Ultra-high resolution CT imaging of interstitial lung disease: impact of photon-counting CT in 112 patients.
Eur Radiol
; 33(8): 5528-5539, 2023 Aug.
Article
em En
| MEDLINE
| ID: mdl-37071165
ABSTRACT
OBJECTIVES:
To compare lung parenchyma analysis on ultra-high resolution (UHR) images of a photon-counting CT (PCCT) scanner with that of high-resolution (HR) images of an energy-integrating detector CT (EID-CT).METHODS:
A total of 112 patients with stable interstitial lung disease (ILD) were investigated (a) at T0 with HRCT on a 3rd-generation dual-source CT scanner; (b) at T1 with UHR on a PCCT scanner; (c) with a comparison of 1-mm-thick lung images.RESULTS:
Despite a higher level of objective noise at T1 (74.1 ± 14.1 UH vs 38.1 ± 8.7 UH; p < 0.0001), higher qualitative scores were observed at T1 with (a) visualization of more distal bronchial divisions (median order; Q1-Q3) (T1 10th division [9-10]; T0 9th division [8-9]; p < 0.0001); (b) greater scores of sharpness of bronchial walls (p < 0.0001) and right major fissure (p < 0.0001). The scores of visualization of CT features of ILD were significantly superior at T1 (micronodules p = 0.03; linear opacities, intralobular reticulation, bronchiectasis, bronchiolectasis, and honeycombing p < 0.0001), leading to the reclassification of 4 patients with non-fibrotic ILD at T0, recognized with fibrotic ILD at T1. At T1, the mean (± SD) radiation dose (CTDI vol 2.7 ± 0.5 mGy; DLP 88.5 ± 21 mGy.cm) was significantly lower than that delivered at T0 (CTDI vol 3.6 ± 0.9 mGy; DLP 129.8 ± 31.7 mGy.cm) (p < 0.0001), corresponding to a mean reduction of 27% and 32% for the CTDIvol and DLP, respectively.CONCLUSIONS:
The UHR scanning mode of PCCT allowed a more precise depiction of CT features of ILDs and reclassification of ILD patterns with significant radiation dose reduction. CLINICAL RELEVANCE STATEMENT Evaluation of lung parenchymal structures with ultra-high-resolution makes subtle changes at the level of the secondary pulmonary lobules and lung microcirculation becoming visually accessible, opening new options for synergistic collaborations between highly-detailed morphology and artificial intelligence. KEY POINTS ⢠Photon-counting CT (PCCT) provides a more precise analysis of lung parenchymal structures and CT features of interstitial lung diseases (ILDs). ⢠The UHR mode ensures a more precise delineation of fine fibrotic abnormalities with the potential of modifying the categorization of ILD patterns. ⢠Better image quality at a lower radiation dose with PCCT opens new horizons for further dose reduction in noncontrast UHR examinations.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
/
Doenças Pulmonares Intersticiais
/
Pulmão
Tipo de estudo:
Qualitative_research
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article