Published in:
01-09-2012 | Chest
Analysis of the impact of digital tomosynthesis on the radiological investigation of patients with suspected pulmonary lesions on chest radiography
Published in: European Radiology | Issue 9/2012
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Objective
To assess the impact of digital tomosynthesis (DTS) on the radiological investigation of patients with suspected pulmonary lesions on chest radiography (CXR).
Methods
Three hundred thirty-nine patients (200 male; age, 71.19 ± 11.9 years) with suspected pulmonary lesion(s) on CXR underwent DTS. Two readers prospectively analysed CXR and DTS images, and recorded their diagnostic confidence: 1 or 2 = definite or probable benign lesion or pseudolesion deserving no further diagnostic workup; 3 = indeterminate; 4 or 5 = probable or definite pulmonary lesion deserving further diagnostic workup by computed tomography (CT). Imaging follow-up by CT (n = 76 patients), CXR (n = 256) or histology (n = 7) was the reference standard.
Results
DTS resolved doubtful CXR findings in 256/339 (76 %) patients, while 83/339 (24 %) patients proceeded to CT. The mean interpretation time for DTS (mean ± SD, 220 ± 40 s) was higher (P < 0.05; Wilcoxon test) than for CXR (110 ± 30 s), but lower than CT (600 ± 150 s). Mean effective dose was 0.06 mSv (range 0.03–0.1 mSv) for CXR, 0.107 mSv (range 0.094–0.12 mSv) for DTS, and 3 mSv (range 2–4 mSv) for CT.
Conclusions
DTS avoided the need for CT in about three-quarters of patients with a slight increase in the interpretation time and effective dose compared to CXR.
Key Points
• Digital tomosynthesis (DTS) improves the diagnostic confidence of chest radiography (CXR)
• DTS reduces the need for CT for a suspected pulmonary lesion
• DTS only imparts a radiation dose of around two CXRs
• DTS takes longer to interpret than conventional chest radiography