Comparison of conventional chest x ray with a novel projection technique for ultra‐low dose CT
Purpose To compare a novel thick‐slab projection technique for ultra‐low dose computed tomography (CT; thoracic tomogram) with conventional chest x ray with respect to 13 diagnostic categories. Methods With the approval of the institutional ethics board, a dataset was retrospectively collected of 22...
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| Veröffentlicht in: | Medical physics (Lancaster) 2021-06, Vol.48 (6), p.2809-2815 |
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| creator | Carey, Sean Kandel, Sonja Farrell, Christin Kavanagh, John Chung, TaeBong Hamilton, William Rogalla, Patrik |
| description | Purpose
To compare a novel thick‐slab projection technique for ultra‐low dose computed tomography (CT; thoracic tomogram) with conventional chest x ray with respect to 13 diagnostic categories.
Methods
With the approval of the institutional ethics board, a dataset was retrospectively collected of 22 consecutive patients who had undergone a clinically requested emergency room conventional chest x ray (CXR) and a same‐day standard‐of‐care non‐contrast CT. Scanner specific noise was added to the CT images to simulate a target dose of 0.18 mSv. A novel algorithm was used to post‐process CT images as coronal isotropic reformats by applying a voxel‐based, locally normalized weighted‐intensity projection to generate 2 cm thick slabs with 1 cm overlap. Three chest radiologists with no prior training for the study reviewed the CXR and thoracic tomogram for each case and assessed each diagnostic category (pneumonic infiltrates, pulmonary edema, interstitial lung disease, nodules > 5 mm, nodules |
| doi_str_mv | 10.1002/mp.14142 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2378000907</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2378000907</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3552-95958ef845e5b7ca0d160007766e194b8b2d46ee94296c8bdc0eae677e03a7953</originalsourceid><addsrcrecordid>eNp1kLtOwzAYRi0EouUi8QTII0uK7dhxPKKIm1QEQ5mD4_xRUyVxsJOWbjwCz8iTkNICE9O3HB0dfQidUTKhhLDLup1QTjnbQ2PGZRhwRtQ-GhOieMA4ESN05P2CEBKFghyiUchoTLkSY_SS2LrVrvS2wbbAxjZLaLrSNrrCZg6-w2_Y6TVeld0ca9zYJVS4dXYBZkPhDsy8KV97wIV1uK86pz_fPyq7wrn1gJPZCToodOXhdLfH6PnmepbcBdPH2_vkahqYUAgWKKFEDEXMBYhMGk1yGg29UkYRUMWzOGM5jwAUZyoycZYbAhoiKYGEWioRHqOLrXeIG3J8l9alN1BVugHb-5SFMh6Eisg_1DjrvYMibV1Za7dOKUk3f6Z1m37_OaDnO2uf1ZD_gj8HDkCwBVZlBet_RenD01b4BSfdfuY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2378000907</pqid></control><display><type>article</type><title>Comparison of conventional chest x ray with a novel projection technique for ultra‐low dose CT</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Alma/SFX Local Collection</source><creator>Carey, Sean ; Kandel, Sonja ; Farrell, Christin ; Kavanagh, John ; Chung, TaeBong ; Hamilton, William ; Rogalla, Patrik</creator><creatorcontrib>Carey, Sean ; Kandel, Sonja ; Farrell, Christin ; Kavanagh, John ; Chung, TaeBong ; Hamilton, William ; Rogalla, Patrik</creatorcontrib><description>Purpose
To compare a novel thick‐slab projection technique for ultra‐low dose computed tomography (CT; thoracic tomogram) with conventional chest x ray with respect to 13 diagnostic categories.
