Objective To assess the impact of digital tomosynthesis
(DTS) on the radiological investigation of patients with
suspected pulmonary lesions on chest radiography (CXR).
Methods Three hundred thirty-nine patients (200 male;
age, 71.19±11.9 years) with suspected pulmonary lesion(s)
on CXR underwent DTS. Two readers prospectively analysed
CXR and DTS images, and recorded their diagnostic confidence:
1 or 20definite or probable benign lesion or pseudolesion
deserving no further diagnostic workup; 3 0
indeterminate; 4 or 50probable or definite pulmonary lesion
deserving further diagnostic workup by computed tomography
(CT). Imaging follow-up by CT (n076 patients), CXR
(n0256) or histology (n07) was the reference standard.
Results DTS resolved doubtful CXR findings in 256/339
(76 %) patients, while 83/339 (24 %) patients proceeded to
CT. The mean interpretation time for DTS (mean±SD,
220±40 s) was higher (P<0.05; Wilcoxon test) than for
CXR (110±30 s), but lower than CT (600±150 s). Mean
effective dose was 0.06 mSv (range 0.03–0.1 mSv) for
CXR, 0.107 mSv (range 0.094–0.12 mSv) for DTS, and
3 mSv (range 2–4 mSv) for CT.
Conclusions DTS avoided the need for CT in about threequarters
of patients with a slight increase in the interpretation
time and effective dose compared to CXR.
