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Gange C, Ku J, Gosangi B, Liu J, Maolinbay M. Next-generation digital chest tomosynthesis. J Clin Imaging Sci 2024; 14:22. [PMID: 38975057 PMCID: PMC11225395 DOI: 10.25259/jcis_4_2024] [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: 01/04/2024] [Accepted: 04/17/2024] [Indexed: 07/09/2024] Open
Abstract
The objective of this study was to demonstrate the performance characteristics and potential utility of a novel tomosynthesis device as applied to imaging the chest, specifically relating to lung nodules. The imaging characteristics and quality of a novel digital tomosynthesis prototype system was assessed by scanning, a healthy volunteer, and an andromorphic lung phantom with different configurations of simulated pulmonary nodules. The adequacy of nodule detection on the phantoms was rated by chest radiologists using a standardized scale. Results from using this tomosynthesis device demonstrate in plane resolution of 16lp/cm, with estimated effective radiation doses of 90% less than low dose CT. Nodule detection was adequate across various anatomic locations on a phantom. These proof-of-concept tests showed this novel tomosynthesis device can detect lung nodules with low radiation dose to the patient. This technique has potential as an alternative to low dose chest CT for lung nodule screening and tracking.
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Affiliation(s)
- Christopher Gange
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut, United States
| | - Jamie Ku
- Product Development, Aixscan Inc., Sunnyvale, California, United States
| | - Babina Gosangi
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut, United States
| | - Jianqiang Liu
- Product Development, Aixscan Inc., Sunnyvale, California, United States
| | - Manat Maolinbay
- Product Development, Aixscan Inc., Sunnyvale, California, United States
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Spogis J, Fusco S, Hagen F, Kaufmann S, Malek N, Hoffmann T. Repeated Lung Ultrasound versus Chest X-ray-Which One Predicts Better Clinical Outcome in COVID-19? Tomography 2023; 9:706-716. [PMID: 36961015 PMCID: PMC10037641 DOI: 10.3390/tomography9020056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 03/25/2023] Open
Abstract
The purpose of this study was to evaluate whether changes in repeated lung ultrasound (LUS) or chest X-ray (CXR) of coronavirus disease 2019 (COVID-19) patients can predict the development of severe disease and the need for treatment in the intensive care unit (ICU). In this prospective monocentric study, COVID-19 patients received standardized LUS and CXR at day 1, 3 and 5. Scores for changes in LUS (LUS score) and CXR (RALE and M-RALE) were calculated and compared. Intra-class correlation was calculated for two readers of CXR and ROC analysis to evaluate the best discriminator for the need for ICU treatment. A total of 30 patients were analyzed, 26 patients with follow-up LUS and CXR. Increase in M-RALE between baseline and follow-up 1 was significantly higher in patients with need for ICU treatment in the further hospital stay (p = 0.008). Both RALE and M-RALE significantly correlated with LUS score (r = 0.5, p < 0.0001). ROC curves with need for ICU treatment as separator were not significantly different for changes in M-RALE (AUC: 0.87) and LUS score (AUC: 0.79), both being good discriminators. ICC was moderate for RALE (0.56) and substantial for M-RALE (0.74). The present study demonstrates that both follow-up LUS and CXR are powerful tools to track the evolution of COVID-19, and can be used equally as predictors for the need for ICU treatment.
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Affiliation(s)
- Jakob Spogis
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Stefano Fusco
- Department of Internal Medicine, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Florian Hagen
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Sascha Kaufmann
- Department of Diagnostic and Interventional Radiology, Siloah St. Trudpert Klinikum, Wilferdinger Straße 67, 75179 Pforzheim, Germany
| | - Nisar Malek
- Department of Internal Medicine, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Tatjana Hoffmann
- Department of Internal Medicine, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
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Avasarala SK, Young B, Gilkeson RC. Enhanced Postbronchoscopic Lung Volume Reduction Pneumothorax Detection with Digital Tomosynthesis. Am J Respir Crit Care Med 2023; 207:e47-e48. [PMID: 36228135 DOI: 10.1164/rccm.202206-1028im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Benjamin Young
- Division of Pulmonary, Critical Care, and Sleep Medicine and
| | - Robert C Gilkeson
- Department of Radiology, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, Ohio
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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.
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Ledda RE, Silva M, McMichael N, Sartorio C, Branchi C, Milanese G, Nayak SM, Sverzellati N. The diagnostic value of grey-scale inversion technique in chest radiography. Radiol Med 2022; 127:294-304. [PMID: 35041136 PMCID: PMC8960630 DOI: 10.1007/s11547-022-01453-0] [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: 08/02/2021] [Accepted: 01/03/2022] [Indexed: 12/01/2022]
Abstract
Purpose We investigated whether the additional use of grey-scale inversion technique improves the interpretation of eight chest abnormalities, in terms of diagnostic performance and interobserver variability. Material and methods A total of 507 patients who underwent a chest computed tomography (CT) examination and a chest radiography (CXR) within 24 h were enrolled. CT was the standard of reference. Images were retrospectively reviewed for the presence of atelectasis, consolidation, interstitial abnormality, nodule, mass, pleural effusion, pneumothorax and rib fractures. Four CXR reading settings, involving 3 readers were organized: only standard; only inverted; standard followed by inverted; and inverted followed by standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy, assessed with the area under the curve (AUC), and their 95% confidence interval were calculated for each reader and setting. Interobserver agreement was tested by Cohen’s K test with quadratic weights (Kw) and its 95%CI.
