Abstract: The purpose is to integrate time-attenuation curves from Electron-Beam CT with flow-time curves from spirometry in the analysis of airflow obstruction. A pressure-sensitive switch was connected between a spirometer mouthpiece and a modified EBCT scanner keyboard. The onset of expiratory flow causes pressure changes which simultaneously trigger EBCT and spirometric acquisitions. Subjects performed a forced expiratory maneuver, during which EBCT images of the lung were obtained every 500 ms using 130 kVp, 630 mA, 100 ms scan time and 3 mm collimation. From EBCT images, time-attenuation curves were generated for each of three zones (non-dependent, middle and dependent lung) using small ROIs (12 mm$+2$/) placed over approximately the same anatomic regions of lung. The resulting time- attenuation curves and flow-time curves were then superimposed. Two normal subjects, two subjects with emphysema and three lung transplant subjects have been studied to date. In normal subjects, lung attenuation increases steadily during the first 4 - 6 seconds of expiration, whereas in patients with emphysema, lung attenuation was relatively constant over the course of expiration. Lung transplant subjects show both of these characteristics - normal characteristics for the transplant lung and emphysematous characteristics for the native lung. Lung transplant subjects may also demonstrate some dynamics between transplant and diseased lung. Respiratory-triggered EBCT can be used to simultaneously acquire time-attenuation and flow-time data. This has been used to characterize dynamic airflow patterns in patients with respiratory disease.!11
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