Dynamic Volume Computed Tomography Imaging of the Upper Airway in Obstructive Sleep Apnea

Study Objectives:

To describe a dynamic three-dimensional (3D) computed tomography (CT) technique for the upper airway and compare the required radiation dose to that used for common clinical studies of a similar anatomical area, such as for subjects undergoing routine clinical facial CT.

Methods:

Dynamic upper-airway CT was performed on eight subjects with persistent obstructive sleep apnea, four of whom were undergoing magnetic resonance imaging and an additional four subjects who had a contraindication to magnetic resonance imaging. This Health Insurance Portability and Accountability Act-compliant study was approved by our institutional review board, and informed consent was obtained. The control subjects (n = 41) for comparison of radiation dose were obtained from a retrospective review of the clinical picture-archiving computer system to identify 10 age-matched patients per age-based control group undergoing facial CT.

Results:

Dynamic 3D CT can be performed with an effective radiation dose of less than 0.38 mSv, a dose that is less than or comparable to that used for clinical facial CT. The resulting data- set is a uniquely complete, dynamic 3D volume of the upper airway through a full respiratory cycle that can be processed for clinical and modeling analyses.

Conclusions:

A dynamic 3D CT technique of the upper airway is described that can be performed with a clinically reasonable radiation dose and sets a benchmark for future use.

Citation:

Fleck RJ, Ishman SL, Shott SR, Gutmark EJ, McConnell KB, Mahmoud M, Mylavarapu G, Subramaniam DR, Szczesniak R, Amin RS. Dynamic volume computed tomography imaging of the upper airway in obstructive sleep apnea. J Clin Sleep Med. 2017;13(2):189–196.

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