Results CXR sensitivity % for any finding was 35.1 (95% CI: 33 to 37) for setting 1, 35.9 (95% CI: 33 to 37), for setting 2, 32.59 (95% CI: 30 to 34) for setting 3, and 35.56 (95% CI: 33 to 37) for setting 4; specificity % 93.78 (95% CI: 91 to 95), 93.92 (95% CI: 91 to 95), 94.43 (95% CI: 92 to 96), 93.86 (95% CI: 91 to 95); PPV % 56.22 (95% CI: 54.2 to 58.2), 56.49 (95% CI: 54.5 to 58.5), 57.15 (95% CI: 55 to 59), 56.75 (95% CI: 54 to 58); NPV % 85.66 (95% CI: 83 to 87), 85.74 (95% CI: 83 to 87), 85.29 (95% CI: 83 to 87), 85.73 (95% CI: 83 to 87); AUC values 0.64 (95% CI: 0.62 to 0.66), 0.65 (95% CI: 0.63 to 0.67), 0.64 (95% CI: 0.62 to 0.66), 0.65 (95% CI: 0.63 to 0.67); Kw values 0.42 (95% CI: 0.4 to 0.44), 0.40 (95% CI: 0.38 to 0.42), 0.42 (95% CI: 0.4 to 0.44), 0.41 (95% CI: 0.39 to 0.43) for settings 1, 2, 3 and 4, respectively.
Conclusions No significant advantages were observed in the use of grey-scale inversion technique neither over standard display mode nor in combination at the detection of eight chest abnormalities. Supplementary Information The online version contains supplementary material available at 10.1007/s11547-022-01453-0.
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Affiliation(s)
- Roberta Eufrasia Ledda
- Department of Medicine and Surgery, University of Parma, Scienze Radiologiche, University Hospital of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy
| | - Mario Silva
- Department of Medicine and Surgery, University of Parma, Scienze Radiologiche, University Hospital of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy
| | - Nicole McMichael
- Department of Radiology Diagnostics, Skåne University Hospital of Malmö, Malmö, Sweden
| | - Carlotta Sartorio
- Department of Medicine and Surgery, University of Parma, Scienze Radiologiche, University Hospital of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy
| | - Cristina Branchi
- Department of Medicine and Surgery, University of Parma, Scienze Radiologiche, University Hospital of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy
| | - Gianluca Milanese
- Department of Medicine and Surgery, University of Parma, Scienze Radiologiche, University Hospital of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy.
| | - Sundeep M Nayak
- Department of Radiology, Kaiser Permanente Northern California, San Leandro, CA, USA
| | - Nicola Sverzellati
- Department of Medicine and Surgery, University of Parma, Scienze Radiologiche, University Hospital of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy
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Meltzer C, Gilljam M, Vikgren J, Norrlund RR, Vult von Steyern K, Båth M, Johnsson ÅA. QUANTIFICATION OF PULMONARY PATHOLOGY IN CYSTIC FIBROSIS-COMPARISON BETWEEN DIGITAL CHEST TOMOSYNTHESIS AND COMPUTED TOMOGRAPHY. RADIATION PROTECTION DOSIMETRY 2021; 195:434-442. [PMID: 33683309 PMCID: PMC8507459 DOI: 10.1093/rpd/ncab017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 09/18/2020] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Digital tomosynthesis (DTS) is currently undergoing validation for potential clinical implications. The aim of this study was to investigate the potential for DTS as a low-dose alternative to computed tomography (CT) in imaging of pulmonary pathology in patients with cystic fibrosis (CF). METHODS DTS and CT were performed as part of the routine triannual follow-up in 31 CF patients. Extent of disease was quantified according to modality-specific scoring systems. Statistical analysis included Spearman's rank correlation coefficient (r) and Krippendorff's alpha (α). MAJOR FINDINGS The median effective dose was 0.14 for DTS and 2.68 for CT. Intermodality correlation was very strong for total score and the subscores regarding bronchiectasis and bronchial wall-thickening (r = 0.82-0.91, P < 0.01). Interobserver reliability was high for total score, bronchiectasis and mucus plugging (α = 0.83-0.93) in DTS. CONCLUSION Chest tomosynthesis could be a low-dose alternative to CT in quantitative estimation of structural lung disease in CF.
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Affiliation(s)
| | - M Gilljam
- Gothenburg CF-Center, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg Sweden
| | - J Vikgren
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Bruna stråket 11b V 2 SU/Sahlgrenska, 413 45 Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Bruna stråket 11b V 2 SU/Sahlgrenska, 413 45 Gothenburg, Sweden
| | - R R Norrlund
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Bruna stråket 11b V 2 SU/Sahlgrenska, 413 45 Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Bruna stråket 11b V 2 SU/Sahlgrenska, 413 45 Gothenburg, Sweden
| | - K Vult von Steyern
- Center for Medical Imaging and Physiology, Skåne University Hospital, Getingevägen 4, 22185 Lund, Sweden
| | - M Båth
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gula stråket 2B, Plan 3, 413 45 Gothenburg, Sweden
- Department of Radiation Physics, Sahlgrenska Academy, University of Gothenburg, Gula stråket 2B, Plan 3, 413 45 Gothenburg, Sweden
| | - Å A Johnsson
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Bruna stråket 11b V 2 SU/Sahlgrenska, 413 45 Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Bruna stråket 11b V 2 SU/Sahlgrenska, 413 45 Gothenburg, Sweden
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Roh YH, Lee S, Ryu JA, Kim YJ, Kim Y, Bae J. Digital Tomosynthesis versus Conventional Radiography for Evaluating Osteonecrosis of the Femoral Head. Korean J Radiol 2021; 22:2026-2033. [PMID: 34564962 PMCID: PMC8628147 DOI: 10.3348/kjr.2021.0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/14/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022] Open
Abstract
Objective The aim of this study was to compare the diagnostic performances of digital tomosynthesis (DTS) and conventional radiography in detecting osteonecrosis of the femoral head (ONFH) using computed tomography (CT), as the reference standard and evaluate the diagnostic reproducibility of DTS. Materials and Methods Forty-five patients (24 male and 21 female; age range, 25–77 years) with clinically suspected ONFH underwent anteroposterior radiography, DTS, and CT. Two musculoskeletal radiologists independently evaluated the presence and type of ONFH. The diagnostic performance of radiography and DTS in detecting the presence of ONFH and determining the types of ONFH were evaluated. The interobserver and intraobserver reliabilities of each imaging modality were analyzed using Cohen's kappa. Results DTS had higher sensitivity (89.4%–100% vs. 74.5%–76.6%) and specificity (97.3%–100% vs. 78.4%–83.8%) for ONFH detection than radiography. DTS showed higher performance than radiography in identifying the subtypes of ONFH with statistical significance in one reader (type 1, 100% vs. 30.8%, p = 0.004; type II, 97.1% vs. 73.5%, p = 0.008). The interobserver agreement was excellent for DTS and moderate for radiography (kappa of 0.86 vs. 0.57, respectively). The intraobserver agreement for DTS was higher than that of radiography (kappa of 0.96 vs. 0.69, respectively). Conclusion DTS showed higher diagnostic performance and reproducibility than radiography in detecting ONFH. DTS may be used as a first-line diagnostic modality instead of radiography for patients suspected of having ONFH.
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Affiliation(s)
- Yun Hwa Roh
- Department of Radiology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea
| | - Seunghun Lee
- Department of Radiology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea.
| | - Jeong Ah Ryu
- Department of Radiology, Hanyang University Guri Hospital, College of Medicine, Hanyang University, Guri, Korea
| | - Yeo Ju Kim
- Department of Radiology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea
| | - Yeesuk Kim
- Department of Orthopaedic Surgery, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea
| | - Jiyoon Bae
- Department of Pathology, National Police Hospital, Seoul, Korea
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Li Q, Liu J, Mo Y, Yu J, Zhang K, Zhang H. [Extraction of respiratory signals from chest tomosynthesis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:916-922. [PMID: 34238745 DOI: 10.12122/j.issn.1673-4254.2021.06.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To analyze the respiratory motion of the scanned object during acquisition of digital chest tomosynthesis (CTS) using a linear model. OBJECTIVE Respiratory signals were generated by extracting the motion of the diaphragm from the projection radiographs. The diaphragm trajectory obtained by dynamic programming (DP) was modeled and fitted, and according to the fitting of the data, the base motion curve and respiratory signal curve of the diaphragm were separated. Multipurpose chest phantom data, simulated digital Xcat phantom data and the datasets of 3 clinical patients were used to validate the performance of the proposed method. OBJECTIVE The motion trajectory of the diaphragm extracted from multipurpose chest phantom simulation data was linear. The respiratory signals could be effectively extracted from the 3 datasets of clinical patients in different respiratory states. The correlation coefficient between the respiratory signal extracted in Xcat simulation experiment and the original design was 0.9797. OBJECTIVE The linear model can effectively obtain the respiratory motion information of patients in real time, thus enabling the physicians to make clinical decisions on a rescan.
