Clinical evaluation of pulmonary nodules with single-exposure dual-energy subtraction chest radiography with an iterative noise-reduction algorithm

Radiology. 1995 Feb;194(2):407-12. doi: 10.1148/radiology.194.2.7824718.


Purpose: To compare the clinical usefulness of the single-exposure dual-energy subtraction method with an iterative noise-reduction algorithm.

Materials and methods: Fourteen radiologists read three sets of images from 44 patients: original computed radiographic images only, original computed radiographic images plus conventional bone-subtracted images, and original computed radiographic images plus iterative noise-reduced bone-subtracted images. Twenty-two patients had one or more (maximum, five) pulmonary nodules; 22 had no pulmonary nodules. Observer performance was evaluated by means of calculation of the average area under the alternative free-response receiver operating characteristic curves (A1).

Results: Compared with the original computed radiographic image only, detection of nodules was significantly better with both the original computed radiographic image plus iterative bone-subtracted image (A1 = 0.72 +/- 0.02 and 0.66 +/- 0.02, respectively; P = .01) and the original computed radiographic image plus conventional bone-subtracted image (A1 = 0.66 +/- 0.02 and 0.61 +/- 0.01, respectively; P = .03).

Conclusion: The iterative noise-reduction algorithm is superior to conventional methods in detection of pulmonary nodules.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Algorithms
  • Female
  • Humans
  • Lung Diseases / diagnostic imaging*
  • Male
  • Middle Aged
  • ROC Curve
  • Radiography, Dual-Energy Scanned Projection*
  • Radiography, Thoracic / methods*
  • Subtraction Technique*