1
|
Kim K, Lee JH, Je Oh S, Chung MJ. AI-based computer-aided diagnostic system of chest digital tomography synthesis: Demonstrating comparative advantage with X-ray-based AI systems. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107643. [PMID: 37348439 DOI: 10.1016/j.cmpb.2023.107643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/26/2023] [Accepted: 06/03/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Compared with chest X-ray (CXR) imaging, which is a single image projected from the front of the patient, chest digital tomosynthesis (CDTS) imaging can be more advantageous for lung lesion detection because it acquires multiple images projected from multiple angles of the patient. Various clinical comparative analysis and verification studies have been reported to demonstrate this, but there is no artificial intelligence (AI)-based comparative analysis studies. Existing AI-based computer-aided detection (CAD) systems for lung lesion diagnosis have been developed mainly based on CXR images; however, CAD-based on CDTS, which uses multi-angle images of patients in various directions, has not been proposed and verified for its usefulness compared to CXR-based counterparts. BACKGROUND AND OBJECTIVE This study develops and tests a CDTS-based AI CAD system to detect lung lesions to demonstrate performance improvements compared to CXR-based AI CAD. METHODS We used multiple (e.g., five) projection images as input for the CDTS-based AI model and a single-projection image as input for the CXR-based AI model to compare and evaluate the performance between models. Multiple/single projection input images were obtained by virtual projection on the three-dimensional (3D) stack of computed tomography (CT) slices of each patient's lungs from which the bed area was removed. These multiple images result from shooting from the front and left and right 30/60∘. The projected image captured from the front was used as the input for the CXR-based AI model. The CDTS-based AI model used all five projected images. The proposed CDTS-based AI model consisted of five AI models that received images in each of the five directions, and obtained the final prediction result through an ensemble of five models. Each model used WideResNet-50. To train and evaluate CXR- and CDTS-based AI models, 500 healthy data, 206 tuberculosis data, and 242 pneumonia data were used, and three three-fold cross-validation was applied. RESULTS The proposed CDTS-based AI CAD system yielded sensitivities of 0.782 and 0.785 and accuracies of 0.895 and 0.837 for the (binary classification) performance of detecting tuberculosis and pneumonia, respectively, against normal subjects. These results show higher performance than the sensitivity of 0.728 and 0.698 and accuracies of 0.874 and 0.826 for detecting tuberculosis and pneumonia through the CXR-based AI CAD, which only uses a single projection image in the frontal direction. We found that CDTS-based AI CAD improved the sensitivity of tuberculosis and pneumonia by 5.4% and 8.7% respectively, compared to CXR-based AI CAD without loss of accuracy. CONCLUSIONS This study comparatively proves that CDTS-based AI CAD technology can improve performance more than CXR. These results suggest that we can enhance the clinical application of CDTS. Our code is available at https://github.com/kskim-phd/CDTS-CAD-P.
Collapse
Affiliation(s)
- Kyungsu Kim
- Medical AI Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea; Department of Data Convergence and Future Medicine, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
| | - Ju Hwan Lee
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Seong Je Oh
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Myung Jin Chung
- Medical AI Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea; Department of Data Convergence and Future Medicine, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea; Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
| |
Collapse
|
2
|
Digital Tomosynthesis as a Problem-Solving Technique to Confirm or Exclude Pulmonary Lesions in Hidden Areas of the Chest. Diagnostics (Basel) 2023; 13:diagnostics13061010. [PMID: 36980318 PMCID: PMC10046899 DOI: 10.3390/diagnostics13061010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
Objectives: To evaluate the capability of digital tomosynthesis (DTS) to characterize suspected pulmonary lesions in the so-called hidden areas at chest X-ray (CXR). Materials and Methods: Among 726 patients with suspected pulmonary lesions at CXR who underwent DTS, 353 patients (201 males, 152 females; age 71.5 ± 10.4 years) revealed suspected pulmonary lesions in the apical, hilar, retrocardiac, or paradiaphragmatic lung zones and were retrospectively included. Two readers analyzed CXR and DTS images and provided a confidence score: 1 or 2 = definitely or probably benign pulmonary or extra-pulmonary lesion, or pulmonary pseudo-lesion deserving no further diagnostic work-up; 3 = indeterminate lesion; 4 or 5 = probably or definitely pulmonary lesion deserving further diagnostic work-up by CT. The nature of DTS findings was proven by CT (n = 108) or CXR during follow-up (n = 245). Results: In 62/353 patients the suspected lung lesions were located in the lung apex, in 92/353 in the hilar region, in 59/353 in the retrocardiac region, and in 140/353 in the paradiaphragmatic region. DTS correctly characterized the CXR findings as benign pulmonary or extrapulmonary lesion (score 1 or 2) in 43/62 patients (69%) in the lung apex region, in 56/92 (61%) in the pulmonary hilar region, in 40/59 (67%) in the retrocardiac region, and in 106/140 (76%) in the paradiaphragmatic region, while correctly recommending CT in the remaining cases due to the presence of true solid pulmonary lesion, with the exception of 22 false negative findings (60 false positive findings). DTS showed a significantly (p < 0.05) increased sensitivity, specificity, and overall diagnostic accuracy and area under ROC curve compared to CXR alone. Conclusions: DTS allowed confirmation or exclusion of the presence of true pulmonary lesions in the hidden areas of the chest.
Collapse
|
3
|
Baratella E, Fiorese I, Minelli P, Veiluva A, Marrocchio C, Ruaro B, Cova MA. Aging-Related Findings of the Respiratory System in Chest Imaging: Pearls and Pitfalls. CURRENT RADIOLOGY REPORTS 2023; 11:1-11. [PMID: 36471674 PMCID: PMC9713755 DOI: 10.1007/s40134-022-00405-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 12/04/2022]
Abstract
Purpose of Review The purpose of this review is to describe the main features of the aging chest, studied through different imaging modalities. Recent Findings Aging-related changes of the respiratory system are inevitable. Therefore, it is mandatory to be familiar with the para-physiological changes that occurs, in order to avoid inappropriate interpretation of radiological findings that put patients at risk of over or undertreatment. Summary The role of the radiologist is fundamental in evaluating aging-related processes affecting the respiratory system and in distinguishing them from frank diseases.
Collapse
Affiliation(s)
- Elisa Baratella
- grid.5133.40000 0001 1941 4308Department of Radiology, Cattinara Hospital, University of Trieste, 34127 Trieste, Italy
| | - Ilaria Fiorese
- grid.5133.40000 0001 1941 4308Department of Radiology, Cattinara Hospital, University of Trieste, 34127 Trieste, Italy
| | - Pierluca Minelli
- grid.5133.40000 0001 1941 4308Department of Radiology, Cattinara Hospital, University of Trieste, 34127 Trieste, Italy
| | - Alberto Veiluva
- grid.5133.40000 0001 1941 4308Department of Radiology, Cattinara Hospital, University of Trieste, 34127 Trieste, Italy
| | - Cristina Marrocchio
- grid.5133.40000 0001 1941 4308Department of Radiology, Cattinara Hospital, University of Trieste, 34127 Trieste, Italy
| | - Barbara Ruaro
- grid.5133.40000 0001 1941 4308Department of Pulmonology, Cattinara Hospital, University of Trieste, 34127 Trieste, Italy
| | - Maria Assunta Cova
- grid.5133.40000 0001 1941 4308Department of Radiology, Cattinara Hospital, University of Trieste, 34127 Trieste, Italy
| |
Collapse
|
4
|
Banifadel M, Vonau M, Young B, Panchabhai T, Gilkeson RC, Schilz R, Matta M. "Digital Tomosynthesis" As a Technique for the Evaluation of Endobronchial Stents in Lung Transplant Recipients. Transplantation 2022; 106:2462-2465. [PMID: 35883241 DOI: 10.1097/tp.0000000000004248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lung transplant patients often suffer from posttransplant airway pathologies that require placement of endobronchial stents. In addition to surveillance bronchoscopy, patients often undergo radiographic stent evaluations. Chest x-rays are extremely limited in their ability to diagnose stent complications, so many patients require chest computed tomography (CT) scans for stent evaluation. Chest CT scans are costly and expose patients to higher cumulative radiation doses. Digital tomosynthesis (DTS) is an imaging modality that provides high-resolution images using limited angle tomography. The costs and radiation doses are comparable to conventional x-ray. We present a series of 4 postlung transplant patients with bronchial stents in whom we performed DTS and chest x-ray simultaneously. The DTS images were far superior to chest x-ray and comparable with CT in evaluating the placement and patency of the stents, especially in the case of silicone stents. Furthermore, the improved resolution provided clinically relevant diagnostic information that resulted in therapeutic bronchoscopy for suctioning of mucus impaction in one of the patients.
Collapse
Affiliation(s)
- Momen Banifadel
- Department of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH
| | - Martin Vonau
- Department of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH
| | - Benjamin Young
- Department of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH
| | - Tanmay Panchabhai
- Department of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH
| | - Robert C Gilkeson
- Department of Radiology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH
| | - Robert Schilz
- Department of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH
| | - Maroun Matta
- Department of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH
| |
Collapse
|
5
|
Diagnostic Accuracy of Chest Digital Tomosynthesis in Patients Recovering after COVID-19 Pneumonia. Tomography 2022; 8:1221-1227. [PMID: 35645386 PMCID: PMC9149814 DOI: 10.3390/tomography8030100] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/13/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose: To assess the diagnostic accuracy of traditional chest X-ray (CXR) and digital tomosynthesis (DTS) compared to computed tomography (CT) in detecting pulmonary interstitial changes in patients having recovered from severe COVID-19. Materials and Methods: This was a retrospective observational study, and received local ethics committee approval. Patients suspected of having COVID-19 pneumonia upon emergency department admission between 1 March and 31 August 2020, and who underwent CXR followed by DTS and CT, were considered. Inclusion criteria were as follows: (1) patients with previous SARS-CoV-2 infection proven by a positive RT-PCR on nasopharyngeal swabs performed upon admission to the hospital, and with complete clinical recovery; (2) a diagnosis of SARS-CoV-2-related ARDS, according to the Berlin criteria, during hospitalization; (3) no recent history of other lung disease; and (4) complete imaging follow-up by CXR, DTS, and CT for at least 6 months and up to one year. Analysis of DTS images was carried out independently by two radiologists with 16 and 10 years of experience in chest imaging, respectively. The following findings were evaluated: (1) ground-glass opacities (GGOs); (2) air-space consolidations with or without air bronchogram; (3) reticulations; and (4) linear consolidation. Indicators of diagnostic performance of RX and digital tomosynthesis were calculated using CT as a reference. All data were analyzed using R statistical software (version 4.0.2, 2020). Results: Out of 44 patients initially included, 25 patients (17 M/8 F), with a mean age of 64 years (standard deviation (SD): 12), met the criteria and were included. The overall average numbers of findings confirmed by CT were GGOs in 11 patients, lung consolidations in 8 patients, 7 lung interstitial reticulations, and linear consolidation in 20 patients. DTS showed a significantly higher diagnostic accuracy compared to CXR in recognizing interstitial lung abnormalities—especially GGOs (p = 0.0412) and linear consolidations (p = 0.0009). The average dose for chest X-ray was 0.10 mSv (0.07–0.32), for DTS was 1.03 mSv (0.74–2.00), and for CT scan was 3 mSv. Conclusions: According to our results, DTS possesses a high diagnostic accuracy, compared with CXR, in revealing lung fibrotic changes in patients who have recovered from COVID-19 pneumonia.
