Evaluation of the clinical utility of temporal subtraction using bone suppression processing in digital chest radiography

Rationale and objectives: To evaluate the usefulness of temporal subtraction using the bone sup -pression method in digital chest radiography for the detection of pulmonary lesions.Materials and methods: The images of 31 patients with pulmonary lesions and 19 normal cases were included in the study. Conventional and bone suppression temporal subtraction were per-formed in the 50 cases selected and used for an observer performance study. Five radiologists participated in the study, and the differences between using conventional and bone suppression temporal subtraction were assessed using jackknife free-response receiver operating characteristic analysis.Results: The average figure-of-merit values for all radiologists increased significantly using the bone suppression method, from 0.619 (conventional) to 0.696 (p = 0.032). The average sensi-tivity for detecting pulmonary lesions improved from 67.9% to 75.4%, and the average number of false-positive per case decreased from 0.336 to 0.252 using bone suppression temporal subtraction.Conclusion: Bone suppression temporal subtraction processing can assist with the detection of subtle pulmonary lesions in digital chest radiographs.