Comparison of low-dose and standard-dose helical CT in the evaluation of pulmonary nodules

Abstract. The purpose of this study was to investigate the diagnostic accuracy of low-dose helical computed tomography by comparing the number of nodules detected at low- and standard-dose CT. The prospective study included 25 patients who were referred to CT scan for the assessment of pulmonary metastases. All patients underwent CT examinations at both standard- (200 mA, 120 kV, collimation 5 mm, table feed 10 mm per rotation) and low-dose (50 mA, 120 kV, collimation 5 mm, table feed 10 mm per rotation). The number of nodules detected at each protocol was recorded. The size of the nodules was measured electronically and categorized as <3, 3–4.9, 5–6.9, 7–9.9, and ≥10 mm. Finally, the nodules detected at only standard- or low-dose CT were assessed for the underlying causes of discrepancy. In 25 patients, 533 nodules were detected at standard-dose, whereas 518 nodules were observed at low-dose CT. There were no statistically significant differences in the number of nodules detected at standard- or low-dose CT (p>0.05). Four hundred ninety-one (87.7%) nodules were detected at both standard- or low-dose CT, 42 (7.5%) nodules were observed only at standard-dose CT, and 27 (4.8%) nodules were seen only at low-dose CT. The sensitivity of low-dose CT was 92.5% for all nodules, 88.1% for nodules <5 mm, and 97.4% for nodules ≥5 mm. No significant image artifact interfering with nodule detection was observed at low-dose CT. The low-dose CT protocol used in this study provided images of adequate quality; thus, it can be used reliably in the detection or exclusion of pulmonary nodules.