Lung Cancer Detection with Digital Chest Tomosynthesis: Baseline Results from the Observational Study SOS

Terzi, Alberto; Bertolaccini, Luca; Viti, Andrea; Comello, L.; Ghirardo, Donatella; Priotto, Roberto; Grosso, Maurizio

doi:10.1097/jto.0b013e318292bdef

Cited by 38 publications

(32 citation statements)

References 16 publications

(12 reference statements)

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“…[24][25][26] However, the inability to extract the number of true-positives, false-positives, true-negatives and false-negatives could be a significant drawback to our study, as this is essential when assessing the appropriateness of utilizing a technique for clinical use. In our meta-analysis, some studies which used CT as the reference standard did not suggest the truenegative number, because they demonstrated only the true-positive number of nodules detected with DTS and chest radiography among nodules detected with CT. 13,22,23 In other studies, sensitivity was estimated on a per-lesion basis, but specificity was exclusively estimated on per-patient basis. 9,11,21,27 Thus, we inevitably analyzed the detection rate from lesion-based data because we considered those information could be significant for evaluating the diagnostic value for the detection of pulmonary nodule despite definite limitations.…”

Section: Discussionmentioning

confidence: 99%

“…9,11,13,[21][22][23] However, we could extract the total numbers of true positives and the total number of pulmonary nodules, which allowed us to calculate and analyze detection rates. Thus, we identified 7 studies (1017 patients) that presented per-patient results 10,12,[17][18][19][20][21] and 10 studies that presented per-lesion results (2159 lesions) 9,11,13,[21][22][23][24][25][26][27] for meta-analysis. Only one study included both per-patient-and per-lesion-based data.…”

Section: Study Characteristics and Patient Populationsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of digital tomosynthesis and chest radiography for the detection of pulmonary nodules: systematic review and meta-analysis

Kim¹,

Lee²,

Kim³

et al. 2016

The British Journal of Radiology

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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 receiveroperating 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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Section: Discussionmentioning

confidence: 99%

Section: Study Characteristics and Patient Populationsmentioning

confidence: 99%

Comparison of digital tomosynthesis and chest radiography for the detection of pulmonary nodules: systematic review and meta-analysis

Kim¹,

Lee²,

Kim³

et al. 2016

The British Journal of Radiology

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“…A digitális tomoszintézis egyik előnye a CT-szűréssel szemben, hogy kisebb az erőforrásigénye mind a szakemberek, mind a költségek vonatkozásában, emellett kevesebb a sugárzáshoz köthető káros hatása is [45]. A szűrés bizonytalansága azonban magasabb, így a DTS-szűrés mint első vonalas beavatkozás egyelőre nem használható.…”

Section: Megbeszélés éS Limitációkunclassified

Az alacsony dózisú CT-vel végzett tüdőrákszűrés magyarországi egészség-gazdaságtani elemzésének koncepcionális terve

