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Congress: ECR24
Poster Number: C-15788
Type: EPOS Radiologist (scientific)
Authorblock: P. Rogalla1, M. May1, S. Ronghe1, J. B. Mendel2, S. Kandel1, K. S. Karim3; 1Toronto, ON/CA, 2Brighton, MA/US, 3Waterloo, ON/CA
Disclosures:
Patrik Rogalla: Equipment Support Recipient: KA Imaging
Mary May: Nothing to disclose
Sandeep Ronghe: Nothing to disclose
Jeffrey Brian Mendel: Nothing to disclose
Sonja Kandel: Nothing to disclose
Karim S Karim: Founder: KA Imaging
Keywords: Thorax, Digital radiography, Diagnostic procedure, Technology assessment, Acute
Purpose Dual-energy subtraction relies on the differential attenuation of low- and high-energy photons by body tissues, enabling enhanced imaging to selectively highlight bones and soft tissues. Historically, the application of dual-energy X-ray imaging has been constrained by heightened radiation exposure and motion artefacts stemming from the necessity for multiple exposures during image acquisition [1]. However, the emergence of portable, single-exposure dual-energy X-ray imaging has mitigated these concerns. This study aims to evaluate the augmented diagnostic confidence in a non-radiological review setting...
Read more Methods and materials A portable, single-exposure, dual-energy X-ray triple-layer detector (SpectralDRTM) was employed, allowing simultaneous acquisition of a conventional radiograph, a soft tissue image, and a bone image. Twenty-eight consecutive chest X-rays were obtained in an intensive care unit using the portable dual-energy detector, following institutional research ethics board approval and participant consent. Images underwent pre-processing to remove annotations and anonymize cases before distribution. A web-based survey-style review involving nine medical professionals and trainees with varying expertise levels was conducted, encompassing one medical...
Read more Results Dual-energy images improved line and tube visibility in 14 cases, as observed by 8 out of 9 reviewers (p<.001). Figure 1 demonstrates an example of increased catheter visibility. Notably, in 16 out of 28 cases (57%), the reviewers reported an increased overall diagnostic confidence when dual-energy X-ray images where available for interpretation. No motion artefacts were noted in the acquired images. The median total reading time for conventional radiographs and dual-energy images showed no significant difference (median, 29:07 vs 29:52...
Read more Conclusion The enhanced line and tube visibility and self-reported diagnostic confidence with dual-energy images underscore the clinical promise of portable dual-energy chest X-ray. Previous studies have also noted increased accuracy and interpretation speed for lung nodule identification with dual-energy subtraction [2]. Additionally, dual-energy X-ray imaging has been demonstrated to have a variety of clinical use cases beyond identification of lines, tubes, and pulmonary nodules, including identification of calcifications and vascular diseases, and bone, pleural, and chest wall abnormalities [3-5]. With single-exposure...
Read more References Gilkeson RC, Sachs PB. Dual energy subtraction digital radiography: technical considerations, clinical applications, and imaging pitfalls. J Thorac Imaging. 2006 Nov;21(4):303-13. doi: 10.1097/01.rti.0000213646.34417.be. PMID: 17110857. Manji F, Wang J, Norman G, Wang Z, Koff D. Comparison of dual energy subtraction chest radiography and traditional chest X-rays in the detection of pulmonary nodules. Quant Imaging Med Surg. 2016 Feb;6(1):1-5. doi: 10.3978/j.issn.2223-4292.2015.10.09. PMID: 26981449; PMCID: PMC4775247. Kuhlman JE, Collins J, Brooks GN, Yandow DR, Broderick LS. Dual-energy subtraction chest radiography: what to look for...
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