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Erschienen in: European Radiology 8/2017

16.01.2017 | Chest

Ultralow dose CT for pulmonary nodule detection with chest x-ray equivalent dose – a prospective intra-individual comparative study

verfasst von: Michael Messerli, Thomas Kluckert, Meinhard Knitel, Stephan Wälti, Lotus Desbiolles, Fabian Rengier, René Warschkow, Ralf W. Bauer, Hatem Alkadhi, Sebastian Leschka, Simon Wildermuth

Erschienen in: European Radiology | Ausgabe 8/2017

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Abstract

Purpose

To prospectively evaluate the accuracy of ultralow radiation dose CT of the chest with tin filtration at 100 kV for pulmonary nodule detection.

Materials and methods

202 consecutive patients undergoing clinically indicated chest CT (standard dose, 1.8 ± 0.7 mSv) were prospectively included and additionally scanned with an ultralow dose protocol (0.13 ± 0.01 mSv). Standard dose CT was read in consensus by two board-certified radiologists to determine the presence of lung nodules and served as standard of reference (SOR). Two radiologists assessed the presence of lung nodules and their locations on ultralow dose CT. Sensitivity and specificity of the ultralow dose protocol was compared against the SOR, including subgroup analyses of different nodule sizes and types. A mixed effects logistic regression was used to test for independent predictors for sensitivity of pulmonary nodule detection.

Results

425 nodules (mean diameter 3.7 ± 2.9 mm) were found on SOR. Overall sensitivity for nodule detection by ultralow dose CT was 91%. In multivariate analysis, nodule type, size and patients BMI were independent predictors for sensitivity (p < 0.001).

Conclusions

Ultralow dose chest CT at 100 kV with spectral shaping enables a high sensitivity for the detection of pulmonary nodules at exposure levels comparable to plain film chest X-ray.

Keypoints

91% of all lung nodules were detected with ultralow dose CT
Sensitivity for subsolid nodule detection is lower in ultralow dose CT (77.5%)
The mean effective radiation dose in 202 patients was 0.13 mSv
Ultralow dose CT seems to be feasible for lung cancer screening
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Metadaten
Titel
Ultralow dose CT for pulmonary nodule detection with chest x-ray equivalent dose – a prospective intra-individual comparative study
verfasst von
Michael Messerli
Thomas Kluckert
Meinhard Knitel
Stephan Wälti
Lotus Desbiolles
Fabian Rengier
René Warschkow
Ralf W. Bauer
Hatem Alkadhi
Sebastian Leschka
Simon Wildermuth
Publikationsdatum
16.01.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 8/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4739-6

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