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Burgard, Caroline Alexandra; Gaass, Thomas; Bonert, Madeleine; Bondesson, David; Thaens, Natalie; Reiser, Maximilian Ferdinand; Dinkel, Julien (2018): Detection of artificial pulmonary lung nodules in ultralow-dose CT using an ex vivo lung phantom.
In: PLOS One 13(1), e0190501
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Abstract

Objectives To assess the image quality of 3 different ultralow-dose CT protocols on pulmonary nodule depiction in a ventilated ex vivo-system. Materials and methods Four porcine lungs were inflated inside a dedicated chest phantom and prepared with n = 195 artificial nodules (0.5-1 mL). The artificial chest wall was filled with water to simulate the absorption of a human chest. Images were acquired with a 2x192-row detector CT using low-dose (reference protocol with a tube voltage of 120 kV) and 3 different ULD protocols (respective effective doses: 1 mSv and 0.1 mSv). A different tube voltage was used for each ULD protocol: 70kV, 100kV with tin filter (100kV_Sn) and 150kV with tin filter (150kV_Sn). Nodule delineation was assessed by two observers (scores 1-5, 1 = unsure, 5 = high confidence). Results The diameter of the 195 detected artificial nodules ranged from 0.9-21.5 mm (mean 7.84 mm +/- 5.31). The best ULD scores were achieved using 100kV_Sn and 70 kV ULD protocols (4.14 and 4.06 respectively). Both protocols were not significantly different (p = 0.244). The mean score of 3.78 in ULD 150kV_Sn was significantly lower compared to the 100kV_Sn ULD protocol (p = 0.008). Conclusion The results of this experiment, conducted in a realistic setting show the feasibility of ultralow-dose CT for the detection of pulmonary nodules.