Digital chest tomosynthesis: the 2017 updated review of an emerging application

Ferrari, Arianna; Bertolaccini, Luca; Solli, Piergiorgio; Salvia, Paola Oriana Di; Scaradozzi, David

doi:10.21037/atm.2017.08.18

Cited by 24 publications

(11 citation statements)

References 40 publications

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“…1 ). 18 , 19 The fluoroscopic navigation module incorporates a proprietary advanced algorithm that uses tomosynthesis 20 , 21 to reconstruct a 3-dimensional model from multiple 2-dimensional C-arm fluoroscopic images taken at various angles around the patient (Fig. 1 D).…”

Section: Methodsmentioning

confidence: 99%

Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction

Pritchett

Bhadra

Mattingley

2020

Journal of Bronchology &Amp; Interventional Pulmonology

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Background: Electromagnetic navigation bronchoscopy (ENB) aids in lung lesion biopsy. However, anatomic divergence between the preprocedural computed tomography (CT) and the actual bronchial anatomy during the procedure can limit localization accuracy. An advanced ENB system has been designed to mitigate CT-to-body divergence using a tomosynthesis-based software algorithm that enhances nodule visibility and allows for intraprocedural local registration. Materials and Methods: A prospective, 2-center study was conducted in subjects with single peripheral lung lesions ≥10 mm to assess localization accuracy of the superDimension navigation system with fluoroscopic navigation technology. Three-dimensional accuracy was confirmed by cone-beam computed tomography. Complications were assessed through 7 days. Results: Fifty subjects were enrolled (25 per site). Lesions were <20 mm in 61.2% (30/49). A bronchus sign was present in 53.1% (26/49). Local registration was completed in 95.9% (47/49). Three-dimensional target overlap (primary endpoint) was achieved in 59.6% (28/47) and 83.0% (39/47) before and after location correction, respectively. Excluding subjects with unevaluable video files, target overlap was achieved 68.3% (28/41) and 95.1% (39/41), respectively. Malignant results were obtained in 53.1% (26/49) by rapid on-site evaluation and 61.2% (30/49) by final pathology of the ENB-aided sample. Diagnostic yield was not evaluated. Procedure-related complications were pneumothorax in 1 subject (no chest tube required) and scant hemoptysis in 3 subjects (no interventions required). Conclusion: ENB with tomosynthesis-based fluoroscopic navigation improved the 3-dimensional convergence between the virtual target and actual lung lesion as confirmed by cone-beam computed tomography. Future studies are necessary to understand the impact of this technology on diagnostic yield.

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Section: Methodsmentioning

confidence: 99%

Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction

Pritchett

Bhadra

Mattingley

2020

Journal of Bronchology &Amp; Interventional Pulmonology

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“…[1][2][3][4] Other lowdose modalities that offer greater sensitivity as compared to CXR have been proposed for applications such as lung cancer screening and high-risk patients. Digital chest tomosynthesis is a tomographic technique that uses a conventional radiographic tube to acquire images at several angles with a radiation dose of 0.13 mSv 5 offering increased sensitivity over CXR and better visualization of opacities; 6 however, the depth resolution is limited compared to CT. 7 Dual-energy CXR acquires two images at different energy levels to create a subtractive image that eliminates the rib shadows to mitigate the effect of superposition. While it does not have the benefits of tomographic techniques, it has been shown to improve detection of nodules over CXR.…”

Section: Introductionmentioning

confidence: 99%

Comparison of conventional chest x ray with a novel projection technique for ultra‐low dose CT

et al. 2021

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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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“…In recent years, many studies had also corroborated the important role of DTS in the discovery and follow-up of chest nodular lesions, and even the discovery and evaluation of lung cancer [16]. With the development and expansion of DTS technology, its role in the neck, breast [17], the thoracic spine, abdomen and skeletal system becomes more and more signi cant [18].…”

Section: Digital Tomosynthesis (Dts)mentioning

confidence: 95%

"Multimodal" Imaging Performance and Clinical Application of Coronavirus Disease 2019 (COVID-19)

Li¹,

Zhou²,

Li³

et al. 2020

Preprint

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Background: To investigate the diagnostic value of three different examination methods of chest radiography (CXR), digital tomosynthesis (DTS) and Computed tomography (CT) scan on the diagnosis of novel coronavirus pneumonia (COVID-19).Methods: A retrospective analysis of three examination methods of chest: CXR, DTS, and CT scan of COVID-19 pneumonia patients diagnosed in our hospital from January, 23, 2020 to February, 29, 2020. And we compared three different imaging methods to COVID-19 display ability of pneumonia intrapulmonary lesions.Results: A total of 37 patients diagnosed as COVID-19 by nucleic acid testing were included. The CXR group (10/37) and DTS group (21/28) of 37 patients with COVID-19 pneumonia showed significant differences in intrapulmonary ground glass opacities (P<0.05); DTS group (21/28) and CT group (25/27) showed no statistically significant differences in intrapulmonary ground glass opacities (P> 0.05). Conclusion: Comparison of the three imaging methods of COVID-19 pneumonia, the diagnostic efficiency of CXR is low, which is easy to be false negative and miss lesions; diagnostic resolutions of DTS are higher than CXR, which can improve the ability to display the fine structure of intrapulmonary lesions; CT scan shows the intrapulmonary of COVID-19 pneumonia low-density ground glass opacities and internal structures have equal capacity compared with DTS. Therefore, DTS and CT are the best choices for the image diagnosis of COVID-19 pneumonia.

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Digital chest tomosynthesis: the 2017 updated review of an emerging application

Cited by 24 publications

References 40 publications

Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction

Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction

Comparison of conventional chest x ray with a novel projection technique for ultra‐low dose CT

"Multimodal" Imaging Performance and Clinical Application of Coronavirus Disease 2019 (COVID-19)

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