Ultra-high resolution CT imaging of interstitial lung disease: impact of photon-counting CT in 112 patients. - Université de Lille Accéder directement au contenu
Article Dans Une Revue European Radiology Année : 2023

Ultra-high resolution CT imaging of interstitial lung disease: impact of photon-counting CT in 112 patients.

Résumé

Objectives To compare lung parenchyma analysis on ultra-high resolution (UHR) images of a photon-counting CT (PCCT) scanner with that of high-resolution (HR) images of an energy-integrating detector CT (EID-CT). Methods A total of 112 patients with stable interstitial lung disease (ILD) were investigated (a) at T0 with HRCT on a 3rd-generation dual-source CT scanner; (b) at T1 with UHR on a PCCT scanner; (c) with a comparison of 1-mm-thick lung images. Results Despite a higher level of objective noise at T1 (74.1 ± 14.1 UH vs 38.1 ± 8.7 UH; p < 0.0001), higher qualitative scores were observed at T1 with (a) visualization of more distal bronchial divisions (median order; Q1–Q3) (T1: 10th division [9–10]; T0: 9th division [8–9]; p < 0.0001); (b) greater scores of sharpness of bronchial walls (p < 0.0001) and right major fissure (p < 0.0001). The scores of visualization of CT features of ILD were significantly superior at T1 (micronodules: p = 0.03; linear opacities, intralobular reticulation, bronchiectasis, bronchiolectasis, and honeycombing: p < 0.0001), leading to the reclassification of 4 patients with non-fibrotic ILD at T0, recognized with fibrotic ILD at T1. At T1, the mean (± SD) radiation dose (CTDI vol: 2.7 ± 0.5 mGy; DLP: 88.5 ± 21 mGy.cm) was significantly lower than that delivered at T0 (CTDI vol: 3.6 ± 0.9 mGy; DLP: 129.8 ± 31.7 mGy.cm) (p < 0.0001), corresponding to a mean reduction of 27% and 32% for the CTDIvol and DLP, respectively. Conclusions The UHR scanning mode of PCCT allowed a more precise depiction of CT features of ILDs and reclassification of ILD patterns with significant radiation dose reduction. Clinical relevance statement Evaluation of lung parenchymal structures with ultra-high-resolution makes subtle changes at the level of the secondary pulmonary lobules and lung microcirculation becoming visually accessible, opening new options for synergistic collaborations between highly-detailed morphology and artificial intelligence. Key Points • Photon-counting CT (PCCT) provides a more precise analysis of lung parenchymal structures and CT features of interstitial lung diseases (ILDs). • The UHR mode ensures a more precise delineation of fine fibrotic abnormalities with the potential of modifying the categorization of ILD patterns. • Better image quality at a lower radiation dose with PCCT opens new horizons for further dose reduction in noncontrast UHR examinations.
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Dates et versions

hal-04546868 , version 1 (15-04-2024)

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Citer

Yann Gaillandre, Alain Duhamel, Thomas Flohr, Jean-Baptiste Faivre, Suonita Khung, et al.. Ultra-high resolution CT imaging of interstitial lung disease: impact of photon-counting CT in 112 patients.. European Radiology, 2023, European Radiology, ⟨10.1007/s00330-023-09616-x⟩. ⟨hal-04546868⟩

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