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1、刘杰 2017.07.12,图像,120kV,图像,70kV,研究目的,To determine the radiation dose, image quality, and clinical utility of non-enhanced chest CT with spectral filtration.,即 将该新技术与普通胸部平扫在如下三方面做对比,辐射剂量 Radiation dose,图像质量 Image quality,临床应用 Clinical utility,ALARA principle,as low as reasonably achievable,How much do
2、se reduction is reasonable？,VS,a detailed assessment of interstitial lung disease,an examination performed for lung nodule detection,require a significantly higher dose,研究背景,In 2014, a third-generation dual-source CT system was introduced. 第三代双源CT问世 This system features a tin filter, which can be po
3、sitioned in front of both X-ray tubes, and which absorbs primarily low-energy photons that contribute little to image quality but increase the dose of radiation that a patient receives. 用该研究来证实,研究背景,Key points Spectral filtration enables non-contrast chest CT with very high dose efficiency. This app
4、roach reduces CTDIvol, DLP, and SSDE (effective chest diameter 28 cm). Lung nodules, pneumonia, and pleural pathologies can be assessed with uncompromised confidence.,关键点,1,点击添加标题,25 non-contrast chest CT examinations acquired with spectral filtration (tin-filtered Sn100 kVp spectrum),25 non-contras
5、t chest CT examinations acquired without spectral filtration (120 kV).,研究方法,实验组,对照组,图像质量评估内容,3.Contrast-to-noise-ratio (CNR) 4.figure-of-merit (FOM) 5.Diagnostic confidence,1.Radiation metrics 2.Image noise,CT acquisition protocol,研究方法,Statistical analysis,MedCalc Software, Ostend, Belgium,Kolmogoro
6、vSmirnov test,MannWhitney tests,chi-square test,P values0.05,Kappa statistics,所用软件：,所用方法：,柯尔莫可洛夫-斯米洛夫检验,曼-惠特尼检验,Patient selection,Radiation metrics,Diagnostic confidence and motion artefacts 主观评价内容,pneumonia diffuse parenchymal lung disease (e.g., emphysema, interstitial lung diseases) pulmonary nod
7、ules pleural pathologies (e.g., pneumothorax, pleural effusion, and pleural thickening) osseous pathologies mediastinal abnormalities (e.g., mediastinal lymphadenopathy),Subjective assessment of diagnostic condifence,Motion artefacts,minor cardiac motion artefacts,major motion artefacts in the basal
8、 lungs,Picture a,b without tin-filter,Image quality is comparable - despite a substantial dose reduction with tin filtration,EXAMPLE,Different pathologies are shown on non-contrast chest CT images acquired with spectral filtration on the novel third-generation dual-source CT system,atypical pneumoni
9、a (a, b),lobar pneumonia (c, d),pulmonary nodules (f),pleural calcifications (e),结论,Despite increased image noise, spectral filtration CT provided sufficient diagnostic confidence for the assessment of pneumonia, pulmonary nodules, and pleural pathologies, while substantially reducing radiation dose
10、.,The protocol appears suitable for lung cancer screening and for surveillance of incidentally detected lung nodules,讨论 & 猜想,Although our study did not evaluate this technique in children, spectral filtration CT may also be of great interest for pediatric chest CT,引申一：该研究也适用于肺癌患者的扫描与发现肺结节,引申二：更适合儿童胸部CT（与儿童Flash序列做对比）,原理,1,点击添加标题,不平凡,1,点击添加标题,启发&疑惑,刘杰 2017.07.12,
