Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
Department of Radiology, UMass Memorial Medical Center and University of Massachusetts Chan Medical School, Worcester, MA, USA.
Eur Radiol. 2024 Nov;34(11):7244-7254. doi: 10.1007/s00330-024-10754-z. Epub 2024 May 9.
To conduct an intrapatient comparison of ultra-low-dose computed tomography (ULDCT) and standard-of-care-dose CT (SDCT) of the chest in terms of the diagnostic accuracy of ULDCT and intrareader agreement in patients with post-COVID conditions.
We prospectively included 153 consecutive patients with post-COVID-19 conditions. All participants received an SDCT and an additional ULDCT scan of the chest. SDCTs were performed with standard imaging parameters and ULDCTs at a fixed tube voltage of 100 kVp (with tin filtration), 50 ref. mAs (dose modulation active), and iterative reconstruction algorithm level 5 of 5. All CT scans were separately evaluated by four radiologists for the presence of lung changes and their consistency with post-COVID lung abnormalities. Radiation dose parameters and the sensitivity, specificity, and accuracy of ULDCT were calculated.
Of the 153 included patients (mean age 47.4 ± 15.3 years; 48.4% women), 45 (29.4%) showed post-COVID lung abnormalities. In those 45 patients, the most frequently detected CT patterns were ground-glass opacities (100.0%), reticulations (43.5%), and parenchymal bands (37.0%). The accuracy, sensitivity, and specificity of ULDCT compared to SDCT for the detection of post-COVID lung abnormalities were 92.6, 87.2, and 94.9%, respectively. The median total dose length product (DLP) of ULDCTs was less than one-tenth of the radiation dose of our SDCTs (12.6 mGycm [9.9; 15.5] vs. 132.1 mGycm [103.9; 160.2]; p < 0.001).
ULDCT of the chest offers high accuracy in the detection of post-COVID lung abnormalities compared to an SDCT scan at less than one-tenth the radiation dose, corresponding to only twice the dose of a standard chest radiograph in two views.
Ultra-low-dose CT of the chest may provide a favorable, radiation-saving alternative to standard-dose CT in the long-term follow-up of the large patient cohort of post-COVID-19 patients.
通过对胸部超低剂量 CT（ULDCT）和标准剂量 CT（SDCT）的患者内比较，评估 ULDCT 对新冠后患者的诊断准确性和观察者内一致性。
我们前瞻性纳入了 153 例连续的新冠后患者。所有患者均接受 SDCT 和 ULDCT 胸部扫描。SDCT 采用标准成像参数，ULDCT 采用固定管电压 100kVp（含锡滤过）、50mAs（剂量调制有效）和 5 级迭代重建算法。4 位放射科医师分别对 CT 扫描结果进行评估，以确定是否存在肺部改变及其与新冠后肺部异常的一致性。计算 ULDCT 的辐射剂量参数及敏感性、特异性和准确性。
在纳入的 153 例患者中（平均年龄 47.4±15.3 岁，48.4%为女性），45 例（29.4%）存在新冠后肺部异常。在这 45 例患者中，最常见的 CT 表现为磨玻璃影（100.0%）、网状影（43.5%）和肺实质条带（37.0%）。与 SDCT 相比，ULDCT 对新冠后肺部异常的检测准确性、敏感性和特异性分别为 92.6%、87.2%和 94.9%。ULDCT 的中位总剂量长度乘积（DLP）不到我们 SDCT 的十分之一（12.6mGycm[9.9；15.5]vs.132.1mGycm[103.9；160.2]；p<0.001）。
与 SDCT 相比，ULDCT 对新冠后肺部异常的检测具有较高的准确性，且辐射剂量不到十分之一，仅为标准双视图胸部 X 线摄影的两倍剂量。
在对大量新冠后患者进行长期随访时，胸部 ULDCT 可能为标准剂量 CT 提供一种有利的、节省辐射剂量的替代方法。
