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J Vasc Interv Radiol. 2019 Jan;30(1):95-102. doi: 10.1016/j.jvir.2018.06.013. Epub 2018 Aug 24.

Efficacy and Radiation Exposure of Ultra-Low-Dose Chest CT at 100 kVp with Tin Filtration in CT-Guided Percutaneous Core Needle Biopsy for Small Pulmonary Lesions Using a Third-Generation Dual-Source CT Scanner.

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Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong Province 250012, China.
Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong Province 250012, China. Electronic address:



To prospectively investigate efficacy and radiation dose of ultra-low-dose CT-guided percutaneous core needle biopsy (PCNB) at 100 kVp with tin filtration (100Sn kVp) for small pulmonary lesions.


Study enrolled and randomly assigned 210 patients to standard-dose CT (n = 70) or ultra-low-dose CT (n = 140; 1:2 randomization scheme) protocol. Standard-dose CT settings were reference 110 kVp and 50 mAs, and ultra-low-dose CT settings were fixed at 100Sn kVp and 70 mAs. All PCNBs in patients with small pulmonary lesions (< 3 cm) were performed on a third-generation dual-source CT scanner. Diagnostic performance, complication rate, image quality, and radiation dose were compared.


Sensitivity, specificity, and accuracy for diagnosis of malignancy were 95.7%, 100%, and 96.9% with standard-dose CT and 93.8%, 100%, and 95.4% with ultra-low-dose CT (P > .05). Complication rate showed no significant differences between protocols (P > .05). Mean volume CT dose index) and total dose-length product were significantly lower in ultra-low-dose CT compared with standard-dose CT (0.24 mGy vs 3.3 mGy ± 1.1 and 9.84 mGy-cm ± 0.70 vs 110.5 mGy-cm ± 45.1; P < .001). Effective dose for ultra-low-dose CT was significantly lower than that for standard-dose CT (0.14 mSv ± 0.02 vs 1.78 mSv ± 0.76; -92.1%; P < .001). Image quality of ultra-low-dose CT met the requirements of PCNB.


Ultra-low-dose CT-guided PCNB at 100Sn kVp spectral shaping significantly reduced radiation dose on a third-generation dual-source CT, while maintaining high diagnostic accuracy and safety for small pulmonary lesions.


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