Association of Focal Radiation Dose Adjusted on Cross Sections with Subsolid Nodule Visibility and Quantification on Computed Tomography Images Using AIDR 3D: Comparison Among Scanning at 84, 42, and 7 mAs

• Published in: Academic radiology Vol. 25; no. 9; pp. 1156 - 1166
• Main Authors: Nagatani, Yukihiro, Moriya, Hiroshi, Noma, Satoshi, Sato, Shigetaka, Tsukagoshi, Shinsuke, Yamashiro, Tsuneo, Koyama, Mitsuhiro, Tomiyama, Noriyuki, Ono, Yoshiharu, Murayama, Sadayuki, Murata, Kiyoshi
• Format: Journal Article
• Language: English
• Published: United States 01-09-2018
• Subjects: Aged; Aged, 80 and over; Female; Humans; Imaging, Three-Dimensional; Male; Middle Aged; Radiation Dosage; Radiographic Image Interpretation, Computer-Assisted - methods; Solitary Pulmonary Nodule - diagnostic imaging; Tomography, X-Ray Computed - methods; iterative reconstruction; Computed tomography; reduced radiation dose; subsolid nodule quantification; size-specific dose estimate
• ISSN: 1878-4046
• DOI: 10.1016/j.acra.2018.01.024

The objectives of this study were to compare the visibility and quantification of subsolid nodules (SSNs) on computed tomography (CT) using adaptive iterative dose reduction using three-dimensional processing between 7 and 42 mAs and to assess the association of size-specific dose estimate (SSDE) with relative measured value change between 7 and 84 mAs (RMVC
) and relative measured value change between 42 and 84 mAs (RMVC
).
As a Japanese multicenter research project (Area-detector Computed Tomography for the Investigation of Thoracic Diseases [ACTIve] study), 50 subjects underwent chest CT with 120 kV, 0.35 second per location and three tube currents: 240 mA (84 mAs), 120 mA (42 mAs), and 20 mA (7 mAs). Axial CT images were reconstructed using adaptive iterative dose reduction using three-dimensional processing. SSN visibility was assessed with three grades (1, obscure, to 3, definitely visible) using CT at 84 mAs as reference standard and compared between 7 and 42 mAs using t test. Dimension, mean CT density, and particular SSDE to the nodular center of 71 SSNs and volume of 58 SSNs (diameter >5 mm) were measured. Measured values (MVs) were compared using Wilcoxon signed-rank tests among CTs at three doses. Pearson correlation analyses were performed to assess the association of SSDE with RMVC
: 100 × (MV at 7 mAs - MV at 84 mAs)/MV at 84 mAs and RMVC
.
SSN visibilities were similar between 7 and 42 mAs (2.76 ± 0.45 vs 2.78 ± 0.40) (P = .67). For larger SSNs (>8 mm), MVs were similar among CTs at three doses (P > .05). For smaller SSNs (<8 mm), dimensions and volumes on CT at 7 mAs were larger and the mean CT density was smaller than 42 and 84 mAs, and SSDE had mild negative correlations with RMVC
(P < .05).
Comparable quantification was demonstrated irrespective of doses for larger SSNs. For smaller SSNs, nodular exaggerating effect associated with decreased SSDE on CT at 7 mAs compared to 84 mAs could result in comparable visibilities to CT at 42 mAs.