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Utility and validity of dynamic chest radiography in cystic fibrosis (dynamic CF): an observational, non-controlled, non-randomised, single-centre, prospective study
  1. Thomas Simon FitzMaurice1,2,
  2. Paul Stephen McNamara2,3,
  3. Dilip Nazareth1,4,
  4. Caroline McCann5,
  5. Ram Bedi6,
  6. Matthew Shaw7 and
  7. Martin Walshaw1,4
  1. 1Adult CF Unit, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
  2. 2Institute of Translational Medicine, University of Liverpool, Liverpool, UK
  3. 3Institute in the Park, Alder Hey Children’s Hospital, Liverpool, UK
  4. 4Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
  5. 5Department of Radiology, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
  6. 6Department of Bioengineering, University of Washington, Seattle, Washington, USA
  7. 7Research Department, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
  1. Correspondence to Dr Thomas Simon FitzMaurice; thomas.fitzmaurice{at}


Introduction Dynamic chest radiography (DCR) uses novel, low-dose radiographic technology to capture images of the thoracic cavity while in motion. Pulmonary function testing is important in cystic fibrosis (CF). The tolerability, rapid acquisition and lower radiation and cost compared with CT imaging may make DCR a useful adjunct to current standards of care.

Methods and analysis This is an observational, non-controlled, non-randomised, single-centre, prospective study. This study is conducted at the Liverpool Heart and Chest Hospital (LHCH) adult CF unit. Participants are adults with CF. This study reviews DCR taken during routine CF Annual Review (n=150), validates DCR-derived lung volumes against whole body plethysmography (n=20) and examines DCR at the start and end of pulmonary exacerbations of CF (n=20). The primary objectives of this study are to examine if DCR provides lung function information that correlates with PFT, and lung volumes that correlate whole body plethysmography.

Ethics and dissemination This study has received the following approvals: HRA REC (11 December 2019) and LHCH R&I (11 October 2019). Results are made available to people with CF, the funders and other researchers. Processed, anonymised data are available from the research team on request.

Trial registration number ISRCTN 64994816.

  • cystic fibrosis
  • lung physiology
  • respiratory muscles
  • respiratory infection

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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  • Contributors TSF authored the manuscript and is Principal Investigator for the study. DN and MW were major contributors in writing the manuscript and designing the protocol. PSM, CM and RB were major contributors to the protocol design. MS provided invaluable support on statistical elements of the study design. RB has offered technical assistance and advice regarding technical aspects of dynamic radiography. All authors read and approved the final manuscript.

  • Funding This study was funded by Liverpool Heart and Chest Hospital. Open Access support was provided by University of Liverpool (100627636).

  • Competing interests RB reports personal fees from PHC Corporation of North America, Konica Minolta and Nihon Kohden Innovation Center outside the submitted work. None of the other authors declare any competing interests.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Ethics approval This study (including written documentation) has been met with approval from the LHCH Service Users Research Endeavour group, which includes review by lay persons and individuals with CF.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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