能谱纯化在胸部CT的应用ChestCTusingspectralfiltration刘杰2022.07.12第一页，共二十五页。图像120kV第二页，共二十五页。图像70kV第三页，共二十五页。研究目的Todeterminetheradiationdose,imagequality,andclinicalutilityofnon-enhancedchestCTwithspectralfiltration.即将该新技术与普通胸部平扫在如下三方面做比照辐射剂量Radiationdose图像质量Imagequality临床应用Clinicalutility第四页，共二十五页。ALARAprincipleaslowasreasonablyachievableHowmuchdosereductionisreasonable？VSadetailedassessmentofinterstitiallungdiseaseanexaminationperformedforlungnoduledetectionrequireasignificantlyhigherdose研究背景第五页，共二十五页。In2022,athird-generationdual-sourceCTsystemwasintroduced.第三代双源CT问世Thissystemfeaturesatinfilter,whichcanbepositionedinfrontofbothX-raytubes,andwhichabsorbsprimarilylow-energyphotonsthatcontributelittletoimagequalitybutincreasethedoseofradiationthatapatientreceives.用该研究来证实研究背景第六页，共二十五页。Keypoints•Spectralfiltrationenablesnon-contrastchestCTwithveryhighdoseefficiency.•ThisapproachreducesCTDIvol,DLP,andSSDE(effectivechestdiameter28cm).•Lungnodules,pneumonia,andpleuralpathologiescanbeassessedwithuncompromisedconfidence.关键点第七页，共二十五页。25non-contrastchestCTexaminationsacquiredwithspectralfiltration(tin-filteredSn100kVpspectrum)25non-contrastchestCTexaminationsacquiredwithoutspectralfiltration(120kV).研究方法实验组对照组图像质量评估内容3.Contrast-to-noise-ratio(CNR)4.figure-of-merit(FOM)5.Diagnosticconfidence1.Radiationmetrics2.Imagenoise第八页，共二十五页。CTacquisitionprotocol研究方法第九页，共二十五页。StatisticalanalysisMedCalcSoftware,Ostend,BelgiumKolmogorov–SmirnovtestMann–Whitneytestschi-squaretestPvalues<0.05Kappastatistics所用软件：所用方法：柯尔莫可洛夫-斯米洛夫检验曼-惠特尼检验第十页，共二十五页。Patientselection第十一页，共二十五页。Radiationmetrics第十二页，共二十五页。Diagnosticconfidenceandmotionartefacts——主观评价内容pneumoniadiffuseparenchymallungdisease(e.g.,emphysema,interstitiallungdiseases)pulmonarynodulespleuralpathologies(e.g.,pneumothorax,pleuraleffusion,andpleuralthickening)osseouspathologiesmediastinalabnormalities(e.g.,mediastinallymphadenopathy)第十三页，共二十五页。Subjectiveassessmentofdiagnosticcondifence第十四页，共二十五页。Motionartefacts第十五页，共二十五页。minorcardiacmotionartefactsmajormotionartefactsinthebasallungs第十六页，共二十五页。Picturea,bwithouttin-filterImagequalityiscomparable---despiteasubstantialdosereductionwithtinfiltrationEXAMPLE第十七页，共二十五页。Differentpathologiesareshownonnon-contrastchestCTimagesacquiredwithspectralfiltrationonthenovelthird-generationdual-sourceCTsystematypicalpneumonia(a,b)lobarpneumonia(c,d)pulmonarynodules(f)pleuralcalcifications(e)第十八页，共二十五页。结论Despiteincreasedimagenoise,spectralfiltrationCTprovidedsufficientdiagnosticconfidencefortheassessmentofpneumonia,pulmonarynodules,andpleuralpathologies,whilesubstantiallyreducingradiationdose.第十九页，共二十五页。Theprotocolappearssuitableforlungcancerscreeningandforsurveillanceofincidentallydetectedlungnodules讨论&猜测Althoughourstudydidnotevaluatethistechniqueinchildren,spectralfiltrationCTmayalsobeofgreatinterestforpediatricchestCT引申一：该研究也适用于肺癌患者的扫描与发现肺结节引申二：更适合儿童胸部CT〔与儿童Flash序列做比照〕第二十页，共二十五页。原理第二十一页，共二十五页。1、这是一篇很常见的低剂量胸部文章2、时效性很强3、加入了对疾病应用范围的研究4、三种及三种以上的统计学方法不平凡第二十二页，共二十五页。1、Sn100与常规胸片在发现肺部病变的能力2、Sn100在儿童中常规应用3、Sn100与Sn150在不同BMI下的应用探讨4、Sn100在鼻窦低剂量的应用启发&疑惑第二十三页，共二十五页。THANKS!刘杰2022.07.12第二十四页，共二十五页。内容总结能谱纯化在胸部CT的应用。2022.07.12。interstitiallungdisease。anexaminationperformed。(tin-filteredSn100kVpspectrum)。CTacquisitionprotocol。引申二：更适合儿童胸部CT〔与儿童Flash序列做比照〕第二十五页，共二十五页。
