title: Effect of clinical experience of chest tomosynthesis on detection of pulmonary nodules.
abstract: BACKGROUND
  The new technique chest tomosynthesis refers to the principle of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest at a radiation dose comparable to that of chest radiography.
  
  
  OBJECTIVE
  To investigate if, for experienced thoracic radiologists, the detectability of pulmonary nodules obtained after only a short initial learning period of chest tomosynthesis improves with additional clinical experience of the new technique.
  
  
  METHODS
  Two readings of the same clinical chest tomosynthesis cases, the first performed after 6 months of clinical experience and the second after an additional period of 1 year, were conducted. Three senior thoracic radiologists, with more than 20 years of experience of chest radiography, acted as observers, with the task of detecting pulmonary nodules in a jackknife free-response receiver operating characteristics (JAFROC1) study. The image material consisted of 42 patients with and 47 patients without pulmonary nodules examined with chest tomosynthesis. Multidetector computed tomography (MDCT) was used as a reference. The total number of nodules was 131. The JAFROC1 figure of merit (FOM) was used as the principal measure of detectability.
  
  
  RESULTS
  The difference in the observer-averaged JAFROC1 FOM of the two readings was 0.004 (95% confidence interval: -0.11, 0.12; F-statistic: 0.01 on 1 and 2.65 df; P=0.91). Thus, no significant improvement in detectability was found after the additional clinical experience of tomosynthesis.
  
  
  CONCLUSIONS
  The study indicates that experienced thoracic radiologists already within the first months of clinical use of chest tomosynthesis are able to take advantage of the new technique in the task of detecting pulmonary nodules.
authors.affiliation: Department of Radiation Physics, University of Gothenburg, Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Zachrisson
authors.forename: J
authors.initials: J
authors.lastname: Vikgren
authors.forename: A
authors.initials: A
authors.lastname: Svalkvist
authors.forename: A A
authors.initials: AA
authors.lastname: Johnsson
authors.forename: M
authors.initials: M
authors.lastname: Boijsen
authors.forename: A
authors.initials: A
authors.lastname: Flinck
authors.forename: L G
authors.initials: LG
authors.lastname: Månsson
authors.forename: S
authors.initials: S
authors.lastname: Kheddache
authors.forename: M
authors.initials: M
authors.lastname: Båth
mesh_terms: D006801:Humans; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging*; D015588:Observer Variation; D019047:Phantoms, Imaging; D012372:ROC Curve; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*