Methods
With the approval of the institutional ethics board, a dataset was retrospectively collected of 22 consecutive patients who had undergone a clinically requested emergency room conventional chest x ray (CXR) and a same‐day standard‐of‐care non‐contrast CT. Scanner specific noise was added to the CT images to simulate a target dose of 0.18 mSv. A novel algorithm was used to post‐process CT images as coronal isotropic reformats by applying a voxel‐based, locally normalized weighted‐intensity projection to generate 2 cm thick slabs with 1 cm overlap. Three chest radiologists with no prior training for the study reviewed the CXR and thoracic tomogram for each case and assessed each diagnostic category (pneumonic infiltrates, pulmonary edema, interstitial lung disease, nodules > 5 mm, nodules < 5 mm, pleural effusion, pericardial effusion, heart size, acute bone fractures, foreign bodies, pneumothorax, mediastinal vessel diameter, free abdominal air) on a Likert scale from −4 (definitely absent/normal) to +4 (definitely present/abnormal). MRMC ROC curves were generated for each category. Time for interpretation and subjective image quality score (0–10) were also assessed.
Results
For focal lung disease (pneumonic infiltrates, nodules < 5 mm, nodules > 5mm), the area under the ROC curve (AUC) was significantly higher for thoracic tomograms than CXR (0.803 vs 0.648, respectively, P = 0.02). For non‐focal lung disease (pulmonary edema, interstitial lung disease) and effusions (pulmonary, pericardial), the AUC was larger for thoracic tomograms than CXR but the difference did not reach significance (0.870 vs 0.833, P = 0.141; and 0.823 vs 0.752, P = 0.296, respectively). For acute bone fractures and foreign bodies, the AUC was smaller for thoracic tomograms than CXR, the difference was however not significant (0.491 vs 0.532, P = 0.42; and 0.871 vs 0.971, P = 0.39, respectively). Other diagnostic categories had no true positive cases in the dataset. The mean time for interpretation for each was 36.9 and 24.0 s with standard deviations of 0.857 and 5.977. The image quality score for each was 8.2 and 7.8 with standard deviations of 0.970 and 1.614.
Conclusion
Thoracic tomograms were found to be diagnostically superior to CXR for focal lung disease, at no increased radiation dose. The thoracic tomogram presents an opportunity to improve the standard‐of‐care for patients who would otherwise receive a conventional CXR.</description><identifier>ISSN: 0094-2405</identifier><identifier>EISSN: 2473-4209</identifier><identifier>DOI: 10.1002/mp.14142</identifier><identifier>PMID: 32181495</identifier><language>eng</language><publisher>United States</publisher><subject>chest x ray ; computed tomography ; image processing</subject><ispartof>Medical physics (Lancaster), 2021-06, Vol.48 (6), p.2809-2815</ispartof><rights>2020 American Association of Physicists in Medicine</rights><rights>2020 American Association of Physicists in Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3552-95958ef845e5b7ca0d160007766e194b8b2d46ee94296c8bdc0eae677e03a7953</citedby><cites>FETCH-LOGICAL-c3552-95958ef845e5b7ca0d160007766e194b8b2d46ee94296c8bdc0eae677e03a7953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmp.14142$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmp.14142$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32181495$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carey, Sean</creatorcontrib><creatorcontrib>Kandel, Sonja</creatorcontrib><creatorcontrib>Farrell, Christin</creatorcontrib><creatorcontrib>Kavanagh, John</creatorcontrib><creatorcontrib>Chung, TaeBong</creatorcontrib><creatorcontrib>Hamilton, William</creatorcontrib><creatorcontrib>Rogalla, Patrik</creatorcontrib><title>Comparison of conventional chest x ray with a novel projection technique for ultra‐low dose CT</title><title>Medical physics (Lancaster)</title><addtitle>Med Phys</addtitle><description>Purpose
To compare a novel thick‐slab projection technique for ultra‐low dose computed tomography (CT; thoracic tomogram) with conventional chest x ray with respect to 13 diagnostic categories.
