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A new era of high-resolution CT diagnostics of the lung : improved image quality, detailed morphology, and reduced radiation dose with high-resolution photon-counting CT of the lungs compared to high-resolution energy-integrated CT

Aurumskjöld, Marie Louise LU ; Sjunnesson, Lotta ; Pistea, Adrian LU ; Ásbjörnsson, Gylfi ; Wellman, Fredrik LU and Bozovic, Gracijela LU (2024) In Acta Radiologica 65(10). p.1211-1221
Abstract

Background: High-resolution computed tomography (HRCT) is dependent on detailed morphology in diagnostic assessment of interstitial lung diseases. Photon-counting CT (PCCT) enables improved resolution while reducing radiation. Purpose: To compare if the image quality, detailed morphology, and radiation dose in HRCT of the lung improves with PCCT compared to energy-integrated CT (EICT). Material and Methods: HRCT with PCCT in patients with body mass index (BMI) from normal to obese, previously examined with different EICT were included. They were evaluated in a five-step scale for image quality according to Quality Criteria for CT (Diagnostic Requirement of the ImPACT group-European standardization). In addition, ground-glass opacities,... (More)

Background: High-resolution computed tomography (HRCT) is dependent on detailed morphology in diagnostic assessment of interstitial lung diseases. Photon-counting CT (PCCT) enables improved resolution while reducing radiation. Purpose: To compare if the image quality, detailed morphology, and radiation dose in HRCT of the lung improves with PCCT compared to energy-integrated CT (EICT). Material and Methods: HRCT with PCCT in patients with body mass index (BMI) from normal to obese, previously examined with different EICT were included. They were evaluated in a five-step scale for image quality according to Quality Criteria for CT (Diagnostic Requirement of the ImPACT group-European standardization). In addition, ground-glass opacities, bronchiectasis, emphysema, nodules, and subpleural detailed morphology (≤1 cm from the pleural border) were evaluated by three independent thoracic and/or pediatric radiologists. Visual grading characteristics (VGC) were used for comparison of image quality and detailed morphology and Fleiss kappa for intra-observer variability. Dose-length product (DLP) and CT dose index-volume (CTDIvol) were collected to calculate effective radiation dose. Results: HRCT with PCCT in 52 women and 48 men (mean age=67.2 ± 13.6 years; age range=27–87 years; BMI=26.9 kg/m2; range=18.6–45 kg/m2) previously examined with EICT (mean age=65.3 ± 13.6 years; age range=27–85 years; BMI=27 kg/m2; range=18.9–45 kg/m2) were included. There were significant differences in image quality for all entities in favor of PCCT. The radiation dose was reduced with PCCT by 47% in all, particularly pronounced in obese with 48.5%. Conclusion: Image quality, detailed morphology, and radiation dose, particularly in obese patients, were significantly improved in HRCT with PCCT compared to conventional EICT. The new technique enables visualization of subpleural structures.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
high resolution, High-resolution computed tomography, photon-counting computed tomography, radiation dose
in
Acta Radiologica
volume
65
issue
10
pages
11 pages
publisher
SAGE Publications
external identifiers
  • pmid:39161325
  • scopus:85201526779
ISSN
0284-1851
DOI
10.1177/02841851241269918
language
English
LU publication?
yes
id
68993565-5f9a-4e07-8525-6b59fd51664f
date added to LUP
2024-11-01 13:35:09
date last changed
2025-07-12 12:10:02
@article{68993565-5f9a-4e07-8525-6b59fd51664f,
  abstract     = {{<p>Background: High-resolution computed tomography (HRCT) is dependent on detailed morphology in diagnostic assessment of interstitial lung diseases. Photon-counting CT (PCCT) enables improved resolution while reducing radiation. Purpose: To compare if the image quality, detailed morphology, and radiation dose in HRCT of the lung improves with PCCT compared to energy-integrated CT (EICT). Material and Methods: HRCT with PCCT in patients with body mass index (BMI) from normal to obese, previously examined with different EICT were included. They were evaluated in a five-step scale for image quality according to Quality Criteria for CT (Diagnostic Requirement of the ImPACT group-European standardization). In addition, ground-glass opacities, bronchiectasis, emphysema, nodules, and subpleural detailed morphology (≤1 cm from the pleural border) were evaluated by three independent thoracic and/or pediatric radiologists. Visual grading characteristics (VGC) were used for comparison of image quality and detailed morphology and Fleiss kappa for intra-observer variability. Dose-length product (DLP) and CT dose index-volume (CTDI<sub>vol</sub>) were collected to calculate effective radiation dose. Results: HRCT with PCCT in 52 women and 48 men (mean age=67.2 ± 13.6 years; age range=27–87 years; BMI=26.9 kg/m<sup>2</sup>; range=18.6–45 kg/m<sup>2</sup>) previously examined with EICT (mean age=65.3 ± 13.6 years; age range=27–85 years; BMI=27 kg/m<sup>2</sup>; range=18.9–45 kg/m<sup>2</sup>) were included. There were significant differences in image quality for all entities in favor of PCCT. The radiation dose was reduced with PCCT by 47% in all, particularly pronounced in obese with 48.5%. Conclusion: Image quality, detailed morphology, and radiation dose, particularly in obese patients, were significantly improved in HRCT with PCCT compared to conventional EICT. The new technique enables visualization of subpleural structures.</p>}},
  author       = {{Aurumskjöld, Marie Louise and Sjunnesson, Lotta and Pistea, Adrian and Ásbjörnsson, Gylfi and Wellman, Fredrik and Bozovic, Gracijela}},
  issn         = {{0284-1851}},
  keywords     = {{high resolution; High-resolution computed tomography; photon-counting computed tomography; radiation dose}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1211--1221}},
  publisher    = {{SAGE Publications}},
  series       = {{Acta Radiologica}},
  title        = {{A new era of high-resolution CT diagnostics of the lung : improved image quality, detailed morphology, and reduced radiation dose with high-resolution photon-counting CT of the lungs compared to high-resolution energy-integrated CT}},
  url          = {{http://dx.doi.org/10.1177/02841851241269918}},
  doi          = {{10.1177/02841851241269918}},
  volume       = {{65}},
  year         = {{2024}},
}