Dark-Field Chest Radiography for Pneumothorax Detection: A Prospective Study.

Gassert, Florian T; Bast, Henriette; Urban, Theresa; Schick, Rafael; Lochschmidt, Maximilian E; Kaster, Lennard; Koehler, Thomas; Karrer, Alexandra; Keppler, Ariane; Steinhardt, Manuel; Marka, Alexander W; Steinhelfer, Lisa; Sauter, Andreas P; Makowski, Marcus R; Pfeiffer, Franz; Pfeiffer, Daniela

doi:10.1148/ryct.240560

journal article

Titel:: Dark-Field Chest Radiography for Pneumothorax Detection: A Prospective Study.
Dokumenttyp:: Journal Article
Autor(en):: Gassert, Florian T; Bast, Henriette; Urban, Theresa; Schick, Rafael; Lochschmidt, Maximilian E; Kaster, Lennard; Koehler, Thomas; Karrer, Alexandra; Keppler, Ariane; Steinhardt, Manuel; Marka, Alexander W; Steinhelfer, Lisa; Sauter, Andreas P; Makowski, Marcus R; Pfeiffer, Franz; Pfeiffer, Daniela
Abstract:: Purpose To evaluate the potential of dark-field chest radiography to improve the detection and assessment of pneumothorax. Materials and Methods This prospective study was conducted between March 2022 and September 2023. Participants with or without pneumothorax underwent chest radiography using a prototype system that acquires attenuation-based and dark-field images simultaneously. Five blinded readers independently assessed attenuation-only radiographs and then, after a 4-week interval, assessed dark-field overlay images. Sensitivity, specificity, accuracy, reading time, and diagnostic confidence for pneumothorax detection were compared between the two approaches using appropriate statistical tests. Results The sample included 100 participants (median age, 62 years; IQR, 52-71 years; 61 male participants), including 36 individuals with clinically confirmed pneumothorax and 64 healthy controls. A nonsignificant increase in sensitivity for pneumothorax detection was observed with dark-field overlays (87.4% [95% CI: 67.5, 95.8]) compared with attenuation-based radiographs (84.2% [95% CI: 73.2, 91.2], P = .61), whereas specificity was nearly identical (97.6% [95% CI: 94.0, 99.1] vs 97.5 [95% CI: 95.7, 98.6], P = .89). The median reading time decreased from 30.8 seconds to 10.3 seconds (P < .001), and diagnostic confidence improved across all readers (median score: 3 vs 4; P < .001). Conclusion The addition of dark-field radiography to conventional chest radiography improves pneumothorax detection, substantially reduces reading time, and enhances diagnostic confidence without loss of sensitivity and specificity. Keywords: Pneumothorax, Radiography, Dark-Field © RSNA, 2025.
Zeitschriftentitel:: Radiol Cardiothorac Imaging
Jahr:: 2025
Band / Volume:: 7
Heft / Issue:: 6
Volltext / DOI:: doi:10.1148/ryct.240560
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/41410570
TUM Einrichtung:: Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski)2025

mediaTUM Gesamtbestand Hochschulbibliographie 2025 Schools TUM School of Medicine and Health Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski)