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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

2016; Springer Science+Business Media; Volume: 26; Issue: 10 Linguagem: Inglês

10.1007/s00330-015-4192-3

1432-1084

A Huber, Julia Landau, Lukas Ebner, Yanik Bütikofer, Lars Leidolt, Barbara Brela, Michelle May, Johannes T. Heverhagen, Andreas Christe,

Medical Imaging Techniques and Applications

To investigate the detection rate of pulmonary nodules in ultralow-dose CT acquisitions.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.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.Lung cancer screening with ultralow-dose CT using the same radiation dose as a conventional chest X-ray is feasible.• 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.