Comparison of 0.3-mSv CT to Standard-Dose CT for Detection of Lung Nodules in Children and Young Adults With Cancer

• DOI: 10.2214/ajr.21.26183
• Publication Date: 2021-07-07T18:24:56Z
• Authors: Samjhana Thapaliya; Leah A. Gilligan; Samuel L. Brady; Christopher G. Anton; Eric J. Crotty; Michael P. Nasser; James I. Geller; Joseph G. Pressey; Bin Zhang; Jonathan R. Dillman; Andrew T. Trout
• Keywords: Male; Lung Neoplasms; Adolescent; Reproducibility of Results; Radiation Dosage; Sensitivity and Specificity; 3. Good health; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Child, Preschool; Humans; Multiple Pulmonary Nodules; Radiographic Image Interpretation, Computer-Assisted; Female; Prospective Studies; Child; Tomography, X-Ray Computed; Lung

BACKGROUND. CT is the imaging modality of choice to identify lung metastasis. OBJECTIVE. The purpose this study was evaluate performance reduced-dose for detection nodules in children and young adults with cancer. METHODS. This prospective enrolled patients 4-21 years old known or suspected malignancy who were undergoing clinically indicated chest CT. Study participants underwent an additional investigational examination same encounter. Separated deidentified examinations reviewed blinded fashion by three independent radiologists. One reviewer performed a subsequent secondary review match between standard- examinations. Diagnostic computed using clinical as reference standard. Intraobserver agreement interobserver calculated Cohen kappa. RESULTS. A total 78 (44 male 34 female patients; mean age, 15.2 ± 3.8 [SD] years) enrolled. estimated effective dose 1.8 1.1 mSv 0.3 0.1 CT, which 83% reduction. Forty-five (58%) had 162 (mean size, 3.4 3.3 mm) detected on 92% visible sensitivity specificity ranged from 63% 77% 80% 90%, respectively, across reviewers. Intraob-server moderate substantial presence (κ = 0.45-0.67) good excellent number 0.68-0.84) nodule size 0.69-0.86). Interobserver both 0.53) 0.54) median one present falsely negative examination. CONCLUSION. Reduced-dose depicts more than 90% Reviewers identified high specificity. CLINICAL IMPACT. at 0.3-mSv has acceptable diagnostic potential reduce patient expand utilization (e.g., replace radiography screening monitoring protocols). TRIAL REGISTRATION. ClinicalTrials.gov NCT03681873.