title: Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis.
abstract: OBJECTIVE
  To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis.
  
  
  METHODS
  A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system.
  
  
  RESULTS
  Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85).
  
  
  CONCLUSIONS
  The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity.
  
  
  CONCLUSIONS
  Tomosynthesis is more sensitive than conventional radiography for pulmonary cystic fibrosis changes. The radiation dose from chest tomosynthesis is low compared with computed tomography. Tomosynthesis may become useful in the regular follow-up of patients with cystic fibrosis.
authors: Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University, 221 85, Lund, Sweden. kristina.vult_von_steyern@med.lu.se
authors: Kristina
authors: K
authors: Vult von Steyern
authors: Isabella M
authors: IM
authors: Björkman-Burtscher
authors: Peter
authors: P
authors: Höglund
authors: Gracijela
authors: G
authors: Bozovic
authors: Marie
authors: M
authors: Wiklund
authors: Mats
authors: M
authors: Geijer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013902:Radiography, Thoracic / Q000379:methods*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*