Lung cancer screening with ultra-low dose CT using full iterative reconstruction

Masayo Fujita, Toru Higaki, Yoshikazu Awaya, Toshio Nakanishi, Yuko Nakamura, Fuminari Tatsugami, Yasutaka Baba, Makoto Iida, Kazuo Awai
Japanese Journal of Radiology 2017, 35 (4): 179-189

PURPOSE: To investigate the diagnostic capability of ultra-low-dose CT (ULDCT) with full iterative reconstruction (f-IR) for lung cancer screening.

MATERIALS AND METHODS: All underwent ULDCT and/or low-dose CT (LD-CT) on a 320-detector scanner. ULDCT images were reconstructed with f-IR. We qualitatively and quantitatively studied 95 nodules in 69 subjects. Two radiologists classified the nodules on ULDCT images as solid-, part-solid-, and pure ground-glass (PGG) and recorded their mean size. Their findings were compared with the reference standard. The observer performance study included 7 other radiologists and 35 subjects with- and 15 without nodules. The results were analyzed by AFROC analysis.

RESULTS: In the qualitative study, the kappa values between observers 1 and 2, respectively, and the reference standard were 0.70 and 0.83; the intra-class correlation coefficients for the nodule diameter between the reference standard and their measurements were 0.84 and 0.90. The 95% confidence interval (CI) for the area under the curve (AUC) difference for nodule detection on LDCT and ULDCT was -0.03 to 0.07. The 95% CI crossed the 0 difference in the AUC but not the pre-defined non-inferiority margin of -0.08.

CONCLUSION: The diagnostic ability of ULDCT using f-IR is comparable to LDCT.

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