Digital Tomosynthesis: Applications in General Radiography

AimDigital tomosynthesis (DT) is a novel imaging modality that has yet to be adopted widespread in Australia, but has potential toenhance patient outcomes both in diagnosis and reducing radiation dose. A review of the literature was performed to develop anintroduction to digital tomosynthesis, and identify its uses and viability in general radiography.MethodsScopus, Ovid, MEDLINE and PubMed were utilised initially to identify literature published within 5-years, using several searchterms linked with AND and OR. Articles were assessed according to specific guidelines, and categorised. Journal databases, medicalimaging vendor websites, and article references were also evaluated for relevant information.ResultsBased 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 paneldetector. The data is reconstructed to produce multiple slices in the acquisition plane, providing limited depth resolution in a radiographicsetting, at a substantially lower dose to computerized tomography (CT) examinations. It’s use has been highlighted inorthopaedic 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 lungnodules, nephrolithiasis and deterioration of arthritic conditions.ConclusionAt a lower cost to CT, digital tomosynthesis has the potential to become a bridging modality from radiography to both save patientdose and reduce their overall waiting times. However, more large-scale studies are required to confirm this.