By Brian Casey, staff writer
    November 13, 2012

    This year's presentations on digital x-ray at RSNA 2012 illustrate the rapid advances being made in this modality. Radiography's conversion to digital is making possible the use of advanced image-processing tools once reserved for more advanced modalities, raising the possibility of better patient care at lower radiation doses.

    Some of the most exciting presentations to be given at McCormick Place later this month will cover tools such as digital tomosynthesis. Researchers are looking to position the technology in a gatekeeper role between standard radiography and CT for working up suspicious lesions found on chest x-rays.

    Digital tomosynthesis will be discussed in a poster presentation on Wednesday at 5:30 p.m. (LL-CHS-WE1D, Lakeside Learning Center), and the basics of tomo for orthopedic applications will be covered in another educational poster (LL-MKE4552). Also, a scientific session will discuss the use of tomosynthesis as a replacement for kidney, ureter, and bladder radiography in patients with suspected urolithiasis (Monday, November 26, 10:40 a.m.-10:50 a.m., SSC14-02, Room S403A).

    Computer-aided detection (CAD) is another exciting new technology. Look for a Tuesday session on how CAD improved the yield of tuberculosis screening in Africa (3:00 p.m.-3:10 p.m., SSJ05-01, Room S404CD), as well as a Wednesday talk on how CAD improved the accuracy of images processed with a bone suppression algorithm (10:30 a.m.-10:40 a.m., SSK03-01, Room S404CD).

    Road to RSNA 2012: Digital X-Ray Preview While we're on the subject of rib suppression, be sure to note a Monday talk on the use of the technique for chest imaging (10:30 a.m.-10:40 a.m., SSC14-01, Room S403A).

    Meanwhile, radiography utilization comes under the microscope of physician self-referral researchers Dr. David C. Levin and Dr. Vijay Rao of Thomas Jefferson University. They analyzed radiography utilization in the Medicare system, finding that growth in volume peaked in 2005 and since then has fallen -- similar to other modalities. Unlike other modalities, they found little evidence of physician self-referral in x-ray. Be sure to check out this poster on Thursday at 12:15 p.m. in the Lakeside Learning Center (LL-HPS-TH2A).

    Don't forget about dose reduction, always an important topic. Duke University researchers will discuss their use of a new technique for estimating radiation dose in a Monday poster presentation (12:15 p.m.-12:45 p.m., LL-PDS-MO2A, Lakeside Learning Center), while also on Monday, Arkansas researchers will demonstrate how DR can lead to lower dose levels for children (12:15 p.m.-12:45 p.m., LL-PDS-MO3A, Lakeside Learning Center).

    Also, researchers from Philips Healthcare will show how they were able to reduce dose by using a lower tube voltage in a Monday evening poster (5:30 p.m.-6:00 p.m., LL-PHS-MO1D, Lakeside Learning Center), while a Carestream Health team will present their own solution for lower dose in pediatric neonatal studies on Tuesday (3:15 p.m.-3:25 p.m., VSPD32-02, Room S102AB).

    In refresher courses worth noting, be sure to check out a Tuesday afternoon session entitled "Common Problems in Thoracic Imaging" (4:30 p.m.-6:00 p.m., RC401, Room S406B), and a Thursday afternoon minicourse that includes a presentation on implementing and managing a computed radiography quality assurance program (4:30 p.m.-6:00 p.m., RC723, Room E351).

    Also be sure not to miss a Thursday afternoon session on digital radiography image processing for technologists (1:00 p.m.-2:00 p.m., MSRT54, Room N230), as well as a poster presentation on "optical illusions" in radiographs that can challenge radiologists (LL-CHE2319, Lakeside Learning Center).

    Finally, check out a poster on how and why dual-energy digital subtraction should be used (LL-CHE2366, Lakeside Learning Center).

    See below for previews of digital x-ray-related scientific papers and posters at this year's RSNA meeting. To view the RSNA's listing of abstracts for this year's scientific and educational program, click here.