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Affiliation(s)
- Q Li
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510000 China
| | - J Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510000 China
| | - Y Mo
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510000 China
| | - J Yu
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510000 China
| | - K Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510000 China
| | - H Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510000 China
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Carey S, Kandel S, Farrell C, Kavanagh J, Chung T, Hamilton W, Rogalla P. Comparison of conventional chest x ray with a novel projection technique for ultra-low dose CT. Med Phys 2021; 48:2809-2815. [PMID: 32181495 DOI: 10.1002/mp.14142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To compare a novel thick-slab projection technique for ultra-low dose computed tomography (CT; thoracic tomogram) with conventional chest x ray with respect to 13 diagnostic categories. METHODS With the approval of the institutional ethics board, a dataset was retrospectively collected of 22 consecutive patients who had undergone a clinically requested emergency room conventional chest x ray (CXR) and a same-day standard-of-care non-contrast CT. Scanner specific noise was added to the CT images to simulate a target dose of 0.18 mSv. A novel algorithm was used to post-process CT images as coronal isotropic reformats by applying a voxel-based, locally normalized weighted-intensity projection to generate 2 cm thick slabs with 1 cm overlap. Three chest radiologists with no prior training for the study reviewed the CXR and thoracic tomogram for each case and assessed each diagnostic category (pneumonic infiltrates, pulmonary edema, interstitial lung disease, nodules > 5 mm, nodules < 5 mm, pleural effusion, pericardial effusion, heart size, acute bone fractures, foreign bodies, pneumothorax, mediastinal vessel diameter, free abdominal air) on a Likert scale from -4 (definitely absent/normal) to +4 (definitely present/abnormal). MRMC ROC curves were generated for each category. Time for interpretation and subjective image quality score (0-10) were also assessed. RESULTS For focal lung disease (pneumonic infiltrates, nodules < 5 mm, nodules > 5mm), the area under the ROC curve (AUC) was significantly higher for thoracic tomograms than CXR (0.803 vs 0.648, respectively, P = 0.02). For non-focal lung disease (pulmonary edema, interstitial lung disease) and effusions (pulmonary, pericardial), the AUC was larger for thoracic tomograms than CXR but the difference did not reach significance (0.870 vs 0.833, P = 0.141; and 0.823 vs 0.752, P = 0.296, respectively). For acute bone fractures and foreign bodies, the AUC was smaller for thoracic tomograms than CXR, the difference was however not significant (0.491 vs 0.532, P = 0.42; and 0.871 vs 0.971, P = 0.39, respectively). Other diagnostic categories had no true positive cases in the dataset. The mean time for interpretation for each was 36.9 and 24.0 s with standard deviations of 0.857 and 5.977. The image quality score for each was 8.2 and 7.8 with standard deviations of 0.970 and 1.614. CONCLUSION Thoracic tomograms were found to be diagnostically superior to CXR for focal lung disease, at no increased radiation dose. The thoracic tomogram presents an opportunity to improve the standard-of-care for patients who would otherwise receive a conventional CXR.
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Affiliation(s)
- Sean Carey
- Joint Department of Medical Imaging, UHN, Toronto General Hospital, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - Sonja Kandel
- Joint Department of Medical Imaging, UHN, Toronto General Hospital, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - Christin Farrell
- Joint Department of Medical Imaging, UHN, Toronto General Hospital, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - John Kavanagh
- Joint Department of Medical Imaging, UHN, Toronto General Hospital, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - TaeBong Chung
- Joint Department of Medical Imaging, UHN, Toronto General Hospital, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - William Hamilton
- Joint Department of Medical Imaging, UHN, Toronto General Hospital, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - Patrik Rogalla
- Joint Department of Medical Imaging, University of Toronto, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
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Meltzer C, Fagman E, Vikgren J, Molnar D, Borna E, Beni MM, Brandberg J, Bergman B, Båth M, Johnsson ÅA. Surveillance of small, solid pulmonary nodules at digital chest tomosynthesis: data from a cohort of the pilot Swedish CArdioPulmonary bioImage Study (SCAPIS). Acta Radiol 2021; 62:348-359. [PMID: 32438877 PMCID: PMC7930602 DOI: 10.1177/0284185120923106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Digital tomosynthesis (DTS) might be a low-dose/low-cost alternative to computed tomography (CT). Purpose To investigate DTS relative to CT for surveillance of incidental, solid pulmonary nodules. Material and Methods Recruited from a population study, 106 participants with indeterminate solid pulmonary nodules on CT underwent surveillance with concurrently performed CT and DTS. Nodule size on DTS was assessed by manual diameter measurements and semi-automatic nodule segmentations were independently performed on CT. Measurement agreement was analyzed according to Bland–Altman with 95% limits of agreement (LoA). Detection of nodule volume change > 25% by DTS in comparison to CT was evaluated with receiver operating characteristics (ROC). Results A total of 81 nodules (76%) were assessed as measurable on DTS by two independent observers. Inter- and intra-observer LoA regarding change in average diameter were ± 2 mm. Calculation of relative volume change on DTS resulted in wide inter- and intra-observer LoA in the order of ± 100% and ± 50%. Comparing relative volume change between DTS and CT resulted in LoA of –58% to 67%. The area under the ROC curve regarding the ability of DTS to detect volumetric changes > 25% on CT was 0.58 (95% confidence interval [CI] = 0.40–0.76) and 0.50 (95% CI = 0.35–0.66) for the two observers. Conclusion The results of the present study show that measurement variability limits the agreement between DTS and CT regarding nodule size change for small solid nodules.
