| 1. |
- Ceder, Erik, et al.
(författare)
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THORACIC SPINE IMAGING: A COMPARISON BETWEEN RADIOGRAPHY AND TOMOSYNTHESIS USING VISUAL GRADING CHARACTERISTICS
- 2016
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Ingår i: Radiation protection dosimetry. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 169:1-4, s. 204-210
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate digital tomosynthesis (DTS) in thoracic spine imaging, comparing the reproduction of anatomical structures with that achieved using digital radiography (DR). In a prospective visual grading study, 23 patients referred in 2014 for elective radiographic examination of the thoracic spine were examined using lateral DR and DTS. The DR image and the DTS section images were read in random order by four radiologists, evaluating the ability of the modalities to present a clear reproduction of nine specific relevant structures of the thoracic vertebrae 3, 6 and 9 (T3, T6 and T9). The data were analysed using visual grading characteristics (VGC) analysis. The VGC analysis revealed a statistically significant difference in favour of DTS for all evaluated structures, except for the anterior vertebral edges and lower end plate surfaces of T6 and T9 and the cancellous bone of T9. The difference was most striking in T3 and for posterior structures. For no structure in any vertebra was the reproduction rated significantly better for DR. In conclusion, DTS of the thoracic spine appears to be a promising alternative to DR, especially in areas where the problem of overlaying anatomy is accentuated, such as posterior and upper thoracic structures.
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| 2. |
- Dobbins, James T, et al.
(författare)
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Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules.
- 2017
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Ingår i: Radiology. - : Radiological Society of North America (RSNA). - 1527-1315 .- 0033-8419. ; 282:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board-approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3-20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3-4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P < .001; 95% confidence interval [CI]: 2.96, 4.15). Case-level sensitivity was higher with tomosynthesis than with conventional chest radiography for all nodules (1.49-fold, P < .001; 95% CI: 1.25, 1.73). Case management decisions showed better overall accuracy with tomosynthesis than with conventional chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P < .001; 95% CI: 1.15, 1.32). There were no differences in any specificity measures. DE imaging did not significantly affect nodule detection when paired with either conventional chest radiography or tomosynthesis. Conclusion Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest radiography or tomosynthesis alone. These findings indicate performance likely achievable with a range of reader expertise. (©) RSNA, 2016 Online supplemental material is available for this article.
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| 3. |
- Engström, Gunnar, et al.
(författare)
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The Swedish CArdioPulmonary BioImage Study : objectives and design
- 2015
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 278:6, s. 645-659
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Tidskriftsartikel (refereegranskat)abstract
- Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'omics' and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.
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| 4. |
- Johnsson, Åse (Allansdotter), 1966, et al.
(författare)
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Incidental findings and their handling in the Swedish CArdioPulmonary bioimage study (SCAPIS)
- 2017
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Ingår i: Incidental Radiological Findings. - Cham : Springer International Publishing. - 0942-5373 .- 2197-4187. - 9783319425818 - 9783319425795 - 9783319826127 ; , s. 91-101
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Bokkapitel (refereegranskat)abstract
- The Swedish CArdioPulmonary bioImage Study (SCAPIS) combines the use of new imaging technologies, large-scale proteomics/metabolomics/genomics, and epidemiological analyses to extensively characterize a Swedish cohort of 30,000 men and women aged between 50 and 64 years. Its main aims are to improve risk prediction and to optimize our ability to study mechanisms of cardiopulmonary diseases. SCAPIS is currently recruiting at six sites in Sweden, and a pilot study was conducted in 2012 to test the feasibility of the comprehensive study protocol. In the planning phase, it was recognized that the detailed phenotyping used in SCAPIS would identify a large number of clinical findings in need of medical attention. This was confirmed by evaluation of results from the pilot study. Here we focus on pulmonary nodules and asymptomatic coronary artery stenosis. These clinical features were observed in a large number of participants, and the clinical handing and prognosis related to these observations are unclear. They thus posed great challenges for the study in their practical and ethical handling. This chapter describes how we developed procedures to handle these findings based on existing evidence and expert consensus as well as deliberations on ethical issues.
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| 5. |
- Meltzer, Carin, et al.
