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Rothschild B. Chest X-Ray Assessment is Incomplete without the Lateral View [Letter]. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:245-246. [PMID: 33692646 PMCID: PMC7939237 DOI: 10.2147/amep.s306149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
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Lin HC, Huang CY, Huang WM, Jhou ZY, Chen CH, Chien YC, Huang CC. Oblique views of chest radiography from a designed rotation angle recommendation increase the contrast ratio between obscured lesions and surrounding structures. Thorac Cancer 2019; 10:2057-2063. [PMID: 31407523 PMCID: PMC6775013 DOI: 10.1111/1759-7714.13167] [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: 06/29/2019] [Revised: 07/28/2019] [Accepted: 07/28/2019] [Indexed: 11/29/2022] Open
Abstract
Background Chest radiography (CXR) is the main tool used to detect pulmonary nodules. Lateral views of CXR are less effective and the aim of our study was to develop a rotation angle recommendation model to obtain the best oblique CXR with significantly increased contrast between lesions and surrounding normal structures in order to enhance the detection rate for potential obscured lesions on traditional posterior and anterior (PA) CXR. Methods A total of 140 subjects receiving low‐dose lung computed tomography (CT) screening were enrolled from the health check‐up database. An additional 14 cases with lung lesions on chest CT were included. Demography was also reviewed. Gross, left and right cardiothoracic ratios (CTR) were measured. All CT images were transformed to CXR to detect the best rotation angles and produce different views of CXR. Contrast ratio was calculated in the transformed CXR from CT with lesions. Comparison of contrast ratio among oblique, posterior‐anterior and lateral views was performed. Results CXR shows smaller gross CTR and left CTR but larger heart width and thoracic width in men than in women. Correlation evaluation displays gross CTR, heart width and left CTR are positively correlated with age only for the women group. The most important factor for the best rotation angle is right CTR for left rotation angle and left CTR for right rotation angle. The contrast ratio of the lesion to surrounding structures is significantly better on the oblique views in the designed angles than that on the traditional views. Conclusion CXR oblique views in the assigned angle from the 10‐degree rotation angle recommendation are able to enhance contrast ratio between the possible obscured lesions and surrounding structures on CXR.
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Affiliation(s)
- Hui-Chen Lin
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Chung-Yao Huang
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Wei-Ming Huang
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Zong-Yi Jhou
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Chia-Hung Chen
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Yu-Chan Chien
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Chun-Chao Huang
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
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Vom J, Williams I. Justification of radiographic examinations: What are the key issues? J Med Radiat Sci 2017; 64:212-219. [PMID: 28188698 PMCID: PMC5587654 DOI: 10.1002/jmrs.211] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 12/02/2016] [Accepted: 12/07/2016] [Indexed: 01/12/2023] Open
Abstract
Justification of radiographic examinations is the practice of evaluating requested radiological examinations to assess for clinical merit and appropriateness based on clinical notes and patient information. This implies that justification in radiography requires the evaluation of requested examinations, the justification of exposures being applied and determining whether patients fit the recommended criteria for the procedure. Medico-legal requirements by the professional registration body, the Medical Radiation Practice Board of Australia (MRPBA), identify justification as an advocated and obligatory practice for radiographers. Yet, justification remains an inconsistent practice implemented amongst Australian radiographers. This review aims to identify associated barriers inhibiting the consistent practice of justification and the hesitance by radiographers in practicing justification responsibilities. It also recommends a change in workplace culture which encourages radiographers to accept a more autonomous role that cultivates critical thinking, reflection and research-informed decision making as justification will ultimately benefit patients.
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Affiliation(s)
- Jason Vom
- Faculty of Medicine, Nursing and Health Sciences, Department of Medical Imaging and Radiation Sciences (DMIRS)Monash UniversityClaytonAustralia
| | - Imelda Williams
- Faculty of Medicine, Nursing and Health Sciences, Department of Medical Imaging and Radiation Sciences (DMIRS)Monash UniversityClaytonAustralia
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Kluthke RA, Kickuth R, Bansmann PM, Tüshaus C, Adams S, Liermann D, Kirchner J. The additional value of the lateral chest radiograph for the detection of small pulmonary nodules-a ROC analysis. Br J Radiol 2016; 89:20160394. [PMID: 27605206 DOI: 10.1259/bjr.20160394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE For the past 30 years, many authors have described different advantages of the use of the additional lateral chest radiograph. However, some radiologic departments gave up performing the lateral view recently. A potential reason for this might be a lack of evidence for any diagnostic benefit of the additional lateral view of the thorax in recent studies. The objective of this study was to evaluate the diagnostic benefit of the additional lateral view for the detection of small pulmonary nodules compared with CT examinations as a gold standard. METHOD The patient population consisted of 45 patients with SPN and 45 patients without SPN. Four radiologists with varying experience in the assessment of thoracic imaging first examined the sole posteroanterior (PA) projection. After a few days, they were instructed to examine the PA and the additional lateral view. A receiver-operating characteristic analysis was accomplished to compare the documented results. RESULTS The mean Az value of the sole PA view was 0.75 and 0.77 by the combination of PA and additional lateral view. So, there was no significant difference between the detectable Az values (Δ = 0.02; p = 0.384). With a cut-off value of >3, the additional view even reduced the sensitivity by averaging to 5.6%. The decrease of sensitivity by using the additional view was most detectable within the group of more experienced radiologists. CONCLUSION The additional lateral view of the chest provides no diagnostic benefit in the detection of small pulmonary nodules in comparison with the sole PA projection. Nevertheless, the results of the present study must not be understood as a general evaluation of the benefits of the lateral radiograph per se, because we did not examine other relevant issues (i.e. cardiac failure, lung parenchyma diseases or abnormalities in hilar anatomy). Advances in knowledge: Our study demonstrates a lack of evidence for any diagnostic benefit of the additional lateral view of the thorax in detecting SPN.
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Affiliation(s)
- Robin Alexander Kluthke
- 1 Zentrum für Diagnostische und Interventionelle Radiologie, Allgemeines Krankenhaus Hagen, Hagen, Germany
| | - Ralph Kickuth
- 2 Institut für Radiologie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Paul Martin Bansmann
- 3 Institut für Diagnostische und Interventionelle Radiologie, Krankenhaus Porz am Rhein, Köln, Germany
| | - Carolin Tüshaus
- 1 Zentrum für Diagnostische und Interventionelle Radiologie, Allgemeines Krankenhaus Hagen, Hagen, Germany
| | - Stephan Adams
- 4 Institut für Diagnostische, Interventionelle Radiologie und Nuklearmedizin, Katholisches Marienhospital Herne Universitätsklinikum der Ruhr-Universität Bochum, Herne, Germany
| | - Dieter Liermann
- 4 Institut für Diagnostische, Interventionelle Radiologie und Nuklearmedizin, Katholisches Marienhospital Herne Universitätsklinikum der Ruhr-Universität Bochum, Herne, Germany
| | - Johannes Kirchner
- 1 Zentrum für Diagnostische und Interventionelle Radiologie, Allgemeines Krankenhaus Hagen, Hagen, Germany
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