Takarabe Shinya, Kuramoto Taku, Kanzaki Yui, Shibayama Yusuke, Yamasaki Yuzo, Kitamura Yoshiyuki, Yoshikawa Hideki, Kato Toyoyuki
Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Radiological Technology, Faculty of Health Sciences, Kobe Tokiwa University, 2-6-2 Otanicho, Nagata-ku, Kobe, 653-0838, Japan.
Phys Eng Sci Med. 2025 May 28. doi: 10.1007/s13246-025-01561-x.
Chest x-ray imaging is widely used for the diagnosis of chest diseases but has low sensitivity for detecting pulmonary nodules due to anatomical overlaps. Dual-energy subtraction (DES) imaging can improve nodule visibility by reducing bone obscuration. This study aims to evaluate the image quality of a new one-shot DES (OSDES) system with a dual-layer flat-panel detector compared with the widely used two-shot DES (TSDES) system. Chest phantom images of various simulated nodules (8,10, and 12 mm) were acquired using both DES systems at several exposure doses, lung regions, and two types of body sizes (standard and large). Independent observers evaluated the visibility of the nodules under each condition using visual grading analysis scores (VGASs). The VGASs of OSDES images were significantly higher than those of TSDES images across all nodule sizes, lung regions, exposure doses, and body sizes, except for the standard chest phantom with a 10-mm nodule and without ribs. In particular, the VGAS of an 8-mm nodule in the region with one overlapping rib of the standard sized phantom was 2.46 with OSDES and 1.03 with TSDES, with the visibility of the nodule being significantly improved with the OSDES system. Thus, the OSDES system, using a dual-layer flat-panel detector and one exposure, offers superior visibility of pulmonary nodules with reduced dose compared with the TSDES system, suggesting its potential for improved clinical diagnosis without motion artifacts.
胸部X光成像广泛用于胸部疾病的诊断，但由于解剖结构重叠，在检测肺结节方面敏感性较低。双能减影（DES）成像可通过减少骨骼遮挡来提高结节的可见性。本研究旨在评估一种新型的采用双层平板探测器的单次DES（OSDES）系统与广泛使用的两次DES（TSDES）系统相比的图像质量。使用这两种DES系统在几种曝光剂量、肺区域以及两种体型（标准体型和大体型）下采集了各种模拟结节（8毫米、10毫米和12毫米）的胸部体模图像。独立观察者使用视觉分级分析评分（VGAS）评估每种情况下结节的可见性。除了标准胸部体模中10毫米结节且无肋骨的情况外，在所有结节大小、肺区域、曝光剂量和体型下，OSDES图像的VGAS均显著高于TSDES图像。特别是，在标准体型体模有一根重叠肋骨的区域中，8毫米结节的VGAS在OSDES系统下为2.46，在TSDES系统下为1.03，OSDES系统使结节的可见性显著提高。因此，与TSDES系统相比，采用双层平板探测器且单次曝光的OSDES系统在降低剂量的情况下能提供更好的肺结节可见性，表明其在改善临床诊断且无运动伪影方面具有潜力。
