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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

  • Xiaoli Xu
  • Xin SuiEmail author
  • Lan Song
  • Yao Huang
  • Yingqian Ge
  • Zhengyu JinEmail author
  • Wei SongEmail author
Chest
  • 26 Downloads

Abstract

Objectives

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).

Methods

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.

Results

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.

Conclusion

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.

Key Points

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.

Keywords

X-ray computed tomography Connective tissue disease Interstitial lung disease Image reconstruction Radiation dosage 

Abbreviations

ADMIRE

Advanced modeled iterative reconstruction

AP

Anteroposterior

CT

Computed tomography

CTD

Connective tissue disease

CTD-ILD

Interstitial lung diseases associated with connective tissue disease

CTDIvol

Volume CT dose index

DLP

Dose-length product

ED

Effective radiation dose

FBP

Filtered back projection

GGO

Ground-glass opacities

HRCT

High-resolution computed tomography

ILD

Interstitial lung disease

IR

Iterative reconstruction

LAT

Lateral

LDCT

Low-dose CT

RDCT

Regular-dose chest CT

SAFIRE

Sinogram-affirmed iterative reconstruction

SNR

Signal-to-noise ratio

SSDEs

Size-specific dose estimates

Notes

Funding

This study was supported by the National Public Welfare Basic Scientific Research Project (2017PT32004).

Compliance with ethical standards

Guarantor

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.

Informed consent

Written informed consent was obtained from all patients in this study.

Ethical approval

Institutional Review Board approval of Peking Union Medical College Hospital was obtained.

Methodology

• retrospective

• observational study

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of Radiology, Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijingChina
  2. 2.Siemens ChinaBeijingChina

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