{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:41:28Z","timestamp":1792842088406,"version":"4.5.0"},"reference-count":22,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background: &lt;\/i&gt;&lt;\/b&gt;Advanced-stage chronic obstructive pulmonary disease (COPD) is associated with severely altered respiratory dynamics. Dynamic airway instability is usually diagnosed by invasive bronchoscopy. Cine-computed tomography (CT) may be used alternatively, but is limited to predefined anatomical positions. Also, a paradoxical diaphragmatic motion has been described in patients with emphysema. &lt;b&gt;&lt;i&gt;Objectives:&lt;\/i&gt;&lt;\/b&gt; As the airways and chest wall show inherently high contrast to airway lumen and lung tissue, low-dose CT acquisitions potentially suffice for depicting tracheobronchial and chest wall motion. Therefore, we propose low-dose dynamic respiratory-gated multidetector CT (4D-CT) of the whole chest as a new method to assess respiratory dynamics. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; 4D-CT was performed in 3 patients (52, 62 and 76 years old) with suspected tracheal instability due to COPD or tracheal stenosis at minimal pitch (0.09) and radiation exposure (1.4-1.9 mSv) during regular tidal breathing registered by a belt system. Image reconstruction involved a raw data-based iterative algorithm (1.5-mm slice thickness, 1.0-mm z-axis increment, 5% respiratory increment), resulting in a stack of 6,700 images, which were evaluated with a 4D-viewing tool. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; An excessive dynamic collapse of the trachea in combination with tracheobronchomalacia (TBM) of the main-stem and segmental bronchi, and a paradoxical diaphragmatic motion were demonstrated in 1 case. Moreover, we detected a saber-sheath trachea and main-stem TBM in another case. The third case showed a fixed tracheal stenosis. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; 4D-CT provides unprecedented z-axis coverage and time-resolved volumetric datasets of the whole chest. Airway instability, stenosis and paradoxical diaphragmatic motion may be assessed simultaneously, preceding interventions such as airway stabilization or lung volume reduction.<\/jats:p>","DOI":"10.1159\/000357448","type":"journal-article","created":{"date-parts":[[2014,3,26]],"date-time":"2014-03-26T07:22:04Z","timestamp":1395818524000},"page":"294-300","source":"Crossref","is-referenced-by-count":30,"title":["Simultaneous Assessment of Airway Instability and Respiratory Dynamics with Low-Dose 4D-CT in Chronic Obstructive Pulmonary Disease: A Technical Note"],"prefix":"10.1159","volume":"87","author":[{"given":"Mark O.","family":"Wielp\u00fctz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Eberhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Puderbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Weinheimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Ulrich","family":"Kauczor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus P.","family":"Heussel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2014,2,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16900-6"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200703-456SO"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000346025"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000275273"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/RTI.0b013e3182277113"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00044602"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1159\/000072902"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1118\/1.2789499"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-010-1991-4"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-009-1437-z"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1097\/RTI.0b013e3182765785"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e328321832d"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-0299"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s003300100818"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2352040309"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-003-1909-5"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcl.2008.11.007"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-007-0772-1"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199604253341704"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0900928"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1159\/000322649"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-004-2461-7"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/357448","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/357448","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T18:28:07Z","timestamp":1745432887000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000357448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,3,1]]},"published-print":{"date-parts":[[2014,3,27]]}},"URL":"https:\/\/doi.org\/10.1159\/000357448","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.4748188","asserted-by":"subject"}]},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014]]}}}