Zachrisson S, Vikgren J, Svalkvist A, Johnsson A A, Boijsen M, Flinck A, Månsson L G, Kheddache S, Båth M
Department of Radiation Physics, University of Gothenburg, Gothenburg, Sweden.
Acta Radiol. 2009 Oct;50(8):884-91. doi: 10.1080/02841850903085584.
The new technique chest tomosynthesis refers to the principle of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest at a radiation dose comparable to that of chest radiography.
To investigate if, for experienced thoracic radiologists, the detectability of pulmonary nodules obtained after only a short initial learning period of chest tomosynthesis improves with additional clinical experience of the new technique.
Two readings of the same clinical chest tomosynthesis cases, the first performed after 6 months of clinical experience and the second after an additional period of 1 year, were conducted. Three senior thoracic radiologists, with more than 20 years of experience of chest radiography, acted as observers, with the task of detecting pulmonary nodules in a jackknife free-response receiver operating characteristics (JAFROC1) study. The image material consisted of 42 patients with and 47 patients without pulmonary nodules examined with chest tomosynthesis. Multidetector computed tomography (MDCT) was used as a reference. The total number of nodules was 131. The JAFROC1 figure of merit (FOM) was used as the principal measure of detectability.
The difference in the observer-averaged JAFROC1 FOM of the two readings was 0.004 (95% confidence interval: -0.11, 0.12; F-statistic: 0.01 on 1 and 2.65 df; P=0.91). Thus, no significant improvement in detectability was found after the additional clinical experience of tomosynthesis.
The study indicates that experienced thoracic radiologists already within the first months of clinical use of chest tomosynthesis are able to take advantage of the new technique in the task of detecting pulmonary nodules.
新技术胸部断层合成是指在不同角度采集胸部低剂量投影，并利用这些投影重建胸部断层图像的原理，其辐射剂量与胸部X线摄影相当。
探讨对于有经验的胸科放射科医生而言，在仅经过短时间的胸部断层合成初始学习期后获得的肺结节检测能力，是否会随着对该新技术的更多临床经验而提高。
对相同的临床胸部断层合成病例进行两次阅片，第一次在有6个月临床经验后进行，第二次在额外的1年时间后进行。三位具有超过20年胸部X线摄影经验的资深胸科放射科医生作为观察者，在无偏倚自由反应接收器操作特性（JAFROC1）研究中负责检测肺结节。图像资料包括42例有肺结节和47例无肺结节的患者的胸部断层合成检查结果。多排螺旋计算机断层扫描（MDCT）用作参考。结节总数为131个。JAFROC1品质因数（FOM）用作检测能力的主要衡量指标。
两次阅片的观察者平均JAFROC1 FOM差异为0.004（95%置信区间：-0.11, 0.12；F统计量：在1和2.65自由度时为0.01；P = 0.91）。因此，在有了额外的胸部断层合成临床经验后，未发现检测能力有显著提高。
该研究表明，有经验的胸科放射科医生在临床使用胸部断层合成的头几个月内，就能在检测肺结节的任务中利用这项新技术。
