Wetzl Matthias, May Matthias Stefan, Weinmann Daniel, Hammon Matthias, Kopp Markus, Ruppel Renate, Trollmann Regina, Woelfle Joachim, Uder Michael, Rompel Oliver
Department of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany.
Imaging Science Institute, University Hospital Erlangen, 91054 Erlangen, Germany.
Diagnostics (Basel). 2021 Feb 10;11(2):270. doi: 10.3390/diagnostics11020270.
Low-dose dual-source computed tomography (DSCT) protocols for the evaluation of lung diseases in children and adolescents are of importance since this age group is particularly prone to radiation damage. The aim of this study was to evaluate image quality of low-dose DSCT of the lung and to assess the potential of radiation dose reduction compared to digital radiographs (DR). Three groups, each consisting of 19 patients, were examined with different DSCT protocols using tin prefiltration (Sn96/64/32 ref. mAs at 100 kV). Different strengths of iterative reconstruction were applied (ADMIRE 2/3/4). DSCT groups were compared to 19 matched patients examined with posterior-anterior DR. Diagnostic confidence, detectability of anatomical structures and small lung lesions were evaluated on a 4-point Likert scale (LS 1 = unacceptable, 4 = fully acceptable; a value ≥ 3 was considered acceptable). Effective dose (ED) was 31-/21-/9-fold higher in Sn96/Sn64/Sn32 compared to DR. Diagnostic confidence was sufficient in Sn96/Sn64 (LS 3.4/3.2), reduced in Sn32 (LS 2.7) and the worst in DR (LS 2.4). In DSCT, detectability of small anatomical structures was always superior to DR ( < 0.05). Mean lesion size ranged from 5.1-7 mm; detectability was acceptable in all DSCT groups (LS 3.0-3.4) and superior to DR (LS 1.9; < 0.05). Substantial dose lowering in DSCT of the pediatric lung enables acceptable detectability of small lung lesions with a radiation dose being about 10-fold higher compared to DR.
低剂量双源计算机断层扫描（DSCT）方案对于评估儿童和青少年的肺部疾病非常重要，因为这个年龄组特别容易受到辐射损伤。本研究的目的是评估肺部低剂量DSCT的图像质量，并评估与数字X线摄影（DR）相比降低辐射剂量的潜力。三组，每组由19名患者组成，使用锡预滤波（100 kV时Sn96/64/32参考mAs）的不同DSCT方案进行检查。应用了不同强度的迭代重建（迭代模型迭代重建2/3/4）。将DSCT组与19名接受后前位DR检查的匹配患者进行比较。在4点李克特量表（LS 1 =不可接受，4 =完全可接受；值≥3被认为是可接受的）上评估诊断置信度、解剖结构和小肺部病变的可检测性。与DR相比，Sn96/Sn64/Sn32的有效剂量（ED）分别高31/21/9倍。Sn96/Sn64的诊断置信度足够（LS 3.4/3.2），Sn32降低（LS 2.7），DR最差（LS 2.4）。在DSCT中，小解剖结构的可检测性总是优于DR（P<0.05）。平均病变大小范围为5.1 - 7 mm；所有DSCT组的可检测性均可接受（LS 3.0 - 3.4），且优于DR（LS 1.9；P<0.05）。儿科肺部DSCT的大幅剂量降低使得小肺部病变具有可接受的可检测性，辐射剂量比DR高约10倍。
