Gergely I, Neumann C, Reiger F, Dorffner R
Röntgenabteilung, Krankenhaus der Barmherzigen Brüder, Eisenstadt, Osterreich.
Rofo. 2005 Aug;177(8):1077-83. doi: 10.1055/s-2005-858370.
To evaluate the value of an ultra-low-dose CT protocol (ULD-CT) in the dectection of lungnodules in follow-up of cancer patients.
Between April and August 2003, 72 consecutive patients with a history of malignancy were prospectively examined on a single-slice helical CT scanner (Aquilion, Toshiba) with ULD-CT (120 kV, 5 mAs, D-eff 0.12 mSv) and regular-dose CT (R-CT) (120 kV, 150 mAs, D-eff 4.8 mSv). The ULD-CT examinations were independently evaluated by two radiologists. Afterwards, consensus reading of the ULD-CT and R-CT examinations was done. Individual nodules were classified benign (benign calcifications) and non-benign. The studies were classified in 4 subgroups: 1) non-benign nodule evident; 2) non-benign nodule probable; 3) non-benign nodule possible, but not likely; 4) no-non benign nodule.
ULD-CT detected 180 nodules in 47 patients, while R-CT showed 168 nodules in 39 patients. The sensitivity of ULD-CT was 87 % in detecting nodules regardless of size and 94 % in detecting nodules > or = 5 mm. Regarding the prediction of a case with non-benign nodules (subgroups 1 to 3), the sensitivity of ULD-CT was 94 % and the specificity 75 %.
ULD-CT is a good diagnostic tool in detecting lung nodules > or = 5 mm. Radiation dose can be markedly reduced. A negative ULD-CT study excludes non-benign nodules in R-CT with a high probability. In case of a positive ULD-CT, R-CT can be immediately followed.
评估超低剂量CT方案（ULD-CT）在癌症患者随访中检测肺结节的价值。
2003年4月至8月期间，对72例有恶性肿瘤病史的连续患者在单层螺旋CT扫描仪（东芝Aquilion）上进行前瞻性检查，采用ULD-CT（120 kV，5 mAs，有效剂量0.12 mSv）和常规剂量CT（R-CT）（120 kV，150 mAs，有效剂量4.8 mSv）。ULD-CT检查由两名放射科医生独立评估。之后，对ULD-CT和R-CT检查进行一致性读片。将单个结节分为良性（良性钙化）和非良性。研究分为4个亚组：1）明显非良性结节；2）可能非良性结节；3）可能但不太可能是非良性结节；4）无非良性结节。
ULD-CT在47例患者中检测到180个结节，而R-CT在39例患者中显示168个结节。ULD-CT检测结节的敏感性，无论结节大小如何为87%，检测≥5 mm结节的敏感性为94%。关于非良性结节病例（亚组1至3）的预测，ULD-CT的敏感性为94%，特异性为75%。
ULD-CT是检测≥5 mm肺结节的良好诊断工具。辐射剂量可显著降低。ULD-CT检查结果为阴性时，极有可能排除R-CT中的非良性结节。若ULD-CT检查结果为阳性，可立即进行R-CT检查。
