Accuracy of Ultralow-Dose Photon-counting CT in the Detection of Lung Changes after Lung Transplant.

Autor:	Milos RI; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Lechner L; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Korajac A; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Kifjak D; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Watzenböck ML; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Tamandl D; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Strassl A; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Stuempflen M; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Beer L; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Weber M; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Jaksch P; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Muraközy G; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Hielle-Wittmann E; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Kovacs Z; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Hoetzenecker K; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria., Prosch H; From the Departments of Biomedical Imaging and Image-guided Therapy (R.I.M., L.L., A.K., D.K., M.L.W., D.T., A.S., M.S., L.B., M.W., H.P.) and Thoracic Surgery (P.J., G.M., E.H.W., Z.K., K.H.), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Jazyk:	angličtina
Zdroj:	Radiology [Radiology] 2024 Sep; Vol. 312 (3), pp. e240271.
DOI:	10.1148/radiol.240271
Abstrakt:	Background Data on the diagnostic accuracy of ultralow-dose (ULD) CT protocols for periodic surveillance in recipients of lung transplant are lacking. Purpose To assess the potential for radiation dose reduction using ULD photon-counting CT (PCT) to detect lung abnormalities in recipients of lung transplant during repeat CT follow-up. Materials and Methods Consecutive adult recipients of lung transplant undergoing same-day standard-of-care low-dose (LD) and ULD PCT from March 2023 to May 2023 were prospectively included. The ULD protocols were performed with two target effective doses comprising 20% (hereafter, ULD1) and 10% (hereafter, ULD2) of the standard LD protocol. The 1-mm reconstructions were reviewed by three readers. Subjective image quality, the visibility of certain anatomic structures (using a five-point Likert scale), and the presence of lung abnormalities were independently assessed. The χ 2 or t tests were used to evaluate differences between the ULD1 and ULD2 protocols. Results A total of 82 participants (median age, 64 years [IQR, 54-69 years]; 47 male) were included (41 participants for each ULD protocol). The mean effective doses per protocol were 1.41 mSv ± 0.44 (SD) for LD, 0.26 mSv ± 0.08 for ULD1, and 0.17 mSv ± 0.04 for ULD2. According to three readers, the subjective image quality of the ULD images was deemed diagnostic (Likert score ≥3) in 39-40 (ULD1) and 40-41 (ULD2) participants, and anatomic structures could be adequately visualized (Likert score ≥3) in 33-41 (ULD1) and 34-41 (ULD2) participants. The detection accuracy for individual lung anomalies exceeded 70% for both ULD protocols, except for readers 1 and 3 detecting proximal bronchiectasis and reader 3 detecting bronchial wall thickening and air trapping. No evidence of a statistically significant difference in noise ( P = .96), signal-to-noise ratio ( P = .77), or reader accuracy (all P ≥ .05) was noted between the ULD protocols. Conclusion ULD PCT was feasible for detecting lung abnormalities following lung transplant, with a tenfold radiation dose reduction. © RSNA, 2024 Supplemental material is available for this article . See also the editorial by Ciet in this issue.
Databáze:	MEDLINE
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