Methods
With the approval of the institutional ethics board, a dataset was retrospectively collected of 22 consecutive patients who had undergone a clinically requested emergency room conventional chest x ray (CXR) and a same‐day standard‐of‐care non‐contrast CT. Scanner specific noise was added to the CT images to simulate a target dose of 0.18 mSv. A novel algorithm was used to post‐process CT images as coronal isotropic reformats by applying a voxel‐based, locally normalized weighted‐intensity projection to generate 2 cm thick slabs with 1 cm overlap. Three chest radiologists with no prior training for the study reviewed the CXR and thoracic tomogram for each case and assessed each diagnostic category (pneumonic infiltrates, pulmonary edema, interstitial lung disease, nodules > 5 mm, nodules < 5 mm, pleural effusion, pericardial effusion, heart size, acute bone fractures, foreign bodies, pneumothorax, mediastinal vessel diameter, free abdominal air) on a Likert scale from −4 (definitely absent/normal) to +4 (definitely present/abnormal). MRMC ROC curves were generated for each category. Time for interpretation and subjective image quality score (0–10) were also assessed.
Results
For focal lung disease (pneumonic infiltrates, nodules < 5 mm, nodules > 5mm), the area under the ROC curve (AUC) was significantly higher for thoracic tomograms than CXR (0.803 vs 0.648, respectively, P = 0.02). For non‐focal lung disease (pulmonary edema, interstitial lung disease) and effusions (pulmonary, pericardial), the AUC was larger for thoracic tomograms than CXR but the difference did not reach significance (0.870 vs 0.833, P = 0.141; and 0.823 vs 0.752, P = 0.296, respectively). For acute bone fractures and foreign bodies, the AUC was smaller for thoracic tomograms than CXR, the difference was however not significant (0.491 vs 0.532, P = 0.42; and 0.871 vs 0.971, P = 0.39, respectively). Other diagnostic categories had no true positive cases in the dataset. The mean time for interpretation for each was 36.9 and 24.0 s with standard deviations of 0.857 and 5.977. The image quality score for each was 8.2 and 7.8 with standard deviations of 0.970 and 1.614.
Conclusion
Thoracic tomograms were found to be diagnostically superior to CXR for focal lung disease, at no increased radiation dose. The thoracic tomogram presents an opportunity to improve the standard‐of‐care for patients who would otherwise receive a conventional CXR.</description><subject>chest x ray</subject><subject>computed tomography</subject><subject>image processing</subject><issn>0094-2405</issn><issn>2473-4209</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kLtOwzAYRi0EouUi8QTII0uK7dhxPKKIm1QEQ5mD4_xRUyVxsJOWbjwCz8iTkNICE9O3HB0dfQidUTKhhLDLup1QTjnbQ2PGZRhwRtQ-GhOieMA4ESN05P2CEBKFghyiUchoTLkSY_SS2LrVrvS2wbbAxjZLaLrSNrrCZg6-w2_Y6TVeld0ca9zYJVS4dXYBZkPhDsy8KV97wIV1uK86pz_fPyq7wrn1gJPZCToodOXhdLfH6PnmepbcBdPH2_vkahqYUAgWKKFEDEXMBYhMGk1yGg29UkYRUMWzOGM5jwAUZyoycZYbAhoiKYGEWioRHqOLrXeIG3J8l9alN1BVugHb-5SFMh6Eisg_1DjrvYMibV1Za7dOKUk3f6Z1m37_OaDnO2uf1ZD_gj8HDkCwBVZlBet_RenD01b4BSfdfuY</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Carey, Sean</creator><creator>Kandel, Sonja</creator><creator>Farrell, Christin</creator><creator>Kavanagh, John</creator><creator>Chung, TaeBong</creator><creator>Hamilton, William</creator><creator>Rogalla, Patrik</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202106</creationdate><title>Comparison of conventional chest x ray with a novel projection technique for ultra‐low dose CT</title><author>Carey, Sean ; Kandel, Sonja ; Farrell, Christin ; Kavanagh, John ; Chung, TaeBong ; Hamilton, William ; Rogalla, Patrik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3552-95958ef845e5b7ca0d160007766e194b8b2d46ee94296c8bdc0eae677e03a7953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>chest x ray</topic><topic>computed tomography</topic><topic>image