Collapse
|
6
|
Jiang B, Li N, Shi X, Zhang S, Li J, de Bock GH, Vliegenthart R, Xie X. Deep Learning Reconstruction Shows Better Lung Nodule Detection for Ultra-Low-Dose Chest CT. Radiology 2022; 303:202-212. [PMID: 35040674 DOI: 10.1148/radiol.210551] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Ultra-low-dose (ULD) CT could facilitate the clinical implementation of large-scale lung cancer screening while minimizing the radiation dose. However, traditional image reconstruction methods are associated with image noise in low-dose acquisitions. Purpose To compare the image quality and lung nodule detectability of deep learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction-V (ASIR-V) in ULD CT. Materials and Methods Patients who underwent noncontrast ULD CT (performed at 0.07 or 0.14 mSv, similar to a single chest radiograph) and contrast-enhanced chest CT (CECT) from April to June 2020 were included in this prospective study. ULD CT images were reconstructed with filtered back projection (FBP), ASIR-V, and DLIR. Three-dimensional segmentation of lung tissue was performed to evaluate image noise. Radiologists detected and measured nodules with use of a deep learning-based nodule assessment system and recognized malignancy-related imaging features. Bland-Altman analysis and repeated-measures analysis of variance were used to evaluate the differences between ULD CT images and CECT images. Results A total of 203 participants (mean age ± standard deviation, 61 years ± 12; 129 men) with 1066 nodules were included, with 100 scans at 0.07 mSv and 103 scans at 0.14 mSv. The mean lung tissue noise ± standard deviation was 46 HU ± 4 for CECT and 59 HU ± 4, 56 HU ± 4, 53 HU ± 4, 54 HU ± 4, and 51 HU ± 4 in FBP, ASIR-V level 40%, ASIR-V level 80% (ASIR-V-80%), medium-strength DLIR, and high-strength DLIR (DLIR-H), respectively, of ULD CT scans (P < .001). The nodule detection rates of FBP reconstruction, ASIR-V-80%, and DLIR-H were 62.5% (666 of 1066 nodules), 73.3% (781 of 1066 nodules), and 75.8% (808 of 1066 nodules), respectively (P < .001). Bland-Altman analysis showed the percentage difference in long diameter from that of CECT was 9.3% (95% CI of the mean: 8.0, 10.6), 9.2% (95% CI of the mean: 8.0, 10.4), and 6.2% (95% CI of the mean: 5.0, 7.4) in FBP reconstruction, ASIR-V-80%, and DLIR-H, respectively (P < .001). Conclusion Compared with adaptive statistical iterative reconstruction-V, deep learning image reconstruction reduced image noise, increased nodule detection rate, and improved measurement accuracy on ultra-low-dose chest CT images. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Lee in this issue.
Collapse
Affiliation(s)
- Beibei Jiang
- From the Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China (B.J., N.L., X.X.); CT Imaging Research Center, GE Healthcare China, Shanghai, China (X.S., S.Z., J.L.); and Departments of Epidemiology (G.H.d.B.) and Radiology (R.V.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Nianyun Li
- From the Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China (B.J., N.L., X.X.); CT Imaging Research Center, GE Healthcare China, Shanghai, China (X.S., S.Z., J.L.); and Departments of Epidemiology (G.H.d.B.) and Radiology (R.V.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Xiaomeng Shi
- From the Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China (B.J., N.L., X.X.); CT Imaging Research Center, GE Healthcare China, Shanghai, China (X.S., S.Z., J.L.); and Departments of Epidemiology (G.H.d.B.) and Radiology (R.V.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Shuai Zhang
- From the Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China (B.J., N.L., X.X.); CT Imaging Research Center, GE Healthcare China, Shanghai, China (X.S., S.Z., J.L.); and Departments of Epidemiology (G.H.d.B.) and Radiology (R.V.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jianying Li
- From the Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China (B.J., N.L., X.X.); CT Imaging Research Center, GE Healthcare China, Shanghai, China (X.S., S.Z., J.L.); and Departments of Epidemiology (G.H.d.B.) and Radiology (R.V.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Geertruida H de Bock
- From the Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China (B.J., N.L., X.X.); CT Imaging Research Center, GE Healthcare China, Shanghai, China (X.S., S.Z., J.L.); and Departments of Epidemiology (G.H.d.B.) and Radiology (R.V.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Rozemarijn Vliegenthart
- From the Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China (B.J., N.L., X.X.); CT Imaging Research Center, GE Healthcare China, Shanghai, China (X.S., S.Z., J.L.); and Departments of Epidemiology (G.H.d.B.) and Radiology (R.V.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Xueqian Xie
- From the Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China (B.J., N.L., X.X.); CT Imaging Research Center, GE Healthcare China, Shanghai, China (X.S., S.Z., J.L.); and Departments of Epidemiology (G.H.d.B.) and Radiology (R.V.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
7
|
Kim BG, Chung MJ, Jeong BH, Kim H. Diagnostic performance of digital tomosynthesis to evaluate silicone airway stents and related complications. J Thorac Dis 2021; 13:5627-5637. [PMID: 34795913 PMCID: PMC8575834 DOI: 10.21037/jtd-21-1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/03/2021] [Indexed: 11/06/2022]
Abstract
Background Digital tomosynthesis (DTS) is an imaging technique with benefits in reconstructing sequential cross-sectional images. We evaluated the diagnostic performance of DTS for silicone airway stents and stent-related complications in patients who underwent bronchoscopic intervention. Methods This retrospective study included patients who underwent bronchoscopic intervention after chest radiography (CXR) and DTS examinations from September 2013 to August 2020. The interval between CXR, DTS, and bronchoscopic intervention was a maximum of 10 days. CXR and DTS images were evaluated using a bronchoscopic view as a reference. We calculated the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for assessing the diagnostic performance. Results The total CXR, DTS, and bronchoscopic intervention-matching datasets comprised 213 cases from 119 patients and, silicone stents were present in 167 of them. The ability of DTS to detect silicone stents was better than that of CXR (sensitivity, 92.8% vs. 71.3%, P<0.001). Of the 167 cases with silicone stents, 53 experienced stent migration and 121 experienced stent obstructions due to granulation tissue or fibrosis. The sensitivity for detecting stent migration was also higher with DTS than with CXR (45.3% vs. 24.5%, P=0.025). The sensitivity for detecting the stent obstruction was better with DTS than with CXR (64.5% vs. 19.0%, P<0.001). Conclusions DTS was more sensitive and accurate in revealing silicone airway stents and silicone stent-related complications than CXR. However, there were limitations in confirming stent migration and obstruction with DTS due to granulation tissue growth and fibrosis.
Collapse
Affiliation(s)
- Bo-Guen Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Myung Jin Chung
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hojoong Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
8
|
Primidis TG, Wells SG, Soloviev VY, Welsch CP. 3D chest tomosynthesis using a stationary flat panel source array and a stationary detector: a Monte Carlo proof of concept. Biomed Phys Eng Express 2021; 8. [PMID: 34757950 DOI: 10.1088/2057-1976/ac3880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/10/2021] [Indexed: 11/12/2022]
Abstract
3D imaging modalities such as computed tomography and digital tomosynthesis typically scan the patient from different angles with a lengthy mechanical movement of a single x-ray tube. Therefore, millions of 3D scans per year require expensive mechanisms to support a heavy x-ray source and have to compensate for machine vibrations and patient movements. However, recent developments in cold-cathode field emission technology allow the creation of compact, stationary arrays of emitters. Adaptix Ltd has developed a novel, low-cost, square array of such emitters and demonstrated 3D digital tomosynthesis of human extremities and small animals. The use of cold-cathode field emitters also makes the system compact and lightweight. This paper presents Monte Carlo simulations of a concept upgrade of the Adaptix system from the current 60 kVp to 90 kVp and 120 kVp which are better suited for chest imaging. Between 90 kVp and 120 kVp, 3D image quality appears insensitive to voltage and at 90 kVp the photon yield is reduced by 40%-50% while effective dose declines by 14%. A square array of emitters can adequately illuminate a subject for tomosynthesis from a shorter source-to-image distance, thereby reducing the required input power, and offsetting the 28%-50% more input power that is required for operation at 90 kVp. This modelling suggests that lightweight, stationary cold-cathode x-ray source arrays could be used for chest tomosynthesis at a lower voltage, with less dose and without sacrificing image quality. This will reduce weight, size and cost, enabling 3D imaging to be brought to the bedside.
Collapse
Affiliation(s)
- Thomas G Primidis
- Department of Physics, University of Liverpool, Liverpool, United Kingdom.,The Cockcroft Institute, Sci-Tech Daresbury, Warrington, United Kingdom
| | - Stephen G Wells
- Adaptix Ltd, Oxford University Begbroke Science Park, Oxford, United Kingdom
| | - Vadim Y Soloviev
- Adaptix Ltd, Oxford University Begbroke Science Park, Oxford, United Kingdom
| | - Carsten P Welsch
- Department of Physics, University of Liverpool, Liverpool, United Kingdom.,The Cockcroft Institute, Sci-Tech Daresbury, Warrington, United Kingdom
| |
Collapse
|
9
|
Tomosynthesis in pediatrics: a retrospective of its application in the world practice and own data. КЛИНИЧЕСКАЯ ПРАКТИКА 2021. [DOI: 10.17816/clinpract77802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Tomosynthesis is a modern effective and informative method of low-dose X-ray diagnostics, which allows obtaining a significant number of layered images with the subsequent volumetric image reconstruction. The use of tomosynthesis provides a one-time examination of a large anatomical area without loss of the image quality and diagnostics of difficult-to-visualize pathological changes that are not detected by digital radiography. The article presents an overview of the problem of improving low-dose imaging options in the radiation diagnostics, as well as the authors own data on the use of tomosynthesis for the diagnosis of community-acquired pneumonia in children.
