Photon Counting Computed Tomography with the Radiation Dose of a Chest X-Ray: Feasibility and Diagnostic Yield.

IF 3.5 3区医学 Q2 RESPIRATORY SYSTEM

Respiration Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI:10.1159/000536065

Sabine Dettmer, Thomas Werncke, Violeta Nikolova Mitkovska, Torben Brod, Oana Joean, Jens Vogel-Claussen, Frank Wacker, Tobias Welte, Jessica Rademacher

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引用次数: 0

Abstract

Introduction: Photon counting (PC) detectors allow a reduction of the radiation dose in CT. Chest X-ray (CXR) is known to have a low sensitivity and specificity for detection of pneumonic infiltrates. The aims were to establish an ultra-low-dose CT (ULD-CT) protocol at a PC-CT with the radiation dose comparable to the dose of a CXR and to evaluate its clinical yield in patients with suspicion of pneumonia.

Methods: A ULD-CT protocol was established with the aim to meet the radiation dose of a CXR. In this retrospective study, all adult patients who received a ULD-CT of the chest with suspected pneumonia were included. Radiation exposure of ULD-CT and CXR was calculated. The clinical significance (new diagnosis, change of therapy, additional findings) and limitations were evaluated by a radiologist and a pulmonologist considering previous CXR and clinical data.

Results: Twenty-seven patients (70% male, mean age 68 years) were included. With our ULD-CT protocol, the radiation dose of a CXR could be reached (mean radiation exposure 0.11 mSv). With ULD-CT, the diagnosis changed in 11 patients (41%), there were relevant additional findings in 4 patients (15%), an infiltrate (particularly fungal infiltrate under immunosuppression) could be ruled out with certainty in 10 patients (37%), and the therapy changed in 10 patients (37%). Two patients required an additional CT with contrast medium to rule out a pulmonary embolism or pleural empyema.

Conclusions: With ULD-CT, the radiation dose of a CXR could be reached while the clinical impact is higher with change in diagnosis in 41%.

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光子计数计算机断层扫描与胸部 X 射线的辐射剂量：可行性与诊断率

简介光子计数（PC）探测器可以减少 CT 的辐射剂量。众所周知，胸部 X 光检查（CXR）对肺部浸润的检测灵敏度和特异性较低。我们的目的是在辐射剂量与 CXR 相当的 PC-CT 上建立超低剂量 CT（ULD-CT）方案，并评估其在怀疑肺炎患者中的临床效果：建立 ULD-CT 方案的目的是为了达到 CXR 的辐射剂量。在这项回顾性研究中，纳入了所有接受胸部 ULD-CT 检查的疑似肺炎成人患者。计算了 ULD-CT 和 CXR 的辐射量。由一名放射科医生和一名肺科医生根据之前的 CXR 和临床数据对临床意义（新诊断、治疗方法改变、额外发现）和局限性进行评估：共纳入 27 名患者（70% 为男性，平均年龄 68 岁）。采用我们的 ULD-CT 方案，可以达到 CXR 的辐射剂量（平均辐射量为 0.11 mSv）。通过 ULD-CT 检查，11 名患者（41%）的诊断结果发生了改变，4 名患者（15%）有了相关的额外发现，10 名患者（37%）可以肯定地排除浸润（尤其是免疫抑制下的真菌浸润），10 名患者（37%）的治疗方法发生了改变。两名患者需要使用造影剂进行额外的 CT 检查，以排除肺栓塞或胸腔积液：结论：通过 ULD-CT 可以达到 CXR 的辐射剂量，但对临床的影响更大，41% 的患者的诊断有所改变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiration 医学-呼吸系统

CiteScore

7.30

自引率

5.40%

发文量

审稿时长

4-8 weeks

期刊介绍： ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.