2022年醫(yī)學(xué)專題-SN100在胸部低劑量的應(yīng)用

1、能譜純化在胸部CT的應(yīng)用Chest CT using spectral filtration 劉杰第一頁(yè)，共二十五頁(yè)。圖像(t xin)120kV第二頁(yè)，共二十五頁(yè)。圖像(t xin)70kV第三頁(yè)，共二十五頁(yè)。研究(ynji)目的To determine the radiation dose, image quality, and clinical utility of non-enhanced chest CT with spectral filtration.即 將該新技術(shù)與普通胸部平掃在如下三方面(fngmin)做對(duì)比輻射(fsh)劑量Radiation dose圖像質(zhì)量Image q

2、uality臨床應(yīng)用Clinical utility第四頁(yè)，共二十五頁(yè)。ALARA principleas low as reasonably achievableHow much dose reduction is reasonable？ VSa detailed assessment of interstitial lung diseasean examination performed for lung nodule detectionrequire a significantly higher dose研究(ynji)背景第五頁(yè)，共二十五頁(yè)。In 2014, a third-gener

3、ation dual-source CT system was introduced. 第三代雙源CT問(wèn)世This system features a tin filter, which can be positioned in front of both X-ray tubes, and which absorbs primarily low-energy photons that contribute little to image quality but increase the dose of radiation that a patient receives. 用該研究(ynji)來(lái)

4、證實(shí)研究(ynji)背景第六頁(yè)，共二十五頁(yè)。Key points Spectral filtration enables non-contrast chest CT with very high dose efficiency. This approach reduces CTDIvol, DLP, and SSDE (effective chest diameter 28 cm). Lung nodules, pneumonia, and pleural pathologies can be assessed with uncompromised confidence.關(guān)鍵點(diǎn)第七頁(yè)，共二十五

5、頁(yè)。1 點(diǎn)擊(din j)添加標(biāo)題25 non-contrast chest CT examinations acquired with spectral filtration (tin-filtered Sn100 kVp spectrum) 25 non-contrast chest CT examinations acquired without spectral filtration (120 kV).研究(ynji)方法實(shí)驗(yàn)組對(duì)照組圖像質(zhì)量(zhling)評(píng)估內(nèi)容3.Contrast-to-noise-ratio (CNR) 4.figure-of-merit (FOM) 5.Dia

6、gnostic confidence1.Radiation metrics 2.Image noise 第八頁(yè)，共二十五頁(yè)。CT acquisition protocol研究(ynji)方法第九頁(yè)，共二十五頁(yè)。Statistical analysisMedCalc Software, Ostend, BelgiumKolmogorovSmirnov testMannWhitney testschi-square testP values0.05Kappa statistics所用(su yn)軟件：所用(su yn)方法：柯爾莫可洛夫(lu f)-斯米洛夫(lu f)檢驗(yàn)曼-惠特尼檢驗(yàn)第十頁(yè)，

7、共二十五頁(yè)。Patient selection第十一頁(yè)，共二十五頁(yè)。Radiation metrics第十二頁(yè)，共二十五頁(yè)。Diagnostic confidence and motion artefacts 主觀評(píng)價(jià)(pngji)內(nèi)容pneumoniadiffuse parenchymal lung disease (e.g., emphysema, interstitial lung diseases)pulmonary nodulespleural pathologies (e.g., pneumothorax, pleural effusion, and pleural thicken

8、ing) osseous pathologies mediastinal abnormalities (e.g., mediastinal lymphadenopathy)第十三頁(yè)，共二十五頁(yè)。Subjective assessment of diagnostic condifence第十四頁(yè)，共二十五頁(yè)。Motion artefacts第十五頁(yè)，共二十五頁(yè)。minor cardiac motion artefactsmajor motion artefacts in the basal lungs第十六頁(yè)，共二十五頁(yè)。Picture a,b without tin-filterImage q

9、uality is comparable - despite a substantial dose reduction with tin filtration EXAMPLE第十七頁(yè)，共二十五頁(yè)。 Different pathologies are shown on non-contrast chest CT images acquired with spectral filtration on the novel third-generation dual-source CT system atypical pneumonia (a, b) lobar pneumonia (c, d)pul

10、monary nodules (f) pleural calcifications (e)第十八頁(yè)，共二十五頁(yè)。結(jié)論(jiln)Despite increased image noise, spectral filtration CT provided sufficient diagnostic confidence for the assessment of pneumonia, pulmonary nodules, and pleural pathologies, while substantially reducing radiation dose.第十九頁(yè)，共二十五頁(yè)。The prot

11、ocol appears suitable for lung cancer screening and for surveillance of incidentally detected lung nodules討論(toln) & 猜想Although our study did not evaluate this technique in children, spectral filtration CT may also be of great interest for pediatric chest CT引申一：該研究(ynji)也適用于肺癌患者的掃描與發(fā)現(xiàn)肺結(jié)節(jié)引申二：更適合(shh)兒童胸部CT（與兒童Flash序列做對(duì)比）第二十頁(yè)，共二十五頁(yè)。原理(yunl)第二十一頁(yè)，共二十五頁(yè)。1 點(diǎn)擊添加(tin ji)標(biāo)題1、這是一篇很常見的低劑量胸部文章2、時(shí)效性很強(qiáng)3、加入了對(duì)疾病應(yīng)用范圍的研究4、三種及三種以上的統(tǒng)計(jì)學(xué)方法 不平凡(pngfn)第二十二頁(yè)，共二十五頁(yè)。1 點(diǎn)擊添加(tin ji)標(biāo)題1、Sn100與常規(guī)胸片在發(fā)現(xiàn)肺部病變的能力2、Sn100在兒童中常規(guī)應(yīng)用3、Sn100與Sn150在不同BMI下的應(yīng)用探討4、Sn100在鼻竇低劑量的應(yīng)用 啟發(fā)(qf)&疑惑第二十三頁(yè)，共二十五頁(yè)。THANKS ! 劉杰第二十四頁(yè)，共二十五頁(yè)。內(nèi)容(nirng)