Author of

• 10962

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  P1.20 - Poster Session 1 - Early Detection and Screening (ID 172)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10967

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    P1.20-005 - Comparison between Chest Radiography, Chest Tomosynthesis and Computed Tomography to Detect Pulmonary Nodules: A Phantom study and clinical experience. (ID 2327)

    09:30 - 09:30  |  Author(s): K. Jirapong
    • Abstract

    Background
    It is true that treatment in the early stage of lung cancer provides the best benefit, so many researchers have actively sought a good screening test for early detection. Although, chest radiography (CXR) is commonly used for evaluating patient with pulmonary disease. There are some limitations in early detection small nodule. Computed Tomography (CT) can easily solve this problem. However, the disadvantages of the CT are high cost and high radiation dose. Recently, there is a new technique called digital tomosynthesis, which can reconstruct sectional images at arbitrary depths by collecting a number of projection images at different angles using a digital detector. The overlapping anatomy of the section images is much less than the standard projection radiograph. Currently, many articles have presented the benefits of DT. The learning curve for interpretation of the technology is also important. The purpose of this study is to find the detection rate of nodule by using CXR, chest digital tomosynthesis (CDT) and CT examination with phantoms and preliminary clinical application in Maharaj Nakorn Chiang Mai hospital.

    Methods
    After institutional review broad approval, in-house chest phantom was made from acrylic, plaster and catheters. The plastic beads, diameter size 1-2 mm., 3-4 mm., 5-6 mm., 7-8 mm. and 9-10 mm. were implanted to represent pulmonary nodules in a phantom. None to 20 nodules were randomly embedded in each model and photographed by digital chest radiograph (CXR), chest digital tomosynthesis (CDT) and chest computed tomography (CT). Two thoracic radiologists were blinded to review and label nodules on each image. Percentage of nodular detection in each study was calculated and compared between each other. After gain experience from phantom study, CDT was preliminary applied to the surgical cases for preoperative evaluation.

    Results
    There were 332 nodules in the 34 phantom-models. Nodule detection rate from each modality was 75.3% of CXR, 91.0% of CDT and 98.8% of CT, respectively. CT could detect all nodules, which were larger than 3 mm in diameter. There were over 90 % of detected nodules from CDT that diameter were larger than 5mm. Percentages of nodular detection of CDT and CT were not statistically significant difference in 5-10 mm sized nodules. Poor nodular detection areas on CXR were mediastinal and hilar regions, while on CDT was costophrenic sulcus. Clinical examinations were shown.

    Conclusion
    CT showed the highest percentage of nodular detection, followed by CDT and digital CXR, respectively. The percentage of detection in nodules size 5 – 10 mm between CT and CDT was not statistically significant difference.