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Thoracic Imaging |
1 From the Institute of Clinical Radiology (S.D., H.L., R.W., Z.P., S.H., T.K., M.E., N.R., P.E.P.) and the Gerhard Do- magk Institute of Pathology (T.M.Y.), University of Münster, Albert-Schweitzer-Str 33, D-48129 Münster, Germany. Received September 30, 1998; revision requested November 17; revision received January 14, 1999; accepted April 15. Address reprint requests to S.D. (e-mail: diestef@uni-muenster.de).
PURPOSE: To compare the number of pulmonary nodules detected at helical low- and standard-dose computed tomography (CT) and to investigate the diagnostic value of low-dose CT with a radiation exposure equivalent to that used at chest radiography.
MATERIALS AND METHODS: Two radiologists recorded pulmonary nodules at standard-dose (250 or 100 mA, pitch of 1; 200 mA, pitch of 2) or low-dose CT (50 or 25 mA, pitch of 1 or 2) in five postmortem specimens and 75 patients. Nodules were assessed by size (5 mm or smaller, 6–10 mm, or larger than 10 mm) and by diagnostic confidence ("definite nodule," "definite lesion, not classic nodule," or "questionable lesion, possibly representing a vessel") with the Wilcoxon signed rank test. Artifacts depicted at low-dose CT were recorded.
RESULTS: There were no statistically significant differences in the number of nodules detected at standard- or low-dose CT except in nodules 5 mm or smaller that were assessed as definite nodules at standard- or low-dose CT (25 mA, pitch of 2) (472 vs 397, P < .05). Artifacts that possibly interfered with nodule detection were observed exclusively at CT with 25 mA and a pitch of 2.
CONCLUSION: Pulmonary nodules were detected reliably at CT with 50 mA and pitch of 2 or with 25 mA and a pitch of 1. However, further reduction of the dose to that used at chest radiography was associated with a significant decrease in the number of nodules 5 mm or smaller that were detected, possibly due to artifacts.
Index terms: Computed tomography (CT), comparative studies, 60.12115 • Computed tomography (CT), experimental studies, 60.12115 • Computed tomography (CT), radiation exposure, 60.12115, 60.47 • Lung, nodule, 60.281 • Lung neoplasms, CT, 60.12115, 60.281 • Lung neoplasms, diagnosis, 60.281
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