Julian Lukas Wichmann MD, Presenter: Nothing to Disclose

Johannes Kraft, Abstract Co-Author: Nothing to Disclose

Eva-Maria Noske, Abstract Co-Author: Nothing to Disclose

Iris Burck MD, Abstract Co-Author: Nothing to Disclose

Jan-Erik Scholtz MD, Abstract Co-Author: Nothing to Disclose

Claudia Frellesen, Abstract Co-Author: Nothing to Disclose

Jens Wagenblast MD, Abstract Co-Author: Nothing to Disclose

Josef Matthias Kerl MD, Abstract Co-Author: Research Consultant, Siemens AG Speakers Bureau, Siemens AG

Ralf W. Bauer MD, Abstract Co-Author: Research Consultant, Siemens AG Speakers Bureau, Siemens AG

Boris Bodelle MD, Abstract Co-Author: Nothing to Disclose

Thomas Lehnert MD, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, PhD, Abstract Co-Author: Nothing to Disclose

Boris Schulz MD, Abstract Co-Author: Nothing to Disclose

To evaluate a low-tube-voltage 80-kVp computed tomography (CT) technique for head and neck imaging in routine clinical practice regarding its effects on diagnostic accuracy and interobserver agreement.

This retrospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. Three radiologists individually analyzed exclusively the 80-kVp scans of 170 patients with a variety of pathologies who had undergone head and neck dual-energy CT. Reviewers were unblinded only to the clinical indication for CT, but otherwise blinded to any other information or image data, and were asked to state a single final relevant diagnosis. Results were compared with the ultimate diagnosis in the medical record charts, histopathology results, or CT reports based on standard blended 120 kVp image series. Diagnoses were grouped as squamous cell carcinoma (SCC) associated (n=110, presence / absence of primary / recurrent SCC or metastatic lymph nodes), lymphoma-associated (n=40, presence / absence of primary / recurrent lymphoma), and benign (n=20, e.g. abscess, sialolithiasis). Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated. Interobserver agreement was evaluated using intraclass correlation coefficients (ICC).

The overall sensitivity, specificity, PPV and NPV were 94.8%, 93.0%, 95.9%, and 91.1%, respectively. Further divided grouped results were also consistently high for SCC-associated (94.8%, 89.1%, 94.3%, 90.1%), lymphoma-associated (95.0%, 100.0%, 100.0%, 95.2%) and benign (94.3%, 93.3%, 98.2%, 85.7%) diagnoses. Global interobserver agreement was almost perfect (ICC, 0.82; 95% confidence intervals: 0.76–0.86). The calculated average dose-length-product was reduced by 48% with 80-kVp acquisition compared to the cumulative dose from the standard dual-energy scan (135.5 mGy•cm vs. 282.2 mGy•cm, P<0.001).

Low-tube-voltage 80-kVp head and neck CT provides sufficient image quality with high diagnostic accuracy and interobserver agreement in routine clinical practice especially for follow-up imaging of SCC or lymphoma and has the potential to significantly decrease radiation exposure. 

Low-tube-voltage 80-kVp CT acquisition provides diagnostic image quality for head and neck imaging in routine clinical practice with a significant reduction of radiation exposure.

Wichmann, J, Kraft, J, Noske, E, Burck, I, Scholtz, J, Frellesen, C, Wagenblast, J, Kerl, J, Bauer, R, Bodelle, B, Lehnert, T, Vogl, T, Schulz, B, Low-Tube-Voltage 80-kVp Head and Neck CT in Routine Clinical Practice: Evaluation of Diagnostic Accuracy and Interobserver Agreement.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003551.html