    Scientific and Educational Presentations
    CT beats radiography for assessing spondyloarthritis
    Sunday, November 25 | 11:45 a.m.-11:55 a.m. | SSA14-07 | Room E451B
    CT is better than radiography for assessing the sacroiliac joints in patients with spondyloarthritis, Canadian researchers confirmed, and CT-based criteria should be developed for guiding therapy of these individuals.
    Rib suppression algorithm enables better chest x-ray imaging
    Monday, November 26 | 10:30 a.m.-10:40 a.m. | SSC14-01 | Room S403A
    The increasing use of digital radiography has given rise to a host of image processing techniques that can improve image quality and reduce dose. In this Monday morning presentation, researchers report on one such algorithm, which suppresses contrast from the ribs to enable the use of a more optimal imaging protocol.
    Digital tomosynthesis may be alternative to KUB urolithiasis
    Monday, November 26 | 10:40 a.m.-10:50 a.m. | SSC14-02 | Room S403A
    Digital tomosynthesis could be a better alternative than conventional kidney, ureter, and bladder (KUB) radiography or unenhanced CT for detecting urinary stones, according to this presentation by Chinese researchers.
    Digital tomosynthesis a good option for paranasal sinusitis
    Monday, November 26 | 11:20 a.m.-11:30 a.m. | SSC14-06 | Room S403A
    The clinical applications for digital tomosynthesis have been growing steadily, and Japanese researchers believe that sinus imaging should be added to the list.
    Technique estimates pediatric dose for DR studies
    Monday, November 26 | 12:15 p.m.-12:45 p.m. | LL-PDS-MO2A | Lakeside Learning Center
    Heightened concern over radiation dose has led to the development of new methods for calculating and reporting dose delivered to patients during imaging exams. Most of the attention has focused on CT -- but what about digital radiography (DR)?
    DR, 320-detector-row CT cut dose in pediatric studies
    Monday, November 26 | 12:15 p.m.-12:45 p.m. | LL-PDS-MO3A | Lakeside Learning Center
    In this lunchtime poster presentation, researchers from the University of Arkansas for Medical Sciences will demonstrate the results of their investigation into lower radiation doses possible for pediatric imaging with two technologies, digital radiography (DR) and 320-detector-row CT.
    Lower DR tube voltage reduces dose while preserving image contrast
    Monday, November 26 | 5:30 p.m.-6:00 p.m. | LL-PHS-MO1D | Lakeside Learning Center
    In this Monday evening poster presentation, researchers from Philips Healthcare will discuss their use of a lower tube voltage to reduce dose in digital radiography (DR) while maintaining a high contrast-to-noise ratio.
    Adding CAD improves tuberculosis x-ray screening in Africa
    Tuesday, November 27 | 3:00 p.m.-3:10 p.m. | SSJ05-01 | Room S404CD
    In this presentation, Dutch researchers will describe how using a computer-aided detection (CAD) algorithm to help interpret digital chest x-ray studies contributed to modest improvement in reader performance.
    Radiation dose can be reduced for neonatal chest radiography
    Tuesday, November 27 | 3:15 p.m.-3:25 p.m. | VSPD32-02 | Room S102AB
    In this scientific presentation, researchers from Carestream Health will share how task-specific techniques can be employed that would promote dose reduction in pediatric imaging in digital radiography (DR) without negatively influencing diagnostic image quality.
    CAD boosts accuracy for lung nodules in bone-suppressed images
    Wednesday, November 28 | 10:30 a.m.-10:40 p.m. | SSK03-01 | Room S404CD
    In this session, researchers will examine two relatively new image-processing technologies, computer-aided detection (CAD) and bone suppression imaging, for their impact on radiologist accuracy for detecting pulmonary nodules.
    Portable wireless DR beats CR for some clinical tasks
    Wednesday, November 28 | 11:20 a.m.-11:30 a.m. | SSK03-06 | Room S404CD
    The incorporation of wireless digital radiography (DR) detectors into portable x-ray systems has brought major workflow advantages to radiology departments compared to computed radiography (CR). But does wireless portable DR also have an image quality advantage?
    DQE can be measured in the clinical environment
    Wednesday, November 28 | 3:40 p.m.-3:50 p.m. | SSM18-05 | Room S403A
    In this presentation, representatives from a Canadian start-up firm will demonstrate their tool for measuring detective quantum efficiency (DQE) of digital x-ray systems in the clinical environment.
    Bone suppression DR improves lung nodule detection
    Wednesday, November 28 | 5:00 p.m.-5:30 p.m. | LL-CHS-WE1C | Lakeside Learning Center
    Dutch researchers will demonstrate in this poster presentation how the use of bone suppression image processing can improve radiologist performance in detecting solitary pulmonary nodules with digital radiography (DR).
    Digital tomosynthesis IDs chest lesions, avoids need for CT
    Wednesday, November 28 | 5:30 p.m.-6:00 p.m. | LL-CHS-WE1D | Lakeside Learning Center
    In this poster presentation, Italian researchers will describe how they use digital tomosynthesis to characterize suspicious chest lesions, avoiding the use of CT and sparing patients radiation dose.
    Ultralow-dose CT matches chest radiography radiation dose
    Thursday, November 29 | 11:20 a.m.-11:30 a.m. | SSQ03-06 | Room S405AB
    Recent advances in iterative reconstruction have put CT radiation doses within range of those found in chest radiography. So is ultralow-dose CT a realistic alternative to x-ray for chest studies? Researchers from Rikshospitalet at the University of Oslo wanted to find out.
    Chest x-ray use remains stable despite growth in advanced imaging
    Thursday, November 29 | 12:15 p.m.-12:45 p.m. | LL-HPS-TH2A | Lakeside Learning Center
    Use of basic chest radiography has remained relatively unchanged over the past decade, despite wide fluctuations in procedure volume for more advanced imaging modalities such as CT and MRI, according to a group from Thomas Jefferson University.
    Dual-energy x-ray detects cardiac calcifications
    LL-CHE2351 | Lakeside Learning Center
    In this poster presentation, researchers from University Hospitals in Cleveland will discuss their use of dual-energy subtraction to detect signs of cardiovascular disease that might not show up on standard chest x-rays.
    Poster offers overview of dual-energy subtraction DR
    LL-CHE2366 | Lakeside Learning Center
    In this poster, a team from the University of Washington will provide an overview of dual-energy subtraction, a relatively new digital radiography (DR) technique.
    Digital tomosynthesis a good option for orthopedic exams
    LL-MKE4552 | Lakeside Learning Center
    In this poster presentation, Japanese researchers will describe the basic principles of digital tomosynthesis radiography for orthopedic applications.