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European Radiology

, Volume 29, Issue 12, pp 6858–6866 | Cite as

Wide-volume versus helical acquisition in unenhanced chest CT: prospective intra-patient comparison of diagnostic accuracy and radiation dose in an ultra-low-dose setting

  • Elsa Meyer
  • Aissam Labani
  • Mickaël Schaeffer
  • Mi-Young Jeung
  • Claire Ludes
  • Alain Meyer
  • Catherine Roy
  • Pierre Leyendecker
  • Mickaël OhanaEmail author
Chest
  • 67 Downloads

Abstract

Objectives

Diagnostic performance and potential radiation dose reduction of wide-area detector CT sequential acquisition (“wide-volume” acquisition (WV)) in unenhanced chest examination are unknown. This study aims to assess the image quality, the diagnostic performance, and the radiation dose reduction of WV mode compared with the classical helical acquisition for lung parenchyma analysis in an ultra-low-dose (ULD) protocol.

Methods

After Institutional Review Board Approval and written informed consent, 64 patients (72% men; 67.6 ± 9.7 years old; BMI 26.1 ± 5.3 kg/m2) referred for a clinically indicated unenhanced chest CT were prospectively included. All patients underwent, in addition to a standard helical acquisition (120 kV, automatic tube current modulation), two ULD acquisitions (135 kV, fixed tube current at 10 mA): one in helical mode and one in WV mode. Image noise, subjective image quality (5-level Likert scale), and diagnostic performance for the detection of 9 predetermined parenchymal abnormalities were assessed by two radiologists and compared using the chi-square or Fisher non-parametric tests.

Results

Subjective image quality (4.2 ± 0.7 versus 4.2 ± 0.8, p = 0.56), image noise (41.7 ± 8 versus 40.9 ± 8.7, p = 0.3), and diagnostic performance were equivalent between ULD WV and ULD helical. Radiation dose was significantly lower for the ULD WV acquisition (mean dose-length product 14.1 ± 1.3 mGy cm versus 15.8 ± 1.3, p < 0.0001).

Conclusion

An additional 11% dose reduction is achieved with the WV mode in ULD chest CT with fixed tube current, with equivalent image quality and diagnostic performance when compared with the helical acquisition.

Key Points

• Image quality and diagnostic performance of ultra-low-dose unenhanced chest CT are identical between wide-volume mode and the reference helical acquisition.

• Wide-volume mode allows an additional radiation dose reduction of 11% (mean dose-length product 14.1 ± 1.3 mGy cm versus 15.8 ± 1.3, p < 0.0001).

Keywords

Multidetector computed tomography Radiation dosage Helical computed tomography Lung 

Abbreviations

ALARA

As Low As Reasonably Achievable

BMI

Body mass index

CT

Computed tomography

DLP

Dose-length product

ROI

Region of interest

SD

Standard deviation

ULD

Ultra-low dose

WV

Wide-volume

Notes

Acknowledgments

The authors would like to thank Mr. Karim Haioun for his help in implementing the technical aspects of this study.

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Mickaël Ohana.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise: Dr. Mickaël Schaeffer is a biostatistician.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Prospective

• Case-control study

• Performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Radiology DepartmentNouvel Hôpital CivilStrasbourgFrance
  2. 2.Physiology DepartmentNouvel Hôpital CivilStrasbourgFrance
  3. 3.ICube LaboratoryIllkirch GraffenstadenFrance

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