HOW dual-energy x-ray can help visualize lung tumors
The DE subtraction technique has superior sensitivity and aids in detecting any soft tissue abnormalities in the lungs. In fact, the 2013 study showed that DE imaging enhanced localization of lung tumors on 95% of the DE images
Reveal™ 35C’s detective quantum efficiency (DQE) is as high as 75%, and this higher DQE requires less
radiation to produce a better image. DE imaging showed improvement in the 2013 study by an average factor
of 4.7 compared to conventional X-rays without increasing image acquisition dose.
Read the blog post below for a summary of the article.
Lung cancer is the most commonly occurring cancer in the world, and the leading cause of malignancy-related deaths2. In the United States, lung cancer accounts for 13% of all cancer diagnoses, but 22% of all cancer deaths1.
In the US, approximately 154,000 lives are lost, and 228,000 people are diagnosed with lung cancer every year. Only 21% of those that are diagnosed survive five years or more1.
The process of diagnosis often includes X-ray and computed tomography (CT) to scan for abnormalities and masses, followed by biopsies and other testing to target therapy. There are many treatments available such as surgery, chemotherapy, and radiation therapy.
Diagnosis is often made only at advanced tumor stages due to the lack of visibility of many small growths. It is of the utmost importance to find lung cancer sooner so it can be treated more effectively in the future.
Tumors also need to be visualized to determine the treatment needed, and often must be localized multiple times throughout treatment, like in kV-based image-guided radiation.
The first known study on comparing dual-energy (DE) imaging to conventional X-ray imaging in terms of tumor visibility for patients undergoing this therapy (in 2013), showed that DE can play an important role3, and is a better solution than conventional X-ray.
Reveal 35C is KA Imaging’s portable dual-energy X-ray detector that can be a great option for localization of lung tumors to assist the process of radiotherapy treatment of lung cancer.
Here are some reasons why:
1. The DE subtraction technique has superior sensitivity and aids in detecting any soft tissue abnormalities in the lungs. In fact, the 2013 study showed that DE imaging enhanced localization of lung tumors on 95% of the DE images3.
2. Reveal’s Detective Quantum Efficiency (DQE) is as high as 75%, and this higher DQE requires less radiation to produce a better image. DE imaging showed improvement in the 2013 study by an average factor of 4.7 compared to conventional X-rays without increasing image acquisition dose3.
3. Reveal provides a high-quality conventional X-ray image, a bone-subtracted image, and a tissue-subtracted one in one shot. The unique triple-stacked layer design allows for easy integration and high quantum efficiency. The bone subtraction image could aid in the visualization of previously unseen small tumors. This study showed that DE subtraction resulted in the complete disappearance of overlying bone in 100% of the images3.
4. Only 12% of these images in the study had some motion artifacts3. The streaks that occur due to unavoidable motion, such as a human heartbeat, can invalidate images and mislead radiologists. This study noted that motion artifacts could be significantly reduced if a faster kV switching generator were used. Reveal could be an ideal alternative to kV switching techniques due to a single exposure detector design that entirely eliminates motion artifacts. This is only possible because Reveal’s multi-layer detector design obtains all images in a single exposure, unlike kV switching which requires a second exposure to obtain dual energy images.
Dual-energy subtraction could be a good solution to the shortcomings of accurate soft tissue visualization in conventional X-ray for the process of lung tumor localization during treatments for patients with lung cancer. DE images have been shown to produce clearer soft tissue (bone subtracted) images thus enabling better tumor visualization. KA Imaging’s dual-energy solution Reveal 35C is motion artifact free, portable, and completely retrofittable for any existing X-ray imaging infrastructure.
References
- Lung Cancer Statistics. LUNGevity. Lung Cancer Statistics | LUNGevity Foundation
- Lung Cancer Statistics. World Cancer Research Fund, American Institute for Cancer Research. Lung cancer statistics | World Cancer Research Fund (wcrf.org)
- Sherertz, T., Hoggarth, M., et al. (Aug. 30, 2013). Prospective Evaluation of Dual-Energy Imaging in Patients Undergoing Image Guided Radiation Therapy for Lung Cancer: Initial Clinical Results. International Journal of Radiation Oncology
- Tumors of the Lung. Radiology Key – Fastest Radiology Insight Engine. Tumors of the Lung | Radiology Key
- 30 Facts about Lung Cancer. Healthline. 30 Lung Cancer Facts: Statistics and (healthline.com)
