Department of Radiology, Hebei General Hospital, Xinhua District, Shijiazhuang, Hebei Province, China.
Department of Urology, The Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei Province, China.
J Appl Clin Med Phys. 2022 Apr;23(4):e13589. doi: 10.1002/acm2.13589. Epub 2022 Mar 16.
To evaluate the accuracy of pulmonary nodule (PN) detection in overweight or obese adult patients using ultralow-dose computed tomography (ULDCT) with tin filtration at 100 kV and advanced model-based iterative reconstruction (ADMIRE).
Eighty-one patients with body mass indices of ≥25 kg/m were enrolled. All patients underwent low-dose chest CT (LDCT), followed by ULDCT. Two radiologists experienced in LDCT established the standard of reference (SOR) for PNs. The number, type, size, and location of PNs were identified in the SOR. Effective dose, objective image quality (IQ), and subjective IQ based on two radiologists' scores were compared between ULDCT and LDCT. The detection performances of radiologists based on ULDCT were calculated according to the nodule analyses. Logistic regression was used to test for independent predictors of PN detection sensitivity.
Both the effective dose and objective IQ were lower for ULDCT than for LDCT (both p < 0.001). Both radiologists rated the subjective IQ of the overall IQ on ULDCT to be diagnostically sufficient. In total, 234 nodules (mean diameter, 3.4 ± 1.9 mm) were classified into 32 subsolid, 149 solid, and 53 calcified nodules according to the SOR. The overall sensitivity of ULDCT for nodule detection was 93.6%. Based on multivariate analyses, the nodule types (p = 0.015) and sizes (p = 0.013) were independent predictors of nodule detection.
Compared with LDCT, ULDCT with tin filtration at 100 kV and ADMIRE could significantly reduce the radiation dose in overweight or obese patients while maintaining good sensitivity for nodule detection.
评估 100kV 锡滤 ultralow-dose 计算机断层扫描（ULDCT）联合高级基于模型的迭代重建（ADMIRE）技术在超重或肥胖成年患者肺部结节（PN）检测中的准确性。
共纳入 81 名 BMI≥25kg/m²的患者。所有患者均行低剂量胸部 CT（LDCT），随后行 ULDCT。两位具有 LDCT 经验的放射科医生建立了 PN 的标准参考（SOR）。在 SOR 中确定了 PN 的数量、类型、大小和位置。比较了 ULDCT 和 LDCT 的有效剂量、客观图像质量（IQ）和两位放射科医生评分的主观 IQ。根据结节分析计算了放射科医生基于 ULDCT 的检测性能。采用逻辑回归检验 PN 检测灵敏度的独立预测因素。
ULDCT 的有效剂量和客观 IQ 均低于 LDCT（均 p<0.001）。两位放射科医生均认为 ULDCT 的整体 IQ 的主观 IQ 具有诊断意义。根据 SOR，总共 234 个结节（平均直径 3.4±1.9mm）分为 32 个亚实性、149 个实性和 53 个钙化结节。ULDCT 对结节检测的总体灵敏度为 93.6%。基于多变量分析，结节类型（p=0.015）和大小（p=0.013）是结节检测的独立预测因素。
与 LDCT 相比，100kV 锡滤 ultralow-dose 计算机断层扫描（ULDCT）联合 ADMIRE 可显著降低超重或肥胖患者的辐射剂量，同时保持良好的结节检测灵敏度。
