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Emphysema Quantification Using Ultralow-Dose CT With Iterative Reconstruction and Filtered Back Projection.

Mizuho Nishio1,2,3, Hisanobu Koyama4, Yoshiharu Ohno2,3

  • 11 Clinical PET Center, Institute of Biomedical Research and Innovation, 2-2, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan.

AJR. American Journal of Roentgenology
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Summary

Ultralow-dose CT (ULDCT) with iterative reconstruction (IR) shows strong agreement with standard-dose CT (SDCT) for emphysema quantification. ULDCT, with or without IR, can effectively replace SDCT for assessing emphysema.

Keywords:
COPDCTemphysemaquantitative evaluationradiation dose

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Area of Science:

  • Radiology
  • Pulmonary Medicine
  • Medical Imaging

Background:

  • Emphysema quantification is crucial for diagnosing and managing chronic obstructive pulmonary disease (COPD).
  • Standard-dose CT (SDCT) is the current standard but involves significant radiation exposure.
  • Ultralow-dose CT (ULDCT) offers reduced radiation but requires validation for accurate emphysema assessment.

Purpose of the Study:

  • To evaluate the agreement between emphysema quantification using SDCT and ULDCT.
  • To assess the impact of iterative reconstruction (IR) on ULDCT image quality and accuracy for emphysema.
  • To determine if ULDCT can serve as a substitute for SDCT in emphysema quantification.

Main Methods:

  • Fifty patients underwent both SDCT and ULDCT scans.
  • ULDCT images were reconstructed with and without adaptive iterative dose reduction with 3D processing (IR).
  • Emphysema was quantified using low-attenuation volume percentage (LAV%), mean lung attenuation, and total lung volume. Concordance correlation coefficients (CCC) assessed agreement.

Main Results:

  • Agreement for LAV% between SDCT and ULDCT significantly improved with IR (CCC 0.934-0.966) compared to without IR (CCC 0.310-0.789).
  • Mean lung attenuation agreement was substantial without IR (CCC 0.957) but poor with IR (CCC 0.890).
  • Total lung volume agreement was substantial with or without IR (CCC >0.982).

Conclusions:

  • ULDCT with IR demonstrates high agreement with SDCT for emphysema quantification.
  • ULDCT, both with and without IR, can be a viable alternative to SDCT for emphysema assessment.
  • The use of IR enhances the accuracy of ULDCT for emphysema quantification, potentially reducing radiation dose.