Journal article
Comparison of Baseline, Bone-Subtracted, and Enhanced Chest Radiographs for Detection of Pneumothorax
Canadian Association of Radiologists journal, Vol.72(3), pp.519-524
08/01/2021
DOI: 10.1177/0846537120908852
PMID: 32186414
Abstract
Purpose: To assess and compare detectability of pneumothorax on unprocessed baseline, single-energy, bone-subtracted, and enhanced frontal chest radiographs (chest X-ray, CXR). Method and Materials: Our retrospective institutional review board-approved study included 202 patients (mean age 53 +/- 24 years; 132 men, 70 women) who underwent frontal CXR and had trace, moderate, large, or tension pneumothorax. All patients (except those with tension pneumothorax) had concurrent chest computed tomography (CT). Two radiologists reviewed the CXR and chest CT for pneumothorax on baseline CXR (ground truth). All baseline CXR were processed to generate bone-subtracted and enhanced images (ClearRead X-ray). Four radiologists (R1-R4) assessed the baseline, bone-subtracted, and enhanced images and recorded the presence of pneumothorax (side, size, and confidence for detection) for each image type. Area under the curve (AUC) was calculated with receiver operating characteristic analyses to determine the accuracy of pneumothorax detection. Results: Bone-subtracted images (AUC: 0.89-0.97) had the lowest accuracy for detection of pneumothorax compared to the baseline (AUC: 0.94-0.97) and enhanced (AUC: 0.96-0.99) radiographs (P < .01). Most false-positive and false-negative pneumothoraces were detected on the bone-subtracted images and the least numbers on the enhanced radiographs. Highest detection rates and confidence were noted for the enhanced images (empiric AUC for R1-R4 0.96-0.99). Conclusion: Enhanced CXRs are superior to bone-subtracted and unprocessed radiographs for detection of pneumothorax.
Details
- Title: Subtitle
- Comparison of Baseline, Bone-Subtracted, and Enhanced Chest Radiographs for Detection of Pneumothorax
- Creators
- Fatemeh Homayounieh - Massachusetts General HospitalSubba R. Digumarthy - Massachusetts General HospitalJennifer A. Febbo - Massachusetts General HospitalSherief Garrana - Massachusetts General HospitalChayanin Nitiwarangkul - Ramathibodi HospitalRamandeep Singh - Massachusetts General HospitalRuhani Doda Khera - Harvard UniversityMatthew Gilman - Massachusetts General HospitalMannudeep K. Kalra - Massachusetts General Hospital
- Resource Type
- Journal article
- Publication Details
- Canadian Association of Radiologists journal, Vol.72(3), pp.519-524
- Publisher
- Sage
- DOI
- 10.1177/0846537120908852
- PMID
- 32186414
- ISSN
- 0846-5371
- eISSN
- 1488-2361
- Number of pages
- 6
- Language
- English
- Date published
- 08/01/2021
- Academic Unit
- Radiology
- Record Identifier
- 9984697722402771
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