Journal Article

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

Fingerle, Alexander A., Gromann, Lukas B., Haller, Bernhard, Pfeiffer, Franz, Noichl, Wolfgang, Kriner, Fabian, Herzen, Julia, De Marco, Fabio, Maack, Hanns-Ingo, Meurer, Felix, Noël, Peter B., Rummeny, Ernst J., Braun, Christian, Fischer, Florian, Andrejewski, Jana, Sauter, Andreas P., Pralow, Thomas, Koehler, Thomas, Willer, Konstantin, Pfeiffer, Daniela, Deniffel, Dominik

2019

Overview

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 κ . 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 ( κ  = 0.793–0.971 and κ  = 0.828–0.893) and transmission images ( κ  = 0.790–0.918 and κ  = 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.

• Publisher: Springer International Publishing,Springer Nature B.V,SpringerOpen
• Subject: Diagnostic Radiology / Imaging / Internal Medicine / Interventional Radiology / Lung / Lungs / Medical imaging / Medicine / Medicine & Public Health / Neuroradiology / Observer variation / Original / Original Article / Radiography (thoracic) / Radiology / Tomography (x-ray computed) / Ultrasound / X-ray dark-field imaging / X-rays