title: Digital tomosynthesis for PNS evaluation: comparisons of patient exposure and image quality with plain radiography.
abstract: OBJECTIVE
  We investigated low dose digital tomosynthesis (DT) for the evaluation of the paranasal sinus (PNS), and compared its diagnostic accuracy with a PNS radiography series (XR).
  
  
  METHODS
  We enrolled 43 patients for whom XR, PNS DT, and OMU CT were performed. We measured effective doses (EDs) of XR, DT, and OMU CT using Monte Carlo simulation software. Two radiologists performed independent observation of both XR and DT. For seven PNSs, they scored anatomic conspicuity of sinuses and confidence on the presence of sinusitis using nine point scales. OMU CT was observed by the third radiologist and the findings were regarded as reference standard. We compared scores for conspicuity and sinusitis confidence between XR and DT.
  
  
  RESULTS
  Mean EDs were 29 ± 6 µSv, 48 ± 10 µSv, and 980 ± 250 µSv, respectively, for XR, DT, and CT. Mean scores for conspicuity were 6.3 and 7.4, respectively, for XR and DT. Sensitivity per patient basis for sinusitis detection were 52% and 96%, respectively, for XR and DT in observer 1 (p = 0.001) and 80% and 92% for observer 2 (p = 0.25). Specificities for sinusitis exclusion were 100% for both XR and DT for observer 1 and 89% and 100% for observer 2 (p = 0.50). Accuracies for sinusitis diagnosis were 72% and 98%, respectively, for XR and DT for observer 1 (p = 0.001) and 84% and 95% for observer 2 (p = 0.125).
  
  
  CONCLUSIONS
  Patient radiation dose from low dose DT is comparable with that of PNS XR. Diagnostic sensitivity of DT for sinusitis was superior to PNS XR.
authors.affiliation: Department of Radiology, Bundang Jesaeng General Hospital, Sungnam, Korea.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Yoo
authors.forename: Myung Jin
authors.initials: MJ
authors.lastname: Chung
authors.forename: Boram
authors.initials: B
authors.lastname: Choi
authors.forename: Hye Na
authors.initials: HN
authors.lastname: Jung
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Koo
authors.forename: Young A
authors.initials: YA
authors.lastname: Bae
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Byun
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009010:Monte Carlo Method; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging*; D012372:ROC Curve; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods*; D012680:Sensitivity and Specificity; D012852:Sinusitis / Q000000981:diagnostic imaging*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*