@article{hbkup:/content/journals/10.5339/qmj.2019.9, author = "Gezer, Mehmet Can and Algin, Oktay and Durmaz, Aytac and Arslan, Halil", title = "Efficiency and reporting confidence analysis of sequential dual-energy subtraction for thoracic x-ray examinations", journal= "Qatar Medical Journal", year = "2019", volume = "2019", number = "1", pages = "", doi = "https://doi.org/10.5339/qmj.2019.9", url = "https://www.qscience.com/content/journals/10.5339/qmj.2019.9", publisher = "Hamad bin Khalifa University Press (HBKU Press)", issn = "2227-0426", type = "Journal Article", keywords = "Direct digital radiography", keywords = "dose", keywords = "chest radiography", keywords = "dual-energy subtraction", keywords = "computed tomography", keywords = "thorax", eid = "9", abstract = "Rationale and objectives: We aimed to report and compare accuracy, reproducibility, and reporting confidence between thoracic dual-energy subtraction (DES) and routine posterior–anterior chest radiography (PA-CR) techniques. Materials (patients) and methods: We obtained DES (D1–D4) images from 96 patients using DES and a high-resolution dynamic flat-panel detector in combination. We compared the DES images of these patients with their PA-CR images. The maximum time interval between performing DES and PA-CR was nine weeks. Two radiologists evaluated abnormal findings on DES and PA-CR images using a three-point scale, and reporting confidence was scored using a four-point scale. The intra- and interobserver agreement values of the scores were analyzed. Further, the radiation exposure doses during PA-CR and DES acquisitions were calculated. Results: The intra- and interobserver agreement values of PA-CR and DES images were good. The reporting confidence scores for DES were generally higher than those for PA-CR. Between bone-subtracted (D3) and soft-tissue-subtracted (D4) images, the former was more successful and useful in the evaluation of bone structures, whereas the latter was better in the evaluation of consolidation and/or solitary nodules. Conclusions: DES has the potential to improve the accuracy, reproducibility, and reporting confidence of thoracic radiography. It also has the potential to provide a better diagnosis of chest pathologies using relatively low dose radiation.", }