Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo, Kumamoto, Japan.
Clin Radiol. 2010 Aug;65(8):609-15. doi: 10.1016/j.crad.2010.02.012.
To investigate the effect of a double-exposure dual-energy subtraction (DES) technique on the diagnostic performance of radiologists detecting small pulmonary nodules on flat-panel detector (FPD) chest radiographs.
Using FPD radiography 41 sets of chest radiographs were obtained from 26 patients with pulmonary nodules measuring <or=20mm and from 15 normal participants. Each dataset included standard and corresponding DES images. There were six non-solid, 10 part-solid, and 10 solid nodules. The mean size of the 26 nodules was 15+/-4.8mm. Receiver operating characteristic (ROC) analysis was performed to compare the performance of the eight board-certified radiologists.
For the eight radiologists, the mean value of the area under the ROC curve (AUC) without and with DES images was 0.62+/-0.05 and 0.68+/-0.05, respectively; the difference was statistically significant (p=0.02). For part-solid nodules, the difference of the mean AUC value was statistically significant (AUC=0.61+/-0.07 versus 0.69+/-0.05; p<0.01); for non-solid nodules it was not (AUC=0.62+/-0.1 versus 0.61+/-0.09; p=0.73), and for solid nodules it was not (AUC=0.75+/-0.1 versus 0.78+/-0.08; p=0.23). For nodules with overlapping bone shadows, the difference of the mean AUC value was statistically significant (p=0.03), for nodules without overlapping, it was not (p=0.26).
Use of a double-exposure DES technique at FPD chest radiography significantly improved the diagnostic performance of radiologists to detect small pulmonary nodules.
研究平板探测器（FPD）胸部 X 线摄影双重曝光双能量减影（DES）技术对放射科医生检测小肺结节的诊断性能的影响。
使用 FPD 射线照相，从 26 例肺结节患者（结节直径≤20mm）和 15 例正常参与者中获得 41 组胸部 X 线片。每个数据集包括标准和相应的 DES 图像。其中有 6 个非实质性结节、10 个部分实质性结节和 10 个实质性结节。26 个结节的平均直径为 15±4.8mm。进行了接收器操作特征（ROC）分析，以比较 8 位具有董事会认证的放射科医生的表现。
对于 8 位放射科医生，无和有 DES 图像时 ROC 曲线下面积（AUC）的平均值分别为 0.62±0.05 和 0.68±0.05；差异具有统计学意义（p=0.02）。对于部分实质性结节，平均 AUC 值的差异具有统计学意义（AUC=0.61±0.07 与 0.69±0.05；p<0.01）；对于非实质性结节，差异无统计学意义（AUC=0.62±0.1 与 0.61±0.09；p=0.73），对于实质性结节，差异无统计学意义（AUC=0.75±0.1 与 0.78±0.08；p=0.23）。对于有重叠骨影的结节，平均 AUC 值的差异具有统计学意义（p=0.03），对于无重叠骨影的结节，差异无统计学意义（p=0.26）。
在 FPD 胸部 X 线摄影中使用双重曝光 DES 技术显著提高了放射科医生检测小肺结节的诊断性能。
