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Comparative Study
. 2016 Aug 22;16(1):48.
doi: 10.1186/s12880-016-0155-7.

Color radiography in lung nodule detection and characterization: comparison with conventional gray scale radiography

Inyoung Song  1 , Jeong Geun Yi  1 , Jeong Hee Park  1 , Kyung Soo Lee  2 , Myung Jin Chung  3   4
Affiliations
Comparative Study

Color radiography in lung nodule detection and characterization: comparison with conventional gray scale radiography

Inyoung Song et al. BMC Med Imaging. .

Abstract

Background: To compare the capability of lung nodule detection and characterization between dual-energy radiography with color-representation (DCR) and conventional gray scale chest radiography (GSR).

Methods: A total of 130 paired chest radiographs (DCR and GSR) obtained from 65 patients (14 with normal scans and 51 with pulmonary nodules) were evaluated. After analysis, 45 non-calcified and 21 calcified nodules were identified. DCR was obtained by adding color space within material-decomposed data (blue for high attenuation and red for low attenuation) and by compounding the manipulated data to one color image. Three radiologists marked suggested nodules on radiographic images and assessed the level of confidence of lesion presence and probability of nodule calcification by using a nine-point rating scale. The jackknife active free-response receiver operating characteristics (JAFROC) analysis was used to evaluate lesion detectability, and multi-reader multi-case receiver operating characteristics (MRMC ROC) analysis was used for the evaluation of the accuracy of nodule calcification prediction.

Results: Figures of merit (FOM) from JAFROC was 0.807 for DCR and 0.811 for GSR, respectively; nodule detectability was not significantly different between DCR and GSR (p = 0.93). Areas under curve (AUC) from MRMC ROC were 0.944 for DCR and 0.828 for GSR, respectively; performance of DCR in predicting lung nodule calcification was significantly higher than that of GSR (p = 0.04).

Conclusions: DCR showed similar performance in terms of lung nodule detection compared with GSR. However, DCR does provide a significant benefit in predicting the presence of nodule calcification.

Keywords: Color radiography; Dual-energy subtraction radiography; Radiography.

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Figures

Fig 1
Fig 1
Conventional gray scale radiography (GSR) and dual-energy radiography with color-representation (DCR) of a 60-year-old woman. a Conventional GSR image shows a nodular opacity in right lower lung zone (arrow). b DCR image shows distinct blue color of the nodular opacity (arrow) indicating calcified nodule. c Axial CT image shows a calcified granuloma in the right lower lobe (arrow)
Fig 2
Fig 2
Conventional gray scale radiography (GSR) and dual-energy radiography with color-representation (DCR) of a 34-year-old man. a Conventional GSR image shows a nodular opacity in right lower lung zone (arrow). b DCR image shows distinct pink color of the nodular opacity (arrow) indicating non-calcified nodule. c Axial CT image shows a non-calcified nodule in the right lower lobe (arrow). This nodule was pathologically proved to be a sclerosing hemangioma
Fig 3
Fig 3
Average free-response ROC curves for nodule detectability on dual-energy radiography with color-representation (DCR) and conventional gray scale radiography (GSR) images by each observer. FPF false positive fraction, LLF lesion localization fraction
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