Regional Heterogeneity of Air Trapping at Expiratory Thin-Section CT of Patients with Bronchiolitis: Potential Implications for Dose Reduction and CT Protocol Planning

Bankier, Alexander A.; Mehrain, Sheida; Kienzl, Daniela; Weber, Michael; Estenne, Marc; Gevenois, Pierre Alain

doi:10.1148/radiol.2473071228

Cited by 17 publications

(10 citation statements)

References 31 publications

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“…However, both techniques allow only limited assessment of the lung 17 18. In this study, we employed another strategy: we decreased the sampling density of CT scans, thereby reducing the effective scan length and, consecutively, the radiation dose, as previously done by Bankier et al and de Jong et al for other indications 7 8. We could herein demonstrate an estimated dose reduction of more than 90% compared to standard HRCT while maintaining high sensitivity for ILD detection.…”

Section: Discussionmentioning

confidence: 80%

“…Various adjustments of acquisition settings have been assessed to reduce radiation, and lowering the tube current is the most widely employed adjustment setting in chest CT 6. Alternatively, a reduced CT scan protocol with a limited number of slices can also be used 7 8. However, this technique carries the risk that with the decrease in image numbers, abnormal findings remain undetected.…”

Section: Introductionmentioning

confidence: 99%

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Screening for interstitial lung disease in systemic sclerosis: the diagnostic accuracy of HRCT image series with high increment and reduced number of slices

et al. 2011

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Screening for interstitial lung disease in systemic sclerosis: the diagnostic accuracy of HRCT image series with high increment and reduced number of slices

et al. 2011

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“…A former prospective study by Winklehner et al showed that the use of a dedicated HRCT based on reduced sequential slices throughout the entire chest can detect lung fibrosis with a high diagnostic sensitivity and accuracy of both 94% with a very low radiation dose (28). Similar strategies with the aim of dose reduction in CT for other indications have also been performed by Bankier et al and de Jong et al (29,30). The advantage of a low sampling protocol is the very low radiation dose of less than 0.028 mSv, which is in the range of a chest X-ray (28).…”

Section: Introductionmentioning

confidence: 92%

The impact of slice-reduced computed tomography on histogram-based densitometry assessment of lung fibrosis in patients with systemic sclerosis

Nguyen-Kim¹,

Maurer²,

Suliman³

et al. 2018

J. Thorac. Dis.

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Background: To evaluate usability of slice-reduced sequential computed tomography (CT) compared to standard high-resolution CT (HRCT) in patients with systemic sclerosis (SSc) for qualitative and quantitative assessment of interstitial lung disease (ILD) with respect to (I) detection of lung parenchymal abnormalities, (II) qualitative and semiquantitative visual assessment, (III) quantification of ILD by histograms and (IV) accuracy for the 20%-cut off discrimination. Methods: From standard chest HRCT of 60 SSc patients sequential 9-slice-computed tomography (reduced HRCT) was retrospectively reconstructed. ILD was assessed by visual scoring and quantitative histogram parameters. Results from standard and reduced HRCT were compared using non-parametric tests and analysed by univariate linear regression analyses. Results: With respect to the detection of parenchymal abnormalities, only the detection of intrapulmonary bronchiectasis was significantly lower in reduced HRCT compared to standard HRCT (P=0.039). No differences were found comparing visual scores for fibrosis severity and extension from standard and reduced HRCT (P=0.051-0.073). All scores correlated significantly (P<0.001) to histogram parameters derived from both, standard and reduced HRCT. Significant higher values of kurtosis and skewness for reduced HRCT were found (both P<0.001). In contrast to standard HRCT histogram parameters from reduced HRCT showed significant discrimination at cut-off 20% fibrosis (sensitivity 88% kurtosis and skewness; specificity 81% kurtosis and 86% skewness; cut-off kurtosis ≤26, cut-off skewness ≤4; both P<0.001). Conclusions: Reduced HRCT is a robust method to assess lung fibrosis in SSc with minimal radiation dose with no difference in scoring assessment of lung fibrosis severity and extension in comparison to standard HRCT.In contrast to standard HRCT histogram parameters derived from the approach of reduced HRCT could discriminate at a threshold of 20% lung fibrosis with high sensitivity and specificity. Hence it might be used to detect early disease progression of lung fibrosis in context of monitoring and treatment of SSc patients.Keywords: Interstitial lung disease (ILD); reduced high-resolution computed tomography of the lung (reduced HRCT of the lung); histogram parameters from reduced high-resolution computed tomography (histogram parameters from reduced HRCT); systemic sclerosis (SSc)

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“…Second, calculation of relative area or volume requires a combination of several esti mates of lung area or volume, which is time consuming because of postpro cessing and possible cumulative errors in calculation. For quantification of small airways obstruction with paired inspiratory and expiratory CT scans, volumetric acquisition should be pre ferred to help overcome possible mis registration if sequential sections are used and to take into account the het erogeneity of air trapping (126).…”

Section: Quantification Of Small Airways Obstructionmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease: CT Quantification of Airways Disease

Hackx¹,

Bankier²,

Gevenois³

2012

Radiology

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Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality worldwide and results in substantial social and economic burdens. COPD is a heterogeneous disease with both extrapulmonary and pulmonary components. The pulmonary component is characterized by an airflow limitation that is not fully reversible. In the authors' opinion, none of the currently available classifications combining airflow limitation measurements with clinical parameters is sufficient to determine the prognosis and treatment of a particular patient with COPD. With regard to the causes of airflow limitation, CT can be used to quantify the two main contributions to COPD: emphysema, and small airways disease (a narrowing of the airways). CT quantification--with subsequent COPD phenotyping--can contribute to improved patient care, assessment of COPD progression, and identification of severe COPD with increasing risk of mortality. Small airways disease can be quantified through measurements reflecting morphology, quantification of obstruction, and changes in airways walls. This article details these three approaches and concludes with perspectives and directions for further research.

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Regional Heterogeneity of Air Trapping at Expiratory Thin-Section CT of Patients with Bronchiolitis: Potential Implications for Dose Reduction and CT Protocol Planning

Abstract: The regional distribution of the extent of air trapping in suspected or overt bronchiolitis is heterogeneous. Because the extent of air trapping can depend on the examination protocol, identical protocols are needed when air trapping is being compared within and between patients.

Cited by 17 publications

References 31 publications

Screening for interstitial lung disease in systemic sclerosis: the diagnostic accuracy of HRCT image series with high increment and reduced number of slices

Screening for interstitial lung disease in systemic sclerosis: the diagnostic accuracy of HRCT image series with high increment and reduced number of slices

The impact of slice-reduced computed tomography on histogram-based densitometry assessment of lung fibrosis in patients with systemic sclerosis

Chronic Obstructive Pulmonary Disease: CT Quantification of Airways Disease

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