ArticleJournal of thoracic disease2026
Comparative assessment of image quality and radiation dose: spectral purification computed tomography (Sn100kV) with adaptive iterative reconstruction for tuberculosis follow-up.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: During tuberculosis treatment, multiple chest computed tomography (CT) scans are required for follow-up, each with an effective radiation dose (ED) of approximately 7 mSv. If treatment outcomes are poor or complications arise, additional scans may be necessary, thereby increasing the cumulative radiation burden. This study aimed to evaluate the effects on image quality of low-dose CT using spectral purification technology, in combination with varying levels of sinogram-affirmed iterative reconstruction (SAFIRE) algorithms, with the goal of identifying the optimal SAFIRE level for imaging in follow-up of active secondary pulmonary tuberculosis in adults. Methods: A total of 90 patients diagnosed with active secondary pulmonary tuberculosis between January and May 2024 undergoing follow-up chest CT scans after treatment were randomly assigned to three groups: conventional dose scanning (Group A), optimal tube voltage scanning with intelligence (Group B), and low-dose scanning (Group C). In Groups A and B, images were reconstructed using SAFIRE level 3 (A3 and B3), while Group C images were reconstructed with SAFIRE levels 1 through 5 (C1 to C5). The overall image quality was evaluated, double-blind, independently by two senior radiologists. Radiation doses, subjective assessments of image quality, and objective image quality metrics were analyzed and compared across the groups. Results: The ED was significantly lower in Group C compared to Groups A and B (0.28±0.05 Conclusions: The combination of spectral purification technology with SAFIRE reconstruction effectively reduced radiation exposure and image noise, and maintained diagnostic adequacy during follow-up for patients with active secondary pulmonary tuberculosis.
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