Collapse
|
10
|
Baratella E, Bozzato AM, Marrocchio C, Natali C, Di Giusto A, Quaia E, Cova MA. Digital tomosynthesis and ground glass nodules: Optimization of acquisition protocol. A phantom study. Radiography (Lond) 2020; 27:574-580. [PMID: 33341379 DOI: 10.1016/j.radi.2020.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Ground-glass nodules may be the expression of benign conditions, pre-invasive lesions or malignancies. The aim of our study was to evaluate the capability of chest digital tomosynthesis (DTS) in detecting pulmonary ground-glass opacities (GGOs). METHODS An anthropomorphic chest phantom and synthetic nodules were used to simulate pulmonary ground-glass nodules. The nodules were positioned in 3 different regions (apex, hilum and basal); then the phantom was scanned by multi-detector CT (MDCT) and DTS. For each set (nodule-free phantom, nodule in apical zone, nodule in hilar zone, nodule in basal zone) seven different scans (n = 28) were performed varying the following technical parameters: Cu-filter (0.1-0.3 mm), dose rateo (10-25) and X-ray tube voltage (105-125 kVp). Two radiologists in consensus evaluated the DTS images and provided in agreement a visual score: 1 for unidentifiable nodules, 2 for poorly identifiable nodules, 3 for nodules identifiable with fair certainty, 4 for nodules identifiable with absolute certainty. RESULTS Increasing the dose rateo from 10 to 15, GGOs located in the apex and in the basal zone were better identified (from a score = 2 to a score = 3). GGOs located in the hilar zone were not visible even with a higher dose rate. Intermediate density GGOs had a good visibility score (score = 3) and it did not improve by varying technical parameters. A progressive increase of voltage (from 105 kVp to 125 kVp) did not provide a better nodule visibility. CONCLUSION DTS with optimized technical parameters can identify GGOs, in particular those with a diameter greater than 10 mm. IMPLICATIONS FOR PRACTICE DTS could have a role in the follow-up of patients with known GGOs identified in lung apex or base region.
Collapse
Affiliation(s)
- E Baratella
- Department of Radiology, University of Trieste, Trieste, Italy.
| | - A M Bozzato
- Department of Medicine, Surgery and Health Science, University of Trieste, Trieste, Italy
| | - C Marrocchio
- Department of Medicine, Surgery and Health Science, University of Trieste, Trieste, Italy
| | - C Natali
- Department of Radiology, Radiology of Gorizia and Monfalcone, Italy
| | - A Di Giusto
- Department of Medicine, Surgery and Health Science, University of Trieste, Trieste, Italy
| | - E Quaia
- Department of Medicine - DIMED, Radiology Institute, University of Padua, Padua, Italy
| | - M A Cova
- Department of Radiology, University of Trieste, Trieste, Italy
| |
Collapse
|
11
|
Tongkum S, Suwanpradit P, Vidhyarkorn S, Siripongsakun S, Oonsiri S, Rakvongthai Y, Khamwan K. Determination of radiation dose and low-dose protocol for digital chest tomosynthesis using radiophotoluminescent (RPL) glass dosimeters. Phys Med 2020; 73:13-21. [PMID: 32279046 DOI: 10.1016/j.ejmp.2020.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/07/2020] [Accepted: 03/29/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This study aimed to determine a low-dose protocol for digital chest tomosynthesis (DTS). METHODS Five simulated nodules with a CT number of approximately 100 HU with size diameter of 3, 5, 8, 10, and 12 mm were inserted into an anthropomorphic chest phantom (N1 Lungman model), and then scanned by DTS system (Definium 8000) with varying tube voltage, copper filter thickness, and dose ratio. Three radiophotoluminescent (RPL) glass dosimeters, type GD-352 M with a dimension of 1.5 × 12 mm, were used to measure the entrance surface air kerma (ESAK) in each protocol. The effective dose (ED) was calculated using the recorded total dose-area-product (DAP). The signal-to-noise ratio (SNR) was determined for qualitative image quality evaluation. The image criteria and nodule detection capability were scored by two experienced radiologists. The selected low-dose protocol was further applied in a clinical study with 30 pulmonary nodule follow-up patients. RESULTS The average ESAK obtained from the standard default protocol was 1.68 ± 0.15 mGy, while an ESAK of 0.47 ± 0.02 mGy was found for a low-dose protocol. The EDs for the default and low-dose protocols were 313.98 ± 0.72 µSv and 100.55 ± 0.28 µSv, respectively. There were small non-significant differences in the image criteria and nodule detection scoring between the low-dose and default protocols interpreted by two radiologists. The effective dose of 98.87 ± 0.08 µSv was obtained in clinical study after applying the low-dose protocol. CONCLUSIONS The low-dose protocol obtained in this study can substantially reduce radiation dose while preserving an acceptable image quality compared to the standard protocol.
Collapse
Affiliation(s)
- Sarawut Tongkum
- Medical Physics Graduate Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Department of Diagnostic and Interventional Radiology, Chulabhorn Hospital, Bangkok 10210, Thailand
| | - Petcharleeya Suwanpradit
- Division of Diagnostic Radiology, Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
| | - Sirachat Vidhyarkorn
- Department of Diagnostic and Interventional Radiology, Chulabhorn Hospital, Bangkok 10210, Thailand
| | - Surachate Siripongsakun
- Sonographer School, Faculty of Heath Science Technology, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Sornjarod Oonsiri
- Division of Radiation Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
| | - Yothin Rakvongthai
- Medical Physics Graduate Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Chulalongkorn University Biomedical Imaging Group, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Kitiwat Khamwan
- Medical Physics Graduate Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Chulalongkorn University Biomedical Imaging Group, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
| |
Collapse
|
12
|
Ye K, Zhu Q, Li M, Lu Y, Yuan H. A feasibility study of pulmonary nodule detection by ultralow-dose CT with adaptive statistical iterative reconstruction-V technique. Eur J Radiol 2019; 119:108652. [PMID: 31521879 DOI: 10.1016/j.ejrad.2019.108652] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/12/2019] [Accepted: 08/23/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE To evaluate the clinical value of ultralow-dose CT (ULDCT) with adaptive statistical iterative reconstruction-V (ASiR-V) in the detection of pulmonary nodules in a Chinese population. METHOD One hundred eighty-eight patients (16.41 ≤ BMI ≤ 29.87 kg/m2) with pulmonary nodules detected on low-dose chest CT (LDCT) underwent local ULDCT at the center of the chosen nodule with a scan length of 3 cm. LDCT was performed using the Assist kV (120/100 kV)/Smart mA mode and at 120 kV/2.8 mAs for ULDCT. After scanning, CT images were reconstructed with ASiR-V 50%. For both scans, nodule diameters were measured and reference standards were established for the presence and types of lung nodules found on LDCT. The sensitivity of ULDCT was compared against the standard, and logistic regression analysis was used to determine the independent predictors for nodule detection. RESULTS Compared with LDCT (0.93 ± 0.32 mSv), a 89.7% dose decrease was seen with ULDCT, for which the calculated effective dose was 0.096 ± 0.006 mSv (P < 0.001). LDCT showed 188 nodules, including 123 solid and 65 subsolid nodules. The overall sensitivity for nodule detection in ULDCT was 90.4% (170/188), and 98.2% (54/55) for nodules ≥ 6 mm. In multivariate analysis, nodule types and diameters were independent predictors of sensitivity (P < 0.05). However, patients' BMI had no effect on nodule detection (P > 0.05). CONCLUSIONS ULDCT can be used in the management of pulmonary nodules for people with BMI ≤ 30 kg/m2 at 10% radiation dose of LDCT.
Collapse
Affiliation(s)
- Kai Ye
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Qiao Zhu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Meijiao Li
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Yuliu Lu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Beijing, China.
| |
Collapse
|
13
|
Accuracy of Digital Tomosynthesis of the Chest in Detection of Interstitial Lung Disease Comparison With Digital Chest Radiography. J Comput Assist Tomogr 2019; 43:109-114. [PMID: 30119061 DOI: 10.1097/rct.0000000000000780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the study was to assess the ability of chest digital tomosynthesis (DTS) for detection of interstitial lung disease (ILD) compared with conventional chest radiography. MATERIALS AND METHODS We retrospectively reviewed 78 patients (60 males, 18 females, mean age = 53.05 years, range, 19-83 years) who underwent chest DTS for a 5-year interval (January 1, 2009-December 31, 2014). Of the 78 patients, 33 (42.3%) carried a diagnosis of ILD and 45 (57.7%) were not ILD. All computed tomography reports and medical records were reviewed. The conventional chest radiography and DTS were separately reviewed by 2 radiologists for the presence of ILD and the confidence in diagnosis. RESULTS The diagnostic accuracy of DTS for the detection of ILD was better than conventional chest radiography (P < 0.05). Digital tomosynthesis had a sensitivity of 83.3% and negative predictive value of 89.0% that were statistically significantly better than conventional chest radiography (43.9% and 70.9%, respectively). Confidence in diagnosing ILD at DTS was higher than conventional chest radiography (P < 0.001) and had higher interobserver agreement than conventional chest radiography (P < 0.01). CONCLUSIONS Digital tomosynthesis improves diagnostic performance and confidence in diagnosing ILD compared with conventional chest radiography. Digital tomosynthesis can be suggested as the initial diagnostic technique for patients with suspected ILD.
Collapse
|
14
|
Mazzei MA, Sartorelli P, Bagnacci G, Gentili F, Sisinni AG, Fausto A, Mazzei FG, Volterrani L. Occupational Lung Diseases: Underreported Diagnosis in Radiological Practice. Semin Ultrasound CT MR 2018; 40:36-50. [PMID: 30686366 DOI: 10.1053/j.sult.2018.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Underreporting of occupational lung diseases is a widespread problem in clinical practice. In Europe there is not a common regulation even for the recognition of occupational cancers. Furthermore epidemiologic data on occupational interstitial lung diseases, in general, is limited by no standardized diagnostic criteria, varied physician awareness and training, limitations inherent to the various data sources, and the long latency period. Therefore, to optimize the management of the patient with occupational pathology, the collaboration and skills of the multidisciplinary at the service of the patient, play a fundamental role. In particular, radiologists should give substance to a clinical suspicion on an anamnestic basis and at the same time should recognize patterns of illness that can lead to the emergence of stories of misunderstood exposures. This article aims to provide an overview of the main occupational lung diseases with attention to diagnostic possibilities of the different imaging techniques. The issue of the radiological error is investigated, providing tools to minimize it in the daily practice.
