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Detection and Characterization of Solid Pulmonary Nodules at Digital Chest Tomosynthesis: Data from a Cohort of the Pilot Swedish Cardiopulmonary Bioimage Study

Journal article
Authors Carin Meltzer
Jenny Vikgren
Bengt Bergman
David Molnar
Rauni Rossi-Norrlund
Asmaa Hassoun
Bengt Gottfridsson
Magnus Båth
Åse (Allansdotter) Johnsson
Published in Radiology
Volume 287
Issue 3
Pages 1018-1027
ISSN 0033-8419
Publication year 2018
Published at Institute of Medicine
Institute of Clinical Sciences, Department of Radiology
Pages 1018-1027
Language en
Links https://doi.org/10.1148/radiol.2018...
Keywords observer performance, computed-tomography, radiography, management, radiology, software, viewdex, lesions, tool, Radiology, Nuclear Medicine & Medical Imaging
Subject categories Radiology, Nuclear Medicine and Medical Imaging, Radiology

Abstract

Purpose: To investigate the performance of digital tomosynthesis (DTS) for detection and characterization of incidental solid lung nodules. Materials and Methods: This prospective study was based on a population study with 1111 randomly selected participants (age range, 50-64 years) who underwent a medical evaluation that included chest computed tomography (CT). Among these, 125 participants with incidental nodules 5 mm or larger were included in this study, which added DTS in conjunction with the follow-up CT and was performed between March 2012 and October 2014. DTS images were assessed by four thoracic radiologists blinded to the true number of nodules in two separate sessions according to the 5-mm (125 participants) and 6-mm (55 participants) cut-off for follow-up of incidental nodules. Pulmonary nodules were directly marked on the images by the readers and graded regarding confidence of presence and recommendation for follow-up. Statistical analyses included jackknife free-response receiver operating characteristic, receiver operating characteristic, and Cohen k coefficient. Results: Overall detection rate ranges of CT-proven nodules 5 mm or larger and 6 mm or larger were, respectively, 49%58% and 48%-62%. Jackknife free-response receiver operating characteristics figure of merit for detection of CT-proven nodules 5 mm or larger and 6 mm or larger was 0.47 and 0.51, respectively, and area under the receiver operating characteristic curve regarding recommendation for follow-up was 0.62 and 0.65, respectively. Conclusion: Routine use of DTS would result in lower detection rates and reduced number of small nodules recommended for follow-up. (C) RSNA, 2018.

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