Lung Nodule Detection by Microdose CT Versus Chest Radiography (Standard and Dual-Energy Subtracted).

Ebner, Lukas Michael; Bütikofer, Yanik Frederik; Ott, Daniel; Huber, Adrian Thomas; Landau, Julia; Roos, Justus E; Heverhagen, Johannes T; Christe, Andreas (2015). Lung Nodule Detection by Microdose CT Versus Chest Radiography (Standard and Dual-Energy Subtracted). American Journal of Roentgenology, 204(4), pp. 727-735. American Roentgen Ray Society 10.2214/AJR.14.12921

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OBJECTIVE The purpose of this study was to investigate the feasibility of microdose CT using a comparable dose as for conventional chest radiographs in two planes including dual-energy subtraction for lung nodule assessment. MATERIALS AND METHODS We investigated 65 chest phantoms with 141 lung nodules, using an anthropomorphic chest phantom with artificial lung nodules. Microdose CT parameters were 80 kV and 6 mAs, with pitch of 2.2. Iterative reconstruction algorithms and an integrated circuit detector system (Stellar, Siemens Healthcare) were applied for maximum dose reduction. Maximum intensity projections (MIPs) were reconstructed. Chest radiographs were acquired in two projections with bone suppression. Four blinded radiologists interpreted the images in random order. RESULTS A soft-tissue CT kernel (I30f) delivered better sensitivities in a pilot study than a hard kernel (I70f), with respective mean (SD) sensitivities of 91.1% ± 2.2% versus 85.6% ± 5.6% (p = 0.041). Nodule size was measured accurately for all kernels. Mean clustered nodule sensitivity with chest radiography was 45.7% ± 8.1% (with bone suppression, 46.1% ± 8%; p = 0.94); for microdose CT, nodule sensitivity was 83.6% ± 9% without MIP (with additional MIP, 92.5% ± 6%; p < 10(-3)). Individual sensitivities of microdose CT for readers 1, 2, 3, and 4 were 84.3%, 90.7%, 68.6%, and 45.0%, respectively. Sensitivities with chest radiography for readers 1, 2, 3, and 4 were 42.9%, 58.6%, 36.4%, and 90.7%, respectively. In the per-phantom analysis, respective sensitivities of microdose CT versus chest radiography were 96.2% and 75% (p < 10(-6)). The effective dose for chest radiography including dual-energy subtraction was 0.242 mSv; for microdose CT, the applied dose was 0.1323 mSv. CONCLUSION Microdose CT is better than the combination of chest radiography and dual-energy subtraction for the detection of solid nodules between 5 and 12 mm at a lower dose level of 0.13 mSv. Soft-tissue kernels allow better sensitivities. These preliminary results indicate that microdose CT has the potential to replace conventional chest radiography for lung nodule detection.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Ebner, Lukas Michael; Bütikofer, Yanik Frederik; Ott, Daniel; Huber, Adrian Thomas; Landau, Julia and Christe, Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1546-3141

Publisher:

American Roentgen Ray Society

Language:

English

Submitter:

Aisha Stefania Mzinga

Date Deposited:

01 May 2015 14:49

Last Modified:

01 May 2015 14:49

Publisher DOI:

10.2214/AJR.14.12921

PubMed ID:

25794062

Uncontrolled Keywords:

CT dose reduction, chest CT dose, lung lesion detection, microdose CT imaging

BORIS DOI:

10.7892/boris.66799

URI:

https://boris.unibe.ch/id/eprint/66799

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