A Multidisciplinary Assessment of Standard Low Dose Versus Ultra-low Dose Chest CT Scans for Pectus Excavatum Imaging.

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2024-10-20 DOI:10.1016/j.jpedsurg.2024.162026

Charles Hehman, Shelby Aughtman, Michael Goretsky, Jamie Golden, Jennifer Rush, Neil Vachhani, John Conery, Turaj Vazifedan, Ricardo Rendel, Robert Obermeyer

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引用次数: 0

Abstract

Aim: Evaluation of ultra-low dose chest CT imaging for the assessment of pectus excavatum severity as determined by pediatric radiologists and pediatric surgeons using Haller (HI) and Correction indices (CI).

Methods: A single institution, prospective evaluation of patients being evaluated for pectus excavatum were scanned with a standard low-dose chest CT protocol (CARE) followed by a consecutive ultra-low dose CT scan (ULTRA). 3 surgeons and 4 radiologists were instructed to determine HI and CI in each series. The Intraclass Correlation Coefficient (ICC) was used to calculate the agreement level between CARE and ULTRA. Bland-Altman (BA) and scatter plots were also performed to determine bias of each approach.

Results: 32 patients had CARE and ULTRA consecutively. The ICC for HI demonstrated good reliability with a value of 0.89 and excellent reliability for CI with a value of 0.91. The reliability for HI was greater in the surgeon group (0.89) compared to the radiologist group (0.88). The reliability for CI was greater in the radiologist group (0.92) compared to the surgeon group (0.90). The Bland Altman plots for the HI and CI demonstrate no consistent bias for CARE or ULTRA approach when evaluating HI and CI.

Conclusion: Ultra-low dose CT scan imaging compared to standard low-dose CT appears to be a reliable alternative for evaluating PE severity as assessed by HI and CI. This work supports the evaluation and potential development of a standardized CT imaging protocol capable of reducing radiation exposure without sacrificing imaging for PE patients.

Level of evidence: 2:

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标准低剂量与超低剂量胸部 CT 扫描用于胸大肌成像的多学科评估。

目的：评估超低剂量胸部 CT 成像，以评估儿科放射科医生和儿科外科医生使用哈勒（HI）和校正指数（CI）确定的乳突严重程度：方法：单个机构前瞻性地评估了正在接受胸肌下垂评估的患者，采用标准低剂量胸部 CT 方案 (CARE) 进行扫描，然后进行连续超低剂量 CT 扫描 (ULTRA)。3 名外科医生和 4 名放射科医生受命在每个系列中确定 HI 和 CI。类内相关系数（ICC）用于计算 CARE 和 ULTRA 的一致性水平。此外，还进行了Bland-Altman（BA）和散点图分析，以确定每种方法的偏差：32名患者连续进行了CARE和ULTRA检查。HI 的 ICC 值为 0.89，显示出良好的可靠性；CI 的 ICC 值为 0.91，显示出极佳的可靠性。外科医生组的 HI 可信度（0.89）高于放射科医生组（0.88）。与外科医生组（0.90）相比，放射科医生组的 CI 可信度更高（0.92）。HI 和 CI 的 Bland Altman 图显示，在评估 HI 和 CI 时，CARE 或 ULTRA 方法没有一致的偏差：结论：与标准低剂量 CT 相比，超低剂量 CT 扫描成像似乎是通过 HI 和 CI 评估 PE 严重程度的可靠替代方法。这项工作支持对标准化 CT 成像方案进行评估和潜在开发，该方案能够在不牺牲 PE 患者成像效果的情况下减少辐射暴露：

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

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.