Evidence mapPaperPMID 41206342Full record

ArticleMedical physics2025

Harmonized low-dose computed tomographic protocols for quantitative lung imaging using dose modulation and advanced reconstructions.

Jarron Atha, Rachel L Eddy, Junfeng Guo, John D Newell, Mario Castro, Frank N Ranallo, Sean B Fain, Jessica C Sieren, Eric A Hoffman, PrecISE study

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Article in Medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Jarron AthaDepartment of Radiology, University of Iowa, Iowa City, USA.
Rachel L EddyCentre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
Junfeng GuoDepartment of Radiology, University of Iowa, Iowa City, USA.
John D NewellDepartment of Radiology, University of Iowa, Iowa City, USA.
Mario CastroDivision of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, USA.
Frank N RanalloDepartment of Medical Physics, University of Wisconsin-Madison, Madison, USA.
Sean B FainDepartment of Radiology, University of Iowa, Iowa City, USA.
Jessica C SierenDepartment of Radiology, University of Iowa, Iowa City, USA.
Eric A HoffmanDepartment of Radiology, University of Iowa, Iowa City, USA.
PrecISE study

Funding

Pulmonary Toxicology FacilityP30ES005605 · UNIVERSITY OF IOWA · 1990 to 2025
$8.8M
NIEHS NIH HHS P30 ES005605NIH HHS S10-OD018526NIH, NHLBI 5UG1HL139119
6 · The paper itself

Abstract

backgroundQuantitative computed tomography (QCT) lung imaging is employed in many multi-center studies. Standardized protocols have used fixed volumetric CT dose index (CTDIvol) adjusted for body mass index to minimize dose while accounting for participant size. Dose modulation and iterative/deep-learning reconstruction (IR/DLR) offer new opportunities for QCT standardization for a multi-center protocol. PURPOSE: To develop harmonized reduced dose lung QCT protocols implementing dose modulation and IR/DLR in the context of the Precision Intervention for Severe Asthma (PrecISE) multi-center study.

methodsA low-dose protocol was first developed on one state-of-the-art scanner having similar quantitative characteristics to a widely used standard-dose protocol as a reference for establishing harmonized protocols for a range of CT systems across four major manufacturers and ten sites. An anthropomorphic chest phantom with outer chest plates (LUNGMAN Chest Phantom, Kyoto; 43.5 cm left-right, 22.9 cm anterior-posterior) and custom inserts containing differently attenuating materials was imaged using varying dose modulation and IR/DLR settings. Hounsfield Unit (HU), standard deviations (SD), and coefficient of variation (CoV) in multiple density standards, including standardized foams, lung tissue, air, and water were compared for measures of accuracy, noise, and precision. The in-plane and z-direction modulation transfer functions (MTF) were also derived from a cubic insert. Purpose-built segmentation software (Pulmonary Analysis Software Suite, PASS) assured sampling of similar regions of interest. Final protocols included dose modulation-IR/DLR combinations yielding target low-dose CTDIvol, which minimized HU mean differences and SD, and maximized MTF compared to the reference-standard.

resultsThe low-dose protocols achieved a mean CTDIvol reduction of 54% ± 7% (range 42%-70%) compared with the current standard-dose (SPIROMICS and MESALung). Compared to the reference-standard, mean HU difference was 12.0 ± 9.2 HU (range 0.4-28.5 HU) for air and 1.9 ± 1.3 HU (range 0.0-4.5 HU) for water inserts across the other nine low-dose protocols, and HU SD was lower in nine of ten low-dose protocols compared to standard-dose. HU CoV for all 10 low-dose protocols were near 0 for air and ranged 2.3-33.4 for water. MTF measurements were 2.71-4.22 and 4.02-7.13 cycles/cm for 50% and 20% cutoffs, respectively, compared with 3.17-3.50 and 4.68-5.54 cycles/cm for standard-dose.

conclusionWe provide harmonized low-dose QCT protocols using manufacturers' current dose modulation and IR/DLR techniques to reduce radiation dose by up to 70% and broadly maintain measurement accuracy and precision suitable for multi-center studies.

Indexed as

Image Processing, Computer-AssistedLungRadiation DosageTomography, X-Ray ComputedHumansPhantoms, Imagingdose modulationiterative reconstructionlow‐dose CTlung CTprotocol developmentquantitative CT

Identifiers

PMID41206342
PMCPMC12596176

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.