Influence of CT Image Matrix Size and Kernel Type on the Assessment of HRCT in Patients with SSC-ILD

Background: Interstitial lung disease (ILD) is a frequent complication of systemic sclerosis (SSc), and its early detection and treatment may prevent deterioration of lung function. Different vendors have recently made larger image matrices available as a post-processing option for computed tomography (CT), which could facilitate the diagnosis of SSc-ILD. Therefore, the objective of this study was to assess the effect of matrix size on lung image quality in patients with SSc by comparing a 1024-pixel matrix to a standard 512-pixel matrix and applying different reconstruction kernels. Methods: Lung scans of 50 patients (mean age 54 years, range 23-85 years) with SSc were reconstructed with these two different matrix sizes, after determining the most appropriate kernel in a first step. Four observers scored the images on a five-point Likert scale regarding image quality and detectability of clinically relevant findings. Results: Among the eight tested kernels, the Br59-kernel (sharp) reached the highest score (19.48 +/- 3.99), although differences did not reach statistical significance. The 1024-pixel matrix scored higher than the 512-pixel matrix HRCT overall (p = 0.01) and in the subcategories sharpness (p < 0.01), depiction of bronchiole (p < 0.01) and overall image impression (p < 0.01), and lower for the detection of ground-glass opacities (GGO) (p = 0.04). No significant differences were found for detection of extent of reticulations/bronchiectasis/fibrosis (p = 0.50) and image noise (p = 0.09). Conclusions: Our results show that with the use of a sharp kernel, the 1024-pixel matrix HRCT, provides a slightly better subjective image quality in terms of assessing interstitial lung changes, whereby GGO are more visible on the 512-pixel matrix. However, it remains to be answered to what extent this is related to the improved representation of the smallest structures.