title: Comparison of digital tomosynthesis and chest radiography for the detection of pulmonary nodules: systematic review and meta-analysis.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of digital tomosynthesis (DTS) with that of chest radiography for the detection of pulmonary nodules by meta-analysis.
  
  
  METHODS
  A systematic literature search was performed to identify relevant original studies from 1 January 1 1976 to 31 August 31 2016. The quality of included studies was assessed by quality assessment of diagnostic accuracy studies-2. Per-patient data were used to calculate the sensitivity and specificity and per-lesion data were used to calculate the detection rate. Summary receiver-operating characteristic curves were drawn for pulmonary nodule detection.
  
  
  RESULTS
  16 studies met the inclusion criteria. 1017 patients on a per-patient basis and 2159 lesions on a per-lesion basis from 16 eligible studies were evaluated. The pooled patient-based sensitivity of DTS was 0.85 [95% confidence interval (CI) 0.83-0.88] and the specificity was 0.95 (0.93-0.96). The pooled sensitivity and specificity of chest radiography were 0.47 (0.44-0.51) and 0.37 (0.34-0.40), respectively. The per-lesion detection rate was 2.90 (95% CI 2.63-3.19).
  
  
  CONCLUSIONS
  DTS has higher diagnostic accuracy than chest radiography for detection of pulmonary nodules. Chest radiography has low sensitivity but similar specificity, comparable with that of DTS. Advances in knowledge: DTS has higher diagnostic accuracy than chest radiography for the detection of pulmonary nodules.
authors.affiliation: 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Jun H
authors.initials: JH
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Kyung H
authors.initials: KH
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Kyoung-Tae
authors.initials: KT
authors.lastname: Kim
authors.affiliation: 2 Institute for Evidence-based Medicine, Cochrane Korea, Seoul, Republic of Korea.|3 Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Hyun J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: 2 Institute for Evidence-based Medicine, Cochrane Korea, Seoul, Republic of Korea.|3 Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Hyeong S
authors.initials: HS
authors.lastname: Ahn
authors.affiliation: 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Yeo J
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Ha Y
authors.initials: HY
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Yong S
authors.initials: YS
authors.lastname: Jeon
mesh_terms: D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*