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Chest tomosynthesis: Technical and clinical perspectives

机译：胸部断层合成：技术和临床观点

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The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work.
机译：胸部断层合成的最新实现是建立在大型，高剂量效率，高分辨率平板探测器的基础上的，该探测器可获取必要数量的投影射线照相，以重建一次屏气时胸部的断层图像。胸部断层合成检查可获得的体积信息量与常规胸部X线检查相当的放射量增加的诊断信息。有证据表明，胸部断层合成检测肺结节的敏感性可能比常规胸部X线检查至少高三倍。敏感性随着结节大小和衰减的增加而增加，而对于位于胸膜下位置的结节，敏感性降低。由于胸部断层合成的深度分辨率有限，胸膜和胸膜下病变之间的区别是一个已知的陷阱。与胸部X线摄影相比，对不同类型病理学的研究报道了增加的可检测性，有利于胸部断层合成。该技术提高了诊断准确性，并增强了对胸部X光片检查可疑肺部病变的诊断的信心，并有助于排除大多数患者的肺部病变，从而无需进行计算机断层扫描（CT）。然而，运动伪影可能是繁琐的限制，并且在断层合成图像获取期间的呼吸可能会导致严重伪影，从而严重影响病理的可检测性。综上所述，在许多任务上，胸部断层合成显示出优于胸部常规X线摄影术，并且在某些情况下可以替代CT。根据我们的经验，胸部断层合成在日常临床工作中是一种有效的解决方案。

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