Department of Radiology, Peking University Third Hospital, Beijing, China.
Department of Radiology, Peking University Third Hospital, Beijing, China.
Eur J Radiol. 2019 Oct;119:108652. doi: 10.1016/j.ejrad.2019.108652. Epub 2019 Sep 7.
To evaluate the clinical value of ultralow-dose CT (ULDCT) with adaptive statistical iterative reconstruction-V (ASiR-V) in the detection of pulmonary nodules in a Chinese population.
One hundred eighty-eight patients (16.41 ≤ BMI ≤ 29.87 kg/m) with pulmonary nodules detected on low-dose chest CT (LDCT) underwent local ULDCT at the center of the chosen nodule with a scan length of 3 cm. LDCT was performed using the Assist kV (120/100 kV)/Smart mA mode and at 120 kV/2.8 mAs for ULDCT. After scanning, CT images were reconstructed with ASiR-V 50%. For both scans, nodule diameters were measured and reference standards were established for the presence and types of lung nodules found on LDCT. The sensitivity of ULDCT was compared against the standard, and logistic regression analysis was used to determine the independent predictors for nodule detection.
Compared with LDCT (0.93 ± 0.32 mSv), a 89.7% dose decrease was seen with ULDCT, for which the calculated effective dose was 0.096 ± 0.006 mSv (P < 0.001). LDCT showed 188 nodules, including 123 solid and 65 subsolid nodules. The overall sensitivity for nodule detection in ULDCT was 90.4% (170/188), and 98.2% (54/55) for nodules ≥ 6 mm. In multivariate analysis, nodule types and diameters were independent predictors of sensitivity (P < 0.05). However, patients' BMI had no effect on nodule detection (P > 0.05).
ULDCT can be used in the management of pulmonary nodules for people with BMI ≤ 30 kg/m at 10% radiation dose of LDCT.
评估超低剂量 CT（ULDCT）联合自适应统计迭代重建-V（ASiR-V）在中国人肺部结节检测中的临床价值。
188 例（BMI 为 16.41≤BMI≤29.87kg/m）患者经低剂量胸部 CT（LDCT）发现肺部结节后，在结节中心进行局部 ULDCT 扫描，扫描长度为 3cm。LDCT 采用 Assist kV（120/100kV）/Smart mA 模式，120kV 时管电流为 2.8mAs，ULDCT 时管电压为 120kV，管电流为 2.8mAs。扫描后，采用 ASiR-V 50%对 CT 图像进行重建。对两种扫描方式均测量结节直径，并以 LDCT 发现的结节存在和类型为参考标准。比较 ULDCT 的敏感性，并采用逻辑回归分析确定结节检测的独立预测因子。
与 LDCT（0.93±0.32mSv）相比，ULDCT 剂量降低了 89.7%，有效剂量为 0.096±0.006mSv（P<0.001）。LDCT 共显示 188 个结节，其中实性结节 123 个，亚实性结节 65 个。ULDCT 检测结节的总敏感性为 90.4%（170/188），直径≥6mm 结节的敏感性为 98.2%（54/55）。多因素分析显示，结节类型和直径是敏感性的独立预测因子（P<0.05）。然而，BMI 对结节检测无影响（P>0.05）。
对于 BMI≤30kg/m 的患者，ULDCT 可用于管理肺部结节，辐射剂量为 LDCT 的 10%。
