Single-exposure dual-energy subtraction chest radiography: detection of pulmonary nodules and masses in clinical practice

Szucs-Farkas, Zsolt; Patak, Michael A; Yuksel-Hatz, Seyran; Ruder, Thomas; Vock, Peter (2008). Single-exposure dual-energy subtraction chest radiography: detection of pulmonary nodules and masses in clinical practice. European radiology, 18(1), pp. 24-31. Berlin: Springer-Verlag 10.1007/s00330-007-0758-z

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The purpose of this retrospective study was to evaluate the impact of energy subtraction (ES) chest radiography on the detection of pulmonary nodules and masses in daily routine. Seventy-seven patients and 25 healthy subjects were examined with a single exposure digital radiography system. Five blinded readers evaluated first the non-subtracted PA and lateral chest radiographs alone and then together with the subtracted PA soft tissue images. The size, location and number of lung nodules or masses were registered with the confidence level. CT was used as standard of reference. For the 200 total lesions, a sensitivity of 33.5-52.5% was found at non-subtracted and a sensitivity of 43.5-58.5% at energy-subtracted radiography, corresponding to a significant improvement in four of five readers (p < 0.05). However, in three of five readers the rate of false positives was higher with ES. With ES, sensitivity, but not the area under the alternative free-response receiver operating characteristics (AFROC) curve, showed a good correlation with reader experience (R = 0.90, p = 0.026). In four of five readers, the diagnostic confidence improved with ES (p = 0.0036). We conclude that single-exposure digital ES chest radiography improves detection of most pulmonary nodules and masses, but identification of nodules <1 cm and false-positive findings remain a problem.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Szücs Farkas, Zsolt; Patak, Michael Andreas; Ruder, Thomas and Vock, Peter

ISSN:

0938-7994

ISBN:

17899105

Publisher:

Springer-Verlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:54

Last Modified:

22 Oct 2019 17:27

Publisher DOI:

10.1007/s00330-007-0758-z

PubMed ID:

17899105

Web of Science ID:

000252593500004

BORIS DOI:

10.7892/boris.23066

URI:

https://boris.unibe.ch/id/eprint/23066 (FactScience: 38793)

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