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Article History

Received: 25 June 2024

Revised: 31 October 2024

Accepted: 18 December 2024

First Online: 1 February 2025

Compliance with ethical standards

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: The scientific guarantor of this publication is Dr. Pierluigi Ciet.

: The author of this manuscript, Harm Tiddens, declares relationships with the following companies: Insmed, TBIO, Thirona, Neupharma and Boehringer. The author of this manuscript, Jean-Paul Charbonnier, declares relationships with Thirona. Daan Caudri is director of the Erasmus MC-LungAnalysis laboratory. The author of this manuscript, Pierluigi Ciet, declares relationships with the following companies: Vertex Pharmaceutical, Chiesi Pharmaceuticals, and Siemens Healthineers. Wieying Kuo is affiliated with Voiant Clinical. The rest of the authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

: One of the authors, Eleni-Rosalina Andrinopoulou, has significant statistical expertise.

: Written informed consent was not required for this study because this is a retrospective study.

: Institutional Review Board approval was obtained.

: The cohort has been previously reported in Kuo et al []. In the previous study, the dataset consisted of 294 out of 1160 chest CT scans of children and adolescents were collected retrospectively by the international multicenter Normal Chest CT Study Group. The previous study aimed to define normative data on central airway dimensions, in particular trachea, right main bronchi, and left main bronchi, in chest CT of children. On these 294 inspiratory CT scans, central airways were semi-automatically analyzed using Myrian XP-Lung software (version 1.19.1, Intrasense). The intrathoracic tracheal length was measured from the carina to the thorax inlet manually. In the recent study, the dataset consisted of 375 out of 1160 chest CT scans of children and young adults. The primary aim of the current study is to establish normative data for the dimensions of peripheral airways extending down to the 6th bronchial generation, in chest CT of children. On these 375 inspiratory CT scans, bronchi and adjacent pulmonary arteries were automatically analyzed using LungQ (version 2.0.1, Thirona). Using this algorithm, we computed the following bronchus and artery parameters from segmental bronchi to the most peripheral detectable bronchi: bronchial outer diameter (Bout), bronchial inner diameter (Bin), adjacent pulmonary artery diameter (A), bronchial wall thickness (Bwt), bronchial wall area (BWA), and bronchial outer area (BOA). From these parameters, we computed the following ratios: Bout/A, Bin/A, Bwt/A, Bwt/Bout, and BWA/BOA. Furthermore, mean lung density, total lung volume, and the square root of wall area of bronchi with a 10-mm lumen perimeter (Pi10) were obtained by using another module from the same software package.

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