Surgical Clinic Munich South, Munich, Bavaria, Germany; Joint Department of Medical Imaging, Toronto General Hospital, Toronto, Ontario, Canada; Institute of Clinical Radiology, Ludwig Maximilians University, Munich, Germany.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Pulmonology. 2021 Jan-Feb;27(1):14-25. doi: 10.1016/j.pulmoe.2020.06.004. Epub 2020 Jun 24.
HRCT is the preferred imaging technique to evaluate Interstitial-Lung-Disease. Optimal Low-Dose-Computed-Tomography protocol for monitoring ILD with lowest radiation dose and optimal diagnostic accuracy and image quality unknown.
28 Patients underwent HRCT. Image reconstructions with varying combinations of tube current (50mA, 20mA, 15 mA, 10mA) and image-thickness/increment (1/1mm, 2/2mm, 3/2.4mm, 5/4mm) were simulated from raw data. 448 CTs evaluated by 2 readers on image quality and ILD-specific features (ground glass opacification (ggo), honeycombing (hc), reticulation (ret)).
Reduced dose settings with 20 mA did not show any significant difference to standard dose settings for all parameters in reader 1, while results were significantly altered in reader 2. Slice thickness did not significantly influence rating of typical ILD features like ggo, hc, ret or total disease extent. The correct differentiation between UIP and NSIP could be made on all dose settings and with all slice thickness. It was even found, that an increased slice thickness can compensate for the noise associated image quality degradation. Overall, for ggo detection a combination of 20 mA and 3 or 5 mm slice thickness was not different to the original evaluation.
Assessment of ILD specific CT features down to 20 mA and a slice thickness of 3 or 5 mm is feasible.
HRCT 是评估间质性肺病的首选成像技术。用于监测间质性肺病的最佳低剂量 CT 方案，其具有最低的辐射剂量、最佳的诊断准确性和图像质量尚不清楚。
28 例患者接受 HRCT 检查。从原始数据中模拟了不同管电流（50mA、20mA、15mA、10mA）和图像厚度/增量（1/1mm、2/2mm、3/2.4mm、5/4mm）组合的图像重建。由 2 名读者对图像质量和特定于间质性肺病的特征（磨玻璃影（ggo）、蜂窝肺（hc）、网状影（ret））进行了 448 次 CT 评估。
在读者 1 中，20mA 的低剂量设置与所有参数的标准剂量设置相比没有任何显著差异，而在读者 2 中，结果则有显著改变。层厚没有显著影响 ggo、hc、ret 或总疾病程度等典型间质性肺病特征的评分。在所有剂量设置和所有层厚下，都可以正确区分 UIP 和 NSIP。甚至发现，增加的层厚可以补偿与图像质量下降相关的噪声。总体而言，对于 ggo 的检测，20mA 和 3 或 5mm 层厚的组合与原始评估没有差异。
评估间质性肺病的 CT 特征，低至 20mA 和 3 或 5mm 层厚是可行的。
