Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-01-10 DOI:10.1186/s13244-024-01888-1

Li Ding, Mingwang Chen, Xiaomei Li, Yuting Wu, Jingxu Li, Shuting Deng, Yikai Xu, Zhao Chen, Chenggong Yan

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引用次数: 0

Abstract

Objectives: To investigate the image quality and diagnostic performance with ultra-low dose dual-layer detector spectral CT (DLSCT) by various reconstruction techniques for evaluation of pulmonary nodules.

Materials and methods: Between April 2023 and December 2023, patients with suspected pulmonary nodules were prospectively enrolled and underwent regular-dose chest CT (RDCT; 120 kVp/automatic tube current) and ultra-low dose CT (ULDCT; 100 kVp/10 mAs) on a DLSCT scanner. ULDCT was reconstructed with hybrid iterative reconstruction (HIR), electron density map (EDM), and virtual monoenergetic images at 40 keV and 70 keV. Quantitative and qualitative image analysis, nodule detectability, and Lung-RADS evaluation were compared using repeated one-way analysis of variance, Friedman test, and weighted kappa coefficient.

Results: A total of 249 participants (mean age ± standard deviation, 50.0 years ± 12.9; 126 male) with 637 lung nodules were included. ULDCT resulted in a significantly lower mean radiation dose than RDCT (0.3 mSv ± 0.0 vs. 3.6 mSv ± 0.8; p < 0.001). Compared with RDCT, ULDCT EDM showed significantly higher signal-noise-ratio (44.0 ± 77.2 vs. 4.6 ± 6.6; p < 0.001) and contrast-noise-ratio (26.7 ± 17.7 vs. 5.0 ± 4.4; p < 0.001) with qualitative scores ranked higher or equal to the average. Using the regular-dose images as a reference, ULDCT EDM images had a satisfactory nodule detection rate (84.6%) and good inter-observer agreements compared with RDCT (κw > 0.60).

Conclusion: Ultra-low dose dual-layer detector CT with 91.2% radiation dose reduction achieves sufficient image quality and diagnostic performance of pulmonary nodules.

Critical relevance statement: Dual-layer detector spectral CT enables substantial radiation dose reduction without impairing image quality for the follow-up of pulmonary nodules or lung cancer screening.

Key points: Radiation dose is a major concern for patients requiring pulmonary nodules CT screening. Ultra-low dose dual-layer detector spectral CT with 91.2% dose reduction demonstrated satisfactory performance. Dual-layer detector spectral CT has the potential for lung cancer screening and management.

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超低剂量双层探测光谱CT筛查肺结节：图像质量及诊断性能。

目的：探讨超低剂量双层光谱CT （DLSCT）不同重建技术对肺结节的成像质量及诊断价值。材料与方法：2023年4月至2023年12月，前瞻性纳入疑似肺结节患者，接受常规剂量胸部CT (RDCT；120 kVp/自动管电流)和超低剂量CT (ULDCT；100 kVp/10 ma)在DLSCT扫描仪上。利用混合迭代重建（HIR）、电子密度图（EDM）和虚拟单能图像在40kev和70kev下重建ULDCT。采用重复单因素方差分析、Friedman检验和加权kappa系数对定量和定性图像分析、结节可检出性和Lung-RADS评价进行比较。结果：共有249名受试者(平均年龄±标准差，50.0岁±12.9；126例男性)，637例肺结节。ULDCT的平均辐射剂量明显低于RDCT (0.3 mSv±0.0 vs. 3.6 mSv±0.8；p 0.60)。结论：辐射剂量降低91.2%的超低剂量双层CT对肺结节具有足够的图像质量和诊断价值。关键相关性声明：双层探测器光谱CT能够在不影响肺结节随访或肺癌筛查图像质量的情况下大幅降低辐射剂量。重点：放射剂量是需要肺结节CT筛查的患者的主要关注点。超低剂量双层探测器光谱CT减剂量91.2%，表现令人满意。双层探测光谱CT在肺癌的筛查和治疗中具有潜在的应用价值。

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

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.