Impact of Simulated Reduced-Dose Chest CT on Diagnosing Pulmonary T1 Tumors and Patient Management
Alan Arthur Peters,
Jaro Munz,
Jeremias Bendicht Klaus,
Ana Macek,
Adrian Thomas Huber,
Verena Carola Obmann,
Njood Alsaihati,
Ehsan Samei,
Waldo Valenzuela,
Andreas Christe,
Johannes Thomas Heverhagen,
Justin Bennion Solomon,
Lukas Ebner
Affiliations
Alan Arthur Peters
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Jaro Munz
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Jeremias Bendicht Klaus
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Ana Macek
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Adrian Thomas Huber
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Verena Carola Obmann
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Njood Alsaihati
Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA
Ehsan Samei
Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA
Waldo Valenzuela
Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
Andreas Christe
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Johannes Thomas Heverhagen
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
Justin Bennion Solomon
Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA
Lukas Ebner
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland
To determine the diagnostic performance of simulated reduced-dose chest CT scans regarding pulmonary T1 tumors and assess the potential impact on patient management, a repository of 218 patients with histologically proven pulmonary T1 tumors was used. Virtual reduced-dose images were simulated at 25%- and 5%-dose levels. Tumor size, attenuation, and localization were scored by two experienced chest radiologists. The impact on patient management was assessed by comparing hypothetical LungRADS scores. The study included 210 patients (41% females, mean age 64.5 ± 9.2 years) with 250 eligible T1 tumors. There were differences between the original and the 5%—but not the 25%—dose simulations, and LungRADS scores varied between the dose levels with no clear trend. Sensitivity of Reader 1 was significantly lower using the 5%-dose vs. 25%-dose vs. original dose for size categorization (0.80 vs. 0.85 vs. 0.84; p = 0.007) and segmental localization (0.81 vs. 0.86 vs. 0.83; p = 0.018). Sensitivities of Reader 2 were unaffected by a dose reduction. A CT dose reduction may affect the correct categorization and localization of pulmonary T1 tumors and potentially affect patient management.