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Affiliation(s)
- Carin Meltzer
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden
- Department of Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
| | - Erika Fagman
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenny Vikgren
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - David Molnar
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eivind Borna
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Maral Mirzai Beni
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - John Brandberg
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bengt Bergman
- Department of Respiratory Medicine, Sahlgrenska University Hospital, Sweden
- Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Magnus Båth
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Åse A Johnsson
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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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.
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Initial clinical evaluation of stationary digital chest tomosynthesis in adult patients with cystic fibrosis. Eur Radiol 2018; 29:1665-1673. [PMID: 30255248 DOI: 10.1007/s00330-018-5703-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 07/19/2018] [Accepted: 07/31/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The imaging evaluation of cystic fibrosis currently relies on chest radiography or computed tomography. Recently, digital chest tomosynthesis has been proposed as an alternative. We have developed a stationary digital chest tomosynthesis (s-DCT) system based on a carbon nanotube (CNT) linear x-ray source array. This system enables tomographic imaging without movement of the x-ray tube and allows for physiological gating. The goal of this study was to evaluate the feasibility of clinical CF imaging with the s-DCT system. MATERIALS AND METHODS CF patients undergoing clinically indicated chest radiography were recruited for the study and imaged on the s-DCT system. Three board-certified radiologists reviewed both the CXR and s-DCT images for image quality relevant to CF. CF disease severity was assessed by Brasfield score on CXR and chest tomosynthesis score on s-DCT. Disease severity measures were also evaluated against subject pulmonary function tests. RESULTS Fourteen patients underwent s-DCT imaging within 72 h of their chest radiograph imaging. Readers scored the visualization of proximal bronchi, small airways and vascular pattern higher on s-DCT than CXR. Correlation between the averaged Brasfield score and averaged tomosynthesis disease severity score for CF was -0.73, p = 0.0033. The CF disease severity score system for tomosynthesis had high correlation with FEV1 (r = -0.685) and FEF 25-75% (r = -0.719) as well as good correlation with FVC (r = -0.582). CONCLUSION We demonstrate the potential of CNT x-ray-based s-DCT for use in the evaluation of cystic fibrosis disease status in the first clinical study of s-DCT. KEY POINTS • Carbon nanotube-based linear array x-ray tomosynthesis systems have the potential to provide diagnostically relevant information for patients with cystic fibrosis without the need for a moving gantry. • Despite the short angular span in this prototype system, lung features such as the proximal bronchi, small airways and pulmonary vasculature have improved visualization on s-DCT compared with CXR. Further improvements are anticipated with longer linear x-ray array tubes. • Evaluation of disease severity in CF patients is possible with s-DCT, yielding improved visualization of important lung features and high correlation with pulmonary function tests at a relatively low dose.
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Blum A, Noël A, Regent D, Villani N, Gillet R, Gondim Teixeira P. Tomosynthesis in musculoskeletal pathology. Diagn Interv Imaging 2018; 99:423-441. [DOI: 10.1016/j.diii.2018.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/15/2018] [Indexed: 01/08/2023]
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Jadidi M, Båth M, Nyrén S. Dependency of image quality on acquisition protocol and image processing in chest tomosynthesis-a visual grading study based on clinical data. Br J Radiol 2018; 91:20170683. [PMID: 29565673 DOI: 10.1259/bjr.20170683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To compare the quality of images obtained with two different protocols with different acquisition time and the influence from image post processing in a chest digital tomosynthesis (DTS) system. METHODS 20 patients with suspected lung cancer were imaged with a chest X-ray equipment with tomosynthesis option. Two examination protocols with different acquisition times (6.3 and 12 s) were performed on each patient. Both protocols were presented with two different image post-processing (standard DTS processing and more advanced processing optimised for chest radiography). Thus, 4 series from each patient, altogether 80 series, were presented anonymously and in a random order. Five observers rated the quality of the reconstructed section images according to predefined quality criteria in three different classes. Visual grading characteristics (VGC) was used to analyse the data and the area under the VGC curve (AUCVGC) was used as figure-of-merit. The 12 s protocol and the standard DTS processing were used as references in the analyses. RESULTS The protocol with 6.3 s acquisition time had a statistically significant advantage over the vendor-recommended protocol with 12 s acquisition time for the classes of criteria, Demarcation (AUCVGC = 0.56, p = 0.009) and Disturbance (AUCVGC = 0.58, p < 0.001). A similar value of AUCVGC was found also for the class Structure (definition of bone structures in the spine) (0.56) but it could not be statistically separated from 0.5 (p = 0.21). For the image processing, the VGC analysis showed a small but statistically significant advantage for the standard DTS processing over the more advanced processing for the classes of criteria Demarcation (AUCVGC = 0.45, p = 0.017) and Disturbance (AUCVGC = 0.43, p = 0.005). A similar value of AUCVGC was found also for the class Structure (0.46), but it could not be statistically separated from 0.5 (p = 0.31). CONCLUSION The study indicates that the protocol with 6.3 s acquisition time yields slightly better image quality than the vender-recommended protocol with acquisition time 12 s for several anatomical structures. Furthermore, the standard gradation processing (the vendor-recommended post-processing for DTS), yields to some extent advantage over the gradation processing/multiobjective frequency processing/flexible noise control processing in terms of image quality for all classes of criteria. Advances in knowledge: The study proves that the image quality may be strongly affected by the selection of DTS protocol and that the vendor-recommended protocol may not always be the optimal choice.
