Detection and Characterization of Solid Pulmonary Nodules at Digital Chest Tomosynthesis: Data from a Cohort of the Pilot Swedish Cardiopulmonary Bioimage Study

Abstract

Purpose To investigate the performance of digital tomosynthesis (DTS) for detection and characterization of incidental solid lung nodules. Materials and Methods This prospective study was based on a population study with 1111 randomly selected participants (age range, 50-64 years) who underwent a medical evaluation that included chest computed tomography (CT). Among these, 125 participants with incidental nodules 5 mm or larger were included in this study, which added DTS in conjunction with the follow-up CT and was performed between March 2012 and October 2014. DTS images were assessed by four thoracic radiologists blinded to the true number of nodules in two separate sessions according to the 5-mm (125 participants) and 6-mm (55 participants) cut-off for follow-up of incidental nodules. Pulmonary nodules were directly marked on the images by the readers and graded regarding confidence of presence and recommendation for follow-up. Statistical analyses included jackknife free-response receiver operating characteristic, receiver operating characteristic, and Cohen κ coefficient. Results Overall detection rate ranges of CT-proven nodules 5 mm or larger and 6 mm or larger were, respectively, 49%-58% and 48%-62%. Jackknife free-response receiver operating characteristics figure of merit for detection of CT-proven nodules 5 mm or larger and 6 mm or larger was 0.47 and 0.51, respectively, and area under the receiver operating characteristic curve regarding recommendation for follow-up was 0.62 and 0.65, respectively. Conclusion Routine use of DTS would result in lower detection rates and reduced number of small nodules recommended for follow-up. RSNA, 2018.

Diagnostic performance of digital tomosynthesis to evaluate silicone airway stents and related complications

“…Simultaneously, the examination can be conducted with a lower radiation dose than that required for chest CT (7)(8)(9). With this advantage, several studies have reported the diagnostic performance of DTS for pulmonary diseases, including lung nodules, mycobacterial infection disease, and lung cancer (10)(11)(12)(13)(14).…”

3D printed CT-based abdominal structure mannequin for enabling research

“…Since the discovery of x-rays in 1895, major advances have taken place in X-ray imaging including computed tomography (CT), dual energy (DE) imaging, cone beam CT (CBCT) and digital tomosynthesis (DT) [1][2][3][4][5][6]. Because these radiologic imaging technologies have been shown to expose the patient to harmful ionizing radiation, rigorous quality assurance (QA) testing is needed to minimize the radiation dose and maximize the diagnostic information from each scan [7].…”

Surveillance of small, solid pulmonary nodules at digital chest tomosynthesis: data from a cohort of the pilot Swedish CArdioPulmonary bioImage Study (SCAPIS)

“…The Fleischner Society (11) suggests that CXR may be a low-cost/low-dose alternative to CT for the follow-up of larger nodules that are well visualized and considered low risk. In this situation, DTS would be superior as nodule detection is improved compared to CXR (13), although not on par with CT (14–17). The question has been raised whether DTS could be an alternative to CT regarding surveillance of indeterminate nodules with low risk of malignancy (14,18).…”

“…In this situation, DTS would be superior as nodule detection is improved compared to CXR (13), although not on par with CT (14)(15)(16)(17). The question has been raised whether DTS could be an alternative to CT regarding surveillance of indeterminate nodules with low risk of malignancy (14,18). S€ oderman et al (19) investigated nodule growth on simulated nodules in DTS, and reported that the modality could be applicable, but nodule size, position, and dose level affected the precision of the measurements.…”