Chunhai Li1, Bo Liu1, Hong Meng1, Weiwei Lv1, Haipeng Jia2. 1. Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong Province 250012, China. 2. Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong Province 250012, China. Electronic address: phjia17@163.com.
Abstract
PURPOSE: To prospectively investigate efficacy and radiation dose of ultra-low-dose CT-guided percutaneous core needle biopsy (PCNB) at 100 kVp with tin filtration (100Sn kVp) for small pulmonary lesions. MATERIALS AND METHODS: Study enrolled and randomly assigned 210 patients to standard-dose CT (n = 70) or ultra-low-dose CT (n = 140; 1:2 randomization scheme) protocol. Standard-dose CT settings were reference 110 kVp and 50 mAs, and ultra-low-dose CT settings were fixed at 100Sn kVp and 70 mAs. All PCNBs in patients with small pulmonary lesions (< 3 cm) were performed on a third-generation dual-source CT scanner. Diagnostic performance, complication rate, image quality, and radiation dose were compared. RESULTS:Sensitivity, specificity, and accuracy for diagnosis of malignancy were 95.7%, 100%, and 96.9% with standard-dose CT and 93.8%, 100%, and 95.4% with ultra-low-dose CT (P > .05). Complication rate showed no significant differences between protocols (P > .05). Mean volume CT dose index) and total dose-length product were significantly lower in ultra-low-dose CT compared with standard-dose CT (0.24 mGy vs 3.3 mGy ± 1.1 and 9.84 mGy-cm ± 0.70 vs 110.5 mGy-cm ± 45.1; P < .001). Effective dose for ultra-low-dose CT was significantly lower than that for standard-dose CT (0.14 mSv ± 0.02 vs 1.78 mSv ± 0.76; -92.1%; P < .001). Image quality of ultra-low-dose CT met the requirements of PCNB. CONCLUSIONS:Ultra-low-dose CT-guided PCNB at 100Sn kVp spectral shaping significantly reduced radiation dose on a third-generation dual-source CT, while maintaining high diagnostic accuracy and safety for small pulmonary lesions.
RCT Entities:
PURPOSE: To prospectively investigate efficacy and radiation dose of ultra-low-dose CT-guided percutaneous core needle biopsy (PCNB) at 100 kVp with tin filtration (100Sn kVp) for small pulmonary lesions. MATERIALS AND METHODS: Study enrolled and randomly assigned 210 patients to standard-dose CT (n = 70) or ultra-low-dose CT (n = 140; 1:2 randomization scheme) protocol. Standard-dose CT settings were reference 110 kVp and 50 mAs, and ultra-low-dose CT settings were fixed at 100Sn kVp and 70 mAs. All PCNBs in patients with small pulmonary lesions (< 3 cm) were performed on a third-generation dual-source CT scanner. Diagnostic performance, complication rate, image quality, and radiation dose were compared. RESULTS: Sensitivity, specificity, and accuracy for diagnosis of malignancy were 95.7%, 100%, and 96.9% with standard-dose CT and 93.8%, 100%, and 95.4% with ultra-low-dose CT (P > .05). Complication rate showed no significant differences between protocols (P > .05). Mean volume CT dose index) and total dose-length product were significantly lower in ultra-low-dose CT compared with standard-dose CT (0.24 mGy vs 3.3 mGy ± 1.1 and 9.84 mGy-cm ± 0.70 vs 110.5 mGy-cm ± 45.1; P < .001). Effective dose for ultra-low-dose CT was significantly lower than that for standard-dose CT (0.14 mSv ± 0.02 vs 1.78 mSv ± 0.76; -92.1%; P < .001). Image quality of ultra-low-dose CT met the requirements of PCNB. CONCLUSIONS: Ultra-low-dose CT-guided PCNB at 100Sn kVp spectral shaping significantly reduced radiation dose on a third-generation dual-source CT, while maintaining high diagnostic accuracy and safety for small pulmonary lesions.
Authors: Bo Liu; Jie Fang; Haipeng Jia; Zhigang Sun; Jian Liao; Hong Meng; Fengmin Pan; Chunhai Li Journal: Thorac Cancer Date: 2019-05-01 Impact factor: 3.500