Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference
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To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference.
Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of −950 HU or lower (LAA−950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used.
ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA−950.
The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA−950.
• Tomosynthesis showed significantly better diagnostic performance for pulmonary emphysema than radiography.
• Interobserver agreement for tomosynthesis was significantly higher than that for radiography.
• Sensitivity increased with increasing LAA −950 in both tomosynthesis and radiography.
• Tomosynthesis imparts a similar radiation dose to two projection chest radiography.
• Radiation dose and cost of tomosynthesis are lower than those of MDCT.
- Litmanovich, D, Boiselle, PM, Bankier, AA (2009) CT of pulmonary emphysema—current status, challenges, and future directions. Eur Radiol 19: pp. 537-551 CrossRef
- Geitung, JT, Skjaerstad, LM, Gothlin, JH (1999) Clinical utility of chest roentgenograms. Eur Radiol 9: pp. 721-723 CrossRef
- Speets, AM, Graaf, Y, Hoes, AW (2006) Chest radiography in general practice: indications, diagnostic yield and consequences for patient management. Br J Gen Pract 56: pp. 574-578
- Washko, GR (2010) Diagnostic imaging in COPD. Semin Respir Crit Care Med 31: pp. 276-285 CrossRef
- Coxson, HO, Rogers, RM (2005) Quantitative computed tomography of chronic obstructive pulmonary disease. Acad Radiol 12: pp. 1457-1463 CrossRef
- Mets, OM, Jong, PA, Ginneken, B, Gietema, HA, Lammers, JW (2012) Quantitative computed tomography in COPD: possibilities and limitations. Lung 190: pp. 133-145 CrossRef
- Mayo, JR, Aldrich, J, Muller, NL (2003) Radiation exposure at chest CT: a statement of the Fleischner Society. Radiology 228: pp. 15-21 CrossRef
- Payne, JT (2005) CT radiation dose and image quality. Radiol Clin North Am 43: pp. 953-962 CrossRef
- Grant, DG (1972) Tomosynthesis: a three-dimensional radiographic imaging technique. IEEE Trans Biomed Eng 19: pp. 20-28 CrossRef
- McAdams, HP, Samei, E, Dobbins, J, Tourassi, GD, Ravin, CE (2006) Recent advances in chest radiography. Radiology 241: pp. 663-683 CrossRef
- Sone, S, Kasuga, T, Sakai, F (1991) Development of a high-resolution digital tomosynthesis system and its clinical application. Radiographics 11: pp. 807-822
- Dobbins, JT, Godfrey, DJ (2003) Digital x-ray tomosynthesis: current state of the art and clinical potential. Phys Med Biol 48: pp. R65-R106 CrossRef
- Dobbins, JT, McAdams, HP, Godfrey, DJ, Li, CM (2008) Digital tomosynthesis of the chest. J Thorac Imaging 23: pp. 86-92 CrossRef
- Dobbins, JT, McAdams, HP, Song, JW (2008) Digital tomosynthesis of the chest for lung nodule detection: interim sensitivity results from an ongoing NIH-sponsored trial. Med Phys 35: pp. 2554-2557 CrossRef
- Johnsson, AA, Vikgren, J, Svalkvist, A (2010) Overview of two years of clinical experience of chest tomosynthesis at Sahlgrenska University Hospital. Radiat Prot Dosim 139: pp. 124-129 CrossRef
- Vikgren, J, Zachrisson, S, Svalkvist, A (2008) Comparison of chest tomosynthesis and chest radiography for detection of pulmonary nodules: human observer study of clinical cases. Radiology 249: pp. 1034-1041 CrossRef
- Dobbins, JT, McAdams, HP (2009) Chest tomosynthesis: technical principles and clinical update. Eur J Radiol 72: pp. 244-251 CrossRef
- Kim, EY, Chung, MJ, Lee, HY, Koh, WJ, Jung, HN, Lee, KS (2010) Pulmonary mycobacterial disease: diagnostic performance of low-dose digital tomosynthesis as compared with chest radiography. Radiology 257: pp. 269-277 CrossRef
- Quaia, E, Baratella, E, Cioffi, V (2010) The value of digital tomosynthesis in the diagnosis of suspected pulmonary lesions on chest radiography: analysis of diagnostic accuracy and confidence. Acad Radiol 17: pp. 1267-1274 CrossRef
- Yamada, Y, Jinzaki, M, Hasegawa, I (2011) Fast scanning tomosynthesis for the detection of pulmonary nodules: diagnostic performance compared with chest radiography, using multidetector-row computed tomography as the reference. Invest Radiol 46: pp. 471-477 CrossRef
- Servomaa, A, Tapiovaara, M (1998) Organ dose calculation in medical X ray examinations by the program PCXMC. Radiat Prot Dosim 80: pp. 213-219 CrossRef
- (2007) The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 37:1–332
- European Guidelines on Quality Criteria for Computed Tomography (1999) Report EUR 16262. European Commission, Brussels. Available at: http://www.drs.dk/guidelines/ct/quality/index.htm. Accessed 18 Aug 2012
- Sutinen, S, Christoforidis, AJ, Klugh, GA, Pratt, PC (1965) Roentgenologic criteria for the recognition of nonsymptomatic pulmonary emphysema. Correlation between roentgenologic findings and pulmonary pathology. Am Rev Respir Dis 91: pp. 69-76
- Nicklaus, TM, Stowell, DW, Christiansen, WR, Renzetti, AD (1966) The accuracy of the roentgenologic diagnosis of chronic pulmonary emphysema. Am Rev Respir Dis 93: pp. 889-899
- Washko, GR, Hunninghake, GM, Fernandez, IE (2011) Lung volumes and emphysema in smokers with interstitial lung abnormalities. N Engl J Med 364: pp. 897-906 CrossRef
- Kim, WJ, Silverman, EK, Hoffman, E (2009) CT metrics of airway disease and emphysema in severe COPD. Chest 136: pp. 396-404 CrossRef
- Gierada, DS, Guniganti, P, Newman, BJ (2011) Quantitative CT assessment of emphysema and airways in relation to lung cancer risk. Radiology 261: pp. 950-959 CrossRef
- Brenner, DJ, Hall, EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357: pp. 2277-2284 CrossRef
- Quaia, E, Baratella, E, Cernic, S (2012) Analysis of the impact of digital tomosynthesis on the radiological investigation of patients with suspected pulmonary lesions on chest radiography. Eur Radiol 22: pp. 1912-1922 CrossRef
- Friedman, PJ (2008) Imaging studies in emphysema. Proc Am Thorac Soc 5: pp. 494-500 CrossRef
- Gurney, JW (1998) Pathophysiology of obstructive airways disease. Radiol Clin North Am 36: pp. 15-27 CrossRef
- Uppaluri, R, Mitsa, T, Sonka, M, Hoffman, EA, McLennan, G (1997) Quantification of pulmonary emphysema from lung computed tomography images. Am J Respir Crit Care Med 156: pp. 248-254 CrossRef
- Sanders, C, Nath, PH, Bailey, WC (1988) Detection of emphysema with computed tomography. Correlation with pulmonary function tests and chest radiography. Invest Radiol 23: pp. 262-266 CrossRef
- Price, D, Freeman, D, Cleland, J, Kaplan, A, Cerasoli, F (2011) Earlier diagnosis and earlier treatment of COPD in primary care. Prim Care Respir J 20: pp. 15-22 CrossRef
- O’Donnell, DE, Hernandez, P, Kaplan, A (2008) Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease—2008 update—highlights for primary care. Can Respir J 15: pp. 1A-8A
- Yamada, Y, Jinzaki, M, Tanami, Y (2012) Model-based iterative reconstruction technique for ultralow-dose computed tomography of the lung: a pilot study. Invest Radiol 47: pp. 482-489 CrossRef
- Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference
Volume 23, Issue 8 , pp 2118-2126
- Cover Date
- Print ISSN
- Online ISSN
- Springer Berlin Heidelberg
- Additional Links
- Pulmonary emphysema
- Multidetector computed tomography
- Industry Sectors
- Author Affiliations
- 1. Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- 2. Department of Radiology, Nippon Koukan Hospital, 1-2-1, Kokandori, Kawasaki-ku, Kawasaki-shi, Kanagawa, 210-0852, Japan
- 3. Center for Clinical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan