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Evaluation of an improved implementation of a method of simulating pulmonary nodules in chest tomosynthesis

Conference contribution
Authors Frida Svensson
Christina Söderman
Angelica Svalkvist
Rauni Rossi-Norrlund
Jenny Vikgren
Åse (Allansdotter) Johnsson
Magnus Båth
Published in Optimisation in X-ray and Molecular Imaging 2015 - the Fourth Malmö Conference on Medical Imaging, Gothenburg, Sweden, 28-30 May 2015
Publication year 2015
Published at Institute of Clinical Sciences, Department of Radiation Physics
Institute of Clinical Sciences, Department of Radiology
Language en
Subject categories Radiology, Radiological physics


Purpose: At the previous Malmö Conference on Medical Imaging, Svalkvist et al presented a method of simulating the presence of pulmonary nodules in chest tomosynthesis images through using computer simulations. The method was later evaluated in an observer study that revealed that although the artificial lung nodules had similar detectability as real nodules, experienced thoracic radiologists to some extent were able to distinguish them from real nodules. Recently, an error was found in the code used to generate the simulated nodules in the evaluation study. This error has now been corrected. The purpose of the present work was to perform a thorough evaluation of the corrected implementation of the nodule simulation method for chest tomosynthesis, comparing the detection rate and appearance of the artificial nodules with those of real nodules in an observer performance experiment. Material and methods: A cohort consisting of 64 patients, 38 patients with a total of 129 identified pulmonary nodules and 26 patients without identified pulmonary nodules, was used in the study. Simulated nodules, matching the real clinically found pulmonary nodules by size, attenuation, and location, were created and randomly inserted into the tomosynthesis section images of the patients. Three thoracic radiologists reviewed the images in an observer performance study divided into two parts. The first part included nodule detection and the second part included rating of the visual appearance of the nodules. The results were evaluated using a modified receiver-operating characteristic (ROC) analysis. Results and conclusions: The data collection is not complete and the final results will be presented at the conference. A preliminary analysis indicates that the corrected code increases the similarity between the artificial nodules and real nodules and that the validity of the implemented method thus has increased.

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