High-Resolution Chest Computed Tomography Imaging of the Lungs
| Autor: | Ahmed F. Halaweish, David J. Bartlett, Cynthia H. McCollough, Brian J. Bartholmai, Joel G. Fletcher, Chi Wan Koo, Kishore Rajendran, Shuai Leng, Jayse M. Weaver |
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| Rok vydání: | 2019 |
| Předmět: |
Bronchus
Lung medicine.diagnostic_test business.industry Radiography High resolution Computed tomography General Medicine Iterative reconstruction respiratory system respiratory tract diseases 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure medicine Radiology Nuclear Medicine and imaging Tomography Nuclear medicine business 030217 neurology & neurosurgery Photon counting detector |
| Zdroj: | Investigative Radiology. 54:129-137 |
| ISSN: | 0020-9996 |
| DOI: | 10.1097/rli.0000000000000524 |
| Popis: | OBJECTIVES The aim of this study was to evaluate if a high-resolution photon-counting detector computed tomography (PCD-CT) system with a 1024×1024 matrix reconstruction can improve the visualization of fine structures in the lungs compared with conventional high-resolution CT (HRCT). MATERIALS AND METHODS Twenty-two adult patients referred for clinical chest HRCT (mean CTDI vol, 13.58 mGy) underwent additional dose-matched PCD-CT (mean volume CT dose index, 13.37 mGy) after written informed consent. Computed tomography images were reconstructed at a slice thickness of 1.5 mm and an image increment of 1 mm with our routine HRCT reconstruction kernels (B46 and Bv49) at 512 and 1024 matrix sizes for conventional energy-integrating detector (EID) CT scans. For PCD-CT, routine B46 kernel and an additional sharp kernel (Q65, unavailable for EID) images were reconstructed at 1024 matrix size. Two thoracic radiologists compared images from EID and PCD-CT noting the highest level bronchus clearly identified in each lobe of the right lung, and rating bronchial wall conspicuity of third- and fourth-order bronchi. Lung nodules were also compared with the B46/EID/512 images using a 5-point Likert scale. Statistical analysis was performed using a Wilcoxon signed rank test with a P < 0.05 considered significant. RESULTS Compared with B46/EID/512, readers detected higher-order bronchi using B46/PCD/1024 and Q65/PCD/1024 images for every lung lobe (P < 0.0015), but in only the right middle lobe for B46/EID/1024 (P = 0.007). Readers were able to better identify bronchial walls of the third- and fourth-order bronchi better using the Q65/PCD/1024 images (mean Likert scores of 1.1 and 1.5), which was significantly higher compared with B46/EID/1024 or B46/PCD/1024 images (mean difference, 0.8; P < 0.0001). The Q65/PCD/1024 images had a mean nodule score of 1 ± 1.3 for reader 1, and -0.1 (0.9) for reader 2, with one reader having improved nodule evaluation scores for both PCD kernels (P < 0.001), and the other reader not identifying any increased advantage over B46/EID/1024 (P = 1.0). CONCLUSIONS High-resolution lung PCD-CT with 1024 image matrix reconstruction increased radiologists' ability to visualize higher-order bronchi and bronchial walls without compromising nodule evaluation compared with current chest CT, creating an opportunity for radiologists to better evaluate airway pathology. |
| Databáze: | OpenAIRE |
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