Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance

Abstract Objectives To investigate the image quality and diagnostic performance with ultra-low dose dual-layer detector spectral CT (DLSCT) by various reconstruction techniques for evaluation of pulmonary nodules. Materials and methods Between April 2023 and December 2023, patients with suspected pu...

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Main Authors: Li Ding, Mingwang Chen, Xiaomei Li, Yuting Wu, Jingxu Li, Shuting Deng, Yikai Xu, Zhao Chen, Chenggong Yan
Format: Article
Language:English
Published: SpringerOpen 2025-01-01
Series:Insights into Imaging
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Online Access:https://doi.org/10.1186/s13244-024-01888-1
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author Li Ding
Mingwang Chen
Xiaomei Li
Yuting Wu
Jingxu Li
Shuting Deng
Yikai Xu
Zhao Chen
Chenggong Yan
author_facet Li Ding
Mingwang Chen
Xiaomei Li
Yuting Wu
Jingxu Li
Shuting Deng
Yikai Xu
Zhao Chen
Chenggong Yan
author_sort Li Ding
collection DOAJ
description Abstract Objectives To investigate the image quality and diagnostic performance with ultra-low dose dual-layer detector spectral CT (DLSCT) by various reconstruction techniques for evaluation of pulmonary nodules. Materials and methods Between April 2023 and December 2023, patients with suspected pulmonary nodules were prospectively enrolled and underwent regular-dose chest CT (RDCT; 120 kVp/automatic tube current) and ultra-low dose CT (ULDCT; 100 kVp/10 mAs) on a DLSCT scanner. ULDCT was reconstructed with hybrid iterative reconstruction (HIR), electron density map (EDM), and virtual monoenergetic images at 40 keV and 70 keV. Quantitative and qualitative image analysis, nodule detectability, and Lung-RADS evaluation were compared using repeated one-way analysis of variance, Friedman test, and weighted kappa coefficient. Results A total of 249 participants (mean age ± standard deviation, 50.0 years ± 12.9; 126 male) with 637 lung nodules were included. ULDCT resulted in a significantly lower mean radiation dose than RDCT (0.3 mSv ± 0.0 vs. 3.6 mSv ± 0.8; p < 0.001). Compared with RDCT, ULDCT EDM showed significantly higher signal-noise-ratio (44.0 ± 77.2 vs. 4.6 ± 6.6; p < 0.001) and contrast-noise-ratio (26.7 ± 17.7 vs. 5.0 ± 4.4; p < 0.001) with qualitative scores ranked higher or equal to the average. Using the regular-dose images as a reference, ULDCT EDM images had a satisfactory nodule detection rate (84.6%) and good inter-observer agreements compared with RDCT (κw > 0.60). Conclusion Ultra-low dose dual-layer detector CT with 91.2% radiation dose reduction achieves sufficient image quality and diagnostic performance of pulmonary nodules. Critical relevance statement Dual-layer detector spectral CT enables substantial radiation dose reduction without impairing image quality for the follow-up of pulmonary nodules or lung cancer screening. Key Points Radiation dose is a major concern for patients requiring pulmonary nodules CT screening. Ultra-low dose dual-layer detector spectral CT with 91.2% dose reduction demonstrated satisfactory performance. Dual-layer detector spectral CT has the potential for lung cancer screening and management. Graphical Abstract
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publishDate 2025-01-01
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series Insights into Imaging
spelling doaj-art-31f9f1c3f5df4022a4660a25c32e34632025-01-12T12:26:33ZengSpringerOpenInsights into Imaging1869-41012025-01-0116111210.1186/s13244-024-01888-1Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performanceLi Ding0Mingwang Chen1Xiaomei Li2Yuting Wu3Jingxu Li4Shuting Deng5Yikai Xu6Zhao Chen7Chenggong Yan8Department of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityDepartment of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityDepartment of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityDepartment of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityDepartment of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityDepartment of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityDepartment of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityDepartment of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityDepartment of Medical Imaging Center, Nanfang Hospital, Southern Medical UniversityAbstract Objectives To investigate the image quality and diagnostic performance with ultra-low dose dual-layer detector spectral CT (DLSCT) by various reconstruction techniques for evaluation of pulmonary nodules. Materials and methods Between April 2023 and December 2023, patients with suspected pulmonary nodules were prospectively enrolled and underwent regular-dose chest CT (RDCT; 120 kVp/automatic tube current) and ultra-low dose CT (ULDCT; 100 kVp/10 mAs) on a DLSCT scanner. ULDCT was reconstructed with hybrid iterative reconstruction (HIR), electron density map (EDM), and virtual monoenergetic images at 40 keV and 70 keV. Quantitative and qualitative image analysis, nodule detectability, and Lung-RADS evaluation were compared using repeated one-way analysis of variance, Friedman test, and weighted kappa coefficient. Results A total of 249 participants (mean age ± standard deviation, 50.0 years ± 12.9; 126 male) with 637 lung nodules were included. ULDCT resulted in a significantly lower mean radiation dose than RDCT (0.3 mSv ± 0.0 vs. 3.6 mSv ± 0.8; p < 0.001). Compared with RDCT, ULDCT EDM showed significantly higher signal-noise-ratio (44.0 ± 77.2 vs. 4.6 ± 6.6; p < 0.001) and contrast-noise-ratio (26.7 ± 17.7 vs. 5.0 ± 4.4; p < 0.001) with qualitative scores ranked higher or equal to the average. Using the regular-dose images as a reference, ULDCT EDM images had a satisfactory nodule detection rate (84.6%) and good inter-observer agreements compared with RDCT (κw > 0.60). Conclusion Ultra-low dose dual-layer detector CT with 91.2% radiation dose reduction achieves sufficient image quality and diagnostic performance of pulmonary nodules. Critical relevance statement Dual-layer detector spectral CT enables substantial radiation dose reduction without impairing image quality for the follow-up of pulmonary nodules or lung cancer screening. Key Points Radiation dose is a major concern for patients requiring pulmonary nodules CT screening. Ultra-low dose dual-layer detector spectral CT with 91.2% dose reduction demonstrated satisfactory performance. Dual-layer detector spectral CT has the potential for lung cancer screening and management. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01888-1Pulmonary noduleUltra-low dose CTDual-layer detector CTImage quality
spellingShingle Li Ding
Mingwang Chen
Xiaomei Li
Yuting Wu
Jingxu Li
Shuting Deng
Yikai Xu
Zhao Chen
Chenggong Yan
Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance
Insights into Imaging
Pulmonary nodule
Ultra-low dose CT
Dual-layer detector CT
Image quality
title Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance
title_full Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance
title_fullStr Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance
title_full_unstemmed Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance
title_short Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance
title_sort ultra low dose dual layer detector spectral ct for pulmonary nodule screening image quality and diagnostic performance
topic Pulmonary nodule
Ultra-low dose CT
Dual-layer detector CT
Image quality
url https://doi.org/10.1186/s13244-024-01888-1
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