Collapse
Affiliation(s)
- Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | - Pietro Sartorelli
- Unit of Occupational Medicine, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy; Department of Medical Biotechnology, Unit of Occupational Medicine, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | - Giulio Bagnacci
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy.
| | - Francesco Gentili
- Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | | | - Alfonso Fausto
- Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | | | - Luca Volterrani
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| |
Collapse
|
15
|
Meltzer C, Vikgren J, Bergman B, Molnar D, Norrlund RR, Hassoun A, Gottfridsson B, Båth M, Johnsson ÅA. Detection and Characterization of Solid Pulmonary Nodules at Digital Chest Tomosynthesis: Data from a Cohort of the Pilot Swedish Cardiopulmonary Bioimage Study. Radiology 2018; 287:1018-1027. [PMID: 29613826 DOI: 10.1148/radiol.2018171481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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.
Collapse
Affiliation(s)
- Carin Meltzer
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| | - Jenny Vikgren
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| | - Bengt Bergman
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| | - David Molnar
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| | - Rauni Rossi Norrlund
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| | - Asmaa Hassoun
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| | - Bengt Gottfridsson
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| | - Magnus Båth
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| | - Åse A Johnsson
- From the Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (C.M., J.V., D.M., R.R.N., Å.A.J.), Department of Radiology and Nuclear Medicine at Oslo University Hospital, Ullevål, Norway (C.M.), Department of Radiology, Sahlgrenska University Hospital, Sweden (J.V., D.M., R.R.N., A.H., B.G., Å.A.J.), Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden (B.B.), Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden (B.B.), Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden (M.B.), Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden (M.B.)
| |
Collapse
|
16
|
The advantage of digital tomosynthesis for pulmonary nodule detection concerning influence of nodule location and size: a phantom study. Clin Radiol 2017; 72:796.e1-796.e8. [DOI: 10.1016/j.crad.2017.03.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 03/14/2017] [Accepted: 03/24/2017] [Indexed: 11/21/2022]
|
17
|
Grosso M, Priotto R, Ghirardo D, Talenti A, Roberto E, Bertolaccini L, Terzi A, Chauvie S. Comparison of digital tomosynthesis and computed tomography for lung nodule detection in SOS screening program. Radiol Med 2017; 122:568-574. [DOI: 10.1007/s11547-017-0765-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/10/2017] [Indexed: 12/19/2022]
|
18
|
Sui X, Du Q, Xu KF, Tian X, Song L, Wang X, Xu X, Wang Z, Wang Y, Gu J, Song W, Jin Z. Quantitative assessment of Pulmonary Alveolar Proteinosis (PAP) with ultra-dose CT and correlation with Pulmonary Function Tests (PFTs). PLoS One 2017; 12:e0172958. [PMID: 28301535 PMCID: PMC5354367 DOI: 10.1371/journal.pone.0172958] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 02/13/2017] [Indexed: 12/14/2022] Open
Abstract
Background The purpose of this study was to investigate whether ultra-low-dose chest computed tomography (CT) can be used for visual assessment of CT features in patients with pulmonary alveolar proteinosis (PAP) and to evaluate the relationship between the quantitative analysis of the ultra-low-dose CT scans and the pulmonary function tests (PFTs). Methods Thirty-eight patients (mean [SD] age, 44.47 [12.28] years; 29 males, 9 females) with PAP were enrolled and subjected to two scans each with low-dose CT (reference parameters: 120 kV and 50 mAs) and ultra-low-dose CT (reference parameters, 80 kV, 25 mAs). Images were reconstructed via filtered back projection (FBP) for low-dose CT and iterative reconstruction (IR) for ultra-low-dose CT. All patients underwent PFT. The Visual analysis for ground glass opacity (GGO) is performed. The quantitative CT and PFT results were analyzed by canonical correlations. Results The mean body mass index (BMI) was 25.37±3.26 kg/m2. The effective radiation doses were 2.30±0.46 and 0.24±0.05 mSv for low-dose and ultra-low-dose CT, respectively. The size-specific dose estimates were 5.81±0.81 and 0.62±0.09 mSv for low-dose and ultra-low-dose CT. GGOs and interlobular septal thickening were observed bilaterally in all patients. The average visual GGO score was lower in the upper field (2.67±1.24) but higher in the middle and lower fields (3.08±1.32 and 3.08±0.97, respectively). The average score for the whole lung was 2.94±1.19. There is a significant correlation between PFTs and quantitative of ultra-low-dose CT (canonical loading = 0.78). Conclusions Ultra-low-dose CT has the potential to quantify the lung parenchyma changes of PAP. This technique could provide a sensitive and objective assessment of PAP and has good relation with PFTs. In addition, the radiation dose of ultra-low-dose CT was very low.
Collapse
Affiliation(s)
- Xin Sui
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qianni Du
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Kai-feng Xu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinlun Tian
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lan Song
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoli Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zixing Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Science, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yuyan Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Science, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Jun Gu
- Siemens Healthineers, Beijing, China
| | - Wei Song
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- * E-mail:
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
19
|
Miyata K, Nagatani Y, Ikeda M, Takahashi M, Nitta N, Matsuo S, Ohta S, Otani H, Nitta-Seko A, Murakami Y, Tsuchiya K, Inoue A, Misaki S, Erdenee K, Kida T, Murata K. A phantom study for ground-glass nodule detectability using chest digital tomosynthesis with iterative reconstruction algorithm by ten observers: association with radiation dose and nodular characteristics. Br J Radiol 2017; 90:20160555. [PMID: 28102693 DOI: 10.1259/bjr.20160555] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To compare detectability of simulated ground-glass nodules (GGNs) on chest digital tomosynthesis (CDT) among 12 images obtained at 6 radiation doses using 2 reconstruction algorithms and to analyze its association with nodular size and density. METHODS 74 simulated GGNs [5, 8 and 10 mm in diameter/-630 and -800 Hounsfield units (HU) in density] were placed in a chest phantom in 14 nodular distribution patterns. 12 sets of coronal images were obtained using CDT at 6 radiation doses: 120 kV-10 mA/20 mA/80 mA/160 mA, 100 kV-80 mA and 80 kV-320 mA with and without iterative reconstruction (IR). 10 radiologists recorded GGN presence and locations by continuously distributed rating. GGN detectability was compared by receiver operating characteristic analysis among 12 images and detection sensitivities (DS) were compared among 12 images in subgroups classified by nodular diameters and densities. RESULTS GGN detectability at 120 kV-160 mA with IR was similar to that at 120 kV-80 mA with IR (0.614 mSv), as area under receiver operating characteristic curve was 0.798 ± 0.024 and 0.788 ± 0.025, respectively, and higher than six images acquired at 120 kV (p < 0.05). For nodules of -630 HU/8 mm, DS at 120 kV-10 mA without IR was 73.5 ± 6.0% and was similar to that by the other 11 data acquisition methods (p = 0.157). For nodules of -800 HU/10 mm, DS both at 120 kV-80 mA and 120 kV-160 mA without IR was improved by IR (56.3 ± 11.9%) (p < 0.05). CONCLUSION CDT demonstrated sufficient detectability for larger more-attenuated GGNs (>8 mm) even in the lowest radiation dose (0.17 mSv) and improved detectability for less-attenuated GGNs with the diameter of 10 mm at submillisievert with IR. Advances in knowledge: IR improved detectability for larger less-attenuated simulated GGNs on CDT.
Collapse
Affiliation(s)
- Katsunori Miyata
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Yukihiro Nagatani
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Mitsuru Ikeda
- 2 Department of Radiological Technology, Nagoya University School of Health Science, Higashi-ku, Nagoya, Japan
| | - Masashi Takahashi
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan.,3 Department of Radiology, Yujin-Yamazaki Hospital, Hikone, Shiga, Japan
| | - Norihisa Nitta
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Satoru Matsuo
- 4 Department of Radiological Technology, Kyoto College of Medical Science, Nantan, Kyoto, Japan
| | - Shinichi Ohta
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Hideji Otani
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Ayumi Nitta-Seko
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Yoko Murakami
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Keiko Tsuchiya
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Akitoshi Inoue
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Sayaka Misaki
- 5 Department of Radiology, Ijinkai-Takeda General Hospital, Fushimi-ku, Kyoto, Japan
| | - Khishigdorj Erdenee
- 6 Department of Radiology, EMC-KENKO Hospital, Health Science University of Mongolia, Orkhon, Mongolia
| | - Tetsuo Kida
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Kiyoshi Murata
- 1 Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| |
Collapse
|
20
|
Dobbins JT, McAdams HP, Sabol JM, Chakraborty DP, Kazerooni EA, Reddy GP, Vikgren J, Båth M. Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules. Radiology 2016; 282:236-250. [PMID: 27439324 DOI: 10.1148/radiol.2016150497] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board-approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3-20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3-4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P < .001; 95% confidence interval [CI]: 2.96, 4.15). Case-level sensitivity was higher with tomosynthesis than with conventional chest radiography for all nodules (1.49-fold, P < .001; 95% CI: 1.25, 1.73). Case management decisions showed better overall accuracy with tomosynthesis than with conventional chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P < .001; 95% CI: 1.15, 1.32). There were no differences in any specificity measures. DE imaging did not significantly affect nodule detection when paired with either conventional chest radiography or tomosynthesis. Conclusion Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest radiography or tomosynthesis alone. These findings indicate performance likely achievable with a range of reader expertise. © RSNA, 2016 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- James T Dobbins
- From the Carl E. Ravin Advanced Imaging Laboratory; Depts of Radiology, Biomedical Engineering, and Physics; and Medical Physics Graduate Program, Duke Univ Medical Ctr, 2424 Erwin Rd, Suite 302, Durham, NC 27705 (J.T.D.); Carl E. Ravin Advanced Imaging Laboratory and Dept of Radiology, Duke Univ Medical Ctr, Durham, NC (H.P.M.); GE Healthcare, Waukesha, Wis (J.M.S.); Dept of Radiology, Univ of Pittsburgh, Pittsburgh, Pa (D.P.C.); Dept of Radiology, Univ of Michigan, Ann Arbor, Mich (E.A.K.); Dept of Radiology, Univ of Washington, Seattle, Wash (G.P.R.); Dept of Radiology, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (J.V.); Dept of Radiation Physics, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (M.B.); and Dept of Medical Physics and Biomedical Engineering, Sahlgrenska Univ Hospital, Gothenburg, Sweden (M.B.)
| | - H Page McAdams
- From the Carl E. Ravin Advanced Imaging Laboratory; Depts of Radiology, Biomedical Engineering, and Physics; and Medical Physics Graduate Program, Duke Univ Medical Ctr, 2424 Erwin Rd, Suite 302, Durham, NC 27705 (J.T.D.); Carl E. Ravin Advanced Imaging Laboratory and Dept of Radiology, Duke Univ Medical Ctr, Durham, NC (H.P.M.); GE Healthcare, Waukesha, Wis (J.M.S.); Dept of Radiology, Univ of Pittsburgh, Pittsburgh, Pa (D.P.C.); Dept of Radiology, Univ of Michigan, Ann Arbor, Mich (E.A.K.); Dept of Radiology, Univ of Washington, Seattle, Wash (G.P.R.); Dept of Radiology, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (J.V.); Dept of Radiation Physics, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (M.B.); and Dept of Medical Physics and Biomedical Engineering, Sahlgrenska Univ Hospital, Gothenburg, Sweden (M.B.)
| | - John M Sabol
- From the Carl E. Ravin Advanced Imaging Laboratory; Depts of Radiology, Biomedical Engineering, and Physics; and Medical Physics Graduate Program, Duke Univ Medical Ctr, 2424 Erwin Rd, Suite 302, Durham, NC 27705 (J.T.D.); Carl E. Ravin Advanced Imaging Laboratory and Dept of Radiology, Duke Univ Medical Ctr, Durham, NC (H.P.M.); GE Healthcare, Waukesha, Wis (J.M.S.); Dept of Radiology, Univ of Pittsburgh, Pittsburgh, Pa (D.P.C.); Dept of Radiology, Univ of Michigan, Ann Arbor, Mich (E.A.K.); Dept of Radiology, Univ of Washington, Seattle, Wash (G.P.R.); Dept of Radiology, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (J.V.); Dept of Radiation Physics, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (M.B.); and Dept of Medical Physics and Biomedical Engineering, Sahlgrenska Univ Hospital, Gothenburg, Sweden (M.B.)
| | - Dev P Chakraborty
- From the Carl E. Ravin Advanced Imaging Laboratory; Depts of Radiology, Biomedical Engineering, and Physics; and Medical Physics Graduate Program, Duke Univ Medical Ctr, 2424 Erwin Rd, Suite 302, Durham, NC 27705 (J.T.D.); Carl E. Ravin Advanced Imaging Laboratory and Dept of Radiology, Duke Univ Medical Ctr, Durham, NC (H.P.M.); GE Healthcare, Waukesha, Wis (J.M.S.); Dept of Radiology, Univ of Pittsburgh, Pittsburgh, Pa (D.P.C.); Dept of Radiology, Univ of Michigan, Ann Arbor, Mich (E.A.K.); Dept of Radiology, Univ of Washington, Seattle, Wash (G.P.R.); Dept of Radiology, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (J.V.); Dept of Radiation Physics, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (M.B.); and Dept of Medical Physics and Biomedical Engineering, Sahlgrenska Univ Hospital, Gothenburg, Sweden (M.B.)
| | - Ella A Kazerooni
- From the Carl E. Ravin Advanced Imaging Laboratory; Depts of Radiology, Biomedical Engineering, and Physics; and Medical Physics Graduate Program, Duke Univ Medical Ctr, 2424 Erwin Rd, Suite 302, Durham, NC 27705 (J.T.D.); Carl E. Ravin Advanced Imaging Laboratory and Dept of Radiology, Duke Univ Medical Ctr, Durham, NC (H.P.M.); GE Healthcare, Waukesha, Wis (J.M.S.); Dept of Radiology, Univ of Pittsburgh, Pittsburgh, Pa (D.P.C.); Dept of Radiology, Univ of Michigan, Ann Arbor, Mich (E.A.K.); Dept of Radiology, Univ of Washington, Seattle, Wash (G.P.R.); Dept of Radiology, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (J.V.); Dept of Radiation Physics, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (M.B.); and Dept of Medical Physics and Biomedical Engineering, Sahlgrenska Univ Hospital, Gothenburg, Sweden (M.B.)
| | - Gautham P Reddy
- From the Carl E. Ravin Advanced Imaging Laboratory; Depts of Radiology, Biomedical Engineering, and Physics; and Medical Physics Graduate Program, Duke Univ Medical Ctr, 2424 Erwin Rd, Suite 302, Durham, NC 27705 (J.T.D.); Carl E. Ravin Advanced Imaging Laboratory and Dept of Radiology, Duke Univ Medical Ctr, Durham, NC (H.P.M.); GE Healthcare, Waukesha, Wis (J.M.S.); Dept of Radiology, Univ of Pittsburgh, Pittsburgh, Pa (D.P.C.); Dept of Radiology, Univ of Michigan, Ann Arbor, Mich (E.A.K.); Dept of Radiology, Univ of Washington, Seattle, Wash (G.P.R.); Dept of Radiology, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (J.V.); Dept of Radiation Physics, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (M.B.); and Dept of Medical Physics and Biomedical Engineering, Sahlgrenska Univ Hospital, Gothenburg, Sweden (M.B.)
| | - Jenny Vikgren
- From the Carl E. Ravin Advanced Imaging Laboratory; Depts of Radiology, Biomedical Engineering, and Physics; and Medical Physics Graduate Program, Duke Univ Medical Ctr, 2424 Erwin Rd, Suite 302, Durham, NC 27705 (J.T.D.); Carl E. Ravin Advanced Imaging Laboratory and Dept of Radiology, Duke Univ Medical Ctr, Durham, NC (H.P.M.); GE Healthcare, Waukesha, Wis (J.M.S.); Dept of Radiology, Univ of Pittsburgh, Pittsburgh, Pa (D.P.C.); Dept of Radiology, Univ of Michigan, Ann Arbor, Mich (E.A.K.); Dept of Radiology, Univ of Washington, Seattle, Wash (G.P.R.); Dept of Radiology, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (J.V.); Dept of Radiation Physics, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (M.B.); and Dept of Medical Physics and Biomedical Engineering, Sahlgrenska Univ Hospital, Gothenburg, Sweden (M.B.)
| | - Magnus Båth
- From the Carl E. Ravin Advanced Imaging Laboratory; Depts of Radiology, Biomedical Engineering, and Physics; and Medical Physics Graduate Program, Duke Univ Medical Ctr, 2424 Erwin Rd, Suite 302, Durham, NC 27705 (J.T.D.); Carl E. Ravin Advanced Imaging Laboratory and Dept of Radiology, Duke Univ Medical Ctr, Durham, NC (H.P.M.); GE Healthcare, Waukesha, Wis (J.M.S.); Dept of Radiology, Univ of Pittsburgh, Pittsburgh, Pa (D.P.C.); Dept of Radiology, Univ of Michigan, Ann Arbor, Mich (E.A.K.); Dept of Radiology, Univ of Washington, Seattle, Wash (G.P.R.); Dept of Radiology, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (J.V.); Dept of Radiation Physics, Inst of Clinical Sciences, Sahlgrenska Academy at Univ of Gothenburg, Gothenburg, Sweden (M.B.); and Dept of Medical Physics and Biomedical Engineering, Sahlgrenska Univ Hospital, Gothenburg, Sweden (M.B.)
| |
Collapse
|
21
|
Comparison of Digital Tomosynthesis and Chest Radiography for the Detection of Noncalcified Pulmonary and Hilar Lesions. J Thorac Imaging 2016; 30:328-35. [PMID: 25844978 DOI: 10.1097/rti.0000000000000144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of this study was to compare the sensitivity and specificity of chest digital tomosynthesis (DTS) with chest radiography (CXR) for the detection of noncalcified pulmonary nodules and hilar lesions using computed tomography (CT) as the reference standard. MATERIALS AND METHODS A total of 78 patients with suspected noncalcified pulmonary lesions on CXR were included in the study. Two radiologists, blinded to the history and CT, analyzed the CXR and the DTS images (separately), whereas a third radiologist analyzed the CXR and DTS images together. Noncalcified intrapulmonary nodules and hilar lesions were recorded for analysis. The interobserver agreement for CXR and DTS was assessed, and the time taken to report the images was recorded. RESULTS A total of 202 lesions were recorded in 78 patients. There were 111 true lesions confirmed on CT in 53 patients; in 25 patients subsequent CT excluded a lesion. The overall sensitivity was 32% for CXR and 49% for DTS. This improved to 54% when the posteroanterior CXR and DTS were reviewed together (CXR-DTS). The overall specificities for CXR, DTS, and CXR-DTS were 49%, 96%, and 98%, respectively. There were 56 suspected hilar lesions with subgroup sensitivities of 76% for CXR, 65% for DTS, and 76% for CXR-DTS. The specificity for hilar lesions was 59%, 92%, and 97% for CXR, DTS, and CXR-DTS, respectively. CONCLUSIONS DTS significantly improves the detectability of noncalcified nodules when compared with and when used in combination with CXR. The specificity and interobserver agreement of DTS in the diagnosis of suspected noncalcified pulmonary nodules and hilar lesions are significantly better than those of CXR and approaches those of CT.
Collapse
|
22
|
Petersson C, Båth M, Vikgren J, Johnsson ÅA. AN ANALYSIS OF THE POTENTIAL ROLE OF CHEST TOMOSYNTHESIS IN OPTIMISING IMAGING RESOURCES IN THORACIC RADIOLOGY. RADIATION PROTECTION DOSIMETRY 2016; 169:165-170. [PMID: 26979807 PMCID: PMC4911966 DOI: 10.1093/rpd/ncw040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of the study was to investigate the potential role of chest tomosynthesis (CTS) at a tertiary referral centre by exploring to what extent CTS could substitute chest radiography (CXR) and computed tomography (CT). The study comprised 1433 CXR, 523 CT and 216 CTS examinations performed 5 years after the introduction of CTS. For each examination, it was decided if CTS would have been appropriate instead of CXR (CXR cases), if CTS could have replaced the performed CT (CT cases) or if CT would have been performed had CTS not been available (CTS cases). It was judged that (a) CTS had been appropriate in 15 % of the CXR examinations, (b) CTS could have replaced additionally 7 % of the CT examinations and (c) CT would have been carried out in 63 % of the performed CTS examinations, had CTS not been available. In conclusion, the potential role for CTS to substitute other modalities during office hours at a tertiary referral centre may be in the order of 20 and 25 % of performed CXR and chest CT, respectively.
Collapse
Affiliation(s)
- Cecilia Petersson
- Department of Radiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Magnus Båth
- Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Jenny Vikgren
- Department of Radiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden Department of Radiology, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Åse Allansdotter Johnsson
- Department of Radiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden Department of Radiology, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden
| |
Collapse
|
23
|
Meltzer C, Båth M, Kheddache S, Ásgeirsdóttir H, Gilljam M, Johnsson ÅA. VISIBILITY OF STRUCTURES OF RELEVANCE FOR PATIENTS WITH CYSTIC FIBROSIS IN CHEST TOMOSYNTHESIS: INFLUENCE OF ANATOMICAL LOCATION AND OBSERVER EXPERIENCE. RADIATION PROTECTION DOSIMETRY 2016; 169:177-87. [PMID: 26842827 PMCID: PMC4911964 DOI: 10.1093/rpd/ncv556] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The aims of this study were to assess the visibility of pulmonary structures in patients with cystic fibrosis (CF) in digital tomosynthesis (DTS) using computed tomography (CT) as reference and to investigate the dependency on anatomical location and observer experience. Anatomical structures in predefined regions of CT images from 21 patients were identified. Three observers with different levels of experience rated the visibility of the structures in DTS by performing a head-to-head comparison with visibility in CT. Visibility of the structures in DTS was reported as equal to CT in 34 %, inferior in 52 % and superior in 14 % of the ratings. Central and peripheral lateral structures received higher visibility ratings compared with peripheral structures anteriorly, posteriorly and surrounding the diaphragm (p ≤ 0.001). Reported visibility was significantly higher for the most experienced observer (p ≤ 0.01). The results indicate that minor pathology can be difficult to visualise with DTS depending on location and observer experience. Central and peripheral lateral structures are generally well depicted.
Collapse
Affiliation(s)
- Carin Meltzer
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden Department of Radiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Magnus Båth
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Susanne Kheddache
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden Department of Radiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Helga Ásgeirsdóttir
- Gothenburg CF-Center, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Marita Gilljam
- Gothenburg CF-Center, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Åse Allansdotter Johnsson
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden Department of Radiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| |
Collapse
|
24
|
Båth M, Söderman C, Svalkvist A. RETROSPECTIVE ESTIMATION OF PATIENT DOSE-AREA PRODUCT IN THORACIC SPINE TOMOSYNTHESIS PERFORMED USING VOLUMERAD. RADIATION PROTECTION DOSIMETRY 2016; 169:281-285. [PMID: 26590395 DOI: 10.1093/rpd/ncv475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate the use of a recently developed method of retrospectively estimating the patient dose-area product (DAP) of a chest tomosynthesis examination, performed using VolumeRAD, in thoracic spine tomosynthesis and to determine the necessary field-size correction factor. Digital imaging and communications in medicine (DICOM) data for the projection radiographs acquired during a thoracic spine tomosynthesis examination were retrieved directly from the modality for 17 patients. Using the previously developed method, an estimated DAP for the tomosynthesis examination was determined from DICOM data in the scout image. By comparing the estimated DAP with the actual DAP registered for the projection radiographs, a field-size correction factor was determined. The field-size correction factor for thoracic spine tomosynthesis was determined to 0.92. Applying this factor to the DAP estimated retrospectively, the maximum difference between the estimated DAP and the actual DAP was <3 %. In conclusion, the previously developed method of retrospectively estimating the DAP in chest tomosynthesis can be applied to thoracic spine tomosynthesis.
Collapse
Affiliation(s)
- Magnus Båth
- Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Christina Söderman
- Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Angelica Svalkvist
- Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| |
Collapse
|
25
|
Maidment ADA. Commentary on “Whole-Body Clinical Applications of Digital Tomosynthesis,” with Response from Dr Machida and Colleagues. Radiographics 2016; 36:750-2. [DOI: 10.1148/rg.2016160028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
26
|
Machida H, Yuhara T, Tamura M, Ishikawa T, Tate E, Ueno E, Nye K, Sabol JM. Whole-Body Clinical Applications of Digital Tomosynthesis. Radiographics 2016; 36:735-50. [DOI: 10.1148/rg.2016150184] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
27
|
Sui X, Meinel FG, Song W, Xu X, Wang Z, Wang Y, Jin Z, Chen J, Vliegenthart R, Schoepf UJ. Detection and size measurements of pulmonary nodules in ultra-low-dose CT with iterative reconstruction compared to low dose CT. Eur J Radiol 2016; 85:564-70. [PMID: 26860668 DOI: 10.1016/j.ejrad.2015.12.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 12/12/2015] [Accepted: 12/16/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Xin Sui
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
| | - Felix G Meinel
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
| | - Wei Song
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoli Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
| | - Zixing Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Science, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China.
| | - Yuyan Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Science, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China.
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
| | | | - Rozemarijn Vliegenthart
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, Department of Radiology, Groningen, The Netherlands.
| | - U Joseph Schoepf
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| |
Collapse
|
28
|
Diagnostic impact of digital tomosynthesis in oncologic patients with suspected pulmonary lesions on chest radiography. Eur Radiol 2015; 26:2837-44. [PMID: 26628064 DOI: 10.1007/s00330-015-4104-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 10/30/2015] [Accepted: 11/10/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To assess the actual diagnostic impact of digital tomosynthesis (DTS) in oncologic patients with suspected pulmonary lesions on chest radiography (CXR). METHODS A total of 237 patients (135 male, 102 female; age, 70.8 ± 10.4 years) with a known primary malignancy and suspected pulmonary lesion(s) on CXR and who underwent DTS were retrospectively identified. Two radiologists (experience, 10 and 15 years) analysed in consensus CXR and DTS images and proposed a diagnosis according to a confidence score: 1 or 2 = definitely or probably benign pulmonary or extrapulmonary lesion, or pseudolesion; 3 = indeterminate; 4 or 5 = probably or definitely pulmonary lesion. DTS findings were proven by CT (n = 114 patients), CXR during follow-up (n = 105) or histology (n = 18). RESULTS Final diagnoses included 77 pulmonary opacities, 26 pulmonary scars, 12 pleural lesions and 122 pulmonary pseudolesions. DTS vs CXR presented a higher (P < 0.05) sensitivity (92 vs 15 %), specificity (91 vs 9 %), overall accuracy (92 vs 12 %), and diagnostic confidence (area under ROC, 0.997 vs 0.619). Mean effective dose of CXR vs DTS was 0.06 vs 0.107 mSv (P < 0.05). CONCLUSIONS DTS improved diagnostic accuracy and confidence in comparison to CXR alone in oncologic patients with suspected pulmonary lesions on CXR with only a slight, though significant, increase in radiation dose. KEY POINTS • Digital tomosynthesis (DTS) improves accuracy of chest radiography (CXR) in oncologic patients. • DTS improves confidence of CXR in oncologic patients. • DTS allowed avoidance of CT in about 50 % of oncologic patients.
Collapse
|
29
|
Bertolaccini L, Viti A, Terzi A. Digital tomosynthesis in lung cancer: state of the art. ANNALS OF TRANSLATIONAL MEDICINE 2015. [PMID: 26207232 DOI: 10.3978/j.issn.2305-5839.2015.06.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Chest digital tomosynthesis (CDT) is a limited angle image tomography, which improves the visibility of anatomy compared with radiographic imaging. Due to the limited acquisition angle of CDT, it has the potential to significantly increase the temporal resolution of patient surveillance at the cost of reduced resolution in one direction. CDT is 3 times more effective in identifying pulmonary nodules compared to conventional radiography and at lower doses and cost compared with routine chest computed tomography (CT) examinations. There is only one report in which CDT was used in a single-arm observational study for lung cancer detection in at-risk population while a few studies suggested that CDT sensitivity is superior to radiography but inferior to CT in detecting lung nodules, other studies on the accuracy of CDT suggest that the specificity is much closer to CT than radiography. Therefore, large-scale randomized controlled trial would be needed to confirm benefits of CDT and identify where it is best used in the clinical setting. CDT seems to be a cost-effectiveness first-line lung cancer screening tool to detect potential lung cancer nodule.
Collapse
Affiliation(s)
- Luca Bertolaccini
- 1 Thoracic Surgery Unit, Sacro Cuore-Don Calabria Research Hospital, Negrar Verona, Italy ; 2 Thoracic Surgery Unit, S. Croce e Carle Hospital, Cuneo, Italy
| | - Andrea Viti
- 1 Thoracic Surgery Unit, Sacro Cuore-Don Calabria Research Hospital, Negrar Verona, Italy ; 2 Thoracic Surgery Unit, S. Croce e Carle Hospital, Cuneo, Italy
| | - Alberto Terzi
- 1 Thoracic Surgery Unit, Sacro Cuore-Don Calabria Research Hospital, Negrar Verona, Italy ; 2 Thoracic Surgery Unit, S. Croce e Carle Hospital, Cuneo, Italy
| |
Collapse
|
30
|
Jadidi M, Sundin A, Aspelin P, Båth M, Nyrén S. Evaluation of a new system for chest tomosynthesis: aspects of image quality of different protocols determined using an anthropomorphic phantom. Br J Radiol 2015; 88:20150057. [PMID: 26118300 DOI: 10.1259/bjr.20150057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the image quality obtained with the different protocols in a new chest digital tomosynthesis (DTS) system. METHODS A chest phantom was imaged with chest X-ray equipment with DTS. 10 protocols were used, and for each protocol, nine acquisitions were performed. Four observers visually rated the quality of the reconstructed section images according to pre-defined quality criteria in four different classes. The data were analysed with visual grading characteristics (VGC) analysis, using the vendor-recommended protocol [12-s acquisition time, source-to-image distance (SID) 180 cm] as reference, and the area under the VGC curve (AUCVGC) was determined for each protocol and class of criteria. RESULTS Protocols with a smaller swing angle resulted in a lower image quality for the classes of criteria "disturbance" and "homogeneity in nodule" but a higher image quality for the class "structure". The class "demarcation" showed little dependency on the swing angle. All protocols but one (6.3 s, SID 130 cm) obtained an AUCVGC significantly <0.5 (indicating lower quality than reference) for at least one class of criteria. CONCLUSION The study indicates that the DTS protocol with 6.3 s yields image quality similar to that obtained with the vendor-recommended protocol (12 s) but with the clinically important advantage for patients with respiratory impairment of a shorter acquisition time. ADVANCES IN KNOWLEDGE The study demonstrates that the image quality may be strongly affected by the choice of protocol and that the vendor-recommended protocol may not be optimal.
Collapse
Affiliation(s)
- M Jadidi
- 1 Departments of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - A Sundin
- 2 Radiology Department, Uppsala University Hospital, Uppsala, Sweden.,3 Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden
| | - P Aspelin
- 4 Departments of Clinical Science, Intervention and Technology, Karolinska University Hospital, Stockholm, Sweden.,5 Radiology Department, Karolinska University Hospital, Stockholm, Sweden
| | - M Båth
- 6 Department of Radiation Physics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,7 Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - S Nyrén
- 8 Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,9 Radiology Department, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
31
|
|
32
|
Wu D, Yan A, Li Y, Wong MD, Zheng B, Wu X, Liu H. Characterization of a high-energy in-line phase contrast tomosynthesis prototype. Med Phys 2015; 42:2404-20. [PMID: 25979035 PMCID: PMC4401810 DOI: 10.1118/1.4917227] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 03/09/2015] [Accepted: 03/13/2015] [Indexed: 12/25/2022] Open
Abstract
PURPOSE In this research, a high-energy in-line phase contrast tomosynthesis prototype was developed and characterized through quantitative investigations and phantom studies. METHODS The prototype system consists of an x-ray source, a motorized rotation stage, and a CMOS detector with a pixel pitch of 0.05 mm. The x-ray source was operated at 120 kVp for this study, and the objects were mounted on the rotation stage 76.2 cm (R1) from the source and 114.3 cm (R2) from the detector. The large air gap between the object and detector guarantees sufficient phase-shift effects. The quantitative evaluation of this prototype included modulation transfer function and noise power spectrum measurements conducted under both projection mode and tomosynthesis mode. Phantom studies were performed including three custom designed phantoms with complex structures: a five-layer bubble wrap phantom, a fishbone phantom, and a chicken breast phantom with embedded fibrils and mass structures extracted from an ACR phantom. In-plane images of the phantoms were acquired to investigate their image qualities through observation, intensity profile plots, edge enhancement evaluations, and/or contrast-to-noise ratio calculations. In addition, the robust phase-attenuation duality (PAD)-based phase retrieval method was applied to tomosynthesis for the first time in this research. It was utilized as a preprocessing method to fully exhibit phase contrast on the angular projection before reconstruction. RESULTS The resolution and noise characteristics of this high-energy in-line phase contrast tomosynthesis prototype were successfully investigated and demonstrated. The phantom studies demonstrated that this imaging prototype can successfully remove the structure overlapping in phantom projections, obtain delineate interfaces, and achieve better contrast-to-noise ratio after applying phase retrieval to the angular projections. CONCLUSIONS This research successfully demonstrated a high-energy in-line phase contrast tomosynthesis prototype. In addition, the PAD-based method of phase retrieval was combined with tomosynthesis imaging for the first time, which demonstrated its capability in significantly improving the contrast-to-noise ratios in the images.
Collapse
Affiliation(s)
- Di Wu
- Center of Bioengineering and School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma 73019
| | - Aimin Yan
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama 35249
| | - Yuhua Li
- Center of Bioengineering and School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma 73019
| | - Molly D Wong
- Center of Bioengineering and School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma 73019
| | - Bin Zheng
- Center of Bioengineering and School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma 73019
| | - Xizeng Wu
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama 35249
| | - Hong Liu
- Center of Bioengineering and School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma 73019
| |
Collapse
|
33
|
Lee KH, Goo JM, Lee SM, Park CM, Bahn YE, Kim H, Song YS, Hwang EJ. Digital tomosynthesis for evaluating metastatic lung nodules: nodule visibility, learning curves, and reading times. Korean J Radiol 2015; 16:430-9. [PMID: 25741205 PMCID: PMC4347279 DOI: 10.3348/kjr.2015.16.2.430] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 11/30/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate nodule visibility, learning curves, and reading times for digital tomosynthesis (DT). MATERIALS AND METHODS We included 80 patients who underwent computed tomography (CT) and DT before pulmonary metastasectomy. One experienced chest radiologist annotated all visible nodules on thin-section CT scans using computer-aided detection software. Two radiologists used CT as the reference standard and retrospectively graded the visibility of nodules on DT. Nodule detection performance was evaluated in four sessions of 20 cases each by six readers. After each session, readers were unblinded to the DT images by revealing the true-positive markings and were instructed to self-analyze their own misreads. Receiver-operating-characteristic curves were determined. RESULTS Among 414 nodules on CT, 53.3% (221/414) were visible on DT. The main reason for not seeing a nodule on DT was small size (93.3%, ≤ 5 mm). DT revealed a substantial number of malignant nodules (84.1%, 143/170). The proportion of malignant nodules among visible nodules on DT was significantly higher (64.7%, 143/221) than that on CT (41.1%, 170/414) (p < 0.001). Area under the curve (AUC) values at the initial session were > 0.8, and the average detection rate for malignant nodules was 85% (210/246). The inter-session analysis of the AUC showed no significant differences among the readers, and the detection rate for malignant nodules did not differ across sessions. A slight improvement in reading times was observed. CONCLUSION Most malignant nodules > 5 mm were visible on DT. As nodule detection performance was high from the initial session, DT may be readily applicable for radiology residents and board-certified radiologists.
Collapse
Affiliation(s)
- Kyung Hee Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul 110-744, Korea
| | - Sang Min Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul 110-744, Korea
| | - Young Eun Bahn
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Hyungjin Kim
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Yong Sub Song
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Eui Jin Hwang
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| |
Collapse
|
34
|
Galea A, Dubbins P, Riordan R, Adlan T, Roobottom C, Gay D. The value of digital tomosynthesis of the chest as a problem-solving tool for suspected pulmonary nodules and hilar lesions detected on chest radiography. Eur J Radiol 2015; 84:1012-8. [PMID: 25757629 DOI: 10.1016/j.ejrad.2015.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 11/28/2014] [Accepted: 02/09/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To assess the capability of digital tomosynthesis (DTS) of the chest compared to a postero-anterior (PA) and lateral chest radiograph (CXR) in the diagnosis of suspected but unconfirmed pulmonary nodules and hilar lesions detected on a CXR. Computed tomography (CT) was used as the reference standard. MATERIALS AND METHOD 78 patients with suspected non-calcified pulmonary nodules or hilar lesions on their CXR were included in the study. Two radiologists, blinded to the history and CT, prospectively analysed the CXR (PA and lateral) and the DTS images using a picture archiving and communication workstation and were asked to designate one of two outcomes: true intrapulmonary lesion or false intrapulmonary lesion. A CT of the chest performed within 4 weeks of the CXR was used as the reference standard. Inter-observer agreement and time to report the modalities were calculated for CXR and DTS. RESULTS There were 34 true lesions confirmed on CT, 12 were hilar lesions and 22 were peripheral nodules. Of the 44 false lesions, 37 lesions were artefactual or due to composite shadow and 7 lesions were real but extrapulmonary simulating non-calcified intrapulmonary lesions. The PA and lateral CXR correctly classified 39/78 (50%) of the lesions, this improved to 75/78 (96%) with DTS. The sensitivity and specificity was 0.65 and 0.39 for CXR and 0.91 and 1 for DTS. Based on the DTS images, readers correctly classified all the false lesions but missed 3/34 true lesions. Two of the missed lesions were hilar in location and one was a peripheral nodule. All three missed lesions were incorrectly classified on DTS as composite shadow. CONCLUSIONS DTS improves diagnostic confidence when compared to a repeat PA and lateral CXR in the diagnosis of both suspected hilar lesions and pulmonary nodules detected on CXR. DTS is able to exclude most peripheral pulmonary nodules but caution and further studies are needed to assess its ability to exclude hilar lesions.
Collapse
Affiliation(s)
- Angela Galea
- Peninsula Radiology Academy, William Prance Road, Plymouth PL65WR, UK.
| | - Paul Dubbins
- Plymouth Hospital NHS Trust, Plymouth PL68DH, UK.
| | | | - Tarig Adlan
- Plymouth Hospital NHS Trust, Plymouth PL68DH, UK.
| | | | - David Gay
- Plymouth Hospital NHS Trust, Plymouth PL68DH, UK.
| |
Collapse
|
35
|
Söderman C, Asplund S, Allansdotter Johnsson Å, Vikgren J, Rossi Norrlund R, Molnar D, Svalkvist A, Gunnar Månsson L, Båth M. Image quality dependency on system configuration and tube voltage in chest tomosynthesis-A visual grading study using an anthropomorphic chest phantom. Med Phys 2015; 42:1200-12. [DOI: 10.1118/1.4907963] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
36
|
Chou SHS, Kicska GA, Pipavath SN, Reddy GP. Digital tomosynthesis of the chest: current and emerging applications. Radiographics 2015; 34:359-72. [PMID: 24617684 DOI: 10.1148/rg.342135057] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Digital tomosynthesis (DTS) of the chest is a technique whose basic components are similar to those of digital radiography, but that also provides some of the benefits of computed tomography (CT). The major advantages of DTS over conventional chest radiography are improved visibility of the pulmonary parenchyma and depiction of abnormalities such as pulmonary nodules. Calcifications, vessels, airways, and chest wall abnormalities are also much more readily visualized at DTS than at chest radiography. DTS could potentially be combined with chest radiography to follow up known nodules, confirm or rule out suspected nodules seen at radiography, or evaluate individuals who are at high risk for lung cancer or pulmonary metastases. DTS generates coronal "slices" through the chest whose resolution is superior to that of coronal reconstructed CT images, but it is limited by its suboptimal depth resolution and susceptibility to motion; consequently, potential pitfalls in recognizing lesions adjacent to the pleura, diaphragm, central vessels, and mediastinum can occur. However, the radiation dose and projected cost of chest DTS are lower than those of standard chest CT. Besides pulmonary nodule detection, specific applications of DTS that are under investigation include evaluation of pulmonary tuberculous and nontuberculous mycobacterial disease, cystic fibrosis, interstitial lung disease, and asbestos-related thoracic diseases. A basic understanding of chest DTS and of the emerging applications of this technique can prove useful to the radiologist. Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Shinn-Huey S Chou
- From the Department of Radiology, University of Washington, 1959 NE Pacific St, UW Mailbox 357115, Seattle, WA 98195-7115
| | | | | | | |
Collapse
|
37
|
Shan J, Tucker AW, Lee YZ, Heath MD, Wang X, Foos DH, Lu J, Zhou O. Stationary chest tomosynthesis using a carbon nanotube x-ray source array: a feasibility study. Phys Med Biol 2014; 60:81-100. [PMID: 25478786 DOI: 10.1088/0031-9155/60/1/81] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Chest tomosynthesis is a low-dose, quasi-3D imaging modality that has been demonstrated to improve the detection sensitivity for small lung nodules, compared to 2D chest radiography. The purpose of this study is to investigate the feasibility and system requirements of stationary chest tomosynthesis (s-DCT) using a spatially distributed carbon nanotube (CNT) x-ray source array, where the projection images are collected by electronically activating individual x-ray focal spots in the source array without mechanical motion of the x-ray source, detector, or the patient. A bench-top system was constructed using an existing CNT field emission source array and a flat panel detector. The tube output, beam quality, focal spot size, system in-plane and in-depth resolution were characterized. Tomosynthesis slices of an anthropomorphic chest phantom were reconstructed for image quality assessment. All 75 CNT sources in the source array were shown to operate reliably at 80 kVp and 5 mA tube current. Source-to-source consistency in the tube current and focal spot size was observed. The incident air kerma reading per mAs was measured as 74.47 uGy mAs(-1) at 100 cm. The first half value layer of the beam was 3 mm aluminum. An average focal spot size of 2.5 × 0.5 mm was measured. The system MTF was measured to be 1.7 cycles mm(-1) along the scanning direction, and 3.4 cycles mm(-1) perpendicular to the scanning direction. As the angular coverage of 11.6°-34°, the full width at half maximum of the artifact spread function improved greatly from 9.5 to 5.2 mm. The reconstructed tomosynthesis slices clearly show airways and pulmonary vascular structures in the anthropomorphic lung phantom. The results show the CNT source array is capable of generating sufficient dose for chest tomosynthesis imaging. The results obtained so far suggest an s-DCT using a distributed CNT x-ray source array is feasible.
Collapse
Affiliation(s)
- Jing Shan
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Johnsson ÅA, Vikgren J, Båth M. A retrospective study of chest tomosynthesis as a tool for optimizing the use of computed tomography resources and reducing patient radiation exposure. Acad Radiol 2014; 21:1427-33. [PMID: 25097012 DOI: 10.1016/j.acra.2014.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 06/03/2014] [Accepted: 06/05/2014] [Indexed: 11/18/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate potential benefits and drawbacks of the clinical use of chest tomosynthesis (CTS), to what extent CTS obviates the need for chest computed tomography (CT), and what reduction in radiation dose thereby can be achieved. MATERIALS AND METHODS The Regional Ethical Review Board approved the follow-up study of patients examined with CTS as part of clinical routine. For each case, two radiologists in consensus determined whether CT would have been performed, had CTS not been an option, and whether CTS was an adequate examination. Thereafter, it was determined whether the use of CTS instead of CT in retrospect was beneficial, neutral, or detrimental for the radiological work-up. The radiation dose to the patient population was determined both for the actual clinical situation and for the alternative scenario that would result, had CTS not been available. RESULTS During 1 month 3.5 years before the survey, 149 patients (74 women, age 18-91 years) had undergone CTS for clinical purposes. It was judged that CT would have been performed in 100 cases, had CTS not been available, and that CTS obviated the need for CT in 80 cases. CTS was judged as beneficial, neutral, and detrimental for the radiological work-up in 85, 13, and two cases, respectively. For the entire study population, the use of CTS decreased the average effective dose from 2.7 to 0.7 mSv. CONCLUSIONS The present study indicates that CTS may have benefits for the radiological work-up as it has the potential to both optimize the use of CT resources and reduce the effective dose to the patient population. A drawback is that CTS examinations may fail to reveal pathology visible with CT and in clinically doubtful cases further investigations including other imaging procedures should be considered.
Collapse
Affiliation(s)
- Åse A Johnsson
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Radiology, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
| | - Jenny Vikgren
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Radiology, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Magnus Båth
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
39
|
Båth M, Söderman C, Svalkvist A. A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD. Med Phys 2014; 41:101905. [DOI: 10.1118/1.4895002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
40
|
Honda T, Seki N. [Lung cancer: progress in diagnosis and treatments. Topics: II. Diagnosis and examination; 2. Diagnostic imaging]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2014; 103:1273-1280. [PMID: 25151790 DOI: 10.2169/naika.103.1273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
41
|
Effect of radiation dose level on the detectability of pulmonary nodules in chest tomosynthesis. Eur Radiol 2014; 24:1529-36. [DOI: 10.1007/s00330-014-3182-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 04/02/2014] [Accepted: 04/08/2014] [Indexed: 12/21/2022]
|
42
|
Diagnostic imaging costs before and after digital tomosynthesis implementation in patient management after detection of suspected thoracic lesions on chest radiography. Insights Imaging 2014; 5:147-55. [PMID: 24420070 PMCID: PMC3948899 DOI: 10.1007/s13244-013-0305-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 11/28/2013] [Accepted: 12/09/2013] [Indexed: 12/19/2022] Open
Abstract
Objectives To evaluate diagnostic imaging costs before and after DTS implementation in patients with suspected thoracic lesions on CXR. Methods Four hundred sixty-five patients (263 male, 202 female; age, 72.47 ± 11.33 years) with suspected thoracic lesion(s) after CXR underwent DTS. Each patient underwent CT when a pulmonary non-calcified lesion was identified by DTS while CT was not performed when a benign pulmonary or extrapulmonary lesion or pseudolesion was identified. The average per-patient imaging cost was calculated by normalising the costs before and after DTS implementation. Results In 229/465 patients who underwent DTS after suspicious CXR, DTS showed 193 pulmonary lesions and 36 pleural lesions, while in the remaining 236/465 patients, lesions were ruled out as pseudolesions of CXR. Chest CT examination was performed in 127/465 (27 %) patients while in the remaining 338/465 patients (73 %) CXR doubtful findings were resolved by DTS. The average per-patient costs of CXR, DTS and CT were €15.15, 41.55 and 113.66. DTS allowed an annual cost saving of €8,090.2 considering unenhanced CT and €19,298.12 considering contrast-enhanced CT. Considering a DTS reimbursement rate of € 62.7 the break even point corresponds to 479 DTS examinations. Conclusion Per-patient diagnostic imaging costs decreased after DTS implementation in patients with suspected thoracic lesions. Main Messages • Digital tomosynthesis improves the diagnostic accuracy and confidence in chest radiography • Digital tomosynthesis reduces the need for CT for a suspected pulmonary lesion • Digital tomosynthesis requires a dose level equivalent to that of around two chest radiographies • Digital tomosynthesis produces a significant per-patient saving in diagnostic imaging costs
Collapse
|
43
|
Quaia E, Baratella E, Poillucci G, Kus S, Cioffi V, Cova MA. Digital tomosynthesis as a problem-solving imaging technique to confirm or exclude potential thoracic lesions based on chest X-ray radiography. Acad Radiol 2013; 20:546-53. [PMID: 23473723 DOI: 10.1016/j.acra.2012.12.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 11/01/2012] [Accepted: 12/14/2012] [Indexed: 12/13/2022]
Abstract
RATIONALE AND OBJECTIVES To assess the capability of digital tomosynthesis (DTS) as a problem-solving imaging technique to confirm or exclude potential thoracic lesions based on chest x-ray radiography (CXR). MATERIALS AND METHODS Four hundred and-sixty five patients (263 male, 202 female; age, 72.47 ± 11.33 years) with suspected thoracic lesion(s) after the initial onsite analysis of CXR underwent DTS. Two independent readers prospectively analyzed in consensus CXR and DTS images on a picture archiving and communications system-integrated workstation and proposed a diagnosis according to a confidence score for each lesion: 1 or 2 = definite or probable pulmonary or pleural benign lesion or pseudolesion deserving no further diagnostic work-up; 3 = indeterminate; 4 or 5 = probable or definite pulmonary lesion deserving further diagnostic work-up by computed tomography (CT). In patients who did not undergo chest CT, the DTS findings had to be confirmed by 6 to 12 months' imaging follow-up. RESULTS Finally, 229 pulmonary lesions (193 thoracic and 36 pleural lesions) and 236 pseudolesions were identified. Based on DTS images, readers correctly classified all pseudolesions except for 10/236 (reader 1) or 11/236 (reader 2) pseudolesions and 7 (reader 1) or 6 (reader 2) pulmonary subpleural lesions located in the anterior or posterior lung region close to the thoracic wall. Chest CT was performed in 127/465 (27%) patients, whereas in 338/465 patients (73%) CXR doubtful findings were resolved by DTS. CONCLUSIONS DTS allowed to exclude most pseudolesions initially considered as potential thoracic lesions on the preliminary onsite assessment of CXR and allowed to exclude pulmonary lesions deserving CT assessment in about three fourths of the patients.
Collapse
|
44
|
Commentary on: Comparison of chest digital tomosynthesis and chest radiography for detection of asbestos-related pleuropulmonary disease. Clin Radiol 2013; 68:336-7. [DOI: 10.1016/j.crad.2012.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 09/19/2012] [Accepted: 09/24/2012] [Indexed: 11/18/2022]
|
45
|
Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference. Eur Radiol 2013; 23:2118-26. [DOI: 10.1007/s00330-013-2814-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Revised: 01/25/2013] [Accepted: 02/09/2013] [Indexed: 10/27/2022]
|
46
|
Neroladaki A, Botsikas D, Boudabbous S, Becker CD, Montet X. Computed tomography of the chest with model-based iterative reconstruction using a radiation exposure similar to chest X-ray examination: preliminary observations. Eur Radiol 2012; 23:360-6. [PMID: 22892722 DOI: 10.1007/s00330-012-2627-7] [Citation(s) in RCA: 169] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 07/18/2012] [Accepted: 07/18/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the diagnostic image quality of ultra-low-dose chest computed tomography (ULD-CT) obtained with a radiation dose comparable to chest radiography and reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) in comparison with standard dose diagnostic CT (SDD-CT) or low-dose diagnostic CT (LDD-CT) reconstructed with FBP alone. METHODS Unenhanced chest CT images of 42 patients acquired with ULD-CT were compared with images obtained with SDD-CT or LDD-CT in the same examination. Noise measurements and image quality, based on conspicuity of chest lesions on all CT data sets were assessed on a five-point scale. RESULTS The radiation dose of ULD-CT was 0.16 ± 0.006 mSv compared with 11.2 ± 2.7 mSv for SDD-CT (P < 0.0001) and 2.7 ± 0.9 mSv for LDD-CT. Image quality of ULD-CT increased significantly when using MBIR compared with FBP or ASIR (P < 0.001). ULD-CT reconstructed with MBIR enabled to detect as many non-calcified pulmonary nodules as seen on SDD-CT or LDD-CT. However, image quality of ULD-CT was clearly inferior for characterisation of ground glass opacities or emphysema. CONCLUSION Model-based iterative reconstruction allows detection of pulmonary nodules with ULD-CT with radiation exposure in the range of a posterior to anterior (PA) and lateral chest X-ray.
Collapse
Affiliation(s)
- Angeliki Neroladaki
- Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 4, Switzerland
| | | | | | | | | |
Collapse
|