Very low-dose (0.15 mGy) chest CT protocols using the COPDGene 2 test object and a third-generation dual-source CT scanner with corresponding third-generation iterative reconstruction software.
Very low-dose (0.15 mGy) chest CT protocols using the COPDGene 2 test object and a third-generation dual-source CT scanner with corresponding third-generation iterative reconstruction software.
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DOI：
10.1097/rli.0000000000000093
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发表时间：
2015-01
影响因子：
6.7
通讯作者：
Hoffman EA
中科院分区：
文献类型：
--
作者：
Newell JD Jr;Fuld MK;Allmendinger T;Sieren JP;Chan KS;Guo J;Hoffman EA
本研究的目的是评价超低辐射剂量单能量计算机断层扫描（CT）采集与Sn预过滤和第三代迭代重建对基于密度的定量测量的影响，这些定量测量在表型肺部疾病中越来越受关注。使用COPDGene 2测试对象评价了降低剂量和不同体型对平均CT衰减测量的准确性和图像噪声（SD）水平的影响，该测试对象包含8种不同的感兴趣材料，从空气到丙烯酸，并包括各种密度的泡沫。使用运行高级建模迭代重建（ADMIRE）软件（Siemens Healthcare AG）的第三代双源多探测器CT扫描仪（Siemens SOMATOM FORCE; Siemens Healthcare AG，埃尔兰根，德国）。我们使用正常和非常大的体型环的剂量水平从1.5到0.15毫戈瑞使用频谱形状（0.6毫米锡）管输出的100千伏（p）。使用两个环在每个剂量水平下获得三次CT扫描。自动提取测试对象扫描中每种材料的感兴趣区域。使用加权滤波反投影（WFBP）在1.5 mGy下的每种材料的Hounsfield单位值用作参考值，以评价使用WFBP或ADMIRE在较低剂量水平下的CT衰减偏移。统计分析包括基本统计、Welch t检验、多变量协变模型（使用F检验评估解释（独立）变量对响应（因）变量的显著性）以及多变量协变模型（包括重建方法）中的CT平均衰减。平均CT衰减值的多变量回归分析显示，随着剂量的降低，ADMIRE和WFBP之间存在显著差异。与WFBP相比，ADMIRE具有更低的噪声和更稳定的CT衰减。环尺寸（P < 0.0001）和剂量水平（P <0.0001）对扫描材料的平均CT衰减值有很强的影响。对于所研究的特定材料，感兴趣区域中的体素数量没有表现出显著影响（P > 0.05）。在所有剂量水平和环尺寸下，ADMIRE的SD均低于WFBP（P < 0.05）。使用第三代迭代重建方法的第三代双源CT扫描仪可以在非常低的剂量水平（0.15 mGy）下获得准确的定量CT图像，并具有可接受的图像噪声。这为肺部CT表型的诊断和研究提供了新的机会，以开发新的治疗方法并增加对肺部疾病的了解。
The purpose of this study was to evaluate the impact of ultralow radiation dose single-energy computed tomographic (CT) acquisitions with Sn prefiltration and third-generation iterative reconstruction on density-based quantitative measures of growing interest in phenotyping pulmonary disease. The effects of both decreasing dose and different body habitus on the accuracy of the mean CT attenuation measurements and the level of image noise (SD) were evaluated using the COPDGene 2 test object, containing 8 different materials of interest ranging from air to acrylic and including various density foams. A third-generation dual-source multidetector CT scanner (Siemens SOMATOM FORCE; Siemens Healthcare AG, Erlangen, Germany) running advanced modeled iterative reconstruction (ADMIRE) software (Siemens Healthcare AG) was used. We used normal and very large body habitus rings at dose levels varying from 1.5 to 0.15 mGy using a spectral-shaped (0.6-mm Sn) tube output of 100 kV(p). Three CT scans were obtained at each dose level using both rings. Regions of interest for each material in the test object scans were automatically extracted. The Hounsfield unit values of each material using weighted filtered back projection (WFBP) at 1.5 mGy was used as the reference value to evaluate shifts in CT attenuation at lower dose levels using either WFBP or ADMIRE. Statistical analysis included basic statistics, Welch t tests, multivariable covariant model using the F test to assess the significance of the explanatory (independent) variables on the response (dependent) variable, and CT mean attenuation, in the multivariable covariant model including reconstruction method. Multivariable regression analysis of the mean CT attenuation values showed a significant difference with decreasing dose between ADMIRE and WFBP. The ADMIRE has reduced noise and more stable CT attenuation compared with WFBP. There was a strong effect on the mean CT attenuation values of the scanned materials for ring size (P < 0.0001) and dose level (P < 0.0001). The number of voxels in the region of interest for the particular material studied did not demonstrate a significant effect (P > 0.05). The SD was lower with ADMIRE compared with WFBP at all dose levels and ring sizes (P < 0.05). The third-generation dual-source CT scanners using third-generation iterative reconstruction methods can acquire accurate quantitative CT images with acceptable image noise at very low-dose levels (0.15 mGy). This opens up new diagnostic and research opportunities in CT phenotyping of the lung for developing new treatments and increased understanding of pulmonary disease.