Ji Yung Choo MD, Presenter: Nothing to Disclose

Ki Yeol Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

Jung Won Choi, Abstract Co-Author: Nothing to Disclose

Seun Ah Lee MD, Abstract Co-Author: Nothing to Disclose

Je Hyeong Kim, Abstract Co-Author: Nothing to Disclose

Seung Heon Lee, Abstract Co-Author: Nothing to Disclose

Eun-Young Kang MD, Abstract Co-Author: Nothing to Disclose

Whan Oh, Abstract Co-Author: Nothing to Disclose

To compare the diagnostic performance of digital tomosynthesis (DTS) with that of chest radiography for the detection and evaluation of neoplastic and non-neoplastic airway abnormalities, using multi-detector computed tomography (CT) as reference.

The institutional review board approved this study and all patients provided informed consent. In this study, 91 subjects (46 study patients, 45 control patients) underwent chest radiography, DTS and CT within a week in each subject. Two blinded chest radiologists independently evaluated the chest radiographs and DTS images for the presence of airway lesion (detection), localization (scoring from trachea to segmental bronchus) and severity (narrowing or obstruction (less than 10% of the proximal diameter of the lesion)) using CT as reference. Weighted kappa statistics, McNemar tests were used for statistical analysis.

In evaluation of location and severity of the airway abnormalities, strength of agreement of DTS by kappa value was good to very good (value of k, 0.763-0.957) and superior to the radiographic findings (value of k, 0.433-0.581; moderate). Overall, sensitivity of DTS was higher (observer 1, 92.5%, observer 2, 99%) than radiography (observer 1, 87.2%; observer 2, 73.8%). The diagnostic accuracy of DTS (observer 1, 95.5%; observer 2, 99%) for the presence of airway abnormalities was significantly better than with radiography (observer 1, 89.4%; observer 2, 83.8%; all p<0.05).

DTS is more accurate and sensitive modality than chests radiography for the detection and evaluation of airway lesions which are easily obscured by soft tissue structures in the mediastinum on chest radiography.

DTS seems to be an appropriate modality for work up or manage of the airway abnormalities with low radiation dose than CT and higher image quality than radiography.

Choo, J, Lee, K, Choi, J, Lee, S, Kim, J, Lee, S, Kang, E, Oh, W, Digital Tomosynthesis for the Airway Evaluation: Performance Comparison with Chest Radiography Using CT as Reference.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009766.html