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Added Value of Bone Subtraction in Dual-energy Digital Radiography in the Detection of Pneumothorax

Abstract : Rationale and objectives: This study aimed to determine the value of dual-energy thoracic radiography in the diagnosis of pneumothorax considering the reader's experience. Materials and methods: Forty patients with a suspected pneumothorax, imaged with dual-energy chest radiographs, were divided into two groups: those with pneumothorax as the final diagnosis (n = 19) and those without (n = 21). The images were analyzed by 36 readers (5 interns, 16 residents, 15 senior physicians) for the presence or absence of pneumothorax during three readout sessions at 2-week intervals: standard images alone (session 1), dual-energy images with bone subtraction alone (session 2), and a combination of the two (session 3). Results: The number of correct responses increased 13.3% between sessions 1 and 2 (P < .001) and 9.4% between sessions 1 and 3 (P < .001). The mean sensitivity for pneumothorax detection was higher in sessions 2 (82%) and 3 (79%) compared to session 1 (70%). There was no statistically significant difference in specificity between the sessions. The number of correct responses for small volume pneumothoraces was higher in sessions 2 (10.6 ± 1.8) and 3 (10.1 ± 2.0) than in session 1 (8.9 ± 2.3), with a statistically significant difference between sessions 1 and 2 (P = .002) and between sessions 1 and 3 (P = .048). Conclusion: Bone subtracted dual-energy thoracic radiographs improve the detection sensitivity of pneumothorax, including in cases of small pneumothoraces, regardless of the reader's level or expertise.
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https://hal.univ-lorraine.fr/hal-03241281
Contributor : Juliette Birker Connect in order to contact the contributor
Submitted on : Friday, May 28, 2021 - 3:13:34 PM
Last modification on : Thursday, November 18, 2021 - 4:56:08 PM

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Ayla Urbaneja, Gauthier Dodin, Gabriela Hossu, Omar Bakour, Rachid Kechidi, et al.. Added Value of Bone Subtraction in Dual-energy Digital Radiography in the Detection of Pneumothorax. Academic Radiology, Elsevier, 2018, 25 (1), pp.82-87. ⟨10.1016/j.acra.2017.06.015⟩. ⟨hal-03241281⟩

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