Elisa Baratella MD, Presenter: Nothing to Disclose

Emilio Quaia MD, Abstract Co-Author: Nothing to Disclose

Stefano Cernic, Abstract Co-Author: Nothing to Disclose

Vincenzo Cioffi MD, Abstract Co-Author: Nothing to Disclose

Maria Assunta Cova MD, Abstract Co-Author: Nothing to Disclose

We investigated the value of digital tomosynthesis in the diagnosis of suspected pulmonary lesions on chest radiography

Two-hundred and twenty-eight patients (133 male, 95 female; age, 70.8±11.1 years) with suspected pulmonary lesions after initial analysis of chest radiography underwent digital tomosynthesis. Two independent readers (experience, 3 and 20 years) prospectively analyzed the chest radiography and digital tomosynthesis images on a PACS–integrated workstation and proposed a diagnostic confidence score for each lesion (1 or 2: definitely or probably extra-pulmonary or pseudolesion; 3: indeterminate; 4 or 5: probably or definitely pulmonary). Chest CT was the reference standard examination

A total number of 251 suspected pulmonary lesions were identified. In 71 patients digital tomosynthesis and CT did not confirm any lesion. In the remaining 157 patients 180 lesions were identified, including 112 pulmonary and 68 extra-pulmonary lesions. In 110 (reader 1) or 123 (reader 2) lesions a correct diagnosis was provided after analysis of the chest radiographs. All lesions were correctly classified after digital tomosynthesis except for 14 extra-pulmonary lesions (both readers) which were misinterpreted as pulmonary, and 10 (reader 1) or 6 (reader 2) pulmonary lesions which were misinterpreted as pleural. Digital radiography vs tomosynthesis differed in accuracy (43% vs 90% -reader 1- and 49% vs 92% -reader 2-; P<.05) and confidence (Az= .788 vs .944 -reader1- and .840 vs .997 -reader 2-; P<.05)

Digital tomosynthesis improved the diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography

 digital tomosynthesis may potentially avoid the need of CT to rule out equivocal pulmonary lesion on chest radiography

Baratella, E, Quaia, E, Cernic, S, Cioffi, V, Cova, M, The Value of Digital Tomosynthesis in the Diagnosis of Suspected Pulmonary Lesions on Chest Radiography: Analysis of Diagnostic Accuracy and Confidence.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007072.html