Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Radiol. 2012 Mar;67(3):232-8. doi: 10.1016/j.crad.2011.08.017. Epub 2011 Sep 21.
To evaluate the performance of digital tomosynthesis (DT) of the chest for detection of lung nodules in patients with colorectal cancer (CRC).
The institutional review board approved this study, and all patients provided informed consent. A commercial caesium iodide/amorphous silicon (CsI/a-Si) flat-panel detector system was used to verify the performance of the DT and chest radiography (XR) methods. DT was performed in 142 patients with CRC. All 142 patients underwent chest computed tomography (CT) within a week of DT. As a reference standard, two radiologists reviewed the chest CT in consensus and recorded the presence of pulmonary nodules. Another two radiologists independently observed the DT images and recorded the presence of pulmonary nodules. The status of all lung nodules was assessed either histologically or by follow-up over a period of 1 year. The nodules were classified into metastasis, benign, and uncertain. Statistical analysis of the results was performed.
Two hundred and thirty-seven nodules from 142 patients were found at CT. These included 71 proven metastases and 126 benign nodules; 40 nodules were uncertain. Observers detected 83% of all lung nodules and 93% of proven metastases using DT. Among 237 nodules, 147 nodules were larger than 4mm in diameter on the CT images. Observers detected 87% of lung nodules that were larger than 4mm.
Despite a reasonably low radiation dose, DT is a sensitive method, and is comparable to chest CT for the detection of lung nodules, particularly metastatic lung nodules in patients with CRC.
评估胸部数字断层融合摄影（DT）检测结直肠癌（CRC）患者肺部结节的性能。
本研究经机构审查委员会批准，所有患者均签署了知情同意书。采用商用铯碘/非晶硅（CsI/a-Si）平板探测器系统验证 DT 和胸部 X 线摄影（XR）方法的性能。对 142 例 CRC 患者进行 DT 检查。所有 142 例患者均在 DT 后一周内行胸部 CT 检查。以胸部 CT 作为参考标准，由两位放射科医师共同阅片并记录肺部结节的存在情况。另外两位放射科医师独立观察 DT 图像并记录肺部结节的存在情况。所有肺部结节的状态均通过组织学或 1 年的随访进行评估。将结节分为转移、良性和不确定。对结果进行统计学分析。
在 CT 上共发现 142 例患者的 237 个结节，包括 71 个已证实的转移灶和 126 个良性结节；40 个结节性质不确定。观察者使用 DT 检测到所有肺部结节的 83%和已证实转移灶的 93%。在 237 个结节中，有 147 个结节在 CT 图像上的直径大于 4mm。观察者检测到直径大于 4mm 的肺部结节的比例为 87%。
尽管辐射剂量较低，但 DT 是一种敏感的方法，与胸部 CT 相比，其对肺部结节，特别是 CRC 患者转移性肺结节的检测具有可比性。
