Yan Qinqin, Yan Fuhua, Lin Qi, Cao Qiqi, Zhang Yajie, Chen Xiaoyan, Schmidt Bernhard, Xu Zhihan, Yang Wenjie
Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, China.
Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, China.
Radiol Med. 2025 Aug;130(8):1207-1220. doi: 10.1007/s11547-025-02057-0. Epub 2025 Jul 29.
PURPOSE: To characterize invasion-associated CT features in pulmonary subsolid nodules using low-dose ultrahigh-resolution (UHR) photon-counting CT (PCCT) images and evaluate UHR's diagnostic superiority over standard high-resolution (HR) images. METHODS: Patients with subsolid lung adenocarcinoma were recruited for chest scan on PCCT to obtain UHR and standard HR images between November 2023 and May 2024. Nodule characteristics were visually assessed and histogram features were extracted from each nodule. Image quality and radiation dose at previous energy-integrating detector CT (EID-CT) of 30 patients were compared with those of PCCT. Differences between UHR and standard HR, PCCT and EID-CT were compared using paired McNemar-test or paired Wilcox-test. RESULTS: One hundred and eighty-four patients with 203 subsolid nodules were collected including 77 precursors, 77 minimally invasive adenocarcinoma (MIA) and 49 IA. UHR significantly outperformed standard HR in revealing CT findings including larger nodular diameter and solid-component diameter, more frequency of heterogeneous attenuation, lobulation, bubble-like sign, air bronchogram, pleural indentation and vascular sign (all P < 0.05). Additionally, UHR images exhibited significantly greater value in histogram-derived parameters compared to standard HR images (all P < 0.05), except for "Median," "Minimum." Furthermore, the radiation dose in PCCT was half of that in EID-CT (effective dose: 1.32 ± 0.27 vs. 3.85 ± 1.65/mSv, P < 0.001. CDTI: 2.97 ± 0.53 vs. 6.90 ± 2.97/mGy, P < 0.001), with image quality significantly better in PCCT. CONCLUSION: The UHR protocol on PCCT provides a magnified perspective to reveal CT characteristics of invasive growth in subsolid LUAD, previously undetectable on standard HR images, achieving halved radiation dose and better image quality than EID-CT.
目的:利用低剂量超高分辨率(UHR)光子计数CT(PCCT)图像,对肺亚实性结节的侵袭相关CT特征进行表征,并评估UHR相较于标准高分辨率(HR)图像的诊断优势。 方法:招募肺亚实性腺癌患者,于2023年11月至2024年5月期间进行PCCT胸部扫描,以获取UHR图像和标准HR图像。对结节特征进行视觉评估,并从每个结节中提取直方图特征。将30例患者之前的能量积分探测器CT(EID-CT)的图像质量和辐射剂量与PCCT的进行比较。使用配对McNemar检验或配对Wilcox检验比较UHR与标准HR、PCCT与EID-CT之间的差异。 结果:共收集了184例患者的203个亚实性结节,其中包括77个前驱病变、77个微浸润腺癌(MIA)和49个浸润性腺癌(IA)。在显示CT表现方面,UHR明显优于标准HR,包括更大的结节直径和实性成分直径、更高的不均匀衰减频率、分叶、气泡样征、空气支气管征、胸膜凹陷和血管征(所有P<0.05)。此外,与标准HR图像相比,UHR图像在直方图衍生参数方面表现出显著更高的值(所有P<0.05),“中位数”“最小值”除外。此外,PCCT的辐射剂量是EID-CT的一半(有效剂量:1.32±0.27 vs. 3.85±1.65/mSv,P<0.001。剂量长度乘积:2.97±0.53 vs. 6.90±2.97/mGy,P<0.001),PCCT的图像质量明显更好。 结论:PCCT上的UHR方案提供了一个放大的视角,以揭示肺亚实性腺癌侵袭性生长的CT特征,这些特征在标准HR图像上以前无法检测到,与EID-CT相比,辐射剂量减半且图像质量更好。
Thorac Cardiovasc Surg. 2024-10
JAMA Netw Open. 2023-10-2