(författare)
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Detection and Characterization of Solid Pulmonary Nodules at Digital Chest Tomosynthesis: Data from a Cohort of the Pilot Swedish Cardiopulmonary Bioimage Study
- 2018
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Ingår i: Radiology. - : Radiological Society of North America (RSNA). - 0033-8419 .- 1527-1315. ; 287:3, s. 1018-1027
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the performance of digital tomosynthesis (DTS) for detection and characterization of incidental solid lung nodules. Materials and Methods: This prospective study was based on a population study with 1111 randomly selected participants (age range, 50-64 years) who underwent a medical evaluation that included chest computed tomography (CT). Among these, 125 participants with incidental nodules 5 mm or larger were included in this study, which added DTS in conjunction with the follow-up CT and was performed between March 2012 and October 2014. DTS images were assessed by four thoracic radiologists blinded to the true number of nodules in two separate sessions according to the 5-mm (125 participants) and 6-mm (55 participants) cut-off for follow-up of incidental nodules. Pulmonary nodules were directly marked on the images by the readers and graded regarding confidence of presence and recommendation for follow-up. Statistical analyses included jackknife free-response receiver operating characteristic, receiver operating characteristic, and Cohen k coefficient. Results: Overall detection rate ranges of CT-proven nodules 5 mm or larger and 6 mm or larger were, respectively, 49%58% and 48%-62%. Jackknife free-response receiver operating characteristics figure of merit for detection of CT-proven nodules 5 mm or larger and 6 mm or larger was 0.47 and 0.51, respectively, and area under the receiver operating characteristic curve regarding recommendation for follow-up was 0.62 and 0.65, respectively. Conclusion: Routine use of DTS would result in lower detection rates and reduced number of small nodules recommended for follow-up. (C) RSNA, 2018.
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| 6. |
- Meltzer, Carin, et al.
(författare)
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Nodule mimics in chest tomosynthesis
- 2017
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Ingår i: World Congress of Thoracic Imaging. June 18-21, 2017, Boston, Massachusetts.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Petersson, Cecilia, et al.
(författare)
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AN ANALYSIS OF THE POTENTIAL ROLE OF CHEST TOMOSYNTHESIS IN OPTIMISING IMAGING RESOURCES IN THORACIC RADIOLOGY
- 2016
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Ingår i: Radiation protection dosimetry. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 169:1-4, s. 165-170
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate the potential role of chest tomosynthesis (CTS) at a tertiary referral centre by exploring to what extent CTS could substitute chest radiography (CXR) and computed tomography (CT). The study comprised 1433 CXR, 523 CT and 216 CTS examinations performed 5 years after the introduction of CTS. For each examination, it was decided if CTS would have been appropriate instead of CXR (CXR cases), if CTS could have replaced the performed CT (CT cases) or if CT would have been performed had CTS not been available (CTS cases). It was judged that (a) CTS had been appropriate in 15 % of the CXR examinations, (b) CTS could have replaced additionally 7 % of the CT examinations and (c) CT would have been carried out in 63 % of the performed CTS examinations, had CTS not been available. In conclusion, the potential role for CTS to substitute other modalities during office hours at a tertiary referral centre may be in the order of 20 and 25 % of performed CXR and chest CT, respectively.
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| 8. |
- Petersson, Cecilia, et al.
(författare)
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Clinical use of chest tomosynthesis – after five years with the new modality
- 2015
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Ingår i: Optimisation in X-ray and Molecular Imaging 2015 - the Fourth Malmö Conference on Medical Imaging, Gothenburg, Sweden, 28-30 May 2015.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: To investigate the use of chest tomosynthesis (CTS) five years after its introduction in clinical praxis at a tertiary center and to explore to which extent CTS could replace computed tomography (CT) and should substitute chest radiography (CR). Methods: A study of examinations performed 24 to 28 months prior to the survey was performed using the radiology information system and picture archiving and communication system. Every posteroanterior CR, CT and CTS examination completed during office hours (07-17) the third week of each month from August to December 2012 was included in the study. By means of predefined criteria it was decided if a CTS would have been appropriate instead of the performed CR and if CTS could have replaced the implemented CT. Regarding the CTS it was judged if CT would have been performed had CTS not been available and whether the use of CTS had resulted in an adverse event (i.e. missed pathology). Results: A total of 2172 examinations had been completed; 1433 CR (714 women, 12-96 years), 523 CT (288 women, 16-95 years) and 216 CTS (125 women, 18 -92 years). It was judged that CT would have been performed in 63% of the CTS cases if CTS had not been available. Regarding the CT examinations, CTS could have served as an alternative in 8% of the cases and concerning the CXR examinations, CTS had been appropriate in at least 14 % of the cases. One adverse event was noted. It was a case where CT examinations prior to and after the intervening follow-up with CTS showed the same ground glass opacities that could not be identified by the CTS examination. Conclusions: The results of the present study indicate that the use of CTS 5 years after its introduction in clinical praxis has not reached its full potential in optimizing the use of CT resources and increasing diagnostic accuracy in chest radiography. CTS may be a viable alternative to CT in approximately 25% of clinical cases and should substitute CR more frequently than today.
