Flat-panel detector computed tomography imaging: Observer performance in detecting pulmonary nodules in comparison with conventional chest radiography and multidetector computed tomography

PURPOSE: The aim of this study was to compare the detectability of lung nodules on images obtained with a flat-panel detector computed tomography (FPD-CT) system and by chest radiographs (CXRs) using receiver-operating characteristic (ROC) analysis. MATERIALS AND METHODS: FPD-CT was conducted with the patients in the sitting position. For the CXR study, the patients stood erect. Our study population consisted of 26 individuals ranging in age from 50 to 83 years. The reference standard was based on the interpretations obtained by consensus of 2 radiologists on multidetector CT images for the presence or absence of nodules. Four other radiologists independently assessed and recorded the absence or presence of lung nodules and their location on FPD-CT and CXR images. ROC analysis was used to evaluate lung nodule detectability by both imaging modalities. RESULTS: Two radiologists identified 34 nodules whose diameter was 5 to 42 mm (mean, 19.3 mm) in 23 of the 26 study participants on the multidetector CT images. Overall, analysis of variance for ROC analysis showed that FPD-CT was significantly better in detecting nodules than CXR (P=0.02). The estimated mean Az value was 0.9818±0.0083 with FPD-CT and 0.7610±0.0908 with CXR. The sensitivity for nodule detection on FPD-CT and CXR images was 79.4% and 33.8%, respectively. CONCLUSION: The detectability of pulmonary nodules was better on images of FPD-CT than on CXRs. Copyright © 2012 by Lippincott Williams &Wilkins.