title: Analysis of the impact of digital tomosynthesis on the radiological investigation of patients with suspected pulmonary lesions on chest radiography.
abstract: OBJECTIVE
  To assess the impact of digital tomosynthesis (DTS) on the radiological investigation of patients with suspected pulmonary lesions on chest radiography (CXR).
  
  
  METHODS
  Three hundred thirty-nine patients (200 male; age, 71.19 ± 11.9 years) with suspected pulmonary lesion(s) on CXR underwent DTS. Two readers prospectively analysed CXR and DTS images, and recorded their diagnostic confidence: 1 or 2 = definite or probable benign lesion or pseudolesion deserving no further diagnostic workup; 3 = indeterminate; 4 or 5 = probable or definite pulmonary lesion deserving further diagnostic workup by computed tomography (CT). Imaging follow-up by CT (n = 76 patients), CXR (n = 256) or histology (n = 7) was the reference standard.
  
  
  RESULTS
  DTS resolved doubtful CXR findings in 256/339 (76 %) patients, while 83/339 (24 %) patients proceeded to CT. The mean interpretation time for DTS (mean ± SD, 220 ± 40 s) was higher (P < 0.05; Wilcoxon test) than for CXR (110 ± 30 s), but lower than CT (600 ± 150 s). Mean effective dose was 0.06 mSv (range 0.03-0.1 mSv) for CXR, 0.107 mSv (range 0.094-0.12 mSv) for DTS, and 3 mSv (range 2-4 mSv) for CT.
  
  
  CONCLUSIONS
  DTS avoided the need for CT in about three-quarters of patients with a slight increase in the interpretation time and effective dose compared to CXR.
authors.affiliation: Department of Radiology, Cattinara Hospital, University of Trieste (Italy), Strada di Fiume 447, 34149 Trieste, Italy. equaia@yahoo.com
authors.forename: Emilio
authors.initials: E
authors.lastname: Quaia
authors.forename: Elisa
authors.initials: E
authors.lastname: Baratella
authors.forename: Stefano
authors.initials: S
authors.lastname: Cernic
authors.forename: Arianna
authors.initials: A
authors.lastname: Lorusso
authors.forename: Federica
authors.initials: F
authors.lastname: Casagrande
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cioffi
authors.forename: Maria Assunta
authors.initials: MA
authors.lastname: Cova
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult