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Clinical results of CsI-detector-based dual-exposure dual energy in chest radiography

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Abstract

The aim of this study was to compare the sensitivity and specificity of digital chest radiography alone with digital chest radiography combined with dual-energy chest radiography in the detection of small non-calcified pulmonary nodules. Standard and dual-energy radiographs were obtained with a flat-panel digital chest system. Four radiologists reviewed digital posteroanterior chest radiographs in random order either alone or in conjunction with dual-energy soft tissue and bone images. Twenty patients with a total of 59 pulmonary nodules (median 0.5 cm, range 0.3 – 2.5 cm) confirmed by computed tomography (HU ≤100) were included. A level of confidence for each diagnosis was documented using a rating scale of 1–5. Brunner and Langer's test was performed for statistical analysis. Subgroup analysis was performed for nodules greater than 1 cm, 1–0.5 cm, and <0.5 cm. For posteroanterior chest radiography, sensitivity was 33%, positive predictive value 83%, specificity 81%, and negative predictive value 30%. Review in conjunction with dual-energy images resulted in a sensitivity of 42%, positive predictive value 88%, specificity 85%, and negative predictive value 34%. The increase of nodule detection overall as well as for different size categories was significant (p<0.05). The increase of the confidence level rating was also significant (p<0.001). Dual energy added to standard posteroanterior chest radiography significantly improves the sensitivity, specificity, and confidence in detection of small non-calcified pulmonary nodules.

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Authors and Affiliations

  1. Department of Radiology, Charité, Campus Virchow-Klinikum, Humboldt University Medical School, Augustenburgerplatz 1, 13353, Berlin, Germany

    Jens Ricke, Frank Fischbach, Torsten Freund, Ulf Teichgräber, Enrique Lopez Hänninen, Rainer Röttgen, Ulrike Engert, Hermann Eichstädt & Roland Felix

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  1. Jens Ricke
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  2. Frank Fischbach
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  3. Torsten Freund
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  4. Ulf Teichgräber
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  5. Enrique Lopez Hänninen
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  7. Ulrike Engert
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  9. Roland Felix
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Correspondence to Jens Ricke.

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Ricke, J., Fischbach, F., Freund, T. et al. Clinical results of CsI-detector-based dual-exposure dual energy in chest radiography. Eur Radiol 13, 2577–2582 (2003). https://doi.org/10.1007/s00330-003-1913-9

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  • DOI: https://doi.org/10.1007/s00330-003-1913-9

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