Science and Research

Photon Counting Computed Tomography with the Radiation Dose of a Chest X-Ray: Feasibility and Diagnostic Yield

INTRODUCTION: Photon counting (PC) detectors allow a reduction of the radiation dose in CT. Chest X-ray (CXR) is known to have a low sensitivity and specificity for detection of pneumonic infiltrates. The aims were to establish an ultra-low-dose CT (ULD-CT) protocol at a PC-CT with the radiation dose comparable to the dose of a CXR and to evaluate its clinical yield in patients with suspicion of pneumonia. METHODS: A ULD-CT protocol was established with the aim to meet the radiation dose of a CXR. In this retrospective study, all adult patients who received a ULD-CT of the chest with suspected pneumonia were included. Radiation exposure of ULD-CT and CXR was calculated. The clinical significance (new diagnosis, change of therapy, additional findings) and limitations were evaluated by a radiologist and a pulmonologist considering previous CXR and clinical data. RESULTS: Twenty-seven patients (70% male, mean age 68 years) were included. With our ULD-CT protocol, the radiation dose of a CXR could be reached (mean radiation exposure 0.11 mSv). With ULD-CT, the diagnosis changed in 11 patients (41%), there were relevant additional findings in 4 patients (15%), an infiltrate (particularly fungal infiltrate under immunosuppression) could be ruled out with certainty in 10 patients (37%), and the therapy changed in 10 patients (37%). Two patients required an additional CT with contrast medium to rule out a pulmonary embolism or pleural empyema. CONCLUSIONS: With ULD-CT, the radiation dose of a CXR could be reached while the clinical impact is higher with change in diagnosis in 41%.

  • Dettmer, S.
  • Werncke, T.
  • Mitkovska, V. N.
  • Brod, T.
  • Joean, O.
  • Vogel-Claussen, J.
  • Wacker, F.
  • Welte, T.
  • Rademacher, J.

Keywords

  • Community-acquired pneumonia
  • Photon counting computed tomography
  • Ultra-low-dose computed tomography
Publication details
DOI: 10.1159/000536065
Journal: Respiration
Pages: 1-7 
Work Type: Original
Location: BREATH
Disease Area: PALI, PLI
Partner / Member: MHH
Access-Number: 38272004

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