title: A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference.
abstract: OBJECTIVE
  To compare the diagnostic performance of digital tomosynthesis (DTS) and chest radiography for detecting airway abnormalities, using computed tomography (CT) as a reference.
  
  
  METHODS
  We evaluated 161 data sets from 149 patients (91 with and 70 without airway abnormalities) who had undergone radiography, DTS, and CT to detect airway problems. Radiographs and DTS were evaluated to localize and score the severity of the airway abnormalities, and to score the image quality using CT as a reference. Receiver operating characteristics (ROC), McNemar's test, weighted kappa, and the paired t-test were used for statistical analysis.
  
  
  RESULTS
  The sensitivity of DTS was higher (reader 1, 93.51 %; reader 2, 94.29 %) than chest radiography (68.83 %; 71.43 %) in detecting airway lesions. The diagnostic accuracy of DTS (90.91 %; 94.70 %) was also significantly better than that of radiography (78.03 %; 82.58 %, all p < 0.05). DTS image quality was significantly better than chest radiography (1.83, 2.74; p < 0.05) in the results of both readers. The inter-observer agreement with respect to DTS findings was moderate and superior when compared to radiography findings.
  
  
  CONCLUSIONS
  DTS is a more accurate and sensitive modality than radiography for detecting airway lesions that are easily obscured by soft tissue structures in the mediastinum.
  
  
  CONCLUSIONS
  • Digital tomosynthesis offers new diagnostic options for airway lesions. • Digital tomosynthesis is more sensitive and accurate than radiography for airway lesions. • Digital tomosynthesis shows better image quality than radiography. • Assessment of lesion severity, via tomosynthesis is comparable to computed tomography.
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, 516, Gojan 1-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, Korea.
authors.forename: Ji Yung
authors.initials: JY
authors.lastname: Choo
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, 516, Gojan 1-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, Korea. kiylee@korea.ac.kr.
authors.forename: Ki Yeol
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Korean Medicine Clinical Trial Center, Kyung Hee University Oriental Medicine Hospital, Seoul, Korea.|Biostatistical Consulting Lab, Medical Science Research Center, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ami
authors.initials: A
authors.lastname: Yu
authors.affiliation: Pulmonology, Korea University Ansan Hospital, Ansan-si, Korea.
authors.forename: Je-Hyeong
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Pulmonology, Korea University Ansan Hospital, Ansan-si, Korea.
authors.forename: Seung Heon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, 516, Gojan 1-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, Korea.
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Radiology, Korea University Guro Hospitals, Seoul, South Korea.
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Kang
authors.affiliation: Radiology, Korea University Anam Hospital, Seoul, South Korea.
authors.forename: Yu Whan
authors.initials: YW
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Airway disease; Chest radiography; Computed tomography; Digital tomosynthesis; Radiation dose