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Affiliation(s)
- Masoud Jadidi
- 1 Departments of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm , Sweden
| | - Magnus Båth
- 2 Department of Radiation Physics, Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden.,3 Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Sven Nyrén
- 4 Molecular medicine and surgery, Karolinska intitutet , Stockholm , Sweden.,5 Department of Thoracic radiology, Karolinska University Hospital , Stockholm , Sweden
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15
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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.
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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.)
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Ferrari A, Bertolaccini L, Solli P, Di Salvia PO, Scaradozzi D. Digital chest tomosynthesis: the 2017 updated review of an emerging application. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:91. [PMID: 29666814 DOI: 10.21037/atm.2017.08.18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Lung cancer is the leading cause of cancer death and second most common cancer among both men and women, but most of them are detected when patients become symptomatic and in late-stage. Chest radiography (CR) is a basic technique for the investigation of lung cancer and has the benefit of convenience and low radiation dose, but detection of malignancy is often difficult. The introduction of computed tomography (CT) for screening has increased the proportion of lung cancer detected but with higher exposure dose and higher costs. Digital chest tomosynthesis (DCT), a tomographic technique, may offer an alternative to CT. DCT uses a conventional radiograph tube, a flat-panel detector, a computer-controlled tube mover and reconstruction algorithms to produce section images. It shows promise in the detection of potentially malignant lung nodules, with higher sensibility than CR, and is emerging as a low-dose and low-cost alternative to CT to improve treatment decisions. In fact, an increasing number of researchers are showing that tomosynthesis could have a role in the detection of lung cancer, in addition to its present role in breast screening. However, DCT offers some limitations, such as limited depth resolution, which may explain the difficulty in detecting pathologies in the subpleural region and the occurrence of artefacts from medical devices. Once solved these limitations and once more studies supporting its use will be available, DCT could become the first-line lung cancer screening tool among patients at considerable risk of lung cancer.
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Affiliation(s)
- Arianna Ferrari
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, Ancona, Italy
| | - Luca Bertolaccini
- Department of Thoracic Surgery, AUSL Romagna Teaching Hospitals, Ravenna, Italy
| | - Piergiorgio Solli
- Department of Thoracic Surgery, AUSL Bologna, Maggiore Bellaria Teaching Hospitals, Bologna, Italy
| | | | - David Scaradozzi
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, Ancona, Italy.,LSIS, CNRS, UMR 7296, Marseille, France
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17
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Cant J, Snoeckx A, Behiels G, Parizel PM, Sijbers J. Can portable tomosynthesis improve the diagnostic value of bedside chest X-ray in the intensive care unit? A proof of concept study. Eur Radiol Exp 2017; 1:20. [PMID: 29708195 PMCID: PMC5909351 DOI: 10.1186/s41747-017-0021-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 08/21/2017] [Indexed: 12/18/2022] Open
Abstract
Portable bedside chest X-ray (CXR) is an important and frequently used tool in the intensive care unit (ICU). Unfortunately, the diagnostic value of portable CXR is often low due to technical limitations and suboptimal patient positioning. Additionally, abnormalities in the chest may be hidden on the projection image by overlapping anatomy and devices such as endotracheal tubes, lines and catheters. Digital tomosynthesis (DTS) can solve the problem of anatomical overlap. In DTS, several low-dose X-ray images from different angles are acquired and subsequently used by a reconstruction algorithm to compute section images along planes parallel to the detector. However, a portable device to be used for portable bedside chest DTS is not on the market yet. In this work, we discuss modifications to a portable X-ray device to enable portable DTS and illustrate the potential of portable DTS to improve the diagnostic value of bedside CXR in the ICU. A simulation, based on computed tomography scans, is presented. Our experiments comparing portable DTS with conventional bedside CXR showed a substantially improved detection of pneumothorax and other abnormalities.
