HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Li, F. Articles by MacMahon, H. Search for Related Content PubMed PubMed Citation Articles by Li, F. Articles by MacMahon, H. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Improved Detection of Small Lung Cancers with Dual-Energy Subtraction Chest Radiography

¹ All authors: Kurt Rossmann Laboratories for Radiologic Image Research and the Department of Radiology, The University of Chicago, 5841 S Maryland Ave., MC-2026, Chicago, IL 60637.

View larger version (155K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Locations of 19 missed cancers (eight in right lungs and 11 in left lungs) in 19 patients are shown superimposed on posteroanterior (PA) chest radiograph.

View larger version (12K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —Receiver operating characteristic (ROC) curves for detection of cancers on chest radiographs with six radiologists. Average area under ROC curve (Az) value was improved significantly from 0.718 to 0.816 with aid of dual-energy subtraction (ES) images.

View larger version (16K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —Bar graph shows number of correct localizations for 19 cancers by six radiologists with dual-energy subtraction images (gray bars) and without dual-energy subtraction images (white bars). For nine of 19 cancers (index numbers 4–6, 9–11, 14, 15, and 17), dual-energy subtraction image had beneficial effect for one or more radiologists. Dual-energy subtraction image had detrimental effect for only one cancer (number 12).

View larger version (173K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —Dual-energy subtraction radiograph in 60-year-old woman (number 5 in Fig. 3) with previously missed bronchoalveolar carcinoma in left lung. Missed cancer (arrows) is very subtle on standard posteroanterior image (A) but is relatively obvious on soft-tissue image (B). Note that no radiologists detected missed cancer without dual-energy subtraction and five radiologists detected it with dual-energy subtraction in this observer study.

View larger version (161K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —Dual-energy subtraction radiograph in 60-year-old woman (number 5 in Fig. 3) with previously missed bronchoalveolar carcinoma in left lung. Missed cancer (arrows) is very subtle on standard posteroanterior image (A) but is relatively obvious on soft-tissue image (B). Note that no radiologists detected missed cancer without dual-energy subtraction and five radiologists detected it with dual-energy subtraction in this observer study.

View larger version (179K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —Dual-energy subtraction radiographs in 66-year-old woman (number 10 in Fig. 3) with missed squamous cell carcinoma in left upper lobe. Standard posteroanterior image shows cancer (black arrow) and another nodular lesion (white arrow).

View larger version (166K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —Dual-energy subtraction radiographs in 66-year-old woman (number 10 in Fig. 3) with missed squamous cell carcinoma in left upper lobe. Soft-tissue image (B) clearly shows missed cancer (arrow, B) and bone image (C) shows that other lesion is a fracture callus (arrow, C). Note that two radiologists detected cancer without dual-energy subtraction image, whereas five radiologists (three more) detected it with dual-energy subtraction image in this observer study.

View larger version (186K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —Dual-energy subtraction radiographs in 66-year-old woman (number 10 in Fig. 3) with missed squamous cell carcinoma in left upper lobe. Soft-tissue image (B) clearly shows missed cancer (arrow, B) and bone image (C) shows that other lesion is a fracture callus (arrow, C). Note that two radiologists detected cancer without dual-energy subtraction image, whereas five radiologists (three more) detected it with dual-energy subtraction image in this observer study.

View larger version (175K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —Dual-energy subtraction radiographs in 61-year-old woman (number 12 in Fig. 3) with primary adenocarcinoma in left lower lobe. Cropped views of left lung show missed cancers (arrows) on standard posteroanterior image (A) and soft-tissue image (B). Note that three radiologists detected cancer without dual-energy subtraction image, but none confirmed it with dual-energy subtraction (detrimental effect). This was probably because nodule appears to represent confluence of vessels on dual-energy subtraction soft-tissue image.

View larger version (155K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —Dual-energy subtraction radiographs in 61-year-old woman (number 12 in Fig. 3) with primary adenocarcinoma in left lower lobe. Cropped views of left lung show missed cancers (arrows) on standard posteroanterior image (A) and soft-tissue image (B). Note that three radiologists detected cancer without dual-energy subtraction image, but none confirmed it with dual-energy subtraction (detrimental effect). This was probably because nodule appears to represent confluence of vessels on dual-energy subtraction soft-tissue image.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati