Performance of ultralow-dose CT with iterative reconstruction in lung cancer screening: limiting radiation exposure to the equivalent of conventional chest X-ray imaging.

Huber, Adrian Thomas; Landau, Julia; Ebner, Lukas; Bütikofer, Yanik Frederik; Leidolt, Lars; Brela, Barbara; May, Michelle; Heverhagen, Johannes; Christe, Andreas (2016). Performance of ultralow-dose CT with iterative reconstruction in lung cancer screening: limiting radiation exposure to the equivalent of conventional chest X-ray imaging. European radiology, 26(10), pp. 3643-3652. Springer 10.1007/s00330-015-4192-3

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OBJECTIVE To investigate the detection rate of pulmonary nodules in ultralow-dose CT acquisitions. MATERIALS AND METHODS In this lung phantom study, 232 nodules (115 solid, 117 ground-glass) of different sizes were randomly distributed in a lung phantom in 60 different arrangements. Every arrangement was acquired once with standard radiation dose (100 kVp, 100 references mAs) and once with ultralow radiation dose (80 kVp, 6 mAs). Iterative reconstruction was used with optimized kernels: I30 for ultralow-dose, I70 for standard dose and I50 for CAD. Six radiologists examined the axial 1-mm stack for solid and ground-glass nodules. During a second and third step, three radiologists used maximum intensity projection (MIPs), finally checking with computer-assisted detection (CAD), while the others first used CAD, finally checking with the MIPs. RESULTS The detection rate was 95.5 % with standard dose (DLP 126 mGy*cm) and 93.3 % with ultralow-dose (DLP: 9 mGy*cm). The additional use of either MIP reconstructions or CAD software could compensate for this difference. A combination of both MIP reconstructions and CAD software resulted in a maximum detection rate of 97.5 % with ultralow-dose. CONCLUSION Lung cancer screening with ultralow-dose CT using the same radiation dose as a conventional chest X-ray is feasible. KEY POINTS • 93.3 % of all lung nodules were detected with ultralow-dose CT. • A sensitivity of 97.5 % is possible with additional image post-processing. • The radiation dose is comparable to a standard radiography in two planes. • Lung cancer screening with ultralow-dose CT is feasible.

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:

Huber, Adrian Thomas; Ebner, Lukas; Bütikofer, Yanik Frederik; Brela, Barbara; Heverhagen, Johannes and Christe, Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0938-7994

Publisher:

Springer

Language:

English

Submitter:

Karin Hofmann

Date Deposited:

19 Apr 2017 12:10

Last Modified:

01 Nov 2017 02:31

Publisher DOI:

10.1007/s00330-015-4192-3

Related URLs:

PubMed ID:

26813670

Uncontrolled Keywords:

Computed tomography; Diagnostic performance with low radiation dosage; Lung adenocarcinoma; Pulmonary nodule detection; Ultralow-dose acquisition

BORIS DOI:

10.7892/boris.94054

URI:

https://boris.unibe.ch/id/eprint/94054

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