Evaluation of chest tomosynthesis for the detection of pulmonary nodules: effect of clinical experience and comparison with chest radiography
2009
Chest tomosynthesis refers to the technique of collecting low-dose projections of the chest at different angles and using
these projections to reconstruct section images of the chest. In this study, a comparison of chest tomosynthesis and chest
radiography in the detection of pulmonary nodules was performed and the effect of clinical experience of chest
tomosynthesis was evaluated. Three senior thoracic radiologists, with more than ten years of experience of chest
radiology and 6 months of clinical experience of chest tomosynthesis, acted as observers in a jackknife free-response
receiver operating characteristics (JAFROC-1) study, performed on 42 patients with and 47 patients without pulmonary
nodules examined with both chest tomosynthesis and chest radiography. MDCT was used as reference and the total
number of nodules found using MDCT was 131. To investigate the effect of additional clinical experience of chest
tomosynthesis, a second reading session of the tomosynthesis images was performed one year after the initial one. The
JAFROC-1 figure of merit (FOM) was used as the principal measure of detectability. In comparison with chest
radiography, chest tomosynthesis performed significantly better with regard to detectability. The observer-averaged
JAFROC-1 FOM was 0.61 for tomosynthesis and 0.40 for radiography, giving a statistically significant difference
between the techniques of 0.21 (p<0.0001). The observer-averaged JAFROC-1 FOM of the second reading of the
tomosynthesis cases was not significantly higher than that of the first reading, indicating no improvement in detectability
due to additional clinical experience of tomosynthesis.
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