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Objectives <p>To evaluate the depiction capability of fine lung nodules and airways using high-resolution settings on ultra-high-resolution energy-integrating detector CT (UHR-CT), incorporating large matrix sizes, thin-slice thickness, and iterative reconstruction (IR)/deep-learning reconstruction (DLR), using cadaveric human lungs and corresponding histological images.</p> Materials and methods <p>Images of 20 lungs were acquired using conventional CT (CCT), UHR-CT, and photon-counting detector CT (PCD-CT). CCT images were reconstructed with a 512 matrix and IR (CCT-512-IR). UHR-CT images were reconstructed with four settings by varying the matrix size and the reconstruction method: UHR-512-IR, UHR-1024-IR, UHR-2048-IR, and UHR-1024-DLR. Two imaging settings of PCD-CT were used: PCD-512-IR and PCD-1024-IR. CT images were visually evaluated and compared with histology.</p> Results <p>Overall, 6769 nodules (median: 1321 µm) and 92 airways (median: 851 µm) were evaluated. For nodules, UHR-2048-IR outperformed CCT-512-IR, UHR-512-IR, and UHR-1024-IR (<i>p</i> &lt; 0.001). UHR-1024-DLR showed no significant difference from UHR-2048-IR in the overall nodule score after Bonferroni correction&#xa0;(uncorrected&#xa0;<i>p</i> = 0.043); however, for nodules &gt; 1000 μm, UHR-2048-IR demonstrated significantly better scores than UHR-1024-DLR (<i>p</i> = 0.003). For airways, UHR-1024-IR&#xa0;and UHR-512-IR showed significant differences (<i>p</i> &lt; 0.001), with no notable differences among UHR-1024-IR, UHR-2048-IR, and UHR-1024-DLR. UHR-2048-IR detected nodules and airways with median diameters of 604 µm and 699 µm, respectively. No significant difference was observed between UHR-512-IR and PCD-512-IR (<i>p</i> &gt; 0.1). PCD-1024-IR outperformed UHR-CTs for nodules &gt; 1000 μm (<i>p</i> ≤ 0.001), while UHR-1024-DLR outperformed PCD-1024-IR for airways &gt; 1000 μm (<i>p</i> = 0.005).</p> Conclusions <p>UHR-2048-IR demonstrated the highest scores among the evaluated EID-CT images. UHR-CT showed potential for detecting submillimeter nodules and airways. With the 512 matrix, UHR-CT demonstrated performance comparable to PCD-CT.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>There are scarce data evaluating the depiction capabilities of ultra-high-resolution energy-integrating detector CT (UHR-CT) for fine structures, nor any comparisons with photon-counting detector CT (PCD-CT).</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>UHR-CT depicted nodules and airways with median diameters of 604</i> µm and 699 µm, showing no significant difference from PCD-CT with the 512 matrix.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>High-resolution imaging is crucial for lung diagnosis. UHR-CT has the potential to contribute to pulmonary nodule diagnosis and airway disease evaluation by detecting fine opacities and airways.</i></p> Graphical Abstract <p></p>

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Morphology-based radiological-histological correlation on ultra-high-resolution energy-integrating detector CT using cadaveric human lungs: nodule and airway analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月26日

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  • Akinori Hata,
  • Masahiro Yanagawa,
  • Keisuke Ninomiya,
  • Noriko Kikuchi,
  • Masako Kurashige,
  • Daiki Nishigaki,
  • Shuhei Doi,
  • Kazuki Yamagata,
  • Yuriko Yoshida,
  • Ryo Ogawa,
  • Yukiko Tokuda,
  • Eiichi Morii,
  • Noriyuki Tomiyama

摘要

Objectives

To evaluate the depiction capability of fine lung nodules and airways using high-resolution settings on ultra-high-resolution energy-integrating detector CT (UHR-CT), incorporating large matrix sizes, thin-slice thickness, and iterative reconstruction (IR)/deep-learning reconstruction (DLR), using cadaveric human lungs and corresponding histological images.

Materials and methods

Images of 20 lungs were acquired using conventional CT (CCT), UHR-CT, and photon-counting detector CT (PCD-CT). CCT images were reconstructed with a 512 matrix and IR (CCT-512-IR). UHR-CT images were reconstructed with four settings by varying the matrix size and the reconstruction method: UHR-512-IR, UHR-1024-IR, UHR-2048-IR, and UHR-1024-DLR. Two imaging settings of PCD-CT were used: PCD-512-IR and PCD-1024-IR. CT images were visually evaluated and compared with histology.

Results

Overall, 6769 nodules (median: 1321 µm) and 92 airways (median: 851 µm) were evaluated. For nodules, UHR-2048-IR outperformed CCT-512-IR, UHR-512-IR, and UHR-1024-IR (p < 0.001). UHR-1024-DLR showed no significant difference from UHR-2048-IR in the overall nodule score after Bonferroni correction (uncorrected p = 0.043); however, for nodules > 1000 μm, UHR-2048-IR demonstrated significantly better scores than UHR-1024-DLR (p = 0.003). For airways, UHR-1024-IR and UHR-512-IR showed significant differences (p < 0.001), with no notable differences among UHR-1024-IR, UHR-2048-IR, and UHR-1024-DLR. UHR-2048-IR detected nodules and airways with median diameters of 604 µm and 699 µm, respectively. No significant difference was observed between UHR-512-IR and PCD-512-IR (p > 0.1). PCD-1024-IR outperformed UHR-CTs for nodules > 1000 μm (p ≤ 0.001), while UHR-1024-DLR outperformed PCD-1024-IR for airways > 1000 μm (p = 0.005).

Conclusions

UHR-2048-IR demonstrated the highest scores among the evaluated EID-CT images. UHR-CT showed potential for detecting submillimeter nodules and airways. With the 512 matrix, UHR-CT demonstrated performance comparable to PCD-CT.

Key Points

Question There are scarce data evaluating the depiction capabilities of ultra-high-resolution energy-integrating detector CT (UHR-CT) for fine structures, nor any comparisons with photon-counting detector CT (PCD-CT).

Findings UHR-CT depicted nodules and airways with median diameters of 604 µm and 699 µm, showing no significant difference from PCD-CT with the 512 matrix.

Clinical relevance High-resolution imaging is crucial for lung diagnosis. UHR-CT has the potential to contribute to pulmonary nodule diagnosis and airway disease evaluation by detecting fine opacities and airways.

Graphical Abstract