TY - JOUR
T1 - Ultra-low dose chest CT with denoising for lung nodule detection
AU - Kerpel, Ariel
AU - Marom, Edith Michelle
AU - Green, Michael
AU - Eifer, Michal
AU - Konen, Eli
AU - Mayer, Arnaldo
AU - Betancourt Cuellar, Sonia L.
N1 - Publisher Copyright:
© 2021 Israel Medical Association. All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - Background: Medical imaging and the resultant ionizing radiation exposure is a public concern due to the possible risk of cancer induction. Objectives: To assess the accuracy of ultra-low-dose (ULD) chest computed tomography (CT) with denoising versus normal dose (ND) chest CT using the Lung CT Screening Reporting and Data System (Lung-RADS). Methods: This prospective single-arm study comprised 52 patients who underwent both ND and ULD scans. Subsequently AI-based denoising methods were applied to produce a denoised ULD scan. Two chest radiologists independently and blindly assessed all scans. Each scan was assigned a Lung-RADS score and grouped as 1 + 2 and 3 + 4. Results: The study included 30 men (58%) and 22 women (42%); mean age 69.9 ± 9 years (range 54–88). ULD scan radiation exposure was comparable on average to 3.6–4.8% of the radiation depending on patient BMI. Denoising increased signal-to-noise ratio by 27.7%. We found substantial inter-observer agreement in all scans for Lung-RADS grouping. Denoised scans performed better than ULD scans when negative likelihood ratio (LR-) was calculated (0.04–-0.08 vs. 0.08–0.12). Other than radiation changes, diameter measurement differences and part-solid nodules misclassification as a ground-glass nodule caused most Lung-RADS miscategorization. Conclusions: When assessing asymptomatic patients for pulmonary nodules, finding a negative screen using ULD CT with denoising makes it highly unlikely for a patient to have a pulmonary nodule that requires aggressive investigation. Future studies of this technique should include larger cohorts and be considered for lung cancer screening as radiation exposure is radically reduced.
AB - Background: Medical imaging and the resultant ionizing radiation exposure is a public concern due to the possible risk of cancer induction. Objectives: To assess the accuracy of ultra-low-dose (ULD) chest computed tomography (CT) with denoising versus normal dose (ND) chest CT using the Lung CT Screening Reporting and Data System (Lung-RADS). Methods: This prospective single-arm study comprised 52 patients who underwent both ND and ULD scans. Subsequently AI-based denoising methods were applied to produce a denoised ULD scan. Two chest radiologists independently and blindly assessed all scans. Each scan was assigned a Lung-RADS score and grouped as 1 + 2 and 3 + 4. Results: The study included 30 men (58%) and 22 women (42%); mean age 69.9 ± 9 years (range 54–88). ULD scan radiation exposure was comparable on average to 3.6–4.8% of the radiation depending on patient BMI. Denoising increased signal-to-noise ratio by 27.7%. We found substantial inter-observer agreement in all scans for Lung-RADS grouping. Denoised scans performed better than ULD scans when negative likelihood ratio (LR-) was calculated (0.04–-0.08 vs. 0.08–0.12). Other than radiation changes, diameter measurement differences and part-solid nodules misclassification as a ground-glass nodule caused most Lung-RADS miscategorization. Conclusions: When assessing asymptomatic patients for pulmonary nodules, finding a negative screen using ULD CT with denoising makes it highly unlikely for a patient to have a pulmonary nodule that requires aggressive investigation. Future studies of this technique should include larger cohorts and be considered for lung cancer screening as radiation exposure is radically reduced.
KW - Computerized tomography (CT)
KW - Lung cancer screening
KW - Lung imaging reporting and data system (Lung-RADS)
KW - Screening chest CT scan
KW - Ultra-low-dose (ULD) computerized tomography (CT)
UR - http://www.scopus.com/inward/record.url?scp=85115282813&partnerID=8YFLogxK
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C2 - 34472229
AN - SCOPUS:85115282813
SN - 1565-1088
VL - 23
SP - 550
EP - 555
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 9
ER -