Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
Siemens China, Beijing, China.
Eur Radiol. 2019 Sep;29(9):4529-4537. doi: 10.1007/s00330-018-5969-y. Epub 2019 Feb 8.
To investigate the feasibility of low-dose CT (LDCT) with tin filtration and third-generation iterative reconstruction (IR) in evaluating interstitial lung diseases associated with connective tissue disease (CTD-ILD).
Fifty-three consecutive adult patients with CTD-ILD underwent regular-dose chest CT (RDCT) at 110 kVp followed by LDCT with tin-filtered 100 kVp. RDCT was reconstructed with filtered back projection (FBP) and advanced modeled iterative reconstruction (ADMIRE); LDCT was reconstructed with ADMIRE. Image noise, streak artifact, image quality, and visualization of normal and abnormal CT features were evaluated and compared among RDCT-ADMIRE, RDCT-FBP, and LDCT-ADMIRE groups.
The mean radiation dose of LDCT was reduced to 20% of RDCT. Objective image noise of RDCT-ADMIRE (38.08 ± 6.37 HU), LDCT-ADMIRE (51.68 ± 9.06 HU), and RDCT-FBP (62.09 ± 10.95 HU) increased progressively (p < 0.001 in any two pairs). RDCT-ADMIRE significantly improved subjective image noise, streak artifact, and overall image quality compared with RDCT-FBP and LDCT-ADMIRE (all p < 0.001), while no significant difference was noted between the latter two groups. All abnormal lung structures were better scored in RDCT-ADMIRE compared with those in RDCT-FBP (all p < 0.001). LDCT-ADMIRE was inferior to RDCT-FBP in visualizing peripheral bronchi and vessels as well as reticulation (all p < 0.001); other normal and abnormal structures were similar between the two groups.
LDCT with tin filtration and third-generation IR was applicable in evaluating ILD lesions of CTD. Image quality was significantly improved after applying ADMIRE algorithm to CT protocols.
• Optimization of CT radiation dose is a clinical concern in patients with connective tissue disease. • Spectral shaping and third-generation iterative reconstruction emerge as promising techniques in reducing radiation dose and acquiring desired image quality of CTD-ILD patients. • The third-generation iterative reconstruction algorithm can optimize visualization of ILD patterns in low-dose CT.
探讨低剂量 CT（LDCT）联合锡滤器和第三代迭代重建（IR）在评估结缔组织病相关间质性肺病（CTD-ILD）中的可行性。
连续纳入 53 例成人 CTD-ILD 患者，先行 110 kVp 常规剂量胸部 CT（RDCT）检查，随后行 100 kVp 锡滤器 LDCT 检查。RDCT 采用滤波反投影（FBP）和高级模型迭代重建（ADMIRE）进行重建；LDCT 采用 ADMIRE 进行重建。评估并比较 RDCT-ADMIRE、RDCT-FBP 和 LDCT-ADMIRE 组的图像噪声、条纹伪影、图像质量以及正常和异常 CT 特征的显示情况。
LDCT 的平均辐射剂量降低至 RDCT 的 20%。RDCT-ADMIRE（38.08±6.37 HU）、LDCT-ADMIRE（51.68±9.06 HU）和 RDCT-FBP（62.09±10.95 HU）的客观图像噪声逐渐增加（任意两组间比较均 P<0.001）。与 RDCT-FBP 和 LDCT-ADMIRE 相比，RDCT-ADMIRE 显著改善了主观图像噪声、条纹伪影和整体图像质量（均 P<0.001），而后两组间差异无统计学意义。与 RDCT-FBP 相比，RDCT-ADMIRE 对所有异常肺结构的评分均更高（均 P<0.001）。LDCT-ADMIRE 显示外周支气管和血管以及网状结构的能力不及 RDCT-FBP（均 P<0.001）；其他正常和异常结构在两组间相似。
联合锡滤器和第三代 IR 的 LDCT 适用于评估 CTD 的间质性肺病病变。在 CT 方案中应用 ADMIRE 算法可显著改善图像质量。
优化 CT 辐射剂量是结缔组织病患者的临床关注点。
能谱成型和第三代迭代重建技术有望降低辐射剂量并获得 CTD-ILD 患者所需的图像质量。
第三代迭代重建算法可优化低剂量 CT 中ILD 模式的可视化。
