SN100在胸部低剂量的应用.pptx

Chest CT using spectral filtration 刘杰刘杰 2017.07.12 120kV120kV 70kV70kV To determine the radiation dose,image quality,and clinical utility of non-enhanced chest CT with spectral filtration.即即 将该新技术与普通胸部平扫在如下三方面做对比将该新技术与普通胸部平扫在如下三方面做对比 辐射剂量辐射剂量 Radiation dose 图像质量图像质量 Image quality 临床应用临床应用 Clinical utility ALARA principle as low as reasonably achievable How much dose reduction is reasonable？VS a detailed assessment of interstitial lung disease an examination performed for lung nodule detection require a significantly higher dose In 2014,a third-generation dual-source CT system was introduced.第三代双源第三代双源CT问世问世 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.用该研究来证实用该研究来证实 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.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).实验组实验组 对照组对照组 图像质量评估内容图像质量评估内容 3.Contrast-to-noise-ratio(CNR)4.figure-of-merit(FOM)5.Diagnostic confidence 1.Radiation metrics 2.Image noise CT acquisition protocol Statistical analysis MedCalc Software,Ostend,Belgium KolmogorovSmirnov test MannWhitney tests chi-square test P values0.05 Kappa statistics 所用软件：所用软件：所用方法：所用方法：柯尔莫可洛夫柯尔莫可洛夫-斯米洛夫检验斯米洛夫检验 曼曼-惠特尼检验惠特尼检验 Patient selection Radiation metrics Diagnostic confidence and motion artefacts 主观评价内容主观评价内容 pneumonia diffuse parenchymal lung disease(e.g.,emphysema,interstitial lung diseases)pulmonary nodules 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 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 pneumonia (a,b)lobar pneumonia (c,d)pulmonary nodules(f)pleural calcifications (e)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.The protocol appears suitable for lung cancer screening and for surveillance of incidentally detected lung nodules 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：更适合儿童胸部引申二：更适合儿童胸部CT（与儿童（与儿童Flash序列做对比）序列做对比）1、这是一篇很常见的低剂量胸部文章、这是一篇很常见的低剂量胸部文章 2、时效性很强、时效性很强 3、加入了对疾病应用范围的研究、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、三种及三种以上的统计学方法 1、Sn100与常规胸片在发现肺部病变的能力与常规胸片在发现肺部病变的能力 2、Sn100在儿童中常规应用在儿童中常规应用 3、Sn100与与Sn150在不同在不同BMI下的应用探讨下的应用探讨 4、Sn100在鼻窦低剂量的应用在鼻窦低剂量的应用 刘杰刘杰 2017.07.12