Yohsuke Suyama1,2,3, Yoshitake Yamada1,2, Hideki Yamaguchi2, Gou Someya4, Seiji Otsuka4, Yoshitami Murayama2, Hiroshi Shinmoto3, Masahiro Jinzaki1, Kenji Ogawa2. 1. 1 Department of Radiology, Keio University School of Medicine , Shinjuku-ku, Tokyo , Japan. 2. 2 Department of Radiology, Nippon Koukan Hospital , Kawasaki-shi, Kanagawa , Japan. 3. 3 Department of Radiology, National Defense Medical College , Tokorozawa-shi, Saitama , Japan. 4. 4 Department of Gastroenterology and Hepatology, Nippon Koukan Hospital , Kawasaki-shi, Kanagawa , Japan.
Abstract
OBJECTIVE: The diagnostic performance of endoscopic retrograde cholangiography (ERC) with radiography is imperfect. We assessed the value of adding tomosynthesis to ERC with radiography for the detection of choledocholithiasis. METHODS: This study included 102 consecutive patients (choledocholithiasis/non-choledocholithiasis, n = 57/45), who underwent both radiography and tomosynthesis for ERC in the same examination and were not diagnosed with malignancy. The reference standard for the existence of choledocholithiasis was confirmed by endoscopic stone extraction during ERC, intraoperative cholangiography, or follow up with magnetic resonance cholangiopancreatography (n = 78, 11, and 13, respectively). A gastroenterologist and a radiologist independently evaluated the radiographs and the combination of tomosynthesis and radiographic images in a blinded and randomised manner. Receiver operating characteristic analysis was used for statistical analysis. RESULTS: The areas under the receiver operating characteristic curve for combined tomosynthesis and radiography were significantly higher than those for radiography alone for both readers: Reader 1/Reader 2, 0.929/0.956 [95% confidence interval (CI), 0.861-0.965/0.890-0.983) vs 0.803/0.769 (95% confidence interval, 0.707-0.873/0.668-0.846), respectively (p = 0.0047/< 0.0001). CONCLUSION: Adding tomosynthesis to radiography improved the diagnostic performance of ERC for detection of choledocholithiasis. Advances in knowledge: Adding tomosynthesis to radiography improves detection of choledocholithiasis and tomosynthesis images can be obtained easily after radiographs and repeated immediately.
OBJECTIVE: The diagnostic performance of endoscopic retrograde cholangiography (ERC) with radiography is imperfect. We assessed the value of adding tomosynthesis to ERC with radiography for the detection of choledocholithiasis. METHODS: This study included 102 consecutive patients (choledocholithiasis/non-choledocholithiasis, n = 57/45), who underwent both radiography and tomosynthesis for ERC in the same examination and were not diagnosed with malignancy. The reference standard for the existence of choledocholithiasis was confirmed by endoscopic stone extraction during ERC, intraoperative cholangiography, or follow up with magnetic resonance cholangiopancreatography (n = 78, 11, and 13, respectively). A gastroenterologist and a radiologist independently evaluated the radiographs and the combination of tomosynthesis and radiographic images in a blinded and randomised manner. Receiver operating characteristic analysis was used for statistical analysis. RESULTS: The areas under the receiver operating characteristic curve for combined tomosynthesis and radiography were significantly higher than those for radiography alone for both readers: Reader 1/Reader 2, 0.929/0.956 [95% confidence interval (CI), 0.861-0.965/0.890-0.983) vs 0.803/0.769 (95% confidence interval, 0.707-0.873/0.668-0.846), respectively (p = 0.0047/< 0.0001). CONCLUSION: Adding tomosynthesis to radiography improved the diagnostic performance of ERC for detection of choledocholithiasis. Advances in knowledge: Adding tomosynthesis to radiography improves detection of choledocholithiasis and tomosynthesis images can be obtained easily after radiographs and repeated immediately.
Authors: K N Jamal; H Smith; K Ratnasingham; M R Siddiqui; G McLachlan; A P Belgaumkar Journal: Ann R Coll Surg Engl Date: 2016-04 Impact factor: 1.891
Authors: W H Schreurs; J R Juttmann; W N H M Stuifbergen; H J M Oostvogel; T J M V van Vroonhoven Journal: Surg Endosc Date: 2002-05-03 Impact factor: 4.584
Authors: M Tanaka; S Takahata; H Konomi; H Matsunaga; K Yokohata; T Takeda; N Utsunomiya; S Ikeda Journal: Gastrointest Endosc Date: 1998-11 Impact factor: 9.427