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Dual-energy subtraction imaging for diagnosing vocal cord paralysis with flat panel detector radiography.

Machida H, Yoda K, Arai Y, Nishida S, Masukawa A, Asanuma M, Yuhara T, Morita S, Suzuki K, Ueno E, Sabol JM - Korean J Radiol (2010)

Bottom Line: Sensitivity by DES was 75%, whereas the specificity was 96%.The diagnostic accuracy by DES was significantly superior (kappa = 0.60, AUC = 0.909) to that by conventional technique (kappa = 0.18, AUC = 0.852) (p = 0.038).Dual energy subtraction is a superior method compared to the conventional FPD radiography for delineating the vocal cord and accurately diagnosing vocal cord paralysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, Japan. machira@dnh.twmu.ac.jp

ABSTRACT

Objective: To investigate the clinical feasibility of dual energy subtraction (DES) imaging to improve the delineation of the vocal cord and diagnostic accuracy of vocal cord paralysis as compared with the anterior-posterior view of flat panel detector (FPD) neck radiography.

Materials and methods: For 122 consecutive patients who underwent both a flexible laryngoscopy and conventional/DES FPD radiography, three blinded readers retrospectively graded the radiographs during phonation and inspiration on a scale of 1 (poor) to 5 (excellent) for the delineation of the vocal cord, and in consensus, reviewed the diagnostic accuracy of vocal cord paralysis employing the laryngoscopy as the reference. We compared vocal cord delineation scores and accuracy of vocal cord paralysis diagnosis by both conventional and DES techniques using kappa statistics and assessing the area under the receiver operating characteristic curve (AUC).

Results: Vocal cord delineation scores by DES (mean, 4.2 +/- 0.4) were significantly higher than those by conventional imaging (mean, 3.3 +/- 0.5) (p < 0.0001). Sensitivity for diagnosing vocal cord paralysis by the conventional technique was 25%, whereas the specificity was 94%. Sensitivity by DES was 75%, whereas the specificity was 96%. The diagnostic accuracy by DES was significantly superior (kappa = 0.60, AUC = 0.909) to that by conventional technique (kappa = 0.18, AUC = 0.852) (p = 0.038).

Conclusion: Dual energy subtraction is a superior method compared to the conventional FPD radiography for delineating the vocal cord and accurately diagnosing vocal cord paralysis.

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Related in: MedlinePlus

75-year-old man with left vocal cord paralysis. Delineation of vocal cord with dual energy subtraction (all readers grade 5) was rated higher than by conventional technique (grades 2, 2, and 3) by three readers. Left vocal cord (arrows) was fixed more definitely at midline on soft-tissue only image during inspiration using dual energy subtraction method. DES = dual energy subtraction
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Figure 3: 75-year-old man with left vocal cord paralysis. Delineation of vocal cord with dual energy subtraction (all readers grade 5) was rated higher than by conventional technique (grades 2, 2, and 3) by three readers. Left vocal cord (arrows) was fixed more definitely at midline on soft-tissue only image during inspiration using dual energy subtraction method. DES = dual energy subtraction

Mentions: We present two illustrative cases from the present study that the DES technique was useful for diagnosing vocal cord paralysis (Figs. 3, 4). We also present each representative false positive and false negative case of DES laryngeal radiography (Figs. 5, 6).


Dual-energy subtraction imaging for diagnosing vocal cord paralysis with flat panel detector radiography.

Machida H, Yoda K, Arai Y, Nishida S, Masukawa A, Asanuma M, Yuhara T, Morita S, Suzuki K, Ueno E, Sabol JM - Korean J Radiol (2010)

75-year-old man with left vocal cord paralysis. Delineation of vocal cord with dual energy subtraction (all readers grade 5) was rated higher than by conventional technique (grades 2, 2, and 3) by three readers. Left vocal cord (arrows) was fixed more definitely at midline on soft-tissue only image during inspiration using dual energy subtraction method. DES = dual energy subtraction
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864859&req=5

Figure 3: 75-year-old man with left vocal cord paralysis. Delineation of vocal cord with dual energy subtraction (all readers grade 5) was rated higher than by conventional technique (grades 2, 2, and 3) by three readers. Left vocal cord (arrows) was fixed more definitely at midline on soft-tissue only image during inspiration using dual energy subtraction method. DES = dual energy subtraction
Mentions: We present two illustrative cases from the present study that the DES technique was useful for diagnosing vocal cord paralysis (Figs. 3, 4). We also present each representative false positive and false negative case of DES laryngeal radiography (Figs. 5, 6).

Bottom Line: Sensitivity by DES was 75%, whereas the specificity was 96%.The diagnostic accuracy by DES was significantly superior (kappa = 0.60, AUC = 0.909) to that by conventional technique (kappa = 0.18, AUC = 0.852) (p = 0.038).Dual energy subtraction is a superior method compared to the conventional FPD radiography for delineating the vocal cord and accurately diagnosing vocal cord paralysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, Japan. machira@dnh.twmu.ac.jp

ABSTRACT

Objective: To investigate the clinical feasibility of dual energy subtraction (DES) imaging to improve the delineation of the vocal cord and diagnostic accuracy of vocal cord paralysis as compared with the anterior-posterior view of flat panel detector (FPD) neck radiography.

Materials and methods: For 122 consecutive patients who underwent both a flexible laryngoscopy and conventional/DES FPD radiography, three blinded readers retrospectively graded the radiographs during phonation and inspiration on a scale of 1 (poor) to 5 (excellent) for the delineation of the vocal cord, and in consensus, reviewed the diagnostic accuracy of vocal cord paralysis employing the laryngoscopy as the reference. We compared vocal cord delineation scores and accuracy of vocal cord paralysis diagnosis by both conventional and DES techniques using kappa statistics and assessing the area under the receiver operating characteristic curve (AUC).

Results: Vocal cord delineation scores by DES (mean, 4.2 +/- 0.4) were significantly higher than those by conventional imaging (mean, 3.3 +/- 0.5) (p < 0.0001). Sensitivity for diagnosing vocal cord paralysis by the conventional technique was 25%, whereas the specificity was 94%. Sensitivity by DES was 75%, whereas the specificity was 96%. The diagnostic accuracy by DES was significantly superior (kappa = 0.60, AUC = 0.909) to that by conventional technique (kappa = 0.18, AUC = 0.852) (p = 0.038).

Conclusion: Dual energy subtraction is a superior method compared to the conventional FPD radiography for delineating the vocal cord and accurately diagnosing vocal cord paralysis.

Show MeSH
Related in: MedlinePlus