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| 9. |
- Svensson, Frida, et al.
(författare)
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Evaluation of a corrected implementation of a method of simulating pulmonary nodules in chest tomosynthesis.
- 2017
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Ingår i: Acta radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 58:4, s. 408-413
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Tidskriftsartikel (refereegranskat)abstract
- A method of simulating pulmonary nodules in tomosynthesis images has previously been developed and evaluated. An unknown feature of a rounding function included in the computer code was later found to introduce an artifact, affecting simulated nodules in low-signal regions of the images. The computer code has now been corrected.To perform a thorough evaluation of the corrected nodule-simulation method, comparing the detection rate and visual appearance of artificial nodules with those of real nodules in an observer performance experiment.A cohort of 64 patients with a total of 129 pulmonary nodules was used in the study. Artificial nodules, each matching a corresponding real nodule by size, attenuation, and anatomical location, were generated and simulated into the tomosynthesis images of the different patients. The detection rate and visual appearance of artificial nodules generated using both the corrected and uncorrected computer code were compared to those of real nodules. The results were evaluated using modified receiver operating characteristic (ROC) analyses.The difference in detection rate between artificial and real nodules slightly increased using the corrected computer code (uncorrected code: area under the curve [AUC], 0.47; 95% CI, 0.43-0.51; corrected code: AUC, 0.42; 95% CI, 0.38-0.46). The visual appearance was however substantially improved using the corrected computer code (uncorrected code: AUC, 0.70; 95% CI, 0.63-0.76; corrected code: AUC, 0.49; 95% CI, 0.29-0.65).The computer code including a correct rounding function generates simulated nodules that are more visually realistic than simulated nodules generated using the uncorrected computer code, but have a slightly different detection rate compared to real nodules.
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| 10. |
- Svensson, Frida, 1979, et al.
(författare)
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Evaluation of an improved implementation of a method of simulating pulmonary nodules in chest tomosynthesis
- 2015
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Ingår i: Optimisation in X-ray and Molecular Imaging 2015 - the Fourth Malmö Conference on Medical Imaging, Gothenburg, Sweden, 28-30 May 2015.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: At the previous Malmö Conference on Medical Imaging, Svalkvist et al presented a method of simulating the presence of pulmonary nodules in chest tomosynthesis images through using computer simulations. The method was later evaluated in an observer study that revealed that although the artificial lung nodules had similar detectability as real nodules, experienced thoracic radiologists to some extent were able to distinguish them from real nodules. Recently, an error was found in the code used to generate the simulated nodules in the evaluation study. This error has now been corrected. The purpose of the present work was to perform a thorough evaluation of the corrected implementation of the nodule simulation method for chest tomosynthesis, comparing the detection rate and appearance of the artificial nodules with those of real nodules in an observer performance experiment. Material and methods: A cohort consisting of 64 patients, 38 patients with a total of 129 identified pulmonary nodules and 26 patients without identified pulmonary nodules, was used in the study. Simulated nodules, matching the real clinically found pulmonary nodules by size, attenuation, and location, were created and randomly inserted into the tomosynthesis section images of the patients. Three thoracic radiologists reviewed the images in an observer performance study divided into two parts. The first part included nodule detection and the second part included rating of the visual appearance of the nodules. The results were evaluated using a modified receiver-operating characteristic (ROC) analysis. Results and conclusions: The data collection is not complete and the final results will be presented at the conference. A preliminary analysis indicates that the corrected code increases the similarity between the artificial nodules and real nodules and that the validity of the implemented method thus has increased.
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