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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, ISSN: 1432-1084, Vol: 26, Issue: 10, Page: 3643-3652
2016
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Article Description

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.

Bibliographic Details

Huber, Adrian; Landau, Julia; Ebner, Lukas; Bütikofer, Yanik; Leidolt, Lars; Brela, Barbara; May, Michelle; Heverhagen, Johannes; Christe, Andreas

Springer Science and Business Media LLC

Medicine

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