2022年医学专题—SN100在胸部低剂量的应用(1).pptx

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 quality,临床应用Clinical utility,第四页，共二十五页。,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,研究(ynji)背景,第五页，共二十五页。,In 2014,a third-generation 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.Diagnostic confidence,1.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 analysis,MedCalc Software,Ostend,Belgium,KolmogorovSmirnov test,MannWhitney tests,chi-square test,P values0.05,Kappa 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，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 thickening)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 artefacts,major motion artefacts in the basal lungs,第十六页，共二十五页。,Picture a,b without tin-filter,Image quality 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),pulmonary 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 protocol 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,不平凡(pngfn),第二十二页，共二十五页。,1,点击添加(tin ji)标题,启发(qf)&疑惑,第二十三页，共二十五页。,刘杰,第二十四页，共二十五页。,内容(nirng)总结,能谱纯化在胸部(xin b)CT的应用。2017.07.12。interstitial lung disease。an examination performed。(tin-filtered Sn100 kVp spectrum)。CT acquisition protocol。引申二：更适合儿童胸部(xin b)CT（与儿童Flash序列做对比）,第二十五页，共二十五页。,