{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:34:10Z","timestamp":1793061250123,"version":"4.5.0"},"reference-count":58,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T00:00:00Z","timestamp":1604275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Chronic obstructive pulmonary disease (COPD) affects \u223c200 million people worldwide. We propose two\u2010dimensional (2D) dual\u2010energy (DE) x\u2010ray imaging of lung structure and function for the assessment of COPD, and investigate the resulting image quality theoretically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated xenon\u2010enhanced DE (XeDE) radiography for functional imaging of COPD and unenhanced DE radiography for structural imaging of COPD. We modeled the ability of human observers to detect ventilation defects in XeDE images and emphysema in (unenhanced) DE images using the detectability index (<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/mp14530-math-0001.png\" xlink:title=\"urn:x-wiley:00942405:media:mp14530:mp14530-math-0001\"\/>) as a figure of merit. We accounted for the extent of emphysematous destruction and functional impairment as a function of disease severity, defect\/lesion contrast, spatial resolution, x\u2010ray scatter, quantum noise, anatomic noise, and the efficiency of human observers. Whether or not disease was detectable was determined based on a detectability threshold of two. For (unenhanced) DE imaging of emphysema, we compared detectability with that of single\u2010energy (SE) imaging. Models of signal and noise were compared to published data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Models of signal and noise agreed well with published data, and model predictions of the detectability of emphysema by SE radiography were consistent with poor sensitivity (i.e., <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/mp14530-math-0002.png\" xlink:title=\"urn:x-wiley:00942405:media:mp14530:mp14530-math-0002\"\/>) to mild to moderate COPD but moderate sensitivity (i.e., <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/mp14530-math-0003.png\" xlink:title=\"urn:x-wiley:00942405:media:mp14530:mp14530-math-0003\"\/>) to severe COPD. The detectability of emphysema by DE radiography was greater than that of SE radiography, but did not cross the threshold of detectability for mild to moderate COPD. The detectability index for XeDE imaging exceeded the detectability threshold for mild, moderate, and severe COPD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dual\u2010energy radiography may offer modest improvements in the detection of emphysema relative to SE imaging, but will unlikely enable detecting mild and moderate COPD. However, XeDE radiography may enable detection of functional abnormalities associated with mild, moderate and severe COPD at x\u2010ray exposures typical of those used in conventional chest radiography, thus warranting further investigation as a low\u2010dose, low\u2010cost alternative to CT\u2010 and MRI\u2010based approaches for functional imaging of COPD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.14530","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T04:18:52Z","timestamp":1602303532000},"page":"6191-6206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Theoretical feasibility of dual\u2010energy radiography for structural and functional imaging of chronic obstructive pulmonary disease"],"prefix":"10.1002","volume":"47","author":[{"given":"Fateen","family":"Basharat","sequence":"first","affiliation":[{"name":"Department of Physics Ryerson University Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Belli","sequence":"additional","affiliation":[{"name":"Department of Physics Ryerson University Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda","family":"Kirby","sequence":"additional","affiliation":[{"name":"Department of Physics Ryerson University Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Tanguay","sequence":"additional","affiliation":[{"name":"Department of Physics Ryerson University Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,2]]},"reference":[{"key":"e_1_2_7_2_2","unstructured":"CruzAA.Global surveillance prevention and control of chronic respiratory diseases: a comprehensive approach. 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