Improved detection of focal pneumonia by chest radiography with bone suppression imaging

• Published in: European radiology 2012-12, Vol.22 (12), p.2729-2735
• Main Authors: Li, Feng, Engelmann, Roger, Pesce, Lorenzo, Armato, Samuel G., MacMahon, Heber
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bone and Bones - diagnostic imaging; Bones; Chest; Diagnostic Radiology; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Lung diseases; Lungs; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Patients; Pneumonia; Pneumonia - diagnostic imaging; Radiographic Image Enhancement - methods; Radiographic Image Interpretation, Computer-Assisted; Radiography; Radiography, Thoracic - methods; Radiology; Retrospective Studies; ROC Curve; Software; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-012-2550-y

Objective To evaluate radiologists’ ability to detect focal pneumonia by use of standard chest radiographs alone compared with standard plus bone-suppressed chest radiographs. Methods Standard chest radiographs in 36 patients with 46 focal airspace opacities due to pneumonia (10 patients had bilateral opacities) and 20 patients without focal opacities were included in an observer study. A bone suppression image processing system was applied to the 56 radiographs to create corresponding bone suppression images. In the observer study, eight observers, including six attending radiologists and two radiology residents, indicated their confidence level regarding the presence of a focal opacity compatible with pneumonia for each lung, first by use of standard images, then with the addition of bone suppression images. Receiver operating characteristic (ROC) analysis was used to evaluate the observers’ performance. Results The mean value of the area under the ROC curve (AUC) for eight observers was significantly improved from 0.844 with use of standard images alone to 0.880 with standard plus bone suppression images ( P