Comparison of Chest Tomosynthesis and Chest Radiography for Detection of Pulmonary Nodules: Human Observer Study of Clinical Cases

Vikgren, Jenny; Zachrisson, Sara; Svalkvist, Angelica; Johnsson, Åse A.; Boijsen, Marianne; Flinck, Agneta; Kheddache, Susanne; Båth, Magnus

doi:10.1148/radiol.2492080304

Cited by 202 publications

(209 citation statements)

References 33 publications

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“…Vikgren and colleagues reported on the sensitivity and specificity of DTS as compared with CXR in a similar study completed in 2008 [7]. Analyzing 80 clinically relevant nodules greater than 4 mm, along with 51 smaller nodules, they found that DTS was 56 % sensitive while CXR found only 17 % of the nodules [7].…”

Section: Introductionmentioning

confidence: 99%

Sensitivity of Thoracic Digital Tomosynthesis (DTS) for the Identification of Lung Nodules

et al. 2015

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Thoracic computed tomography (CT) is considered the gold standard for detection lung pathology, yet its efficacy as a screening tool in regards to cost and radiation dose continues to evolve. Chest radiography (CXR) remains a useful and ubiquitous tool for detection and characterization of pulmonary pathology, but reduced sensitivity and specificity compared to CT. This prospective, blinded study compares the sensitivity of digital tomosynthesis (DTS), to that of CT and CXR for the identification and characterization of lung nodules. Ninety-five outpatients received a posteroanterior (PA) and lateral CXR, DTS, and chest CT at one care episode. The CXR and DTS studies were independently interpreted by three thoracic radiologists. The CT studies were used as the gold standard and read by a fourth thoracic radiologist. Nodules were characterized by presence, location, size, and composition. The agreement between observers and the effective radiation dose for each modality was objectively calculated. One hundred forty-five nodules of greatest diameter larger than 4 mm and 215 nodules less than 4 mm were identified by CT. DTS identified significantly more >4 mm nodules than CXR (DTS 32 % vs. CXR 17 %). CXR and DTS showed no significant difference in the ability to identify the smaller nodules or central nodules within 3 cm of the hilum. DTS outperformed CXR in identifying pleural nodules and those nodules located greater than 3 cm from the hilum. Average radiation dose for CXR, DTS, and CT were 0.10, 0.21, and 6.8 mSv, respectively. Thoracic digital tomosynthesis requires significantly less radiation dose than CT and nearly doubles the sensitivity of that of CXR for the identification of lung nodules greater than 4 mm. However, sensitivity and specificity for detection and characterization of lung nodules remains substantially less than CT. The apparent benefits over CXR, low cost, rapid acquisition, and minimal radiation dose of thoracic DTS suggest that it may be a useful procedure. Work-up of a newly diagnosed nodule will likely require CT, given its superior cross-sectional characterization. Further investigation of DTS as a diagnostic, screening, and surveillance tool is warranted.

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Section: Introductionmentioning

confidence: 99%

Sensitivity of Thoracic Digital Tomosynthesis (DTS) for the Identification of Lung Nodules

et al. 2015

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“…The lateral tomosynthesis scan was performed using the VolumeRad software. The tomosynthesis system and its principles have been described in detail previously [7,8,18,19]. Briefly, 60 low-dose exposures by the moving X-ray tube from tube angles -15 degrees to +15 degrees on a stationary detector are used to reconstruct about 60 tomographic sections of arbitrary thickness.…”

Section: Radiography and Tomosynthesismentioning

confidence: 99%

“…The technique has previously been evaluated in mainly chest radiography [8][9][10] and mammography [11], but has also been applied in abdominal imaging [12] and in musculoskeletal radiography. In a pilot study on scaphoid fracture detection at the two-weeks' follow-up of suspect occult fracture [13], radiography detected one scaphoid waist fracture not detected at radiography at the time of the trauma, while tomosynthesis detected this fracture and two additional fractures, not seen with radiography.…”

Section: Introductionmentioning

confidence: 99%

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Tomosynthesis of the thoracic spine: added value in diagnosing vertebral fractures in the elderly

et al. 2016

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“…Digital tomosynthesis (DT) combines the benefits of digital imaging [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] with the tomographic benefits of computed tomography. The DT approach can be easily implemented in conjunction with radiography at reduced radiation doses and cost.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Reconstruction Algorithms for Decreasing the Exposure Dose During Digital Tomosynthesis for Arthroplasty: a Phantom Study

et al. 2016

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To explore the possibility of decreasing the radiation dose during digital tomosynthesis (DT) for arthroplasty, we compared the image qualities of several reconstruction algorithms, such as filtered back projection (FBP) and two iterative reconstruction (IR), methods maximum likelihood expectation maximization (MLEM) and the simultaneous iterative reconstruction technique (SIRT) under different radiation doses. The three algorithms were implemented using a DT system and experimentally evaluated by contrast-to-noise ratio (CNR), artifact spread function (ASF), and power spectrum measurements on a prosthesis phantom. The CNR and ASF data were statistically analyzed by a one-way analysis of variance. The effectiveness of each technique for enhancing the visibility of the prosthesis phantom was quantified by the CNR (reference dose vs. 20 % reduced dose in FBP, P = 0.62; reference vs. 37 % reduced dose in FBP, P = 0.16; reference vs. 55 % reduced dose in FBP, P < 0.05; reference vs. 20 % reduced dose in IR, P = 0.92; reference vs. 37 % reduced dose in IR, P = 0.40; reference vs. 55 % reduced dose in IR, P < 0.05) and ASF (reference dose vs. 20 % reduced dose in FBP, P = 0.25; reference vs. 37 and 55 % reduced dose in FBP, P < 0.05; reference vs. 20 % reduced dose in IR, P = 0.16; reference vs. 37 and 55 % reduced dose in IR, P < 0.05). The power spectra under the reference and reduced doses are equivalent. In this phantom study, the radiation dose of the reference dose could be decreased by 20 % with FBP and IR for consideration of common factors.

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Comparison of Chest Tomosynthesis and Chest Radiography for Detection of Pulmonary Nodules: Human Observer Study of Clinical Cases

Abstract: For the detection of pulmonary nodules, the performance of chest tomosynthesis is better, with increased sensitivity especially for nodules smaller than 9 mm, than that of chest radiography.

Cited by 202 publications

References 33 publications

Sensitivity of Thoracic Digital Tomosynthesis (DTS) for the Identification of Lung Nodules

Sensitivity of Thoracic Digital Tomosynthesis (DTS) for the Identification of Lung Nodules

Tomosynthesis of the thoracic spine: added value in diagnosing vertebral fractures in the elderly

Comparison of Reconstruction Algorithms for Decreasing the Exposure Dose During Digital Tomosynthesis for Arthroplasty: a Phantom Study

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