TY - JOUR
T1 - CT patterns of fungal pulmonary infections of the lung
T2 - Comparison of standard-dose and simulated low-dose CT
AU - Christe, Andreas
AU - Lin, Margaret C.
AU - Yen, Andrew C.
AU - Hallett, Rich L.
AU - Roychoudhury, Kingshuk
AU - Schmitzberger, Florian
AU - Fleischmann, Dominik
AU - Leung, Ann N.
AU - Rubin, Geoffry D.
AU - Vock, Peter
AU - Roos, Justus E.
N1 - Funding Information:
This study was financially supported by the Swiss National Science Foundation (SSMBS, Patronage of Swiss Academy of Medical Sciences), NIH RO1 CA109089, GE healthcare, Guerbet AG and Bracco Switzerland. Special thanks to the Department of Radiology at Stanford University for providing the tremendous infrastructure and manpower.
PY - 2012/10
Y1 - 2012/10
N2 - Purpose: To assess the effect of radiation dose reduction on the appearance and visual quantification of specific CT patterns of fungal infection in immuno-compromised patients. Materials and methods: Raw data of thoracic CT scans (64 × 0.75 mm, 120 kVp, 300 reference mAs) from 41 consecutive patients with clinical suspicion of pulmonary fungal infection were collected. In 32 patients fungal infection could be proven (median age of 55.5 years, range 35-83). A total of 267 cuboids showing CT patterns of fungal infection and 27 cubes having no disease were reconstructed at the original and 6 simulated tube currents of 100, 40, 30, 20, 10, and 5 reference mAs. Eight specific fungal CT patterns were analyzed by three radiologists: 76 ground glass opacities, 42 ground glass nodules, 51 mixed, part solid, part ground glass nodules, 36 solid nodules, 5 lobulated nodules, 6 spiculated nodules, 14 cavitary nodules, and 37 foci of air-space disease. The standard of reference was a consensus subjective interpretation by experts whom were not readers in the study. Results: The mean sensitivity and standard deviation for detecting pathological cuboids/disease using standard dose CT was 0.91 ± 0.07. Decreasing dose did not affect sensitivity significantly until the lowest dose level of 5 mAs (0.87 ± 0.10, p = 0.012). Nodular pattern discrimination was impaired below the dose level of 30 reference mAs: specificity for fungal 'mixed nodules' decreased significantly at 20, 10 and 5 reference mAs (p < 0.05). At lower dose levels, classification drifted from 'solid' to 'mixed nodule', although no lesion was missed. Conclusion: Our simulation data suggest that tube current levels can be reduced from 300 to 30 reference mAs without impairing the diagnostic information of specific CT patterns of pulmonary fungal infections.
AB - Purpose: To assess the effect of radiation dose reduction on the appearance and visual quantification of specific CT patterns of fungal infection in immuno-compromised patients. Materials and methods: Raw data of thoracic CT scans (64 × 0.75 mm, 120 kVp, 300 reference mAs) from 41 consecutive patients with clinical suspicion of pulmonary fungal infection were collected. In 32 patients fungal infection could be proven (median age of 55.5 years, range 35-83). A total of 267 cuboids showing CT patterns of fungal infection and 27 cubes having no disease were reconstructed at the original and 6 simulated tube currents of 100, 40, 30, 20, 10, and 5 reference mAs. Eight specific fungal CT patterns were analyzed by three radiologists: 76 ground glass opacities, 42 ground glass nodules, 51 mixed, part solid, part ground glass nodules, 36 solid nodules, 5 lobulated nodules, 6 spiculated nodules, 14 cavitary nodules, and 37 foci of air-space disease. The standard of reference was a consensus subjective interpretation by experts whom were not readers in the study. Results: The mean sensitivity and standard deviation for detecting pathological cuboids/disease using standard dose CT was 0.91 ± 0.07. Decreasing dose did not affect sensitivity significantly until the lowest dose level of 5 mAs (0.87 ± 0.10, p = 0.012). Nodular pattern discrimination was impaired below the dose level of 30 reference mAs: specificity for fungal 'mixed nodules' decreased significantly at 20, 10 and 5 reference mAs (p < 0.05). At lower dose levels, classification drifted from 'solid' to 'mixed nodule', although no lesion was missed. Conclusion: Our simulation data suggest that tube current levels can be reduced from 300 to 30 reference mAs without impairing the diagnostic information of specific CT patterns of pulmonary fungal infections.
KW - CT patterns
KW - Fungal pulmonary infection
KW - Low-dose thoracic CT
KW - Radiation dose reduction
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U2 - 10.1016/j.ejrad.2011.06.059
DO - 10.1016/j.ejrad.2011.06.059
M3 - Article
C2 - 21835569
AN - SCOPUS:84865239107
SN - 0720-048X
VL - 81
SP - 2860
EP - 2866
JO - European Journal of Radiology
JF - European Journal of Radiology
IS - 10
ER -