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Feasibility of low-dose CT with spectral shaping and third-generation iterative reconstruction in evaluating interstitial lung diseases associated with connective tissue disease: an intra-individual comparison study

  • Chest
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Abstract

Objectives

To investigate the feasibility of low-dose CT (LDCT) with tin filtration and third-generation iterative reconstruction (IR) in evaluating interstitial lung diseases associated with connective tissue disease (CTD-ILD).

Methods

Fifty-three consecutive adult patients with CTD-ILD underwent regular-dose chest CT (RDCT) at 110 kVp followed by LDCT with tin-filtered 100 kVp. RDCT was reconstructed with filtered back projection (FBP) and advanced modeled iterative reconstruction (ADMIRE); LDCT was reconstructed with ADMIRE. Image noise, streak artifact, image quality, and visualization of normal and abnormal CT features were evaluated and compared among RDCT-ADMIRE, RDCT-FBP, and LDCT-ADMIRE groups.

Results

The mean radiation dose of LDCT was reduced to 20% of RDCT. Objective image noise of RDCT-ADMIRE (38.08 ± 6.37 HU), LDCT-ADMIRE (51.68 ± 9.06 HU), and RDCT-FBP (62.09 ± 10.95 HU) increased progressively (p < 0.001 in any two pairs). RDCT-ADMIRE significantly improved subjective image noise, streak artifact, and overall image quality compared with RDCT-FBP and LDCT-ADMIRE (all p < 0.001), while no significant difference was noted between the latter two groups. All abnormal lung structures were better scored in RDCT-ADMIRE compared with those in RDCT-FBP (all p < 0.001). LDCT-ADMIRE was inferior to RDCT-FBP in visualizing peripheral bronchi and vessels as well as reticulation (all p < 0.001); other normal and abnormal structures were similar between the two groups.

Conclusion

LDCT with tin filtration and third-generation IR was applicable in evaluating ILD lesions of CTD. Image quality was significantly improved after applying ADMIRE algorithm to CT protocols.

Key Points

• Optimization of CT radiation dose is a clinical concern in patients with connective tissue disease.

• Spectral shaping and third-generation iterative reconstruction emerge as promising techniques in reducing radiation dose and acquiring desired image quality of CTD-ILD patients.

• The third-generation iterative reconstruction algorithm can optimize visualization of ILD patterns in low-dose CT.

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Abbreviations

ADMIRE:

Advanced modeled iterative reconstruction

AP:

Anteroposterior

CT:

Computed tomography

CTD:

Connective tissue disease

CTD-ILD:

Interstitial lung diseases associated with connective tissue disease

CTDIvol :

Volume CT dose index

DLP:

Dose-length product

ED:

Effective radiation dose

FBP:

Filtered back projection

GGO:

Ground-glass opacities

HRCT:

High-resolution computed tomography

ILD:

Interstitial lung disease

IR:

Iterative reconstruction

LAT:

Lateral

LDCT:

Low-dose CT

RDCT:

Regular-dose chest CT

SAFIRE:

Sinogram-affirmed iterative reconstruction

SNR:

Signal-to-noise ratio

SSDEs:

Size-specific dose estimates

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Funding

This study was supported by the National Public Welfare Basic Scientific Research Project (2017PT32004).

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Authors and Affiliations

  1. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China

    Xiaoli Xu, Xin Sui, Lan Song, Yao Huang, Zhengyu Jin & Wei Song

  2. Siemens China, Beijing, China

    Yingqian Ge

Authors
  1. Xiaoli Xu
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  2. Xin Sui
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  3. Lan Song
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  4. Yao Huang
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  5. Yingqian Ge
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  6. Zhengyu Jin
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  7. Wei Song
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Corresponding authors

Correspondence to Xin Sui, Zhengyu Jin or Wei Song.

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Guarantor

The scientific guarantor of this publication is Zhengyu Jin.

Conflict of interest

Yingqian Ge is an employee of Siemens. She had no control on the study raw data and analysis.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all patients in this study.

Ethical approval

Institutional Review Board approval of Peking Union Medical College Hospital was obtained.

Methodology

• retrospective

• observational study

• performed at one institution

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Xu, X., Sui, X., Song, L. et al. Feasibility of low-dose CT with spectral shaping and third-generation iterative reconstruction in evaluating interstitial lung diseases associated with connective tissue disease: an intra-individual comparison study. Eur Radiol 29, 4529–4537 (2019). https://doi.org/10.1007/s00330-018-5969-y

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  • DOI: https://doi.org/10.1007/s00330-018-5969-y

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