Van Ballaer Valerie, Dubbeldam Adriana, Muscogiuri Emanuele, Cockmartin Lesley, Bosmans Hilde, Coudyzer Walter, Coolen Johan, de Wever Walter
Department of Radiology, University Hospitals Leuven, Herestraat 49 3000, Louvain, Belgium.
Eur Radiol. 2024 Mar;34(3):1895-1904. doi: 10.1007/s00330-023-10174-5. Epub 2023 Aug 31.
To compare clinical image quality and perceived impact on diagnostic interpretation of chest CT findings between ultra-high-resolution photon-counting CT (UHR-PCCT) and conventional high-resolution energy-integrating-detector CT (HR-EIDCT) using visual grading analysis (VGA) scores.
Fifty patients who underwent a UHR-PCCT (matrix 512 × 512, 768 × 768, or 1024 × 1024; FOV average 275 × 376 mm, 120 × 0.2 mm; focal spot size 0.6 × 0.7 mm) between November 2021 and February 2022 and with a previous HR-EIDCT within the last 14 months were included. Four readers evaluated central and peripheral airways, lung vasculature, nodules, ground glass opacities, inter- and intralobular lines, emphysema, fissures, bullae/cysts, and air trapping on PCCT (0.4 mm) and conventional EIDCT (1 mm) via side-by-side reference scoring using a 5-point diagnostic quality score. The median VGA scores were compared and tested using one-sample Wilcoxon signed rank tests with hypothesized median values of 0 (same visibility) and 2 (better visibility on PCCT with impact on diagnostic interpretation) at a 2.5% significance level.
Almost all lung structures had significantly better visibility on PCCT compared to EIDCT (p < 0.025; exception for ground glass nodules (N = 2/50 patients, p = 0.157)), with the highest scores seen for peripheral airways, micronodules, inter- and intralobular lines, and centrilobular emphysema (mean VGA > 1). Although better visibility, a perceived difference in diagnostic interpretation could not be demonstrated, since the median VGA was significantly different from 2.
UHR-PCCT showed superior visibility compared to HR-EIDCT for central and peripheral airways, lung vasculature, fissures, ground glass opacities, macro- and micronodules, inter- and intralobular lines, paraseptal and centrilobular emphysema, bullae/cysts, and air trapping.
UHR-PCCT has emerged as a promising technique for thoracic imaging, offering improved spatial resolution and lower radiation dose. Implementing PCCT into daily practice may allow better visibility of multiple lung structures and optimization of scan protocols for specific pathology.
• The aim of this study was to verify if the higher spatial resolution of UHR-PCCT would improve the visibility and detection of certain lung structures and abnormalities. • UHR-PCCT was judged to have superior clinical image quality compared to conventional HR-EIDCT in the evaluation of the lungs. UHR-PCCT showed better visibility for almost all tested lung structures (except for ground glass nodules). • Despite superior image quality, the readers perceived no significant impact on the diagnostic interpretation of the studied lung structures and abnormalities.
使用视觉分级分析（VGA）评分，比较超高分辨率光子计数CT（UHR-PCCT）与传统高分辨率能量积分探测器CT（HR-EIDCT）的临床图像质量以及对胸部CT检查结果诊断解读的感知影响。
纳入2021年11月至2022年2月期间接受UHR-PCCT（矩阵512×512、768×768或1024×1024；视野平均275×376 mm，120×0.2 mm；焦点尺寸0.6×0.7 mm）且在过去14个月内曾接受过HR-EIDCT检查的50例患者。四位阅片者通过并排参考评分，使用5分诊断质量评分对PCCT（0.4 mm）和传统EIDCT（1 mm）上的中央和外周气道、肺血管、结节、磨玻璃影、小叶内和小叶间线、肺气肿、叶间裂、肺大疱/囊肿以及空气潴留进行评估。使用单样本Wilcoxon符号秩检验比较并测试VGA评分中位数，假设中位数为0（可见度相同）和2（PCCT上可见度更好且对诊断解读有影响），显著性水平为2.5%。
与EIDCT相比，几乎所有肺结构在PCCT上的可见度均显著更好（p < 0.025；磨玻璃结节除外（N = 2/50例患者，p = 0.157）），外周气道、微结节、小叶内和小叶间线以及小叶中心型肺气肿的评分最高（平均VGA > 1）。尽管可见度更好，但由于VGA中位数与2有显著差异，因此无法证明在诊断解读上存在可感知的差异。
与HR-EIDCT相比，UHR-PCCT在中央和外周气道、肺血管、叶间裂、磨玻璃影、大小结节、小叶内和小叶间线、间隔旁和小叶中心型肺气肿、肺大疱/囊肿以及空气潴留方面显示出更高的可见度。
UHR-PCCT已成为一种有前景的胸部成像技术，具有更高的空间分辨率和更低的辐射剂量。将PCCT应用于日常实践可能会使多种肺结构的可见度更好，并优化针对特定病理情况的扫描方案。
• 本研究的目的是验证UHR-PCCT更高的空间分辨率是否会提高某些肺结构和异常的可见度及检出率。• 在肺部评估中，与传统HR-EIDCT相比，UHR-PCCT被判定具有更高的临床图像质量。UHR-PCCT对几乎所有测试的肺结构（磨玻璃结节除外）显示出更好的可见度。• 尽管图像质量更高，但阅片者认为对所研究的肺结构和异常的诊断解读没有显著影响。