Vokó¹,

Barra²,

Molnár³

et al. 2017

Orvosi Hetilap

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Bevezetés: A tüdőrák gyors lefolyású, jellemzően végzetes kimenetelű betegség, amely világszerte jelentős terhet ró a társadalomra. A magyar egészségügy forrásoldalának szűkösségét ismerve egészségpolitikai szempontból alapvető jelentőségű a szűrés bevezetésével kapcsolatban a költség-hatékonyság kérdése. Célkitűzés: A tanulmány célja a magyarországi alacsony dózisú komputertomográfiával végzett tüdőrákszűrés költség-hatékonysági modell koncepciójának kialakítása, illetve az elemzés megvalósításához szükséges lépések számbavétele. Módszer: Célzott irodalomkutatást végeztünk a szűrés hatásosságára és költség-hatékonyságára vonatkozó bizonyíté-kok azonosítására, majd a találatokat a magyarországi viszonyokra való általánosíthatóság alapján értékeltük. Emellett áttekintettük a hazai tudományos bizonyítékokat és rekonstruáltuk a szűrés során előforduló betegutakat. Eredmények: Mindezek alapján Magyarországon az alacsony dózisú komputertomográfiával végzett tüdőrákszűrés teljes körű gazdasági elemzéséhez egy komplex, több almodellből álló modellstruktúrát javaslunk, amely alkalmas a kockázatnak kitett populáció élethosszig tartó követésére. Következtetések: A költség-hatékonysági modell adatokat szolgáltathat további olyan elemzésekhez, amelyek segítik az alacsony dózisú komputertomográfiával végzett tüdőrákszűrés népegészségügyi programként történő bevezetésére vonatkozó szakmai döntések meghozatalát. Orv Hetil. 2017; 158(25): 963-975. Kulcsszavak: alacsony dózisú CT, tüdőrákszűrés, egészség-gazdaságtani modell, költség-hatékonyság Model concept of the health economic evaluation of low-dose CT lung cancer screening in HungaryIntroduction: Lung cancer is a rapidly progressing, often life-threatening disease that constitutes a huge societal burden. Because of the scarce resources of the Hungarian health care system, the cost-effectiveness of introducing lowdose computed tomography screening is a relevant health policy matter. Aim: The aim of this study is to design a model concept for assessing the cost-effectiveness of low-dose computed tomography lung cancer screening in Hungary, and to define the required steps for performing the analysis. Method: A targeted literature review was conducted to identify and synthesize the evidence on efficacy and effectiveness of screening, and results were evaluated based on adaptability to Hungarian settings. We also summarized the available Hungarian scientific evidence and reconstructed the potential patient pathways. Results: In accordance with these findings, we recommend to perform the full health-economic evaluation of lowdose computed tomography lung cancer screening using a complex model structure that consists of several sub-models and is capable to follow the population at risk on life-time horizon.

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“…[22][23][24] Finally, owing to the very low dose of DTS, it has been suggested as a suitable technique for lung cancer screening. 25 Three DTS systems for chest tomosynthesis currently exist. The studies described above were performed using the systems from Shimadzu Corporation (Kyoto, Japan) and GE Healthcare (Chalfont St Giles, UK).…”

Section: Introductionmentioning

confidence: 99%

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

Jadidi

Sundín

Aspelin

et al. 2015

BJR

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Cite this article as: Jadidi M, Sundin A, Aspelin P, Båth M, Nyrén S. Evaluation of a new system for chest tomosynthesis: aspects of image quality of different protocols determined using an anthropomorphic phantom. Objective: To compare the image quality obtained with the different protocols in a new chest digital tomosynthesis (DTS) system. Methods: A chest phantom was imaged with chest X-ray equipment with DTS. 10 protocols were used, and for each protocol, nine acquisitions were performed. Four observers visually rated the quality of the reconstructed section images according to pre-defined quality criteria in four different classes. The data were analysed with visual grading characteristics (VGC) analysis, using the vendorrecommended protocol [12-s acquisition time, source-toimage distance (SID) 180 cm] as reference, and the area under the VGC curve (AUC VGC ) was determined for each protocol and class of criteria.Results: Protocols with a smaller swing angle resulted in a lower image quality for the classes of criteria "disturbance" and "homogeneity in nodule" but a higher image quality for the class "structure". The class "demarcation" showed little dependency on the swing angle. All protocols but one (6.3 s, SID 130 cm) obtained an AUC VGC significantly ,0.5 (indicating lower quality than reference) for at least one class of criteria. Conclusion:The study indicates that the DTS protocol with 6.3 s yields image quality similar to that obtained with the vendor-recommended protocol (12 s) but with the clinically important advantage for patients with respiratory impairment of a shorter acquisition time. Advances in knowledge:The study demonstrates that the image quality may be strongly affected by the choice of protocol and that the vendor-recommended protocol may not be optimal.

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Lung Cancer Detection with Digital Chest Tomosynthesis: Baseline Results from the Observational Study SOS

Cited by 38 publications

References 16 publications

Comparison of digital tomosynthesis and chest radiography for the detection of pulmonary nodules: systematic review and meta-analysis

Comparison of digital tomosynthesis and chest radiography for the detection of pulmonary nodules: systematic review and meta-analysis

Az alacsony dózisú CT-vel végzett tüdőrákszűrés magyarországi egészség-gazdaságtani elemzésének koncepcionális terve

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

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