• Caroline Alexandra Burgard, Thomas Gaass, Madeleine Bonert, David Bondesson, Natalie Thaens, Maximilian Ferdinand Reiser, and Julien Dinkel.
• Department of Clinical Radiology, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany.
• Plos One. 2018 Jan 1; 13 (1): e0190501.

ObjectivesTo assess the image quality of 3 different ultralow-dose CT protocols on pulmonary nodule depiction in a ventilated ex vivo-system.Materials And MethodsFour porcine lungs were inflated inside a dedicated chest phantom and prepared with n = 195 artificial nodules (0.5-1 mL). The artificial chest wall was filled with water to simulate the absorption of a human chest. Images were acquired with a 2x192-row detector CT using low-dose (reference protocol with a tube voltage of 120 kV) and 3 different ULD protocols (respective effective doses: 1mSv and 0.1mSv). A different tube voltage was used for each ULD protocol: 70kV, 100kV with tin filter (100kV_Sn) and 150kV with tin filter (150kV_Sn). Nodule delineation was assessed by two observers (scores 1-5, 1 = unsure, 5 = high confidence).ResultsThe diameter of the 195 detected artificial nodules ranged from 0.9-21.5 mm (mean 7.84 mm ± 5.31). The best ULD scores were achieved using 100kV_Sn and 70 kV ULD protocols (4.14 and 4.06 respectively). Both protocols were not significantly different (p = 0.244). The mean score of 3.78 in ULD 150kV_Sn was significantly lower compared to the 100kV_Sn ULD protocol (p = 0.008).ConclusionThe results of this experiment, conducted in a realistic setting show the feasibility of ultralow-dose CT for the detection of pulmonary nodules.

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