University of Alabama at Birmingham Reaches 1,000 Patient Pulmonary Exams With Dynamic Digital Radiography

DDR is a radiographic technique that provides a series of individual digital X-ray images acquired at high speed and low radiation dose. These images provide diagnostic-quality views of anatomical structures in motion and the ability to visualize the dynamic interaction with physiological changes over time.

Satinder Singh, MD, FCCP, FNASCI, FSABI, Professor of Radiology & Medicine and Chief of Cardiopulmonary Radiology in the Department of Radiology at UAB, explains that “DDR is a viable replacement for chest fluoroscopy in the evaluation of diaphragm function. It provides good visibility of lung abnormalities and increases our diagnostic confidence. Based on our extensive evaluation and utilization of this technology, we have now transitioned to DDR instead of traditional chest fluoroscopy to evaluate an elevated diaphragm. All lung transplant patients currently receive a DDR exam as part of their pre-surgical workup.”

DDR provides enriched radiographic information and enhanced diagnostic capabilities. Compared to fluoroscopy, the patient’s radiation dose is lower with DDR, comparable to a standard two-view X-ray exam. Dr. Singh and his colleagues at UAB use DDR to routinely assess diaphragm function in transplant patients and, in some cases, monitor treatment effects, examine airways and evaluate pulmonary function in their patients.

At a Konica Minolta Healthcare sponsored Lunch and Learn event held during the Radiological Society of North America (RSNA) 2022 Annual Meeting, Dr. Singh presented initial results from a pilot study led by Donald G. Benson, Jr., MD, PhD, Assistant Professor, Cardiopulmonary Imaging Section, comparing lung perfusion results from DDR with nuclear medicine scintigraphy. The pilot study compared differential lung perfusion between the right and left lungs from both modalities. Results are being analyzed for statistical correlation, including the percent of perfusion in each lung and in different portions of the lung in each patient.

Dr. Benson says, “We are finding out there is no discrepancy between these two modalities in how we manage patients clinically. Our transplant patients already receive a chest X-ray, so by adding DDR to this technique we can get that diaphragm information and perfusion all in one exam, with low radiation dose.”

DDR images are acquired in the same X-ray system and in the study as static images, making this new technology easy to integrate into our current workflow.

Jeff McGough, Senior Director Imaging Services, Department of Radiology, UAB Hospital

“As with any imaging modality, DDR integrates with our HIS and RIS, so the DDR data is automatically moved to our PACS for processing,” says Jeff McGough, Senior Director Imaging Services, Department of Radiology, UAB Hospital. “DDR images are acquired in the same X-ray system and in the study as static images, making this new technology easy to integrate into our current workflow. Additionally, most of our patients are already scheduled to receive a chest X-ray, so adding DDR to the study gives us additional diaphragm information in one exam, with low radiation dose and without creating discomfort for our patients.”

According to McGough, since DDR is a radiographic procedure, acquisition can occur without having a physician present, unlike a fluoroscopic exam. This significantly improves the workflow efficiency for the department. DDR enables efficient routine dynamic imaging, for example sniff tests of their transplant patients, without dedicated scheduling or disrupting the regular reading schedule.

At UAB, DDR is installed on a Shimadzu RADspeed Pro X-ray system, which is also used for conventional static X-ray acquisitions. DDR is also available on Konica Minolta’s KDR® Advanced U-Arm System, KDR® Flex Overhead X-ray System, mKDR xPress™ Mobile X-ray System and the Chiropractic Straight Arm from 20/20 Imaging, a division of Konica Minolta Healthcare.

“Konica Minolta congratulates UAB on achieving this significant milestone of 1,000-plus patient exams using DDR in lung patients,” says John Sabol, PhD, Clinical Research Manager, Konica Minolta Healthcare. “The clinical evidence supporting the use of DDR in pulmonary imaging at UAB is impressive and growing, further demonstrating the clinical value of this novel technology across an array of lung diseases. Drs. Singh and Benson are highly regarded experts in cardiopulmonary imaging, and we look forward to continuing to collaborate with them and the entire clinical team at UAB as they investigate and demonstrate the utility of DDR.”