Pulmonary Mycobacterial Disease: Diagnostic Performance of Low-Dose Digital Tomosynthesis as Compared with Chest Radiography

Kim, Eun Young; Chung, Myung Jin; Lee, Ho Yun; Koh, Won‐Jung; Jung, Hye Na; Lee, Kyung Soo

doi:10.1148/radiol.10100303

Cited by 65 publications

(50 citation statements)

References 21 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…24,25,27 Also, several studies demonstrated the effective dose of each modality for standard patient in each study protocol, [9][10][11][12]21 and we found that the radiation dose for DTS was approximately twice that for chest radiography and DTS required a much smaller radiation dose in comparison with CT.…”

Section: Discussionsupporting

confidence: 52%

“…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%

“…Because it eliminates overlapping anatomy or composite artefact, DTS facilitates improved lesion detection, depth localization and contrast resolution compared with plain radiography, 6,7 and compared with CT, the cost and radiation dose of DTS are lower. [8][9][10] Therefore, DTS has been recommended by several authors as an alternative to both chest radiography and CT, and the greater diagnostic performance of DTS for detecting pulmonary nodules has been reported. 9,[11][12][13] However, differences in the diagnostic performance for detection of pulmonary nodules between chest radiography and DTS have not been clearly delineated.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 52%

Section: Study Characteristics and Patient Populationsmentioning

confidence: 99%

Section: Introductionmentioning

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

View full text Add to dashboard Cite

show abstract

“…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.…”

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

View full text Add to dashboard Cite

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.

show abstract

“…igital tomosynthesis has been applied to a variety of applications, including breast imaging (1-3), orthopedic imaging (4-8), urologic imaging (9), and chest imaging (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Digital chest tomosynthesis has been available and cleared by the U.S. Food and Drug Administration since 2006.…”

mentioning

confidence: 99%

Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules

Dobbins

McAdams

Sabol³

et al. 2017

Radiology

View full text Add to dashboard Cite

Purpose:To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods:In this binational, institutional review board-approved, HIPAAcompliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3-20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3-4 mm, .4 mm to 6 mm, .6 mm to 8 mm, and .8 mm to 20 mm). Results:Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P , .001; 95% confidence interval [CI]: 2.96, 4.15). Case-level sensitivity was higher with tomosynthesis than with conventional chest radiography for all nodules (1.49-fold, P , .001; 95% CI: 1.25, 1.73). Case management decisions showed better overall accuracy with tomosynthesis than with conventional chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P , .001; 95% CI: 1.15, 1.32). There were no differences in any specificity measures. DE imaging did not significantly affect nodule detection when paired with either conventional chest radiography or tomosynthesis. Conclusion:Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest radiography or tomosynthesis alone. These findings indicate performance likely achievable with a range of reader expertise.Online supplemental material is available for this article. Imaging data were collected from subjects at four tertiary care sitesthree in the United States and one in Sweden. The study (ClinicalTrials.gov no. NCT00963651) was approved by the institutional review board of each institution, and informed consent was obtained from each subject prior to enrollment. The study was compliant with the Health Insurance Portability and Accountability Act. Subjects enrolled were referred for, or had recently undergone,...

show abstract

Pulmonary Mycobacterial Disease: Diagnostic Performance of Low-Dose Digital Tomosynthesis as Compared with Chest Radiography

Abstract: DTS performed with a low-dose technique is superior to radiography for the detection of lung lesions in patients with pulmonary mycobacterial disease.

Cited by 65 publications

References 21 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

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

Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules

Contact Info

Product

Resources

About