography Ventilation Imaging (CTVI) is an investigational technique that has its basis in functional lung avoidance radiotherapy. It offers a cost-effective and accessible alternative to nuclear medicine imaging by generating lung ventilation maps from 4DCT or paired inhale/exhale breath-hold CT (BHCT) scans. Despite over a decade of clinical validation, there is still no consensus on how algorithm parameters and patient-specific factors influence CTVI accuracy. Further research is needed to understand CTVI's sensitivity to these variables and to standardize its implementation for clinical use. PURPOSE: This study evaluates how key algorithm parameters and patient-specific factors affect the accuracy of CTVI. MATERIALS AND
methodsCT ventilation images were generated from BHCT scans and compared to Galligas PET ventilation scans. The VESPIR toolkit was used to compute ventilation based on deformable image registration (DIR) evaluation of volume change (CTVI
resultsThe correlation between CTVI and Galligas PET was demonstrated to be robust within identified parameter ranges: lung segmentation threshold -600 HU to -150 HU for CTVI
conclusionsCTVI accuracy was relatively stable across the range of parameter values tested with no strong indication of the need for patient-specific parameter sets. Patient-specific differences appear to be a driving factor for inter-patient variability in CTVI accuracy as parameter selection alone was insufficient to explain the variability. The strong association of CTVI
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