Reduced-Dose Full-Body CT in Lymphoma Follow-up: A Pilot Study

Abstract

Background: How to reduce the radiation dose received from full-body CT scans during the follow-up of lymphoma patients is a concern. Objective: To investigate the image quality and radiation dose of reduced-dose full-body computerized tomography [CT] in lymphoma patients during follow-up. Methods: 121 patients were included and divided into conventional CT group [group 1, 120-kVp, n = 61] or reduced-dose CT group [group 2, 100-kVp combined dual-energy CT [DECT], n = 60]. 140-kVp polychromatic images and 70-keV monochromatic images were reconstructed from DECT. The abdominal virtual non-enhanced [VNE] images were reconstructed from monochromatic images. Two radiologists rated the overall image quality with a five-point scale and graded the depiction of lesions using a four-point scale. The objective image quality was evaluated using image noise, signal-to-noise ratio, contrast-to-noise ratio. The radiation dose and image quality were compared between groups. Results: The comparable subjective image quality was observed between 70-keV and 120-kVp images in the neck, while 120-kVp images showed better objective image quality. 70-keV images showed better objective image quality in the chest. While the subjective image quality of abdominal VNE images was inferior to that of true non-enhanced images, the improved objective image quality was observed in VNE images. In the abdominal arterial phase, similar subjective image quality was observed between groups. Abdominal 70-keV images in the arterial phase showed improved objective image quality. Similar image quality was obtained in the abdominal venous phase between groups. The effevtive radiation dose in group 2 showed a significant reduction. Conclusion: The application of reduced-dose full-body CT can significantly reduce the radiation dose for lymphoma patients during follow-up while maintaining or improving image quality.