Imaging features in post-mortem x-ray dark-field chest radiographs and correlation with conventional x-ray and CT.

ABSTRACT:

Background

Although x-ray dark-field imaging has been intensively investigated for lung imaging in different animal models, there is very limited data about imaging features in the human lungs. Therefore, in this work, a reader study on nine post-mortem human chest x-ray dark-field radiographs was performed to evaluate dark-field signal strength in the lungs, intraobserver and interobserver agreement, and image quality and to correlate with findings of conventional x-ray and CT.

Methods

In this prospective work, chest x-ray dark-field radiography with a tube voltage of 70 kVp was performed post-mortem on nine humans (3 females, 6 males, age range 52-88?years). Visual quantification of dark-field and transmission signals in the lungs was performed by three radiologists. Results were compared to findings on conventional x-rays and 256-slice computed tomography. Image quality was evaluated. For ordinal data, median, range, and dot plots with medians and 95% confidence intervals are presented; intraobserver and interobserver agreement were determined using weighted Cohen ?.

Results

Dark-field signal grading showed significant differences between upper and middle (p?=?0.004-0.016, readers 1-3) as well as upper and lower zones (p?=?0.004-0.016, readers 1-2). Median transmission grading was indifferent between all lung regions. Intraobserver and interobserver agreements were substantial to almost perfect for grading of both dark-field (??=?0.793-0.971 and ??=?0.828-0.893) and transmission images (??=?0.790-0.918 and ??=?0.700-0.772). Pulmonary infiltrates correlated with areas of reduced dark-field signal. Image quality was rated good for dark-field images.

Conclusions

Chest x-ray dark-field images provide information of the lungs complementary to conventional x-ray and allow reliable visual quantification of dark-field signal strength.

SUBMITTER: Fingerle AA 

PROVIDER: S-EPMC6620231 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature