Digital Tomosynthesis: Applications in General Radiography

*Corresponding author: Samantha Yew* and Euclid Seeram

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systematic review

Abstract

Aim

Digital tomosynthesis (DT) is a novel imaging modality that has yet to be adopted widespread in Australia, but has potential to enhance patient outcomes both in diagnosis and reducing radiation dose. A review of the literature was performed to develop an introduction to digital tomosynthesis, and identify its uses and viability in general radiography.

Methods

Scopus, Ovid, MEDLINE and PubMed were utilised initially to identify literature published within 5-years, using several search terms linked with AND and OR. Articles were assessed according to specific guidelines, and categorised. Journal databases, medical imaging vendor websites, and article references were also evaluated for relevant information.

Results

Based on tomography, digital tomosynthesis is offered as an add-on to general radiographic equipment from general electric (GE), ShimadzuTM and Fujifilm. It’s technology involves a sweep of the X-ray tube over a limited angle onto a stationary flat panel detector. The data is reconstructed to produce multiple slices in the acquisition plane, providing limited depth resolution in a radiographic setting, at a substantially lower dose to computerized tomography (CT) examinations. It’s use has been highlighted in orthopaedic imaging, in detecting occult fractures when radiography has ambiguous results. Additional uses are mainly in surveillance; digital tomosynthesis has higher sensitivity and similar specificity to radiography, and thus can be used to monitor solid lung nodules, nephrolithiasis and deterioration of arthritic conditions.

Conclusion

At a lower cost to CT, digital tomosynthesis has the potential to become a bridging modality from radiography to both save patient dose and reduce their overall waiting times. However, more large-scale studies are required to confirm this.

Keywords

Digital tomosynthesis (DT); Radiography; Medical imaging; Emerging imaging; Whole body imaging; Tomosynthesis; Future prospects.