Ultra-Low-Dose Computed Tomography of the Lung: Evidence and Prospects of a New Method

The introduction of state-of-the-art tube, detector, and image reconstruction techniques has made ultra-low-dose CT (ULD-CT) of the lungs technologically feasible, resulting in radiation exposure comparable to that of chest X-rays. Due to its high-contrast structures, the lung as target organ is generally well suited for reducing radiation exposure while maintaining diagnostic accuracy, which could already be shown for the earlier development of low-dose CT (LDCT). The current state of the literature already demonstrates significant benefits of ULD-CT for the diagnosis of respiratory diseases, including COPD, pneumonia, interstitial lung disease, pediatric lung disease, as well as in interventional procedures. It is expected that ULD-CT will significantly expand the range of indications for CT and, in certain areas, will be able to replace chest X-rays as the initial imaging modality once its availability in institutions increases. Limitations currently arise from the known dependencies of quantitative methods on radiation exposure and image noise, and the fact that in-depth validation has not yet taken place.

· Ultra-low-dose computed tomography (ULD-CT) reduces radiation exposure to the level of a conventional chest X-ray through the latest tube, detector, and reconstruction technologies.. · ULD-CT can already be used for the diagnosis of solid pulmonary nodules, pneumonia, and chronic inflammatory airway diseases.. · Especially in children and immunosuppressed patients, ULD-CT should be considered for monitoring the progression of inflammatory lung diseases.. · There is insufficient evidence for the use of ULD-CT in interstitial lung diseases.. · In the future, ULD-CT could replace conventional chest X-ray for many indications in thoracic imaging..

· Wielpütz MO, Stiller W, Bayerl N et al. Ultra-Low-Dose Computed Tomography of the Lung: Evidence and Prospects of a New Method. Rofo 2026; DOI 10.1055/a-2977-0644.