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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

General Research Article

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

Author(s): Renjun Huang, Jiulong Yan, Hongzhi Geng, Qiuyu Yu, Zongqiong Sun, Wenyan Liu, Ling Zhang*, Caixia Li* and Yonggang Li*

Volume 19, Issue 1, 2023

Published on: 27 July, 2022

Article ID: e160522204839 Pages: 14

DOI: 10.2174/1573405618666220516123155

Price: $65

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: The aim of the study was to investigate the image quality and radiation dose of reduced-dose full-body computerized tomography (CT) in lymphoma patients during the 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, and contrast-to-noise ratio. The radiation dose and image quality were compared between the 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 the 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 the groups. The effective 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 the follow-up while maintaining or improving the image quality.

Keywords: Tomography, X-ray computed, dual-energy, lymphoma, radiation dose, image quality.

Graphical Abstract

[1]
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin 2020; 70(1): 7-30.
[http://dx.doi.org/10.3322/caac.21590] [PMID: 31912902]
[2]
Crowley MP, O’Neill SB, Kevane B, et al. Ionizing radiation exposure as a result of diagnostic imaging in patients with lymphoma. Clin Transl Oncol 2016; 18(5): 533-6.
[http://dx.doi.org/10.1007/s12094-015-1394-8] [PMID: 26307754]
[3]
Riva E, Oliver C, Pérez MC, Telis O, Díaz L, Mikhael JR. Current imaging follow-up of non-Hodgkin lymphoma exposes patients to significant radiation but does not detect asymptomatic relapses. Leuk Lymphoma 2016; 57(6): 1363-6.
[http://dx.doi.org/10.3109/10428194.2015.1094694] [PMID: 26374395]
[4]
National Comprehensive Cancer Network. Treatment Guide: Classical Hodgkin lymphoma Follow-up Care (Version 2.2019). 2019. Available from: https://www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf (Accessed on January 9, 2021).
[5]
Wagner-Johnston ND, Bartlett NL. Role of routine imaging in lymphoma. J Natl Compr Canc Netw 2011; 9(5): 575-84.
[http://dx.doi.org/10.6004/jnccn.2011.0048] [PMID: 21550970]
[6]
Kang KW, Lee SR, Kim DS, et al. Lack of usefulness of computed tomography for surveillance in patients with aggressive non-Hodgkin lymphoma. PLoS One 2018; 13(2): e0192656.
[http://dx.doi.org/10.1371/journal.pone.0192656] [PMID: 29444176]
[7]
Schindera ST, Diedrichsen L, Müller HC, et al. Iterative reconstruction algorithm for abdominal multidetector CT at different tube voltages: Assessment of diagnostic accuracy, image quality, and radiation dose in a phantom study. Radiology 2011; 260(2): 454-62.
[http://dx.doi.org/10.1148/radiol.11102217] [PMID: 21493795]
[8]
Meng D, Cui X, Bai C, et al. Application of low-concentration contrast agents and low-tube-voltage computed tomography to chest enhancement examinations: A multicenter prospective study. Sci Prog 2020; 103(1): 36850419892193.
[http://dx.doi.org/10.1177/0036850419892193] [PMID: 31791209]
[9]
Hoang JK, Yoshizumi TT, Nguyen G, et al. Variation in tube voltage for adult neck MDCT: Effect on radiation dose and image quality. AJR Am J Roentgenol 2012; 198(3): 621-7.
[http://dx.doi.org/10.2214/AJR.11.6831] [PMID: 22358002]
[10]
Zaehringer C, Euler A, Karwacki GM, Hohmann J, Pansini M, Szucs-Farkas Z, et al. Manual adjustment of tube voltage from 120 to 100 kVp during abdominal CT in patients with body weights </=75 kg: Assessment of image quality and radiation dose in a prospective, randomised trial. Clinical radiology 2016; 71(6): 615 e1-.
[11]
Partovi S, Trischman T, Rafailidis V, et al. Multimodality imaging assessment of endoleaks post-endovascular aortic repair. Br J Radiol 2018; 91(1087): 20180013.
[http://dx.doi.org/10.1259/bjr.20180013] [PMID: 29658769]
[12]
Sun EX, Wortman JR, Uyeda JW, Lacson R, Sodickson AD. Virtual monoenergetic dual-energy CT for evaluation of hepatic and splenic lacerations. Emerg Radiol 2019; 26(4): 419-25.
[http://dx.doi.org/10.1007/s10140-019-01687-y] [PMID: 30963313]
[13]
Sauter AP, Shapira N, Kopp FK, et al. CTPA with a conventional CT at 100 kVp vs. a spectral-detector CT at 120 kVp: Comparison of radiation exposure, diagnostic performance and image quality. Eur J Radiol Open 2020; 7: 100234.
[http://dx.doi.org/10.1016/j.ejro.2020.100234] [PMID: 32420413]
[14]
Lv P, Zhou Z, Liu J, et al. Can virtual monochromatic images from dual-energy CT replace low-kVp images for abdominal contrast-enhanced CT in small- and medium-sized patients? Eur Radiol 2019; 29(6): 2878-89.
[http://dx.doi.org/10.1007/s00330-018-5850-z] [PMID: 30506223]
[15]
Lee S, Jung SE, Rha SE, Byun JY. Reducing radiation in CT urography for hematuria: Effect of using 100 kilovoltage protocol. Eur J Radiol 2012; 81(8): e830-4.
[http://dx.doi.org/10.1016/j.ejrad.2012.02.019] [PMID: 22565148]
[16]
Li J, Chen XY, Xu K, et al. Detection of insulinoma: One-stop pancreatic perfusion CT with calculated mean temporal images can replace the combination of bi-phasic plus perfusion scan. Eur Radiol 2020; 30(8): 4164-74.
[http://dx.doi.org/10.1007/s00330-020-06657-4] [PMID: 32189051]
[17]
Lam S, Gupta R, Levental M, Yu E, Curtin HD, Forghani R. Optimal virtual monochromatic images for evaluation of normal tissues and head and neck cancer using dual-energy CT. AJNR Am J Neuroradiol 2015; 36(8): 1518-24.
[http://dx.doi.org/10.3174/ajnr.A4314] [PMID: 26021623]
[18]
Bongartz GGS, Jurik AG, Leonardi M, et al. European guidelines on quality criteria for computed tomography. Rep EUR 1999; 1999: 16262.
[19]
American Association of Physicists in Medicine. The measurement, reporting, and management of radiation dose in CT: Report of AAPM Task Group 23 of the Diagnostic Imaging Council CT Committee. College Park, MD: AAPM 2008.
[20]
Tonkopi E, Ross AA, MacDonald A. JOURNAL CLUB: CT dose optimization for whole-body PET/CT examinations. AJR Am J Roentgenol 2013; 201(2): 257-63.
[http://dx.doi.org/10.2214/AJR.12.10495] [PMID: 23883207]
[21]
Schmidt D, Söderberg M, Nilsson M, Lindvall H, Christoffersen C, Leander P. Evaluation of image quality and radiation dose of abdominal dual-energy CT. Acta Radiol 2018; 59(7): 845-52.
[http://dx.doi.org/10.1177/0284185117732806] [PMID: 28927299]
[22]
Altenbernd J, Heusner TA, Ringelstein A, Ladd SC, Forsting M, Antoch G. Dual-energy-CT of hypervascular liver lesions in patients with HCC: Investigation of image quality and sensitivity. Eur Radiol 2011; 21(4): 738-43.
[http://dx.doi.org/10.1007/s00330-010-1964-7] [PMID: 20936520]
[23]
Yu L, Liu X, Leng S, et al. Radiation dose reduction in computed tomography: Techniques and future perspective. Imaging Med 2009; 1(1): 65-84.
[http://dx.doi.org/10.2217/iim.09.5] [PMID: 22308169]
[24]
D’Angelo T, Cicero G, Mazziotti S, et al. Dual energy computed tomography virtual monoenergetic imaging: Technique and clinical applications. Br J Radiol 2019; 92(1098): 20180546.
[http://dx.doi.org/10.1259/bjr.20180546] [PMID: 30919651]
[25]
Canellas R, Digumarthy S, Tabari A, et al. Radiation dose reduction in chest dual-energy computed tomography: Effect on image quality and diagnostic information. Radiol Bras 2018; 51(6): 377-84.
[http://dx.doi.org/10.1590/0100-3984.2017.0136] [PMID: 30559555]
[26]
Lv P, Lin XZ, Chen K, Gao J. Spectral CT in patients with small HCC: Investigation of image quality and diagnostic accuracy. Eur Radiol 2012; 22(10): 2117-24.
[http://dx.doi.org/10.1007/s00330-012-2485-3] [PMID: 22618521]
[27]
Walter SS, Schneeweiß S, Maurer M, et al. Virtual non-enhanced dual-energy CT reconstruction may replace true non-enhanced CT scans in the setting of suspected active hemorrhage. Eur J Radiol 2018; 109: 218-22.
[http://dx.doi.org/10.1016/j.ejrad.2018.10.026] [PMID: 30392950]
[28]
Kaza RK, Raff EA, Davenport MS, Khalatbari S. Variability of CT attenuation measurements in virtual unenhanced images generated using multimaterial decomposition from fast kilovoltage-switching dual-energy CT. Acad Radiol 2017; 24(3): 365-72.
[http://dx.doi.org/10.1016/j.acra.2016.09.002] [PMID: 27769822]
[29]
Matsumoto K, Jinzaki M, Tanami Y, Ueno A, Yamada M, Kuribayashi S. Virtual monochromatic spectral imaging with fast kilovoltage switching: Improved image quality as compared with that obtained with conventional 120-kVp CT. Radiology 2011; 259(1): 257-62.
[http://dx.doi.org/10.1148/radiol.11100978] [PMID: 21330561]
[30]
Wang XP, Wang B, Hou P, Li R, Gao JB. Screening and comparison of polychromatic and monochromatic image reconstruction of abdominal arterial energy spectrum CT. J Biol Regul Homeost Agents 2017; 31(1): 189-94.
[PMID: 28337891]

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