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Ultra-low-dose chest CT in adult patients with cystic fibrosis using a third-generation dual-source CT scanner

  • Chest Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Introduction

Chest computed tomography (CT) examinations are performed routinely in some cystic fibrosis (CF) centers in order to evaluate lung disease progression in CF patients. Continuous CT technological advancement in theory could allows a lower radiation exposure of CF patients during chest CT examinations without an image quality reduction, and this could become increasingly important over time in order to reduce the cumulative radiation dose effects given the continuous increase of CF patients predicted median survival.

Objective

The aim of this study was to compare objective and subjective image quality and radiation dose between low-dose chest CT examinations performed in adult CF patients using a third-generation DSCT scanner and a 64-slices single-source CT (SSCT) scanner.

Materials and methods

Between January 2016 and August 2019, 81 CF patients underwent low-dose chest CT examinations using both a 64-slices SSCT scanner (2016–2017) and a third-generation DSCT scanner (2018–2019). Objective image noise standard deviation (INSD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), overall subjective image quality (OSIQ), subjective image noise (SIN), subjective evaluation of streaking artifacts (SA), movement artifacts (MA) and edge resolution (ER), dose-length product (DLP), volume computed tomography dose index (CTDIvol) and effective radiation dose (ERD) were compared between DSCT and SSCT examinations. DSCT examinations consisted in spiral inspiratory end expiratory acquisitions. SSCT examinations consisted in spiral inspiratory acquisitions and five axial expiratory ones.

Results

DSCT protocol showed statistically significant lower spiral inspiratory phase mean DLP, CTDIvol and ERD than SSCT protocol, with a 25% DLP, CTDIvol and ERD reduction. DSCT protocol showed statistically significant higher overall (inspiratory and expiratory phases) mean DLP, CTDIvol and ERD than SSCT protocol, with a 40% DLP, CTDIvol and ERD increase. Objective image quality (INSD, SNR and CNR) and SIN differences were not statistically significant, but subjective evaluation of DSCT images showed statistically significant better OSIQ and ER, as well as statistically significant lower SA and MA with respect to SSCT images.

Conclusions

To our knowledge, this is the first study evaluating chest CT image quality and radiation dose in adult CF patients using a third-generation DSCT scanner, and it showed that technological advancements could be used in order to reduce radiation exposure of volumetric examinations. The spiral inspiratory dose reduction can be obtained with concomitant improvements in subjective image quality with comparable objective quality. This will probably allow a wider use of this imaging modality in order to assess bronchiectasis and will probably foster spiral expiratory acquisition for small airways disease evaluation.

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Authors and Affiliations

  1. School of Radiology, Università Politecnica Delle Marche, Ancona, Italy

    Corrado Tagliati

  2. Department of Radiological Sciences, Azienda Ospedaliero Universitaria Ospedali Riuniti, Università Politecnica Delle Marche, Ancona, Italy

    Cecilia Lanza, Giovanni Pieroni, Lucia Amici, Marina Carotti, Gian Marco Giuseppetti & Andrea Giovagnoni

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  1. Corrado Tagliati
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  2. Cecilia Lanza
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  3. Giovanni Pieroni
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  4. Lucia Amici
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  5. Marina Carotti
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  6. Gian Marco Giuseppetti
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  7. Andrea Giovagnoni
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Correspondence to Corrado Tagliati.

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The authors declared no potential conflicts of interests associated with this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 declaration of HELSINKI and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants (or their parental guardian) included in the study.

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Tagliati, C., Lanza, C., Pieroni, G. et al. Ultra-low-dose chest CT in adult patients with cystic fibrosis using a third-generation dual-source CT scanner. Radiol med 126, 544–552 (2021). https://doi.org/10.1007/s11547-020-01304-w

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  • DOI: https://doi.org/10.1007/s11547-020-01304-w

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