Ultra-low-dose vs. standard-of-care-dose CT of the chest in patients with post-COVID-19 conditions—a prospective intra-patient multi-reader study

作者：Christian Wassipaul, Daria Kifjak, Ruxandra‐Iulia Milos, Florian Prayer, Sebastian Roehrich, Melanie Winter, Lucian Beer, Martin L. Watzenboeck, Svitlana Pochepnia, Michael H. Weber, Dietmar Tamandl, Peter Homolka, Wolfgang Birkfellner, Helmut Ringl, Helmut Prosch, Benedikt H. Heidinger · 发表于：European Radiology · 年份：2024 · DOI：10.1007/s00330-024-10754-z · 被引用次数：5 · 研究领域：Radiation Dose and Imaging、Advanced X-ray and CT Imaging、Cardiac Imaging and Diagnostics

OBJECTIVES: To conduct an intrapatient comparison of ultra-low-dose computed tomography (ULDCT) and standard-of-care-dose CT (SDCT) of the chest in terms of the diagnostic accuracy of ULDCT and intrareader agreement in patients with post-COVID conditions. METHODS: We prospectively included 153 consecutive patients with post-COVID-19 conditions. All participants received an SDCT and an additional ULDCT scan of the chest. SDCTs were performed with standard imaging parameters and ULDCTs at a fixed tube voltage of 100 kVp (with tin filtration), 50 ref. mAs (dose modulation active), and iterative reconstruction algorithm level 5 of 5. All CT scans were separately evaluated by four radiologists for the presence of lung changes and their consistency with post-COVID lung abnormalities. Radiation dose parameters and the sensitivity, specificity, and accuracy of ULDCT were calculated. RESULTS: Of the 153 included patients (mean age 47.4 ± 15.3 years; 48.4% women), 45 (29.4%) showed post-COVID lung abnormalities. In those 45 patients, the most frequently detected CT patterns were ground-glass opacities (100.0%), reticulations (43.5%), and parenchymal bands (37.0%). The accuracy, sensitivity, and specificity of ULDCT compared to SDCT for the detection of post-COVID lung abnormalities were 92.6, 87.2, and 94.9%, respectively. The median total dose length product (DLP) of ULDCTs was less than one-tenth of the radiation dose of our SDCTs (12.6 mGy*cm [9.9; 15.5] vs. 132.1 mGy*cm [103.9; 160...