在 COPD 患者中，超低剂量 CT 与常规剂量 CT 检测和肺结节大小量化的对比研究。
Detection and size quantification of pulmonary nodules in ultralow-dose versus regular-dose CT: a comparative study in COPD patients.
机构信息
Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
出版信息
Br J Radiol. 2023 Mar 1;96(1144):20220709. doi: 10.1259/bjr.20220709. Epub 2023 Feb 20.
OBJECTIVE
To evaluate detectability and semi-automatic diameter and volume measurements of pulmonary nodules in ultralow-dose CT (ULDCT) regular-dose CT (RDCT).
METHODS
Fifty patients with chronic obstructive pulmonary disease (COPD) underwent RDCT on 64-multidetector CT (120 kV, filtered back projection), and ULDCT on third-generation dual source CT (100 kV with tin filter, advanced modeled iterative reconstruction). One radiologist evaluated the presence of nodules on both scans in random order, with discrepancies judged by two independent radiologists and consensus reading. Sensitivity of nodule detection on RDCT and ULDCT was compared to reader consensus. Systematic error in semi-automatically derived diameter and volume, and 95% limits of agreement (LoA) were evaluated. Nodule classification was compared by κ statistics.
RESULTS
ULDCT resulted in 83.1% (95% CI: 81.0-85.2) dose reduction compared to RDCT ( < 0.001). 45 nodules were present, with diameter range 4.0-25.3 mm and volume range 16.0-4483.0 mm. Detection sensitivity was non-significant ( = 0.503) between RDCT 88.8% (95% CI: 76.0-96.3) and ULDCT 95.5% (95% CI: 84.9-99.5). No systematic bias in diameter measurements (median difference: -0.2 mm) or volumetry (median difference: -6 mm) was found for ULDCT compared to RDCT. The 95% LoA for diameter and volume measurements were ±3.0 mm and ±33.5%, respectively. κ value for nodule classification was 0.852 for diameter measurements and 0.930 for volumetry.
CONCLUSION
ULDCT based on Sn100 kV enables comparable detectability of solid pulmonary nodules in COPD patients, at 83% reduced radiation dose compared to RDCT, without relevant difference in nodule measurement and size classification.
ADVANCES IN KNOWLEDGE
Pulmonary nodule detectability and measurements in ULDCT are comparable to RDCT.
目的
评估超低剂量 CT（ULDCT）与常规剂量 CT（RDCT）在肺部结节检测中的可探测性以及半自动直径和体积测量。
方法
50 例慢性阻塞性肺疾病（COPD）患者分别在 64 层多排 CT（120 kV，滤波反投影）和第三代双源 CT（100 kV 锡滤器，先进的模型迭代重建）上进行 RDCT 和 ULDCT。一位放射科医生以随机顺序评估两次扫描中结节的存在情况，通过两位独立的放射科医生判断并进行共识阅读，以判断结果差异。比较 RDCT 和 ULDCT 对结节检测的敏感性，并评估半自动直径和体积测量的系统误差和 95%一致性界限（LoA）。通过 κ 统计比较结节分类。
结果
与 RDCT 相比，ULDCT 降低了 83.1%（95%CI：81.0-85.2）的剂量（<0.001）。共发现 45 个结节，直径范围为 4.0-25.3mm，体积范围为 16.0-4483.0mm。RDCT 的检测灵敏度为 88.8%（95%CI：76.0-96.3），ULDCT 为 95.5%（95%CI：84.9-99.5），两者之间无显著差异（=0.503）。与 RDCT 相比，ULDCT 测量的直径（中位数差异：-0.2mm）和体积（中位数差异：-6mm）无系统偏差。直径和体积测量的 95%LoA 分别为±3.0mm 和±33.5%。直径测量的 κ 值为 0.852，体积测量的 κ 值为 0.930。
结论
基于 Sn100 kV 的 ULDCT 能够在 COPD 患者中实现固体肺结节的可探测性，与 RDCT 相比，剂量降低了 83%，而结节测量和大小分类没有明显差异。
知识进展
在 ULDCT 中，肺结节的探测性和测量结果与 RDCT 相当。
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