Bone Suppression Imaging Ups Small Lung Cancer Detection

However, dual-energy subtraction imaging provides even higher accuracy

WEDNESDAY, Nov. 30 (HealthDay News) -- Accuracy of small lung cancer detection on chest radiographs is higher when using bone suppression (BS) imaging with a standard radiograph, and the accuracy improves when using dual-energy subtraction (DES) radiography, according to a study published in the December issue of Radiology.

Feng Li, M.D., Ph.D., from the University of Chicago, and colleagues compared the accuracy of small lung cancer detection using standard chest radiographs plus BS imaging versus standard radiographs alone, and investigated whether BS imaging accuracy is equivalent to that of DES radiography. Analyses were made of standard and DES chest radiographs from 55 confirmed primary nodular cancers in 50 patients, and from 30 patients without cancer. Corresponding BS images were created by applying a new BS imaging processing system, which can suppress bone conspicuity, to the standard radiographs. Receiver operating characteristic (ROC) analysis was used to evaluate reviewer performance of 10 radiologists (six experienced, four residents), who indicated their confidence level regarding presence or absence of lung cancer using a standard image first, followed by the BS image, and finally DES soft-tissue and bone images.

The investigators found that, for all reviewers, the average area under the ROC curve (AUC) improved significantly, from 0.807 with standard images to 0.867 and 0.916 with BS imaging and DES, respectively. For the six experienced radiologists, there was significant improvement of the average AUC, from 0.846 using standard images to 0.894 using BS images, and then to 0.945 when using DES images.

"Use of BS imaging together with a standard radiograph can improve radiologists' accuracy for detection of small lung cancers on chest radiographs," the authors write.

All of the study authors disclosed financial ties to the biotechnology industry.

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