Low dose CT screening for lung cancer is done at low Kv settings. Can this be combined with a non contrast cardiac CT for calcium scoring? A retrospective reconstruction can be done in lung and mediastinal windows for better resolution after the scan. I think it should be possible. This helps to reduce patient radiation and maximize information given to the patient and clinician. Is there any study/paper on this or is it being done anywhere?
The only addition is that CAC screening requires a fixed 120kV (ate least for now). So you can not gain advantage of 80 and 100kV settings. At the same time, if you want to cover the whole lung field you will have to increase your DLP. Considering that a regular CAC scan gives you around 1-2mSv you would have to increase those values to 3-5 for the lung screening. With future ITR for CAC, then we would move to the desirable < 1mSv threshold.
Dear Juliano Fernandes, that was the question in my mind..as we would be doing it as a part of health check ups in high risk groups..the radiation is a thing to look out for.
Not only can you do the CAC, but you can also do Bone density. There is no reason to do 3 exams instead of one to obtain all the diagnostic information on 3 big diseases. The current pressure on medical costs and concerns about radiation will increase interest in this kind of efficient medicine. Who of us, when scanned would not want all the diagnostic information possible?
I don't believe you require 120 kVp for CAC. In fact a lower beam energy will increase the detection sensitivity for small calcifications. It would be wise to measure the mass score however in this case.
Dear Ben Arnold, thank you for sharing your thoughts ! I am trying to configure the same on our CT machine. I think a Kv of 80-100 should suffice in obtaining a good quality scan. I think its a good idea as suugested by you to do bone density..will work on including it too..
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