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Analysis of the impact of digital tomosynthesis on the radiological investigation of patients with suspected pulmonary lesions on chest radiography

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Abstract

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

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Abbreviations

CXR:

Chest radiography

DTS:

Digital tomosynthesis

CT:

Computed tomography

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Acknowledgments

We thank Dr John Sabol, GE Healthcare, for invaluable help in the VolumeRad dose calculations.

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Authors and Affiliations

  1. Department of Radiology, Cattinara Hospital, University of Trieste (Italy), Strada di Fiume 447, 34149, Trieste, Italy

    Emilio Quaia, Elisa Baratella, Stefano Cernic, Arianna Lorusso, Federica Casagrande, Vincenzo Cioffi & Maria Assunta Cova

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  1. Emilio Quaia
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  2. Elisa Baratella
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  3. Stefano Cernic
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  4. Arianna Lorusso
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  5. Federica Casagrande
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  6. Vincenzo Cioffi
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  7. Maria Assunta Cova
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Correspondence to Emilio Quaia.

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Quaia, E., Baratella, E., Cernic, S. et al. Analysis of the impact of digital tomosynthesis on the radiological investigation of patients with suspected pulmonary lesions on chest radiography. Eur Radiol 22, 1912–1922 (2012). https://doi.org/10.1007/s00330-012-2440-3

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  • DOI: https://doi.org/10.1007/s00330-012-2440-3

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