processing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carey, Sean</creatorcontrib><creatorcontrib>Kandel, Sonja</creatorcontrib><creatorcontrib>Farrell, Christin</creatorcontrib><creatorcontrib>Kavanagh, John</creatorcontrib><creatorcontrib>Chung, TaeBong</creatorcontrib><creatorcontrib>Hamilton, William</creatorcontrib><creatorcontrib>Rogalla, Patrik</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medical physics (Lancaster)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carey, Sean</au><au>Kandel, Sonja</au><au>Farrell, Christin</au><au>Kavanagh, John</au><au>Chung, TaeBong</au><au>Hamilton, William</au><au>Rogalla, Patrik</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of conventional chest x ray with a novel projection technique for ultra‐low dose CT</atitle><jtitle>Medical physics (Lancaster)</jtitle><addtitle>Med Phys</addtitle><date>2021-06</date><risdate>2021</risdate><volume>48</volume><issue>6</issue><spage>2809</spage><epage>2815</epage><pages>2809-2815</pages><issn>0094-2405</issn><eissn>2473-4209</eissn><abstract>Purpose
To compare a novel thick‐slab projection technique for ultra‐low dose computed tomography (CT; thoracic tomogram) with conventional chest x ray with respect to 13 diagnostic categories.
Methods
With the approval of the institutional ethics board, a dataset was retrospectively collected of 22 consecutive patients who had undergone a clinically requested emergency room conventional chest x ray (CXR) and a same‐day standard‐of‐care non‐contrast CT. Scanner specific noise was added to the CT images to simulate a target dose of 0.18 mSv. A novel algorithm was used to post‐process CT images as coronal isotropic reformats by applying a voxel‐based, locally normalized weighted‐intensity projection to generate 2 cm thick slabs with 1 cm overlap. Three chest radiologists with no prior training for the study reviewed the CXR and thoracic tomogram for each case and assessed each diagnostic category (pneumonic infiltrates, pulmonary edema, interstitial lung disease, nodules > 5 mm, nodules < 5 mm, pleural effusion, pericardial effusion, heart size, acute bone fractures, foreign bodies, pneumothorax, mediastinal vessel diameter, free abdominal air) on a Likert scale from −4 (definitely absent/normal) to +4 (definitely present/abnormal). MRMC ROC curves were generated for each category. Time for interpretation and subjective image quality score (0–10) were also assessed.
Results
For focal lung disease (pneumonic infiltrates, nodules < 5 mm, nodules > 5mm), the area under the ROC curve (AUC) was significantly higher for thoracic tomograms than CXR (0.803 vs 0.648, respectively, P = 0.02). For non‐focal lung disease (pulmonary edema, interstitial lung disease) and effusions (pulmonary, pericardial), the AUC was larger for thoracic tomograms than CXR but the difference did not reach significance (0.870 vs 0.833, P = 0.141; and 0.823 vs 0.752, P = 0.296, respectively). For acute bone fractures and foreign bodies, the AUC was smaller for thoracic tomograms than CXR, the difference was however not significant (0.491 vs 0.532, P = 0.42; and 0.871 vs 0.971, P = 0.39, respectively). Other diagnostic categories had no true positive cases in the dataset. The mean time for interpretation for each was 36.9 and 24.0 s with standard deviations of 0.857 and 5.977. The image quality score for each was 8.2 and 7.8 with standard deviations of 0.970 and 1.614.
Conclusion
Thoracic tomograms were found to be diagnostically superior to CXR for focal lung disease, at no increased radiation dose. The thoracic tomogram presents an opportunity to improve the standard‐of‐care for patients who would otherwise receive a conventional CXR.</abstract><cop>United States</cop><pmid>32181495</pmid><doi>10.1002/mp.14142</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete; Alma/SFX Local Collection |
| subjects | chest x ray computed tomography image processing |
| title | Comparison of conventional chest x ray with a novel projection technique for ultra‐low dose CT |
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