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18
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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]
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19
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Koo BS, Song Y, Lee S, Sung YK, Sung IH, Jun JB. Prevalence and distribution of sesamoid bones and accessory ossicles of the foot as determined by digital tomosynthesis. Clin Anat 2017; 30:1072-1076. [DOI: 10.1002/ca.22952] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/12/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Bon San Koo
- Department of Internal Medicine; Inje University Seoul Paik Hospital, Inje University College of Medicine; Seoul Republic of Korea
| | - Yoonah Song
- Department of Radiology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Seunghun Lee
- Department of Radiology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Yoon-Kyoung Sung
- Department of Rheumatology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Il-Hoon Sung
- Department of Orthopedics; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Jae-Bum Jun
- Department of Rheumatology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
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20
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Koo BS, Song Y, Sung YK, Lee S, Jun JB. Prevalence and distribution of sesamoid bones in the hand determined using digital tomosynthesis. Clin Anat 2017; 30:608-613. [DOI: 10.1002/ca.22881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/18/2017] [Accepted: 03/20/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Bon San Koo
- Department of Internal Medicine; Inje University Seoul Paik Hospital, Inje University College of Medicine; Seoul Republic of Korea
| | - Yoonah Song
- Department of Radiology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Yoon-Kyoung Sung
- Department of Rheumatology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Seunghun Lee
- Department of Radiology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Jae-Bum Jun
- Department of Rheumatology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
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21
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Puett C, Inscoe C, Hartman A, Calliste J, Franceschi DK, Lu J, Zhou O, Lee YZ. An update on carbon nanotube-enabled X-ray sources for biomedical imaging. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2017; 10. [PMID: 28398001 DOI: 10.1002/wnan.1475] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 02/04/2017] [Accepted: 03/11/2017] [Indexed: 11/10/2022]
Abstract
A new imaging technology has emerged that uses carbon nanotubes (CNT) as the electron emitter (cathode) for the X-ray tube. Since the performance of the CNT cathode is controlled by simple voltage manipulation, CNT-enabled X-ray sources are ideal for the repetitive imaging steps needed to capture three-dimensional information. As such, they have allowed the development of a gated micro-computed tomography (CT) scanner for small animal research as well as stationary tomosynthesis, an experimental technology for large field-of-view human imaging. The small animal CT can acquire images at specific points in the respiratory and cardiac cycles. Longitudinal imaging therefore becomes possible and has been applied to many research questions, ranging from tumor response to the noninvasive assessment of cardiac output. Digital tomosynthesis (DT) is a low-dose and low-cost human imaging tool that captures some depth information. Known as three-dimensional mammography, DT is now used clinically for breast imaging. However, the resolution of currently-approved DT is limited by the need to swing the X-ray source through space to collect a series of projection views. An array of fixed and distributed CNT-enabled sources provides the solution and has been used to construct stationary DT devices for breast, lung, and dental imaging. To date, over 100 patients have been imaged on Institutional Review Board-approved study protocols. Early experience is promising, showing an excellent conspicuity of soft-tissue features, while also highlighting technical and post-acquisition processing limitations that are guiding continued research and development. Additionally, CNT-enabled sources are being tested in miniature X-ray tubes that are capable of generating adequate photon energies and tube currents for clinical imaging. Although there are many potential applications for these small field-of-view devices, initial experience has been with an X-ray source that can be inserted into the mouth for dental imaging. Conceived less than 20 years ago, CNT-enabled X-ray sources are now being manufactured on a commercial scale and are powering both research tools and experimental human imaging devices. WIREs Nanomed Nanobiotechnol 2018, 10:e1475. doi: 10.1002/wnan.1475 This article is categorized under: Diagnostic Tools > Diagnostic Nanodevices Diagnostic Tools > In Vivo Nanodiagnostics and Imaging.
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Affiliation(s)
- Connor Puett
- Joint Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA
| | - Christina Inscoe
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, NC, USA.,Department of Applied Physical Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Allison Hartman
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, NC, USA
| | - Jabari Calliste
- Department of Applied Physical Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Dora K Franceschi
- Department of Radiology, University of North Carolina, Chapel Hill, NC, USA
| | - Jianping Lu
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, NC, USA.,Department of Applied Physical Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Otto Zhou
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, NC, USA.,Department of Applied Physical Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Yueh Z Lee
- Joint Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA.,Department of Physics and Astronomy, University of North Carolina, Chapel Hill, NC, USA.,Department of Radiology, University of North Carolina, Chapel Hill, NC, USA
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22
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Kim JH, Lee KH, Kim KT, Kim HJ, Ahn HS, Kim YJ, Lee HY, Jeon YS. Comparison of digital tomosynthesis and chest radiography for the detection of pulmonary nodules: systematic review and meta-analysis. Br J Radiol 2016; 89:20160421. [PMID: 27759428 DOI: 10.1259/bjr.20160421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the diagnostic accuracy of digital tomosynthesis (DTS) with that of chest radiography for the detection of pulmonary nodules by meta-analysis. METHODS A systematic literature search was performed to identify relevant original studies from 1 January 1 1976 to 31 August 31 2016. The quality of included studies was assessed by quality assessment of diagnostic accuracy studies-2. Per-patient data were used to calculate the sensitivity and specificity and per-lesion data were used to calculate the detection rate. Summary receiver-operating characteristic curves were drawn for pulmonary nodule detection. RESULTS 16 studies met the inclusion criteria. 1017 patients on a per-patient basis and 2159 lesions on a per-lesion basis from 16 eligible studies were evaluated. The pooled patient-based sensitivity of DTS was 0.85 [95% confidence interval (CI) 0.83-0.88] and the specificity was 0.95 (0.93-0.96). The pooled sensitivity and specificity of chest radiography were 0.47 (0.44-0.51) and 0.37 (0.34-0.40), respectively. The per-lesion detection rate was 2.90 (95% CI 2.63-3.19). CONCLUSION DTS has higher diagnostic accuracy than chest radiography for detection of pulmonary nodules. Chest radiography has low sensitivity but similar specificity, comparable with that of DTS. Advances in knowledge: DTS has higher diagnostic accuracy than chest radiography for the detection of pulmonary nodules.
