AN ANALYSIS OF THE POTENTIAL ROLE OF CHEST TOMOSYNTHESIS IN OPTIMISING IMAGING RESOURCES IN THORACIC RADIOLOGY.

Cecilia Petersson,Åse Allansdotter Johnsson,Jenny Vikgren,Magnus Båth

doi:10.1093/rpd/ncw040

Cecilia Petersson, Åse Allansdotter Johnsson + Show 2 more

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https://doi.org/10.1093/rpd/ncw040

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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.

Highlights

Chest tomosynthesis (CTS) is a relatively new technique of acquiring several low-dose projection radiographs over a limited angular range and using these projection radiographs to reconstruct contiguous section images of the chest
CTS has been suggested as an imaging alternative to computed tomography (CT) in the followup of patients with cystic fibrosis, taking the superior sensitivity compared with CXR in detecting pathology and the lower radiation dose compared with CT into account[12, 13]
The pathology of interest for the CTS examinations was known from previously performed CT in 48 % of the cases and in 39 % a CT was performed during the follow-up period

Summary

Introduction

Chest tomosynthesis (CTS) is a relatively new technique of acquiring several low-dose projection radiographs over a limited angular range and using these projection radiographs to reconstruct contiguous section images of the chest. The modality offers an increased sensitivity regarding detection of pulmonary pathology in comparison with chest radiography (CXR) at a modest increase (,0.1 mSv) in radiation dose[1,2,3]. There is scientific evidence that CTS is decisive for confirming or ruling out pathology suspected on CXR[9, 10] and that clinical implementation of CTS results in reduced costs for diagnostic imaging[11]. CTS has been suggested as an imaging alternative to computed tomography (CT) in the followup of patients with cystic fibrosis, taking the superior sensitivity compared with CXR in detecting pathology and the lower radiation dose compared with CT into account[12, 13]. Concerning other pulmonary pathology, CTS has been reported as superior in comparison with CXR regarding detection of emphysema[14] and asbestos-related changes[15]. Ground-glass opacities have been reported as a potential pitfall for the new modality[17, 18]

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