Ultra-low dose computed tomography protocols using spectral shaping for lung cancer screening: Comparison with low-dose for volumetric LungRADS classification.

Autor: Milanese G; Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy; Fondazione IRCCS Istituto Nazionale dei Tumori, Thoracic Surgery, Milan, Lombardia, Italy. Electronic address: gianluca.milanese@unipr.it., Ledda RE; Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy; Fondazione IRCCS Istituto Nazionale dei Tumori, Thoracic Surgery, Milan, Lombardia, Italy. Electronic address: robertaeufrasia.ledda@unipr.it., Sabia F; Fondazione IRCCS Istituto Nazionale dei Tumori, Thoracic Surgery, Milan, Lombardia, Italy. Electronic address: federica.sabia@istitutotumori.mi.it., Ruggirello M; Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Diagnostic Imaging and Radiotherapy, Milan, Italy. Electronic address: margherita.ruggirello@istitutotumori.mi.it., Sestini S; Fondazione IRCCS Istituto Nazionale dei Tumori, Thoracic Surgery, Milan, Lombardia, Italy. Electronic address: stefano.sestini@istitutotumori.mi.it., Silva M; Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy. Electronic address: mario.silva@unipr.it., Sverzellati N; Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy. Electronic address: nicola.sverzellati@unipr.it., Marchianò AV; Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Diagnostic Imaging and Radiotherapy, Milan, Italy. Electronic address: alfonso.marchiano@istitutotumori.mi.it., Pastorino U; Fondazione IRCCS Istituto Nazionale dei Tumori, Thoracic Surgery, Milan, Lombardia, Italy. Electronic address: ugo.pastorino@istitutotumori.mi.it.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2023 Apr; Vol. 161, pp. 110760. Date of Electronic Publication: 2023 Feb 28.
DOI: 10.1016/j.ejrad.2023.110760
Abstrakt: Purpose: To compare Low-Dose Computed Tomography (LDCT) with four different Ultra-Low-Dose Computed Tomography (ULDCT) protocols for PN classification according to the Lung Reporting and Data System (LungRADS).
Methods: Three hundred sixty-one participants of an ongoing lung cancer screening (LCS) underwent single-breath-hold double chest Computed Tomography (CT), including LDCT (120kVp, 25mAs; CTDIvol 1,62 mGy) and one ULDCT among: fully automated exposure control ("ULDCT 1 "); fixed tube-voltage and current according to patient size ("ULDCT 2 "); hybrid approach with fixed tube-voltage ("ULDCT 3 ") and tube current automated exposure control ("ULDCT 4 "). Two radiologists (R1, R2) assessed LungRADS 2022 categories on LDCT, and then after 2 weeks on ULDCT using two different kernels (R1: Qr49 ADMIRE 4 ; R2: Br49 ADMIRE 3 ). Intra-subject agreement for LungRADS categories between LDCT and ULDCT was measured by the k-Cohen Index with Fleiss-Cohen weights.
Results: LDCT-dominant PNs were detected in ULDCT in 87 % of cases on Qr49 ADMIRE 4 and 88 % on Br49 ADMIRE 3 . The intra-subject agreement was: κULDCT 1  = 0.89 [95 %CI 0.82-0.96]; κULDCT 2  = 0.90 [0.81-0.98]; κULDCT 3  = 0.91 [0.84-0.99]; κULDCT 4  = 0.88 [0.78-0.97] on Qr49 ADMIRE 4 , and κULDCT 1  = 0.88 [0.80-0.95]; κULDCT 2  = 0.91 [0.86-0.96]; κULDCT 3  = 0.87 [0.78-0.95]; and κULDCT 4  = 0.88 [0.82-0.94] on Br49 ADMIRE 3 . LDCT classified as LungRADS 4B were correctly identified as LungRADS 4B at ULDCT 3 , with the lowest radiation exposure among the tested protocols (median effective doses were 0.31, 0.36, 0.27 and 0.37 mSv for ULDCT 1 , ULDCT 2 , ULDCT 3 , and ULDCT 4 , respectively).
Conclusions: ULDCT by spectral shaping allows the detection and characterization of PNs with an excellent agreement with LDCT and can be proposed as a feasible approach in LCS.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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