2022年医学专题-SN100在胸部低剂量的应用

1、能谱纯化在胸部CT的应用Chest CT using spectral filtration 刘杰第一页，共二十五页。图像(t xin)120kV第二页，共二十五页。图像(t xin)70kV第三页，共二十五页。研究(ynji)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(fngmin)做对比辐射(fsh)剂量Radiation dose图像质量Image q

2、uality临床应用Clinical utility第四页，共二十五页。ALARA principleas low as reasonably achievableHow much dose reduction is reasonable？ VSa detailed assessment of interstitial lung diseasean examination performed for lung nodule detectionrequire a significantly higher dose研究(ynji)背景第五页，共二十五页。In 2014, a third-gener

3、ation dual-source CT system was introduced. 第三代双源CT问世This system features a tin filter, which can be positioned 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(ynji)来

4、证实研究(ynji)背景第六页，共二十五页。Key points Spectral filtration enables non-contrast chest CT with very high dose efficiency. This approach reduces CTDIvol, DLP, and SSDE (effective chest diameter 28 cm). Lung nodules, pneumonia, and pleural pathologies can be assessed with uncompromised confidence.关键点第七页，共二十五

5、页。1 点击(din j)添加标题25 non-contrast chest CT examinations acquired with spectral filtration (tin-filtered Sn100 kVp spectrum) 25 non-contrast chest CT examinations acquired without spectral filtration (120 kV).研究(ynji)方法实验组对照组图像质量(zhling)评估内容3.Contrast-to-noise-ratio (CNR) 4.figure-of-merit (FOM) 5.Dia

6、gnostic confidence1.Radiation metrics 2.Image noise 第八页，共二十五页。CT acquisition protocol研究(ynji)方法第九页，共二十五页。Statistical analysisMedCalc Software, Ostend, BelgiumKolmogorovSmirnov testMannWhitney testschi-square testP values0.05Kappa statistics所用(su yn)软件：所用(su yn)方法：柯尔莫可洛夫(lu f)-斯米洛夫(lu f)检验曼-惠特尼检验第十页，

7、共二十五页。Patient selection第十一页，共二十五页。Radiation metrics第十二页，共二十五页。Diagnostic confidence and motion artefacts 主观评价(pngji)内容pneumoniadiffuse parenchymal lung disease (e.g., emphysema, interstitial lung diseases)pulmonary nodulespleural pathologies (e.g., pneumothorax, pleural effusion, and pleural thicken

8、ing) osseous pathologies mediastinal abnormalities (e.g., mediastinal lymphadenopathy)第十三页，共二十五页。Subjective assessment of diagnostic condifence第十四页，共二十五页。Motion artefacts第十五页，共二十五页。minor cardiac motion artefactsmajor motion artefacts in the basal lungs第十六页，共二十五页。Picture a,b without tin-filterImage q

9、uality is comparable - despite a substantial dose reduction with tin filtration EXAMPLE第十七页，共二十五页。 Different pathologies are shown on non-contrast chest CT images acquired with spectral filtration on the novel third-generation dual-source CT system atypical pneumonia (a, b) lobar pneumonia (c, d)pul

10、monary nodules (f) pleural calcifications (e)第十八页，共二十五页。结论(jiln)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.第十九页，共二十五页。The prot

11、ocol appears suitable for lung cancer screening and for surveillance of incidentally detected lung nodules讨论(toln) & 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(ynji)也适用于肺癌患者的扫描与发现肺结节引申二：更适合(shh)儿童胸部CT（与儿童Flash序列做对比）第二十页，共二十五页。原理(yunl)第二十一页，共二十五页。1 点击添加(tin ji)标题1、这是一篇很常见的低剂量胸部文章2、时效性很强3、加入了对疾病应用范围的研究4、三种及三种以上的统计学方法 不平凡(pngfn)第二十二页，共二十五页。1 点击添加(tin ji)标题1、Sn100与常规胸片在发现肺部病变的能力2、Sn100在儿童中常规应用3、Sn100与Sn150在不同BMI下的应用探讨4、Sn100在鼻窦低剂量的应用 启发(qf)&疑惑第二十三页，共二十五页。THANKS ! 刘杰第二十四页，共二十五页。内容(nirng)