Detection of pulmonary nodules with scoutless fixed-dose ultra-low-dose CT: a prospective study

Gheysens, Gerald; Wever, Walter De; Cockmartin, Lesley; Bosmans, Hilde; Coudyzer, Walter; Vuysere, Sofie De; Lefere, Mathieu

doi:10.1007/s00330-022-08584-y

Cited by 13 publications

(9 citation statements)

References 31 publications

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“…In terms of nodule volumetry, two studies have reported slight underestimation of nodule volume in ULDCT when compared to RDCT, using comparable reconstruction settings as in our study. 30,31 However, the underestimation was negligible in absolute volume, which is in line with our findings.…”

Section: Discussionsupporting

confidence: 92%

Detection and size quantification of pulmonary nodules in ultralow-dose versus regular-dose CT: a comparative study in COPD patients

Han

Cai

Heus

et al. 2023

BJR

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Objectives: To evaluate detectability and semi-automatic diameter and volume measurements of pulmonary nodules in ultralow-dose CT (ULDCT) versus regular-dose CT (RDCT). Methods: Fifty patients with chronic obstructive pulmonary disease (COPD) underwent RDCT on 64-multidetector CT (120 kV, filtered back projection), and ULDCT on third-generation dual source CT (100 kV with tin filter, advanced modeled iterative reconstruction). One radiologist evaluated the presence of nodules on both scans in random order, with discrepancies judged by two independent radiologists and consensus reading. Sensitivity of nodule detection on RDCT and ULDCT was compared to reader consensus. Systematic error in semi-automatically derived diameter and volume, and 95% limits of agreement (LoA) were evaluated. Nodule classification was compared by κ statistics. Results: ULDCT resulted in 83.1% (95%CI: 81.0–85.2) dose reduction compared to RDCT (p < 0.001). Forty-five nodules were present, with diameter range 4.0–25.3 mm and volume range 16.0–4483.0 mm3. Detection sensitivity was nonsignificant (p = 0.503) between RDCT 88.8% (95%CI: 76.0–96.3) and ULDCT 95.5% (95%CI: 84.9–99.5). No systematic bias in diameter measurements (median difference: −0.2 mm) or volumetry (median difference: −6 mm3) was found for ULDCT compared to RDCT. The 95%LoA for diameter and volume measurements were ±3.0 mm and ±33.5%, respectively. κ value for nodule classification was 0.852 for diameter measurements and 0.930 for volumetry. Conclusion: ULDCT based on Sn100 kV enables comparable detectability of solid pulmonary nodules in COPD patients, at 83% reduced radiation dose compared to RDCT, without relevant difference in nodule measurement and size classification. Advances in knowledge: Pulmonary noduledetectability and measurements in ultralow-dose CT are comparable to regular dose CT.

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Section: Discussionsupporting

confidence: 92%

Detection and size quantification of pulmonary nodules in ultralow-dose versus regular-dose CT: a comparative study in COPD patients

Han

Cai

Heus

et al. 2023

BJR

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“…In a study by Huber and colleagues, the ULDCT detection rate was lower than standard CT (93.3 vs. 95.5%, respectively) due to the under-detection of <5 mm solid and sub-solid nodules, which, however, was compensated by using maximum intensity projection (MIP) reconstructions and a computer-aided-detection (CAD) software [ 73 ]. Another study by Gheysens and colleagues evaluated nodule assessment of ULDCT by using a scoutless CT at a fixed CTDIvol of 0.15 mGy [ 74 ]. The authors found that nodule detection rate was comparable between standard CT and ULDCT: 76 and 78%, respectively; however detection significantly relied on nodule size, since up to 20% of <5 mm nodules were missed by ULDCT [ 74 ].…”

Section: Future Directionmentioning

confidence: 99%

“…Another study by Gheysens and colleagues evaluated nodule assessment of ULDCT by using a scoutless CT at a fixed CTDIvol of 0.15 mGy [ 74 ]. The authors found that nodule detection rate was comparable between standard CT and ULDCT: 76 and 78%, respectively; however detection significantly relied on nodule size, since up to 20% of <5 mm nodules were missed by ULDCT [ 74 ]. Due to the blurred edges, the nodule measurements were 9% lower compared to standard CT; given that this value is below the interscan variability, this difference would not affect the nodule management [ 74 ].…”

