Dose-Optimized Computed Tomography for Screening and Follow-Up of Solid Pulmonary Nodules in Obesity: A Phantom Study.
To determine the lowest CT radiation dose-level at maintained image-quality and high sensitivity for detection of pulmonary-nodules in obesity. Single-energy CT with tin-filtration was performed in a chest-phantom with solid pulmonary-nodules simulating over-weight and obesity. CTDIvolof the standard-protocol was 0.41 mGy, subsequent scans were obtained at 1/2 and 1/4 dose-levels. Images were reconstructed using FBP and advanced-modeled iterative reconstruction (ADMIRE). Noise, image-quality, and sensitivity for nodule-detection were assessed. Noise was significantly reduced with ADMIRE (standard-dose: 73%; 1/2 dose: 73%; 1/4 dose: 71.2%; p < 0.001) compared to FBP. Image-quality was diagnostic for all images reconstructed with ADMIRE5. Sensitivity for nodule-detection was 100% at 1/2 and 1/4 dose-level for the phantom simulating over-weight and 97.37% (1/2 dose-level) and 81.58% (1/4 dose-level) for the phantom simulating obesity using ADMIRE5. In conclusion, single-energy CT with tin-filtration and ADMIRE shows potential for dose reduction in a phantom experiment down to 0.1 mGy in over-weight and 0.21 mGy obese subjects, while image quality and sensitivity for detection of solid pulmonary nodules remains high.
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (CH), Zurich, Switzerland. Electronic address: katharina.martini@usz.ch.
Katharina
K
Martini
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (CH), Zurich, Switzerland.
Borna K
BK
Barth
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (CH), Zurich, Switzerland.
Kai
K
Higashigaito
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (CH), Zurich, Switzerland.
Stephan
S
Baumueller
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (CH), Zurich, Switzerland.
Hatem
H
Alkadhi
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (CH), Zurich, Switzerland.
Thomas
T
Frauenfelder
D000465:Algorithms; D006801:Humans; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging*; D009765:Obesity / Q000150:complications*; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity; D014001:Tin; D014057:Tomography, X-Ray Computed / Q000379:methods*
D014001:Tin