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Journal of Radiological Review 2021 June;8(2):69-79

DOI: 10.23736/S2723-9284.21.00126-9


lingua: Inglese

High-resolution computed tomography technique and radiation dose in interstitial lung disease: pearls and pitfalls

Andrea BORGHESI 1 , Stefano PALMUCCI 2, Silvia MICHELINI 3, Salvatore GOLEMI 1, Nicola CARAPELLA 1, Angelo ZIGLIANI 1, Cristiano RAMPINELLI 4, Giancarlo CORTESE 5, Nicola SVERZELLATI 6, Anna Rita LARICI 7

1 Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy; 2 Department of Medical Surgical Sciences and Advanced Technologies G.F. Ingrassia, Unit of Radiology 1, AOU G. Rodolico-San Marco, University of Catania, Catania, Italy; 3 Department of Radiology, Poliambulanza Foundation Hospital, Brescia, Italy; 4 Department of Medical Imaging and Radiation Sciences, European Institute of Oncology IRCCS (IEO), Milan, Italy; 5 Department of Radiology, Maria Vittoria Hospital, ASL Città di Torino, Turin, Italy; 6 Radiological Sciences, Department of Medicine and Surgery, University of Parma, Parma, Italy; 7 Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Diagnostic Imaging Area, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy

Radiological imaging is a key tool for identifying and establishing a confident diagnosis of interstitial lung disease (ILD). Although chest X-ray is the first-line method in the evaluation of the lung and may identify lung abnormalities in patients with ILD, its limited spatial and contrast resolution provides information that is usually nonspecific. High-resolution computed tomography (HRCT) is considered the most effective method for the characterization and differential diagnosis of ILD, particularly in the early stage of the disease. HRCT imaging is able to represent normal lung anatomy with excellent spatial resolution and demonstrates with high accuracy the typical findings of ILD. A confident diagnosis of ILD is typically based on the detection of a specific combination and distribution of HRCT findings representing specific pattern of disease. In several cases, the information provided by HRCT avoids the need to perform a surgical biopsy. Therefore, HRCT is currently the reference standard for imaging the lungs in the setting of ILD. An appropriate technique must be used to obtain high-quality HRCT images. Unfortunately, not all HRCT examinations are performed optimally, and different radiology departments use different acquisition and reconstruction parameters. Therefore, there is still no consensus on the HRCT protocol in the evaluation of interstitial lung diseases. The purpose of this article was to review the main technical and dosimetric aspects required to obtain adequate HRCT images in patients with known or suspected ILD.

KEY WORDS: Lung diseases, interstitial; Reconstructive surgical procedures; Review

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