Abstract
The recent implementation of chest tomosynthesis is built on the availability of large,
dose-efficient, high-resolution flat panel detectors, which enable the acquisition
of the necessary number of projection radiographs to allow reconstruction of section
images of the chest within one breath hold. A chest tomosynthesis examination obtains
the increased diagnostic information provided by volumetric imaging at a radiation
dose comparable to that of conventional chest radiography. There is evidence that
the sensitivity of chest tomosynthesis may be at least three times higher than for
conventional chest radiography for detection of pulmonary nodules. The sensitivity
increases with increasing nodule size and attenuation and decreases for nodules with
subpleural location. Differentiation between pleural and subpleural lesions is a known
pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different
types of pathology report increased detectability in favor of chest tomosynthesis
in comparison to chest radiography. The technique provides improved diagnostic accuracy
and confidence in the diagnosis of suspected pulmonary lesions on chest radiography
and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding
the need for computed tomography (CT). However, motion artifacts can be a cumbersome
limitation and breathing during the tomosynthesis image acquisition may result in
severe artifacts significantly affecting the detectability of pathology. In summary,
chest tomosynthesis has been shown to be superior to chest conventional radiography
for many tasks and to be able to replace CT in selected cases. In our experience chest
tomosynthesis is an efficient problem solver in daily clinical work.
Keywords
chest - radiography - tomosynthesis - computed tomography
