title: Clinical evaluation of pulmonary nodules with dual-exposure dual-energy subtraction chest radiography.
abstract: OBJECTIVE
  The purpose of this study was to assess the effect of dual-exposure dual-energy (DE) subtraction chest radiography with flat-panel detector.
  
  
  METHODS
  One hundred patients underwent dual-exposure DE subtraction chest radiography and chest CT for evaluation of pulmonary nodules. Fifty-two patients with pulmonary nodules and 48 patients with normal lungs were selected for receiver operating characteristic (ROC) curve analysis. Ten radiologists who were unaware of the CT results evaluated chest radiography alone and chest radiography with DE subtraction images in the detection of pulmonary nodules. For each radiologist, we calculated the areas under the ROC curve (Az) for chest radiography alone and chest radiography with DE subtraction images.
  
  
  RESULTS
  The average detectability of dual-exposure DE subtraction chest radiography was statistically significantly higher than that of chest radiography without subtraction images (mean Az value increased from 0.784 to 0.815, p<0.001).
  
  
  CONCLUSIONS
  Dual-exposure DE subtraction chest radiography improves diagnostic accuracy of pulmonary nodules.
authors.affiliation: Department of Radiology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Uemura
authors.forename: Masao
authors.initials: M
authors.lastname: Miyagawa
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yasuhara
authors.forename: Tadashi
authors.initials: T
authors.lastname: Murakami
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Ikura
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tagashira
authors.forename: Kenji
authors.initials: K
authors.lastname: Arakawa
authors.forename: Teruhito
authors.initials: T
authors.lastname: Mochizuki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D013382:Subtraction Technique