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Effect of Temporal Subtraction Technique on Interpretation Time and Diagnostic Accuracy of Chest Radiography

Shingo Kakeda1, Koji Kamada1, Yoshihisa Hatakeyama1, Takatoshi Aoki1, Yukunori Korogi1, Shigehiko Katsuragawa2 and Kunio Doi3

1 Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
2 Department of Radiology, School of Health Sciences, Kumamoto University, Kumamoto, Japan.
3 Department of Radiology, Kurt Rossmann Laboratories for Radiologic Image Research, The University of Chicago, Chicago, IL.


Figure 1
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  		Fig. 1A —Images of negative findings in 51-year-old woman. Previous (A) and current (B) posteroanterior radiographs.

 

Figure 2
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  		Fig. 1B —Images of negative findings in 51-year-old woman. Previous (A) and current (B) posteroanterior radiographs.

 

Figure 3
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  		Fig. 1C —Images of negative findings in 51-year-old woman. Temporal subtraction image that was classified as clean image. Normal anatomic structures are clearly subtracted on this temporal subtraction image.

 

Figure 4
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  		Fig. 2A —Images of 62-year-old man with lung metastasis. Previous (A) and current (B) posteroanterior radiographs.

 

Figure 5
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  		Fig. 2B —Images of 62-year-old man with lung metastasis. Previous (A) and current (B) posteroanterior radiographs.

 

Figure 6
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  		Fig. 2C —Images of 62-year-old man with lung metastasis. Temporal subtraction image. Temporal subtraction image enhances visibility of lung metastasis (arrow) overlapping mediastinum and also indicates suspicious areas (arrowheads), which are easily recognized as artifacts due to misregistration of bilateral breast.

 

Figure 7
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  		Fig. 3 —Receiver operating characteristic (ROC) curves for detection of newly developed chest abnormalities with and without temporal subtraction images. Az = mean area under ROC curve.

 

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