Effects of low-dose computed tomography parameter optimization on diagnostic performance and radiation exposure in pulmonary nodules
10.13491/j.issn.1004-714X.2026.01.007
- VernacularTitle:优化低剂量CT扫描参数对肺部结节诊断效能及辐射暴露的影响
- Author:
Mengyin HE
1
;
Zhongle WANG
1
;
Jie LEI
2
Author Information
1. Department of Radiology, Wuhan Hospital of Traditional Chinese Medicine, Wuhan 430050, China.
2. Orthopedics and Traumatology Diagnosis and Treatment Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, China.
- Publication Type:OriginalArticles
- Keywords:
Low-dose computed tomography;
Scanning parameter optimization;
Pulmonary nodules;
Diagnostic accuracy;
Radiation exposure
- From:
Chinese Journal of Radiological Health
2026;35(1):36-42
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively analyze the impact of low-dose computed tomography (LDCT) parameter optimization on the diagnostic accuracy for pulmonary nodules and their radiation exposure, and to provide a basis for balancing diagnostic performance and radiation safety. Methods Data from 300 high-risk individuals who underwent pulmonary LDCT screening at Wuhan Hospital of Traditional Chinese Medicine between January 2023 and December 2024 were collected. Participants were divided into an optimized LDCT group (n = 150; 100 kV, 70-90 mA) and a traditional LDCT group (n = 150; 120 kV, 140-160 mA) based on scanning parameters. Baseline characteristics, radiation dose, image quality, and diagnostic accuracy were compared between the two groups. Key factors influencing diagnostic accuracy were analyzed. Results In the optimized group, the volume CT dose index, dose-length product, and effective dose decreased by over 40% (t = 37.492, 35.351, and 35.262, respectively, all P<0.001). Similarly, tube voltage and current decreased significantly (t = 14.582 and 28.653, respectively, both P<0.001), while scan time showed no significant change (t = 0.321, P = 0.760). The overall image quality score of the optimized group was slightly lower than that of the traditional group (4.21 ± 0.43 vs. 4.38 ± 0.39; t = 3.587, P<0.001), but remained within the good-to-excellent range. Both groups demonstrated high diagnostic confidence (4.25 vs. 4.41; t = 3.361, P = 0.001) and high inter-evaluator consistency as indicated by an intraclass correlation coefficient of 0.82. No significant differences were observed between the two groups in sensitivity (94.83% vs. 96.43%; Z = 0.393), specificity (91.30% vs. 90.22%; Z = 0.292), accuracy (92.78% vs. 93.33%; χ2 = 0.031), and area under the receiver operating characteristic curve (0.931 vs. 0.938; Z = 0.202) (all P>0.05). Diagnostic performance for<6 mm nodules showed no significant difference (P = 0.778). Multivariable analysis identified nodule size, solid density, lobulated margins, and image quality score as independent predictors of diagnostic accuracy. Conclusion Optimized LDCT can significantly reduce radiation exposure (by over 40%) while maintaining diagnostic accuracy for pulmonary nodules, including small nodules, and good image quality, making it suitable for lung cancer screening in high-risk populations.
