{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:23:42Z","timestamp":1760059422918,"version":"build-2065373602"},"reference-count":14,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Division of Intramural Research, National Heart, Lung and Blood Institute, NIH Intramural Research Program, the National Institutes of Health, USA","award":["HL006141"],"award-info":[{"award-number":["HL006141"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MPs"],"abstract":"<jats:p>In computed tomography (CT)-based evaluation of the extent of cystic changes in the lungs of patients with cystic lung diseases, such as Lymphangioleiomyomatosis (LAM), there is a lack of a lung phantom containing air-filled cavities that mimic pulmonary cysts to calibrate the measurement of cystic volumes from CT scans. We describe an easy-to-replicate cystic lung phantom consisting of basic lung structures of a trachea and two lung compartments. The lung compartments contain air cavities of varying sizes to mimic cystic lesions. The lung compartments are made of a foam material recommended by NIST to simulate the radiodensity of human lung parenchyma. In tests performed on a clinical scanner, various structures in the lung phantom were correctly recognized by two types of lung analysis software. The resulting cystic volume measurements revealed the relationship between the size of the cysts and the accuracy of the measurement. The significant finding was that the volumes of individual cysts were underestimated for small cysts. The error increased with decreasing cyst sizes. Such underestimation has not been mentioned previously and deserves the attention of clinicians using CT scans to assess the cyst burden in the lungs, particularly in patients presenting with numerous small pulmonary cysts.<\/jats:p>","DOI":"10.3390\/mps8030063","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T03:53:12Z","timestamp":1749786792000},"page":"63","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cystic Lung Phantom to Validate Clinical CT Protocols"],"prefix":"10.3390","volume":"8","author":[{"given":"Shefra","family":"Shah","sequence":"first","affiliation":[{"name":"Laboratory of Imaging Physics, Biochemistry and Biophysics Center, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farah","family":"Hussaini","sequence":"additional","affiliation":[{"name":"Laboratory of Imaging Physics, Biochemistry and Biophysics Center, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dumitru","family":"Mazilu","sequence":"additional","affiliation":[{"name":"Laboratory of Imaging Physics, Biochemistry and Biophysics Center, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric E.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Laboratory of Imaging Physics, Biochemistry and Biophysics Center, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6844-2997","authenticated-orcid":false,"given":"Han","family":"Wen","sequence":"additional","affiliation":[{"name":"Laboratory of Imaging Physics, Biochemistry and Biophysics Center, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1093\/qjmed\/hcr116","article-title":"Use of Variability in National and Regional Data to Estimate the Prevalence of Lymphangioleiomyomatosis","volume":"104","author":"Harknett","year":"2011","journal-title":"QJM Int. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.ejim.2007.10.015","article-title":"Lymphangioleiomyomatosis: A Review","volume":"19","author":"Hohman","year":"2008","journal-title":"Eur. J. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1164\/rccm.201607-1384ST","article-title":"Official American Thoracic Society\/Japanese Respiratory Society Clinical Practice Guidelines: Lymphangioleiomyomatosis Diagnosis and Management","volume":"194","author":"McCormack","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1164\/ajrccm.164.4.2101154","article-title":"Prevalence and Clinical Characteristics of Lymphangioleiomyomatosis (LAM) in Patients with Tuberous Sclerosis Complex","volume":"164","author":"Moss","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_5","unstructured":"Janes, S.M. (2022). 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StatPearls, StatPearls Publishing."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.chest.2021.01.077","article-title":"Ultra-Small Lung Cysts Impair Diffusion Without Obstructing Air Flow in Lymphangioleiomyomatosis","volume":"160","author":"Matthew","year":"2021","journal-title":"Chest"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lee, S., Lebron, A., Matthew, B., Moss, J., and Wen, H. (2023). Automated Segmentation and Measurements of Pulmonary Cysts in Lymphangioleiomyomatosis across Multiple CT Scanner Platforms over a Period of Two Decades. Bioengineering, 10.","DOI":"10.3390\/bioengineering10111255"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.clinimag.2019.11.004","article-title":"Clinical CT Underestimation of the Percentage Volume Occupied by Cysts in Patients with Lymphangioleiomyomatosis","volume":"59","author":"Larsen","year":"2020","journal-title":"Clin. Imaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1148\/radiology.176.2.2367651","article-title":"Lymphangiomyomatosis\u2014CT, Chest Radiographic, and Functional Correlations","volume":"176","author":"Aberle","year":"1990","journal-title":"Radiology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1378\/chest.109.1.131","article-title":"Quantitative CT Predicts the Severity of Physiologic Dysfunction in Patients with Lymphangioleiomyomatosis","volume":"109","author":"Crausman","year":"1996","journal-title":"Chest"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Baral, A., Lee, S., Hussaini, F., Matthew, B., Lebron, A., Wang, M., Hsu, L.-Y., Moss, J., and Wen, H. (2024). Clinical Trial Validation of Automated Segmentation and Scoring of Pulmonary Cysts in Thoracic CT Scans. 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