Imaging features in post-mortem x-ray dark-field chest radiographs and correlation with conventional x-ray and CT

Alexander A. Fingerle, Fabio De Marco, Jana Andrejewski, Konstantin Willer, Lukas B. Gromann, Wolfgang Noichl, Fabian Kriner, Florian Fischer, Christian Braun, Hanns Ingo Maack, Thomas Pralow, Thomas Koehler, Peter B. Noël, Felix Meurer, