Purpose:

When performing chest radiography, a decision needs to be taken on all thoracic bone-tissue and bronchovascular markers by examining a two dimensional plane. The aim of this study was to investigate whether topogram-based assessment is equivalent to digital radiography. If so, it may be possible to continue to the exam by ultra low dose computed tomography (CT) or finish it. May the direct radiography would still be necessary if so...

Materials and Methods:

100 cases were included in this study. Digital antero-posterior chest radiographies and thoracic CT images (meadiastinal and parenchymal windows) taken using ultra low dose, two-tube CT scan were available for the cases. These diagnosis of the cases was based on epicrisis. The diagnosis and CT scans were considered gold standard and chest radiographies and CT topogram findings were evaluated by two independent radiology experts. For benign (hematoma, fibrous nodule and calcified nodule) and metastatic nodules, lesions with a diameter smaller and greater than 1 cm were evaluated separately. For both tests, the radiographs and CT topograms were labeled as positive (p) and negative (n) depending on the presence and absence, respectively, of the pathological abnormality. Statistical analysis was undertaken accordingly.

Results:

While topogram findings were superior in cases of bronchiectasis, for benign and malignant nodules larger than 1 cm and for malignant nodules smaller than 1 cm, both topogram and digital chest radiography detected lesions with similar efficiency. Neither of the two methods detected ground glass opacities. For all other pathologies, information obtained via digital chest radiography was significantly superior to that obtained via topogram.

Conclusion:

For the advanced evaluation of pulmonary pathologies, despite the fact that CT technologies are well developed, digital radiographies taken prior to topogram are not unnecessary and will possibly be used forever. While they provide similar images, for most of the important pulmonary or thoracic pathologies except bronchiectasis, digital chest radiography provides information similar or more frequently superior to topogram.

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