Learning aspects and potential pitfalls regarding detection of pulmonary nodules in chest tomosynthesis and proposed related quality criteria

Abstract

The results indicate that inexperienced observers can reach a high level of performance regarding nodule detection in tomosynthesis after learning with feedback and that the main problem with chest tomosynthesis is related to the limited depth resolution.

A Retrospective Study of Chest Tomosynthesis as a Tool for Optimizing the use of Computed Tomography Resources and Reducing Patient Radiation Exposure

“…Additionally, Vikgren et al (8) performed a detectability study and showed that only 16% of the CT-proven nodules were detected using CXR, whereas 56% were detected with CTS. The threefold increase in sensitivity thus reported by Vikgren et al has later been confirmed in studies by Yamada et al (11), Jung et al (12), Zachrisson et al (13), and Asplund et al (14).…”

Evaluation of a new system for chest tomosynthesis: aspects of image quality of different protocols determined using an anthropomorphic phantom

“…12 Inexperienced observers can also perform well in this task after a short learning session with feedback. 13 Third, because the technology is fairly new, there are no established quality criteria for chest tomosynthesis. For the present study, we therefore developed image quality criteria for DTS based on established quality criteria for chest radiography 29 and chest CT 30 and criteria proposed for chest DTS 13 in combination with the clinical experience of the authors and the observers.…”

“…13 Third, because the technology is fairly new, there are no established quality criteria for chest tomosynthesis. For the present study, we therefore developed image quality criteria for DTS based on established quality criteria for chest radiography 29 and chest CT 30 and criteria proposed for chest DTS 13 in combination with the clinical experience of the authors and the observers. The image quality criteria applied in the present study take into account several aspects of the effect of different sweep angles and also relate to anatomical structures throughout the chest in order to be relevant for the clinical validity of the results.…”

“…The criteria developed for the study were based on the European guidelines on quality criteria for diagnostic radiographic images 29,30 and the quality criteria proposed for chest tomosynthesis by Asplund et al 13 in combination with the clinical experience of the observers ( Table 2). The criteria focused on eight anatomical regions of the thorax and were distributed to cover various distances to the detector and different types of structures ( Figure 3).…”

“…This reduces the tissue overlap problem of chest radiography while exposing the patient to only a slightly higher radiation dose as compared with chest radiography. [8][9][10] In comparisons with chest radiography, DTS has been shown to substantially increase the detection of pathology such as pulmonary nodules, 5,[11][12][13][14][15] mycobacterial disease, 16 pleuropulmonary disease, 17 and pulmonary emphysema. 18 The clinical interest has also been based on the successful use of DTS as a problem-solving tool after chest radiography, [19][20][21] substantially reducing the need for CT after a non-conclusive chest radiography.…”