Low-dose ultrahigh-resolution PCCT enhances subsolid nodule characterization

作者：Qinqin Yan, Fuhua Yan, Lin Qi, Qiqi Cao, Yajie Zhang, Xiaoyan Chen, Bernhard Schmidt, Zhihan Xu, Wenjie Yang · 发表于：La radiologia medica · 年份：2025 · DOI：10.1007/s11547-025-02057-0 · 被引用次数：5 · 研究领域：Advanced X-ray and CT Imaging、Lung Cancer Diagnosis and Treatment、Advanced Radiotherapy Techniques

Abstract Purpose To characterize invasion-associated CT features in pulmonary subsolid nodules using low-dose ultrahigh-resolution (UHR) photon-counting CT (PCCT) images and evaluate UHR’s diagnostic superiority over standard high-resolution (HR) images. Methods Patients with subsolid lung adenocarcinoma were recruited for chest scan on PCCT to obtain UHR and standard HR images between November 2023 and May 2024. Nodule characteristics were visually assessed and histogram features were extracted from each nodule. Image quality and radiation dose at previous energy-integrating detector CT (EID-CT) of 30 patients were compared with those of PCCT. Differences between UHR and standard HR, PCCT and EID-CT were compared using paired McNemar-test or paired Wilcox-test. Results One hundred and eighty-four patients with 203 subsolid nodules were collected including 77 precursors, 77 minimally invasive adenocarcinoma (MIA) and 49 IA. UHR significantly outperformed standard HR in revealing CT findings including larger nodular diameter and solid-component diameter, more frequency of heterogeneous attenuation, lobulation, bubble-like sign, air bronchogram, pleural indentation and vascular sign (all P < 0.05). Additionally, UHR images exhibited significantly greater value in histogram-derived parameters compared to standard HR images (all P < 0.05), except for “Median,” “Minimum.” Furthermore, the radiation dose in PCCT was half of that in EID-CT (effective dose: 1.32 ± 0.27 vs. 3.85...