title: Digital tomosynthesis of the thorax: the influence of respiratory motion artifacts on lung nodule detection.
abstract: BACKGROUND
  Digital tomosynthesis considerably reduces problems created by overlapping anatomy compared with chest X-ray (CXR). However, digital tomosynthesis requires a longer scan time compared with CXR, and thus may be vulnerable to motion artifacts.
  
  
  OBJECTIVE
  To compare the diagnostic performance of digital tomosynthesis in subjects with and without respiratory motion artifacts.
  
  
  METHODS
  The institutional review board approved this retrospective study, and the requirement for written informed consent was waived. A total of 46 subjects with imaging containing respiratory motion artifacts were enrolled in this study, 18 of whom were positive and 28 of whom were negative for lung nodules on computed tomography (CT). The control group was comprised of 92 age-matched subjects with imaging devoid of motion artifacts. Of these, 36 were positive and 56 were negative for lung nodules on subsequent CT scan. The size criteria of nodules were 4-10 mm. Three chest radiologists independently evaluated the radiographs and digital tomosynthesis images for the presence of pulmonary nodules. Multireader multicase receiver-operating characteristic (ROC) analyses was used for statistical comparisons.
  
  
  RESULTS
  Within the control group, the areas under curve (AUC) for observer performances in detecting lung nodules on digital tomosynthesis was higher than that on CXR (P = 0.017). Within the study group, there were no significant differences in AUCs for observer performances (P = 0.576).
  
  
  CONCLUSIONS
  When no motion artifacts are present, the detection performance of nodules (4-10 mm) on digital tomosynthesis is significantly better than that on CXR, whereas there is not a significant difference in cases with motion artifacts.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sung Mok
authors.initials: SM
authors.lastname: Kim
authors.forename: Myung Jin
authors.initials: MJ
authors.lastname: Chung
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Hee
authors.initials: H
authors.lastname: Kang
authors.forename: In-Young
authors.initials: IY
authors.lastname: Song
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Lee
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016477:Artifacts; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009010:Monte Carlo Method; D019047:Phantoms, Imaging; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D012119:Respiration; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D014963:X-Ray Intensifying Screens
keywords: Adults; digital radiography; lung; motion artifacts; observer performance