Prospective Study of Low- and Standard-dose Chest CT for Pulmonary Nodule Detection: A Comparison of Image Quality, Size Measurements and Radiation Exposure

• Published in: Current medical science 2021-10, Vol.41 (5), p.966-973
• Main Authors: Hu, Qiong-jie, Liu, Yi-wen, Chen, Chong, Kang, Shi-chao, Sun, Zi-yan, Wang, Yu-jin, Xiang, Min, Xia, Li-ming, Guan, Han-xiong
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Lung Neoplasms - diagnostic imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Prospective Studies; Radiation Dosage; Radiation Exposure; Radiographic Image Enhancement - methods; Tomography, X-Ray Computed - methods
• ISSN: 2096-5230; 2523-899X
• DOI: 10.1007/s11596-021-2433-z

Objective To comprehensively and accurately analyze the out-performance of low-dose chest CT (LDCT) vs. standard-dose CT (SDCT). Methods The image quality, size measurements and radiation exposure for LDCT and SDCT protocols were evaluated. A total of 117 patients with extra-thoracic malignancies were prospectively enrolled for non-enhanced CT scanning using LDCT and SDCT protocols. Three experienced radiologists evaluated subjective image quality independently using a 5-point score system. Nodule detection efficiency was compared between LDCT and SDCT based on nodule characteristics (size and volume). Radiation metrics and organ doses were analyzed using Radimetrics. Results The images acquired with the LDCT protocol yielded comparable quality to those acquired with the SDCT protocol. The sensitivity of LDCT for the detection of pulmonary nodules ( n =650) was lower than that of SDCT ( n =660). There was no significant difference in the diameter and volume of pulmonary nodules between LDCT and SDCT (for BMI 0.05). The individualized volume CT dose index (CTDI vol ), the size specific dose estimate and effective dose were significantly reduced in the LDCT group compared with the SDCT group (all P