Dose-Optimized Computed Tomography for Screening and Follow-Up of Solid Pulmonary Nodules in Obesity: A Phantom Study

To determine the lowest CT radiation dose-level at maintained image-quality and high sensitivity for detection of pulmonary-nodules in obesity. Single-energy CT with tin-filtration was performed in a chest-phantom with solid pulmonary-nodules simulating over-weight and obesity. CTDI vol of the standard-protocol was 0.41 mGy, subsequent scans were obtained at 1/2 and 1/4 dose-levels. Images were reconstructed using FBP and advanced-modeled iterative reconstruction (ADMIRE). Noise, image-quality, and sensitivity for nodule-detection were assessed. Noise was significantly reduced with ADMIRE (standard-dose: 73%; 1/2 dose: 73%; 1/4 dose: 71.2%; p