Dynamic Airway CT for Morphometric Analysis of Pediatric Tracheomalacia Throughout Respiration.

Dynamic airway computed topography (4D-CT) can be used to evaluate the trachea in pediatric patients with tracheomalacia. The 4D-CT enables objective and quantitative evaluation throughout all phases of respiration; however, current systems focus on qualitative review of generated 4D images. Few analytic workflows are available to assist in the extraction of the quantitative geomorphic data generated. In this study, we share a protocol developed within the 3D Slicer framework that performs semi-automatic tracheal segmentation and subsequent geomorphic analysis. This methodology is applied to 4 sample cases with varying degrees of tracheal collapse throughout all phases of respiration to demonstrate output of cross-sectional area, aspect ratio (defined as the ratio between minor-to-major luminal axis lengths), and tracheal volume (bound by the subglottis and carina) metrics.