Feasibility of low-dose CT with spectral shaping and third-generation iterative reconstruction in evaluating interstitial lung diseases associated with connective tissue disease: an intra-individual comparison study
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To investigate the feasibility of low-dose CT (LDCT) with tin filtration and third-generation iterative reconstruction (IR) in evaluating interstitial lung diseases associated with connective tissue disease (CTD-ILD).
Fifty-three consecutive adult patients with CTD-ILD underwent regular-dose chest CT (RDCT) at 110 kVp followed by LDCT with tin-filtered 100 kVp. RDCT was reconstructed with filtered back projection (FBP) and advanced modeled iterative reconstruction (ADMIRE); LDCT was reconstructed with ADMIRE. Image noise, streak artifact, image quality, and visualization of normal and abnormal CT features were evaluated and compared among RDCT-ADMIRE, RDCT-FBP, and LDCT-ADMIRE groups.
The mean radiation dose of LDCT was reduced to 20% of RDCT. Objective image noise of RDCT-ADMIRE (38.08 ± 6.37 HU), LDCT-ADMIRE (51.68 ± 9.06 HU), and RDCT-FBP (62.09 ± 10.95 HU) increased progressively (p < 0.001 in any two pairs). RDCT-ADMIRE significantly improved subjective image noise, streak artifact, and overall image quality compared with RDCT-FBP and LDCT-ADMIRE (all p < 0.001), while no significant difference was noted between the latter two groups. All abnormal lung structures were better scored in RDCT-ADMIRE compared with those in RDCT-FBP (all p < 0.001). LDCT-ADMIRE was inferior to RDCT-FBP in visualizing peripheral bronchi and vessels as well as reticulation (all p < 0.001); other normal and abnormal structures were similar between the two groups.
LDCT with tin filtration and third-generation IR was applicable in evaluating ILD lesions of CTD. Image quality was significantly improved after applying ADMIRE algorithm to CT protocols.
• Optimization of CT radiation dose is a clinical concern in patients with connective tissue disease.
• Spectral shaping and third-generation iterative reconstruction emerge as promising techniques in reducing radiation dose and acquiring desired image quality of CTD-ILD patients.
• The third-generation iterative reconstruction algorithm can optimize visualization of ILD patterns in low-dose CT.
KeywordsX-ray computed tomography Connective tissue disease Interstitial lung disease Image reconstruction Radiation dosage
Advanced modeled iterative reconstruction
Connective tissue disease
Interstitial lung diseases associated with connective tissue disease
Volume CT dose index
Effective radiation dose
Filtered back projection
High-resolution computed tomography
Interstitial lung disease
Regular-dose chest CT
Sinogram-affirmed iterative reconstruction
Size-specific dose estimates
This study was supported by the National Public Welfare Basic Scientific Research Project (2017PT32004).
Compliance with ethical standards
The scientific guarantor of this publication is Zhengyu Jin.
Conflict of interest
Yingqian Ge is an employee of Siemens. She had no control on the study raw data and analysis.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all patients in this study.
Institutional Review Board approval of Peking Union Medical College Hospital was obtained.
• observational study
• performed at one institution
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