Digital tomosynthesis of the chest for lung nodule detection: Interim sensitivity results from an ongoing NIH-sponsored trial
Digital tomosynthesis of the chest for lung nodule detection: Interim sensitivity results from an ongoing NIH-sponsored trial
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DOI：
10.1118/1.2937277
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发表时间：
2008-06-01
期刊：
影响因子：
3.8
通讯作者：
Martinez-Jimenez, Santiago
中科院分区：
文献类型：
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作者：
Dobbins, James T.;McAdams, H. Page;Martinez-Jimenez, Santiago
作者报告了由美国国立卫生研究院赞助的一项正在进行的试验的中期临床结果，该试验旨在评估数字胸部断层合成技术改善小肺结节的可探测性。21名接受计算机断层扫描(CT)随访肺结节的患者同意接受额外的数字PA胸片和数字断层合成检查。断层合成是用商用的CSI/α-Si平板探测器和定制的管移动器进行的。采集了11例S的71幅图像，采用矩阵逆变换层析算法在5 mm的平面间隔重建，然后对其进行平均(7个平面)以减少噪声和低对比度伪影。断层合成成像的总曝光量相当于11张数字PA X线片(相当于一张典型的屏幕胶片侧位片或两张数字侧位片)。复习CT扫描(1.25 mm层厚)以确定结节的存在和位置。三位胸部放射科医生独立审查了断层合成图像和PA胸片，以确认CT确定的结节的可视化。对结节进行评分：明确可见、不确定或不可见。CT显示175个结节(直径3.5~25.5 mm)，按大小分组：5 mm、5~10 mm和10 mm。当仅考虑评分明确可见的结节为真阳性时，CT合成和PA摄影对所有结节的敏感性分别为70%(+/-5%)和22%(+/-4%)，(p<；0.0001)。与PA胸片相比，数字断层合成显示在所有三个大小的组中，对已知的小肺结节的检测灵敏度都显著提高。(C)2008年美国医学物理学家协会
The authors report interim clinical results from an ongoing NIH-sponsored trial to evaluate digital chest tomosynthesis for improving detectability of small lung nodules. Twenty-one patients undergoing computed tomography (CT) to follow up lung nodules were consented and enrolled to receive an additional digital PA chest radiograph and digital tomosynthesis exam. Tomosynthesis was performed with a commercial CsI/alpha-Si flat-panel detector and a custom-built tube mover. Seventy-one images were acquired in 11 s, reconstructed with the matrix inversion tomosynthesis algorithm at 5-mm plane spacing, and then averaged (seven planes) to reduce noise and low-contrast artifacts. Total exposure for tomosynthesis imaging was equivalent to that of 11 digital PA radiographs (comparable to a typical screen-film lateral radiograph or two digital lateral radiographs). CT scans (1.25-mm section thickness) were reviewed to confirm presence and location of nodules. Three chest radiologists independently reviewed tomosynthesis images and PA chest radiographs to confirm visualization of nodules identified by CT. Nodules were scored as: definitely visible, uncertain, or not visible. 175 nodules (diameter range 3.5-25.5 mm) were seen by CT and grouped according to size: < 5, 5-10, and > 10 mm. When considering as true positives only nodules that were scored definitely visible, sensitivities for all nodules by tomosynthesis and PA radiography were 70% (+/- 5%) and 22% (+/- 4%), respectively, (p < 0.0001). Digital tomosynthesis showed significantly improved sensitivity of detection of known small lung nodules in all three size groups, when compared to PA chest radiography. (C) 2008 American Association of Physicists in Medicine