SU-D-217BCD-04: How Do We Know How Low Can We Go in Lung Cancer Screening CT?

Medical Physics
L ChenCynthia H McCollough

Abstract

To demonstrate a technique for determining the acceptable radiation dose level for lung cancer screening CT. 20 patients who underwent a clinically indicated routine chest CT scan with 120 kV and 180 quality reference mAs were enrolled in this IRB approved study. Automatic exposure control was used to adjust for patient size. Scanner output, as expressed in CTDIvol, varied accordingly (mean=16.8 mGy, range=7.6 to 26.6 mGy). A previously validated noise insertion software tool developed in our lab was used to simulate scans acquired with reduced dose levels (12.5%, 25%, 50% of the original dose level). Images reconstructed from the same raw data but at the original and simulated, reduced dose levels were randomized and blindly reviewed by three thoracic radiologists. Lung and soft tissue regions were graded for two different imaging tasks: 1) routine diagnostic CT exam of the chest and 2) screening exam of the chest for lung cancer. A 5 point scale was used to rate each exam for each task (1=too noisy, significantly impacted confidence to 5=excellent quality, excellent confidence). Exams were considered acceptable when at least two of the three radiologists gave a score of 3 or higher. The percentage of patients meeting this def...Continue Reading

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