2021 Volume 36 Issue 4 Pages 516-523
Objective: The purpose of this study was to evaluate the usefulness of dual-energy subtraction (DES) chest X-ray images of soft and bony tissues in improving the detection of lesions and provide patients with clear explanations.
Methods: In the 3 years immediately before and after the introduction of DES, 22,000 and 26,276 patients underwent chest X-ray examination, respectively. We compared the rates of exact examinations requested and cancer detection before and after the introduction of DES. In addition, we surveyed five doctors each for the usefulness of DES in diagnostic and explanatory tasks.
Results: The request rate for a detailed examination increased from 1.92% prior to the introduction of DES to 2.34% post introduction. The cancer detection rate increased from 0.03% to 0.08% post introduction of DES (p<0.05). In the questionnaire for doctors who perform diagnostic reading, all doctors responded that DES was useful as a supporting technique, and 4 out of 5 doctors agreed that DES was useful for explaining the results.
Conclusions: DES imaging of soft and bony tissues improved lesion detection. In addition, DES was useful for improving accuracy, supporting interpretation, and explaining the findings of chest X-ray examinations to patients. As patients can clearly see the lesions on DES images, they may be encouraged to undergo a full examination, and consequently, the cancer detection rate may increase. Moreover, detection of calcifications in the coronary arteries alerts physicians regarding the presence of cardiac disease and is useful in lifestyle guidance.
