Comparison of the ultra-low-dose Veo algorithm with the gold standard filtered back projection for detecting pulmonary asbestos-related conditions: a clinical observational study

Marielle Tekath, Frédéric Dutheil, Romain Bellini, Antoine Roche, Bruno Pereira, Geraldine Naughton, Alain Chamoux, Jean-Luc Michel, Marielle Tekath, Frédéric Dutheil, Romain Bellini, Antoine Roche, Bruno Pereira, Geraldine Naughton, Alain Chamoux, Jean-Luc Michel

Abstract

Objectives: Radiation delivered during CT is a major concern, especially for individuals undergoing repeated screening. We aimed to compare a new ultra-low-dose algorithm called Veo with the gold standard filtered back projection (FBP) for detecting pulmonary asbestos-related conditions.

Setting: University Hospital CHU G. Montpied, Clermont-Ferrand, France

Participants: Asbestos-exposed workers were recruited following referral to screening for asbestos-related conditions. Two acquisitions were performed on a 64-slice CT: the gold standard FBP followed by Veo reconstruction.

Outcome measures: Two radiologists independently assessed asbestos-related abnormalities, pulmonary nodules, radiation doses and image quality (noise).

Results: We included 27 asbestos-exposed workers (63.3±6.5 years with 11.9±9.7 years of asbestos exposure). We observed 297 pleural plaques in 20 participants (74%). All patients (100%) had pulmonary nodules, totalling 167 nodules. Detection rates did not differ for pleural plaques (Veo 87% vs FBP 97%, NS), pleural thickening (100% for both) and pulmonary nodules (80% for both). Interstitial abnormalities were depicted less frequently with Veo than FBP. False negative and false positive did not exceed 2.7%. Compared with FBP, Veo decreased the radiation dose up to 87% (Veo 0.23±0.07 vs FBP 1.83±0.88 mSv, p<0.001). The objective image noise also decreased with Veo as much as 23% and signal-to-noise ratio increased up to 33%.

Conclusions: A low-dose CT with Veo reconstruction substantially reduced radiation. Veo compared favourably with FBP in detecting pleural plaques, pleural thickening and pulmonary nodules. These results should be confirmed on a larger sample size before the use of Veo in clinical routine practice in asbestos-related conditions, especially regarding the low prevalence of interstitial abnormalities in this study.

Trial registration number: NCT01955018.

Keywords: OCCUPATIONAL & INDUSTRIAL MEDICINE; PUBLIC HEALTH.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Figures

Figure 1
Figure 1
Flow chart of participants. FBP, filtered back projection.
Figure 2
Figure 2
Typical pleural plaques (1; white arrows), diffuse pleural thickening (2; white arrows) and parenchymal band (2; black arrows), and pulmonary nodule (3; white arrows) in axial plane and an example of normal images in axial plane (4). All Veo and filtered back projection (FBP) images are captured at the same anatomic level, with 100 kV and 20 mAs/section for Veo and 120 kV, 60 mAs for FBP.

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