May M, Heiß R, Köhnen J, Wetzl M, Wiesmüller M, Treutlein C, Uder M, Kopp M, Bräuer L (2022)
Publication Type: Journal article
Publication year: 2022
Book Volume: 57
Pages Range: 148-156
Journal Issue: 3
DOI: 10.1097/RLI.0000000000000822
OBJECTIVES: The purpose of this study was to evaluate the minimum diagnostic radiation dose level for the detection of high-resolution (HR) lung structures, pulmonary nodules (PNs), and infectious diseases (IDs). MATERIALS AND METHODS: A preclinical chest computed tomography (CT) trial was performed with a human cadaver without known lung disease with incremental radiation dose using tin filter-based spectral shaping protocols. A subset of protocols for full diagnostic evaluation of HR, PN, and ID structures was translated to clinical routine. Also, a minimum diagnostic radiation dose protocol was defined (MIN). These protocols were prospectively applied over 5 months in the clinical routine under consideration of the individual clinical indication. We compared radiation dose parameters, objective and subjective image quality (IQ). RESULTS: The HR protocol was performed in 38 patients (43%), PN in 21 patients (24%), ID in 20 patients (23%), and MIN in 9 patients (10%). Radiation dose differed significantly among HR, PN, and ID (5.4, 1.2, and 0.6 mGy, respectively; P < 0.001). Differences between ID and MIN (0.2 mGy) were not significant (P = 0.262). Dose-normalized contrast-to-noise ratio was comparable among all groups (P = 0.087). Overall IQ was perfect for the HR protocol (median, 5.0) and decreased for PN (4.5), ID-CT (4.3), and MIN-CT (2.5). The delineation of disease-specific findings was high in all dedicated protocols (HR, 5.0; PN, 5.0; ID, 4.5). The MIN protocol had borderline IQ for PN and ID lesions but was insufficient for HR structures. The dose reductions were 78% (PN), 89% (ID), and 97% (MIN) compared with the HR protocols. CONCLUSIONS: Personalized chest CT tailored to the clinical indications leads to substantial dose reduction without reducing interpretability. More than 50% of patients can benefit from such individual adaptation in a clinical routine setting. Personalized radiation dose adjustments with validated diagnostic IQ are especially preferable for evaluating ID and PN lesions.
APA:
May, M., Heiß, R., Köhnen, J., Wetzl, M., Wiesmüller, M., Treutlein, C.,... Bräuer, L. (2022). Personalized Chest Computed Tomography: Minimum Diagnostic Radiation Dose Levels for the Detection of Fibrosis, Nodules, and Pneumonia. Investigative Radiology, 57(3), 148-156. https://dx.doi.org/10.1097/RLI.0000000000000822
MLA:
May, Matthias, et al. "Personalized Chest Computed Tomography: Minimum Diagnostic Radiation Dose Levels for the Detection of Fibrosis, Nodules, and Pneumonia." Investigative Radiology 57.3 (2022): 148-156.
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