科研之友
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摘要
Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly. Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55-92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose-area product values. For all observers significantly more vertebrae were seen with tomosynthesis than with radiography (mean 12.4/9.3, P < 0.001) as well as significantly more fractures (mean 0.9/0.7, P = 0.017). The image quality score for tomosynthesis was significantly higher than for radiography, for all evaluated structures. Tomosynthesis took longer to evaluate than radiography. Despite this, all observers scored a clear preference for tomosynthesis. Observer agreement was substantial (mean kappa = 0.73, range 0.51-0.94). The calibration or conversion factor was 0.11 mSv/(Gy cm(2)) for the combined examination. The resulting effective dose was 0.87 mSv. Tomosynthesis can increase the detection rate of thoracic vertebral fractures in the elderly, at low added radiation dose. aEuro cent Tomosynthesis helps evaluate the thoracic spine in the elderly. aEuro cent Observer agreement for thoracic spine tomosynthesis was substantial (mean kappa = 0.73). aEuro cent Significantly more vertebrae and significantly more fractures were seen with tomosynthesis. aEuro cent Tomosynthesis took longer to evaluate than radiography. aEuro cent There was a clear preference among all observers for tomosynthesis over radiography.
- 出版日期2017-2
