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首页> 外文期刊>Investigative radiology >Model-based iterative reconstruction technique for ultralow-dose chest CT: Comparison of pulmonary nodule detectability with the adaptive statistical iterative reconstruction technique
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Model-based iterative reconstruction technique for ultralow-dose chest CT: Comparison of pulmonary nodule detectability with the adaptive statistical iterative reconstruction technique

机译：低剂量胸部CT基于模型的迭代重建技术：肺结节可检测性与自适应统计迭代重建技术的比较

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PURPOSE: The purpose of this study was to evaluate whether model-based iterative reconstruction (MBIR) enables dose reduction over adaptive iterative reconstruction (ASIR) while maintaining diagnostic performance. METHODS: In this institutional review board-approved and Health Insurance Portability and Accountability Act-compliant study, 59 patients (mean [SD] age, 64.7 [13.4] years) gave informed consent to undergo reference-, low-, and ultralow-dose chest computed tomography (CT) with 64-row multidetector CT. The reference- and low-dose CT involved the use of automatic tube current modulation with fixed noise indices (31.5 and 70.44 at 0.625 mm, respectively) and were reconstructed with 50% ASIR-filtered back projection blending. The ultralow-dose CT was acquired with a fixed tube current-time product of 5 mA s and reconstructed with MBIR. Two radiologists evaluated 2.5- and 0.625-mm-slice-thick axial images from low-dose ASIR and ultralow-dose MBIR, recorded the pattern of each nodule candidate, and assigned each a confidence score. A reference standard was established by a consensus panel of 2 different radiologists, who identified 84 noncalcified nodules with diameters of 4 mm or greater on reference-dose ASIR (ground-glass opacity, n = 18; partly solid, n = 11; solid, n = 55). Sensitivity in nodule detection was assessed using the McNemar test. Jackknife alternative free-response receiver operating characteristic (JAFROC) analysis was applied to assess the results including confidence scores. RESULTS: Compared with the low-dose CT, a 78.1% decrease in dose-length product was seen with the ultralow-dose CT. No significant differences were observed between the low-dose ASIR and the ultralow-dose MBIR for overall nodule detection in sensitivity (P = 0.48-0.69) or the JAFROC analysis (P = 0.57). Likewise, no significant differences were seen for ground-glass opacity, partly solid, or solid nodule detection in sensitivity (P = 0.08-0.65) or the JAFROC analysis (P = 0.21-0.90). CONCLUSIONS: Model-based iterative reconstruction enables nearly an 80% reduction in radiation dose for chest CT from a low-dose level to an ultralow-dose level, without affecting nodule detectability.
机译：目的：本研究的目的是评估基于模型的迭代重建（MBIR）是否能够在保持诊断性能的同时，使剂量减少超过自适应迭代重建（ASIR）。方法：在该机构审查委员会批准的且符合《健康保险携带与责任法案》的研究中，有59例患者（平均[SD]年龄，64.7 [13.4]岁）知情同意接受参考，低剂量和超低剂量治疗胸部计算机断层扫描（CT）和64行多探测器CT。参考剂量和低剂量CT涉及使用具有固定噪声指数（分别在0.625 mm处分别为31.5和70.44）的自动管电流调制，并通过50％ASIR滤波的反投影混合重建。超低剂量CT使用固定的5 mA s的管电流时间乘积获取，并用MBIR重建。两位放射科医生评估了来自低剂量ASIR和超低剂量MBIR的2.5毫米和0.625毫米切片厚度的轴向图像，记录了每个结节候选者的模式，并为每个患者分配了置信度评分。由2位不同放射线医师组成的共识小组建立了参考标准，他们确定了84个直径为4 mm或更大的非钙化结节，其参考剂量为ASIR（玻璃杯混浊，n = 18;部分为固态，n = 11;固态， n = 55）。结节检测的敏感性使用McNemar测试进行评估。使用折刀替代性自由响应接收机工作特性（JAFROC）分析来评估结果，包括置信度得分。结果：与低剂量CT相比，超低剂量CT的剂量长度乘积减少了78.1％。低剂量ASIR和超低剂量MBIR在总结节检测灵敏度（P = 0.48-0.69）或JAFROC分析（P = 0.57）之间没有观察到显着差异。同样，对于毛玻璃的不透明性，部分固体或固体结节检测的敏感性（P = 0.08-0.65）或JAFROC分析（P = 0.21-0.90）也没有显着差异。结论：基于模型的迭代重建可将胸部CT的放射剂量从低剂量水平降低到超低剂量水平，减少近80％，而不会影响结节的可检测性。

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