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Affiliation(s)
- Jun H Kim
- 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Kyung H Lee
- 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Kyoung-Tae Kim
- 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Hyun J Kim
- 2 Institute for Evidence-based Medicine, Cochrane Korea, Seoul, Republic of Korea.,3 Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hyeong S Ahn
- 2 Institute for Evidence-based Medicine, Cochrane Korea, Seoul, Republic of Korea.,3 Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Yeo J Kim
- 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Ha Y Lee
- 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yong S Jeon
- 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
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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.
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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
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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.
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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
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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]
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Lee C, Baek J. A Sphere Phantom Approach to Measure Directional Modulation Transfer Functions for Tomosynthesis Imaging Systems. IEEE TRANSACTIONS ON MEDICAL IMAGING 2016; 35:871-881. [PMID: 26571519 DOI: 10.1109/tmi.2015.2498930] [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
We propose a sphere phantom approach to measure spatially varying directional modulation transfer functions (MTFs) for tomosynthesis imaging systems. Since the reconstructed tomosynthesis images contain significant artifacts, traditional background detrending techniques may not be effective to estimate the background trends accurately, which is essential to acquire sphere only data. A background detrending technique optimized for local volumes with different cone angles is presented. To measure directional MTFs, we calculate plane integrals of ideal sphere phantom and sphere only data. To minimize the effects of the high level of noise in tomosynthesis images, Richardson-Lucy deconvolution with Tikhonov-Miller is used to estimate directional plane spread function (PlSF). Then, directional MTFs are calculated by taking the modulus of the Fourier transform of the directional PlSFs. The measured directional MTFs are compared with the ideal directional MTFs calculated from a simulated point object. Our results show that the proposed method reliably measures directional MTFs along any desired directions, especially near low frequency regions.
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Cha MJ, Lee KS, Kim HS, Lee SW, Jeong CJ, Kim EY, Lee HY. Improvement in imaging diagnosis technique and modalities for solitary pulmonary nodules: from ground-glass opacity nodules to part-solid and solid nodules. Expert Rev Respir Med 2016; 10:261-78. [PMID: 26751340 DOI: 10.1586/17476348.2016.1141053] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
With advances in CT technology and the popularity of low-dose CT as a device for lung cancer screening, the detection rate of sub-solid pulmonary nodules as well as solid nodules has been increased. Distinguishing solid from sub-solid features is an essential step in the CT evaluation of solitary pulmonary nodules (SPNs) because strategies for nodule characterization and guidelines for management are different for each category. In addition to conventional CT parameters, numerous novel concepts and modalities have been developed. Although there is currently no single effective method for differentiating malignant from benign nodules, growth rate measurement using volumetry, evaluation of tumor vascularity on dynamic helical CT, dual-energy CT and MRI and physiologic evaluation with PET/CT can all be useful for nodule characterization. New techniques such as tomosynthesis can improve detection over radiography alone. The purpose of this article is to enhance our understanding of the evidence-based strategies involved in diagnosing SPNs.
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Affiliation(s)
- Min Jae Cha
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Kyung Soo Lee
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Hyun Su Kim
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - So Won Lee
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Chae Jin Jeong
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Eun Young Kim
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Ho Yun Lee
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
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A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference. Eur Radiol 2015; 26:3147-54. [DOI: 10.1007/s00330-015-4127-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 11/11/2015] [Accepted: 11/17/2015] [Indexed: 10/22/2022]
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Use of Tomosynthesis for Detection of Bone Erosions of the Foot in Patients With Established Rheumatoid Arthritis: Comparison With Radiography and CT. AJR Am J Roentgenol 2015. [PMID: 26204289 DOI: 10.2214/ajr.14.14120] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The purpose of this study was to compare tomosynthesis with radiography for the detection of bone erosions of the foot in patients with established rheumatoid arthritis (RA) using MDCT as a reference standard. SUBJECTS AND METHODS Eighteen consecutive patients with established RA were included. Each patient underwent radiography, tomosynthesis, and CT examinations of the feet on the same day. Two radiologists independently determined the number of bone erosions and the Sharp-van der Heijde score with each of the three imaging modalities. RESULTS On a total of 216 joints from 18 patients, 216 bone erosions were detected on CT, 215 on tomosynthesis, and 181 with radiography. The mean (± SD) Sharp-van der Heijde score was equivalent for tomosynthesis (18.8 ± 16.8) and CT (19.8 ± 18.5) but was statistically lower for radiography (16.4 ± 18.0) (p = 0.030). The respective overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for tomosynthesis were 80%, 75%, 78%, 76%, and 80%, whereas the respective corresponding values for radiography were 66%, 81%, 74%, 77%, and 71%. The radiation burden of tomosynthesis was almost equivalent to that of radiography. CONCLUSION Tomosynthesis has a higher sensitivity than radiography to detect bone erosions of the foot in patients with established RA and imparts an almost equivalent radiation burden.
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Lacout A, Marcy PY. Insights into Digital Tomosynthesis of Interstitial Lung Disease. Radiographics 2014; 34:1871. [DOI: 10.1148/rg.347140199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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