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Image quality and radiation dose reduction in chest CT in pulmonary infection

  • CHEST RADIOLOGY
  • Published:
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Abstract

Purpose

To evaluate the effect of dose reduction with iterative reconstruction (IR) on image quality of chest CT scan comparing two protocols.

Materials and methods

Fifty-nine patients were enrolled. The two CT protocols were applied using Iterative Reconstruction (ASIR™) 40% but different noise indexes, recording dose-length product (DLP) and volume computed tomography dose index (CTDIvol). The subjective IQ was rated based on the distinction of anatomic details using a 4-point Likert scale based on the European Guidelines on Quality Criteria for CT. For each patient, two single CTs, at enrollment (group 1) and at follow-up after lowering the dose (group 2), were evaluated by two radiologists evaluating, for each examination, five different lung regions (central zone—CZ; peripheral zone—PZ; sub-pleural region—SPR; centrilobular region—CLR; and apical zone—AZ). An inter-observer agreement was expressed by weighted Cohen’s kappa statistics (k) and intra-individual differences of subjective image analysis through visual grading characteristic (VGC) analysis.

Results

An average 50.4% reduction in CTDIvol and 51.5% reduction in DLP delivered were observed using the dose-reduced protocol. An agreement between observers evaluating group 1 CTs was perfect (100%) and moderate to good in group 2 examinations (k-Cohen ranging from 0.56 for PZ and AZ to 0.70 for SPR). In the VGC analysis, image quality ratings were significantly better for group 1 than group 2 scans for all regions (AUCVGC ranging from 0.56 for CZ to 0.62). However, disagreement was limited to a score 4 (excellent)-to-score 3 (good) IQ transition; apart from a single case in PZ, both the observers scored the IQ at follow-up as 2 (sufficient) starting from a score 4 (excellent).

Conclusion

Dose reduction achieved in the follow-up CT scans, although a lower IQ still allows a good diagnostic confidence.

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Authors and Affiliations

  1. Radiology Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Via Portuense 292, 00149, Rome, Italy

    Massimo Cristofaro, Elisa Busi Rizzi, Elisa Pianura, Ada Petrone, Nicoletta Fusco, Federica Di Stefano & Vincenzo Schinina’

  2. Clinical Epidemiology Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, Via Portuense 292, 00149, Rome, Italy

    Pierluca Piselli

Authors
  1. Massimo Cristofaro
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  2. Elisa Busi Rizzi
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  3. Pierluca Piselli
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  4. Elisa Pianura
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  5. Ada Petrone
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  7. Federica Di Stefano
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Correspondence to Pierluca Piselli.

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All the authors are aware of the content of the manuscript and have no conflict of interest 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.

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This study was approved by the local ethical board, and the informed consensus was obtained from all individual participants included in the study.

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Cristofaro, M., Busi Rizzi, E., Piselli, P. et al. Image quality and radiation dose reduction in chest CT in pulmonary infection. Radiol med 125, 451–460 (2020). https://doi.org/10.1007/s11547-020-01139-5

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  • DOI: https://doi.org/10.1007/s11547-020-01139-5

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