Section: Future Directionmentioning

confidence: 99%

“…The authors found that nodule detection rate was comparable between standard CT and ULDCT: 76 and 78%, respectively; however detection significantly relied on nodule size, since up to 20% of <5 mm nodules were missed by ULDCT [ 74 ]. Due to the blurred edges, the nodule measurements were 9% lower compared to standard CT; given that this value is below the interscan variability, this difference would not affect the nodule management [ 74 ]. However, up to 10% of solid nodules were misdiagnosed as sub-solid nodules at ULDCT, potentially compromising their further management [ 74 ].…”

Section: Future Directionmentioning

confidence: 99%

“…Due to the blurred edges, the nodule measurements were 9% lower compared to standard CT; given that this value is below the interscan variability, this difference would not affect the nodule management [ 74 ]. However, up to 10% of solid nodules were misdiagnosed as sub-solid nodules at ULDCT, potentially compromising their further management [ 74 ].…”

Section: Future Directionmentioning

confidence: 99%

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Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned?

Pozzessere

Garnier

2023

Tomography

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Lung cancer screening (LCS) programs through low-dose Computed Tomography (LDCT) are being implemented in several countries worldwide. Radiation exposure of healthy individuals due to prolonged CT screening rounds and, eventually, the additional examinations required in case of suspicious findings may represent a concern, thus eventually reducing the participation in an LCS program. Therefore, the present review aims to assess the potential radiation risk from LDCT in this setting, providing estimates of cumulative dose and radiation-related risk in LCS in order to improve awareness for an informed and complete attendance to the program. After summarizing the results of the international trials on LCS to introduce the benefits coming from the implementation of a dedicated program, the screening-related and participant-related factors determining the radiation risk will be introduced and their burden assessed. Finally, future directions for a personalized screening program as well as technical improvements to reduce the delivered dose will be presented.

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[18F]FDG PET/MRI combined with chest HRCT in early cancer detection: a retrospective study of 3020 asymptomatic subjects

Peng

Liu

Zhou

et al. 2023

Eur J Nucl Med Mol Imaging

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Purpose PET/MRI has become an important medical imaging approach in clinical practice. In this study, we retrospectively investigated the detectability of fluorine-18 (18F)-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ([18F]FDG PET/MRI) combined with chest computerized tomography (CT) for early cancer in a large cohort of asymptomatic subjects. Methods This study included a total of 3020 asymptomatic subjects who underwent whole-body 18F- PET/MRI and chest HRCT examinations. All subjects received a 2–4-year follow-up for cancer development. Cancer detection rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the [18F]FDG PET/MRI with or without chest HRCT were calculated and analyzed. Results Sixty-one subjects were pathologically diagnosed with cancers, among which 59 were correctly detected by [18F]FDG PET/MRI combined with chest HRCT. Of the 59 patients (32 with lung cancer, 9 with breast cancer, 6 with thyroid cancer, 5 with colon cancer, 3 with renal cancer, 1 with prostate cancer, 1 with gastric cancer, 1 with endometrial cancer, and 1 with lymphoma), 54 (91.5%) were at stage 0 or stage I (according to the 8th edition of the tumor-node-metastasis [TNM] staging system), 33 (55.9%) were detected by PET/MRI alone (27 with non-lung cancers and 6 with lung cancer). Cancer detection rate, sensitivity, specificity, PPV, and NPV for PET/MRI combined with chest CT were 2.0%, 96.7%, 99.6%, 83.1%, and 99.9%, respectively. For PET/MRI alone, the metrics were 1.1%, 54.1%, 99.6%, 73.3%, and 99.1%, respectively, and for PET/MRI in non-lung cancers, the metrics were 0.9%, 93.1%, 99.6%, 69.2%, and 99.9%, respectively. Conclusions [18F]FDG PET/MRI holds great promise for the early detection of non-lung cancers, while it seems insufficient for detecting early-stage lung cancers. Chest HRCT can be complementary to whole-body PET/MRI for early cancer detection. Trial registration ChiCTR2200060041. Registered 16 May 2022. Public site: https://www.chictr.org.cn/index.html

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Detection of pulmonary nodules with scoutless fixed-dose ultra-low-dose CT: a prospective study

Cited by 13 publications

References 31 publications

Detection and size quantification of pulmonary nodules in ultralow-dose versus regular-dose CT: a comparative study in COPD patients

Detection and size quantification of pulmonary nodules in ultralow-dose versus regular-dose CT: a comparative study in COPD patients

Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned?

[18F]FDG PET/MRI combined with chest HRCT in early cancer detection: a retrospective study of 3020 asymptomatic subjects

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