Dynamic chest radiography: a state-of-the-art review.
Fred Fyles, Thomas S FitzMaurice, Ryan E Robinson...
https://pubmed.ncbi.nlm.nih.gov/37332064/Actively Recruiting
Led by Brigham and Women's Hospital · Updated on 2025-10-29
230
Participants Needed
1
Research Sites
52 weeks
Total Duration
Researchers are evaluating the use of portable dynamic digital radiography DDR, a new advanced chest X-ray technology, in intensive care unit ICU patients. DDR captures dynamic images of lung motion, ventilation, and perfusion at a high frame rate, potentially providing more detailed and quantitative lung function information compared to traditional chest X-rays. This trial aims to test the feasibility and safety of portable DDR in the ICU and to compare its diagnostic value with current standard imaging methods. Participants will receive one to three sets of DDR scans, including 7-second breathing and breath-holding scans. These images will be compared to gold standard clinical exams such as chest X-rays, CT scans, or ventilation-perfusion VQ scans. The study will observe how DDR performs in diagnosing lung conditions like diaphragmatic dysfunction, pulmonary embolism, and pulmonary edema, alongside routine clinical imaging. Throughout the study, participants will undergo DDR imaging alongside their routine clinical imaging. Researchers will analyze these images to measure lung motion, diaphragmatic movement, and perfusion. The primary outcomes include assessing the precision of DDR in evaluating cardiopulmonary functions related to the diaphragm and lung motion as well as pulmonary blood flow, over a period of up to two months. The study will monitor safety and diagnostic accuracy while patients receive standard care.
CONDITIONS
Clinical Utility of Portable Dynamic Chest X Ray (DDR) in the ICU
G
Gyorgy Frendl, MD PhD
P
Poorva Bagchee, BS
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Brigham and Women's Hospital
Lead Sponsor
Konica Minolta
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Portable DDR | Current Clinical Imaging |
|---|---|---|
| What is it? | Portable dynamic digital radiography (DDR) is a bedside X-ray technique that produces movies of the chest during breathing, enabling visualization and measurement of diaphragm and lung motion. | Standard clinical imaging includes chest X-ray, computed tomography (CT), or ultrasound, selected based on the patient’s clinical indication and commonly used for ICU chest disease diagnosis. |
| Role in study | DDR is the new diagnostic method being tested and compared to the reference imaging standard in all enrolled participants. | Reference imaging represents the current diagnostic method, serving as the gold standard for comparison with DDR. |
| Primary use | Intended to provide real-time evaluation of diaphragm movement, lung aeration, pulmonary blood flow, and help detect conditions such as atelectasis, airway obstruction, aspiration risk, and changes after procedures. | Used to identify and characterize chest diseases, evaluate lung aeration, identify effusions, pulmonary edema, infections, embolism, or diaphragm dysfunction. |
| How is it performed? | A portable DDR scanner is positioned at the bedside; patients undergo two 7-second X-ray scans—one during normal breathing and one during breath-hold or ventilator pause. Additional scans are done if needed. | Standard chest X-ray is performed with a portable or fixed device, CT requires patient transport, and ultrasound is done at bedside as indicated. |
| Evidence maturity | Published studies and state-of-the-art reviews show emerging evidence on DDR’s technical feasibility and promise for detecting diaphragm dysfunction and lung changes, but its accuracy and impact on patient outcomes in ICUs remain under investigation. | Chest X-ray, CT, and ultrasound have extensive evidence supporting their accuracy, diagnostic value, and established roles in ICU patient management. |
| Important limitations | The clinical value of DDR in the ICU is still being studied—publications note limited availability, limited outcome data, and unclear diagnostic accuracy compared to CT or ultrasound for some pathologies. Additional radiation above routine care is also a consideration. | Standard chest imaging may miss subtle or functional disease changes and typically cannot provide direct visualization of pulmonary motion or flow. CT involves significant radiation exposure and often requires patient transport even in the ICU. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
You will not qualify if you...
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Up to 2 months
Participants undergo portable dynamic digital radiography (DDR) scans and corresponding clinical gold standard imaging to assess lung and diaphragm function.
1 to 3 imaging sessions depending on clinical condition
Duration - Up to 2 months
Participants may have follow-up imaging to monitor changes in lung and diaphragm function over time.
Follow-up imaging as clinically indicated
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
DIAGNOSTIC
Number of Arms
1
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Lead Sponsor
Konica Minolta
Collaborating Sponsor