Francesco Macri1, Joel Greffier2, Elina Khasanova3, Pierre-Geraud Claret4, Sophie Bastide5, Ahmed Larbi2, Xavier Bobbia4, Fabricio R Pereira2, Jean-Emmanuel de la Coussaye4, Jean P Beregi2. 1. Department of Emergency and Trauma Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Radiology, Medical Imaging Group Nîmes, Centre Hospitalier Universitaire de Nîmes, University of Montpellier-Nîmes, Nîmes, France. Electronic address: francesco.macri@yahoo.it. 2. Department of Radiology, Medical Imaging Group Nîmes, Centre Hospitalier Universitaire de Nîmes, University of Montpellier-Nîmes, Nîmes, France. 3. Department of Emergency and Trauma Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Radiology, Medical Imaging Group Nîmes, Centre Hospitalier Universitaire de Nîmes, University of Montpellier-Nîmes, Nîmes, France. 4. Department of Emergency Care and Traumatology, Centre Hospitalier Universitaire de Nîmes, University of Montpellier-Nîmes, Nîmes, France. 5. Department of Biostatistics, Public Health, Epidemiology and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nîmes, University of Montpellier-Nîmes, Nîmes, France.
Abstract
STUDY OBJECTIVE: To evaluate the diagnostic performance of chest ultralow-dose computed tomography (CT) compared with chest radiograph for minor blunt thoracic trauma. METHODS: One hundred sixty patients with minor blunt thoracic trauma were evaluated first by chest radiograph and subsequently with a double-acquisition nonenhanced chest CT protocol: reference CT and ultralow-dose CT with iterative reconstruction. Two study radiologists independently assessed injuries with a structured report and subjective image quality and calculated certainty of diagnostic confidence level. RESULTS: Ultralow-dose CT had a sensitivity and specificity of 100% compared with reference CT in the detection of injuries (187 lesions) in 104 patients. Chest radiograph detected abnormalities in 82 patients (79% of the population), with lower sensitivity and specificity compared with ultralow-dose CT (P<.05). Despite an only fair interobserver agreement for ultralow-dose CT image quality (κ=0.26), the diagnostic confidence level was certain for 95.6% of patients (chest radiograph=79.3%). Ultralow-dose CT effective dose (0.203 mSv [SD 0.029 mSv]) was similar (P=.14) to that of chest radiograph (0.175 mSv [SD 0.155 mSv]) and significantly less (P<.001) than that of reference CT (1.193 mSv [SD 0.459 mSv]). CONCLUSION: Ultralow-dose CT with iterative reconstruction conveyed a radiation dose similar to that of chest radiograph and was more reliable than a radiographic study for minor blunt thoracic trauma assessment. Radiologists, regardless of experience with ultralow-dose CT, were more confident with chest ultralow-dose CT than chest radiograph.
STUDY OBJECTIVE: To evaluate the diagnostic performance of chest ultralow-dose computed tomography (CT) compared with chest radiograph for minor blunt thoracic trauma. METHODS: One hundred sixty patients with minor blunt thoracic trauma were evaluated first by chest radiograph and subsequently with a double-acquisition nonenhanced chest CT protocol: reference CT and ultralow-dose CT with iterative reconstruction. Two study radiologists independently assessed injuries with a structured report and subjective image quality and calculated certainty of diagnostic confidence level. RESULTS: Ultralow-dose CT had a sensitivity and specificity of 100% compared with reference CT in the detection of injuries (187 lesions) in 104 patients. Chest radiograph detected abnormalities in 82 patients (79% of the population), with lower sensitivity and specificity compared with ultralow-dose CT (P<.05). Despite an only fair interobserver agreement for ultralow-dose CT image quality (κ=0.26), the diagnostic confidence level was certain for 95.6% of patients (chest radiograph=79.3%). Ultralow-dose CT effective dose (0.203 mSv [SD 0.029 mSv]) was similar (P=.14) to that of chest radiograph (0.175 mSv [SD 0.155 mSv]) and significantly less (P<.001) than that of reference CT (1.193 mSv [SD 0.459 mSv]). CONCLUSION: Ultralow-dose CT with iterative reconstruction conveyed a radiation dose similar to that of chest radiograph and was more reliable than a radiographic study for minor blunt thoracic trauma assessment. Radiologists, regardless of experience with ultralow-dose CT, were more confident with chest ultralow-dose CT than chest radiograph.
Authors: Björg Kristjánsdóttir; Maria Taekker; Michael B Andersen; Lasse P Bentsen; Mikkel H Berntsen; Jan Dahlin; Maja L Fransen; Kristina Gosvig; Pernille W Greisen; Christian B Laursen; Bo Mussmann; Stefan Posth; Claus-Henrik Rasmussen; Hannes Sjölander; Ole Graumann Journal: Medicine (Baltimore) Date: 2022-08-05 Impact factor: 1.817