Clinical evaluation of pulmonary nodules with single-exposure dual-energy subtraction chest radiography with an iterative noise-reduction algorithm.
OBJECTIVE
To compare the clinical usefulness of the single-exposure dual-energy subtraction method with an iterative noise-reduction algorithm.


METHODS
Fourteen radiologists read three sets of images from 44 patients: original computed radiographic images only, original computed radiographic images plus conventional bone-subtracted images, and original computed radiographic images plus iterative noise-reduced bone-subtracted images. Twenty-two patients had one or more (maximum, five) pulmonary nodules; 22 had no pulmonary nodules. Observer performance was evaluated by means of calculation of the average area under the alternative free-response receiver operating characteristic curves (A1).


RESULTS
Compared with the original computed radiographic image only, detection of nodules was significantly better with both the original computed radiographic image plus iterative bone-subtracted image (A1 = 0.72 +/- 0.02 and 0.66 +/- 0.02, respectively; P = .01) and the original computed radiographic image plus conventional bone-subtracted image (A1 = 0.66 +/- 0.02 and 0.61 +/- 0.01, respectively; P = .03).


CONCLUSIONS
The iterative noise-reduction algorithm is superior to conventional methods in detection of pulmonary nodules.
Kido
S
S
Department of Radiology, Osaka University Medical School, Japan.
Ikezoe
J
J
Naito
H
H
Arisawa
J
J
Tamura
S
S
Kozuka
T
T
Ito
W
W
Shimura
K
K
Kato
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015900:Radiography, Dual-Energy Scanned Projection; D013902:Radiography, Thoracic / Q000379:methods*; D013382:Subtraction Technique