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A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference

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Abstract

Objectives

To compare the diagnostic performance of digital tomosynthesis (DTS) and chest radiography for detecting airway abnormalities, using computed tomography (CT) as a reference.

Materials and methods

We evaluated 161 data sets from 149 patients (91 with and 70 without airway abnormalities) who had undergone radiography, DTS, and CT to detect airway problems. Radiographs and DTS were evaluated to localize and score the severity of the airway abnormalities, and to score the image quality using CT as a reference. Receiver operating characteristics (ROC), McNemar’s test, weighted kappa, and the paired t-test were used for statistical analysis.

Results

The sensitivity of DTS was higher (reader 1, 93.51 %; reader 2, 94.29 %) than chest radiography (68.83 %; 71.43 %) in detecting airway lesions. The diagnostic accuracy of DTS (90.91 %; 94.70 %) was also significantly better than that of radiography (78.03 %; 82.58 %, all p < 0.05). DTS image quality was significantly better than chest radiography (1.83, 2.74; p < 0.05) in the results of both readers. The inter-observer agreement with respect to DTS findings was moderate and superior when compared to radiography findings.

Conclusions

DTS is a more accurate and sensitive modality than radiography for detecting airway lesions that are easily obscured by soft tissue structures in the mediastinum.

Key Points

• Digital tomosynthesis offers new diagnostic options for airway lesions.

• Digital tomosynthesis is more sensitive and accurate than radiography for airway lesions.

• Digital tomosynthesis shows better image quality than radiography.

• Assessment of lesion severity, via tomosynthesis is comparable to computed tomography.

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Acknowledgments

The scientific guarantor of this publication is Ki Yeol Lee. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Statisticians kindly provided statistical advice for this manuscript. One of the authors (Ami Yu) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, 516, Gojan 1-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, Korea

    Ji Yung Choo, Ki Yeol Lee & Jung Won Choi

  2. Korean Medicine Clinical Trial Center, Kyung Hee University Oriental Medicine Hospital, Seoul, Korea

    Ami Yu

  3. Biostatistical Consulting Lab, Medical Science Research Center, Korea University College of Medicine, Seoul, Korea

    Ami Yu

  4. Pulmonology, Korea University Ansan Hospital, Ansan-si, Korea

    Je-Hyeong Kim & Seung Heon Lee

  5. Radiology, Korea University Guro Hospitals, Seoul, South Korea

    Eun-Young Kang

  6. Radiology, Korea University Anam Hospital, Seoul, South Korea

    Yu Whan Oh

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  1. Ji Yung Choo
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  2. Ki Yeol Lee
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  3. Ami Yu
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  4. Je-Hyeong Kim
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  6. Jung Won Choi
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  7. Eun-Young Kang
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  8. Yu Whan Oh
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Correspondence to Ki Yeol Lee.

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Choo, J.Y., Lee, K.Y., Yu, A. et al. A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference. Eur Radiol 26, 3147–3154 (2016). https://doi.org/10.1007/s00330-015-4127-z

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  • DOI: https://doi.org/10.1007/s00330-015-4127-z

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