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Improved Detection of Lung Nodules by Using a Temporal Subtraction Technique¹

¹ From the Department of Radiology, University of Occupational and Environmental Health School of Medicine, Iseigaoka 1-1, Yahatanisi-ku, Kitakyushu-shi 807-8555, Japan (S. Kakeda, K.N., K.K., H.W., H.N.); Research Center, Nippon Bunri University, Ooita-shi, Japan (S. Katsuragawa); and Kurt Rossmann Laboratories for Radiologic Image Research, Department of Radiology, University of Chicago, Ill (K.D.). Received August 17, 2001; revision requested May 10; final revision received January 8, 2002; accepted January 29. Address correspondence to S. Kakeda (e-mail: kakeda@med.uoeh-u.ac.jp).

PURPOSE: To evaluate the effect of a temporal subtraction technique for digital chest radiography with regard to the accuracy of detection of lung nodules.

MATERIALS AND METHODS: Twenty solitary lung nodules smaller than 30 mm in diameter, including 10 lung cancers and 10 benign nodules, were used. The nodules were grouped subjectively according to their subtlety. For nonnodular cases, 20 nodules without perceptible interval changes were selected. All chest radiographs were obtained by using a computed radiographic system, and temporal subtraction images were produced by using a program developed at the University of Chicago. The effect of the temporal subtraction image was evaluated by using an observer performance study, with use of receiver operating characteristic analysis.

RESULTS: Observer performance with temporal subtraction images was substantially improved (A_z = 0.980 and 0.958), as compared with that without temporal subtraction images (A_z = 0.920 and 0.825) for the certified radiologists and radiology residents, respectively. The temporal subtraction technique clearly improved diagnostic accuracy for detecting lung nodules, especially subtle cases.

CONCLUSION: The temporal subtraction technique is useful for improving detection accuracy for peripheral lung nodules on digital chest radiographs.

© RSNA, 2002

Index terms: Diagnostic radiography, observer performance • Diagnostic radiology, 60.1215 • Lung, abnormalities, 60.31, 60.3211, 60.3212, 60.3213 • Lung neoplasms, diagnosis, 60.1215, 60.31, 60.3211, 60.3212, 60.3213 • Subtraction, digital, 60.1215

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