CHEST RADIOGRAPHY - ESTIMATED LUNG-VOLUME AND PROJECTED AREA OBSCURED BY THE HEART, MEDIASTINUM, AND DIAPHRAGM

PURPOSE: To estimate what fraction of the lung volume and projected lung area are obscured by the heart, mediastinum, and diaphragm on frontal chest radiographs. MATERIALS AND METHODS: Digital images from 25 computed tomographic examinations of the chest (10-mm section thickness and spacing) were analyzed, lung regions were identified in each image section, and simulated frontal radiographs were constructed from the resultant data to estimate the obscured-volume and obscured-area fractions for each patient. Means and standard deviations of the measured lung fractions were computed. RESULTS: On average, 26.4% of the lung volume (standard deviation, 5.1) and 43.0% of the lung area (standard deviation, 6.6) were obscured. CONCLUSION: These substantial lung fractions should be considered in the selection of a screen-film system for chest radiography, because the obscured portion of the lung can be poorly imaged if an inappropriate system is chosen.