title: "Single-exposure" dual energy digital radiography in the detection of pulmonary nodules and calcifications.
abstract: We studied the detectability of mineralized and non-mineralized simulated pulmonary nodules with dual energy digital radiography. "Soft tissue" and "bone" images (pixel size = 0.2 mm, 10 bits deep) were obtained with subtraction image processing after a single simultaneous exposure (100 kVp, 8 mAs, 17 mR skin exposure dose) of two storage phosphors with an interleaved 0.9 mm copper wafer. Three classes of paraffin-based nodules (0.5 to 3.0 cm) of varying mineral concentration (0, 120 and 190 mg/cm3 K2HPO4) were randomly positioned on the chest wall of two healthy volunteers to simulate calcified and non-calcified nodules. The average receiver operating characteristics (ROC) area of six readers (n = 2880 observations) showed that digital "bone" images (ROC area: 0.77 +/- 0.03) were significantly better (P less than 0.04) than conventional radiographs (OC Film, Lanex medium screens, 141 kVp, 19 mR skin exposure dose) (ROC area: 0.71 +/- 0.05) in detecting calcification in nodules. The unsubtracted digital images of lower kilovoltage were not superior to the 141 kVp conventional radiographs in a subgroup of two readers (ROC area: 0.73 +/- 0.02). Digital "soft tissue" images were equivalent to conventional chest radiographs in detecting soft tissue pulmonary nodules (ROC areas: 0.92 +/- 0.04 and 0.92 +/- 0.05, respectively.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston 02114.
authors.forename: J W
authors.initials: JW
authors.lastname: Oestmann
authors.forename: R
authors.initials: R
authors.lastname: Greene
authors.forename: J T
authors.initials: JT
authors.lastname: Rhea
authors.forename: H
authors.initials: H
authors.lastname: Rosenthal
authors.forename: R M
authors.initials: RM
authors.lastname: Koenker
authors.forename: C L
authors.initials: CL
authors.lastname: Tillotson
authors.forename: K D
authors.initials: KD
authors.lastname: Pearsen
authors.forename: J W
authors.initials: JW
authors.lastname: Hill
authors.forename: R H
authors.initials: RH
authors.lastname: Velaj
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods