European Radiology

, Volume 23, Issue 8, pp 2118–2126

Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

  • Yoshitake Yamada
  • Masahiro Jinzaki
  • Masahiro Hashimoto
  • Eisuke Shiomi
  • Takayuki Abe
  • Sachio Kuribayashi
  • Kenji Ogawa
Chest

Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusions

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.

Key Points

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 LAA950in 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.

Keywords

Tomosynthesis Thorax Pulmonary emphysema Multidetector computed tomography Radiography 

Abbreviations

LAA−950

Low-attenuation area with attenuation values of −950 HU or lower

GEE

Generalised estimating equations

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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Yoshitake Yamada
    • 1
    • 2
  • Masahiro Jinzaki
    • 1
  • Masahiro Hashimoto
    • 1
  • Eisuke Shiomi
    • 1
  • Takayuki Abe
    • 3
  • Sachio Kuribayashi
    • 1
  • Kenji Ogawa
    • 2
  1. 1.Department of Diagnostic RadiologyKeio University School of MedicineTokyoJapan
  2. 2.Department of RadiologyNippon Koukan HospitalKawasaki-shiJapan
  3. 3.Center for Clinical ResearchKeio University School of MedicineTokyoJapan

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