Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Sharma, Madhurima; Sandhu, Manavjit Singh; Gorsi, Ujjwal; Gupta, Dheeraj; Khandelwal, Niranjan
• Is Part Of: European journal of radiology. Volume 84:Issue 9(2015)
• Page Start: 1820
• Page End: 1827
• Publication Date: 2015-09
• Subjects: AEC automatic exposure control -- AFB acid fast bacilli -- ATT anti-tubercular therapy -- BAL bronchoalveolar lavage -- CR computed radiography -- CT computed tomography -- DES-DR dual energy subtraction digital radiography -- DR digital radiography -- DTS digital tomosynthesis -- MDCT multidetector computed tomography -- FNAC fine needle aspiration cytology -- TB tuberculosis; Tuberculosis -- Digital tomosynthesis -- Dual-energy subtraction digital radiography -- CT; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2015.05.031
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. Digital tomosynthesis has a sensitivity of 100% in detection of cavities. Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better than DR in detection of nodules, consolidation and cavitation in pulmonary TB. DTS gives better results than DES-DR, particularly in detection of cavitation and has moderate sensitivity for detection of centrilobular nodules. Thus DTS can be used for evaluation of patients of suspected pulmonary TB, thereby giving a more confident diagnosis of active disease and also in follow up.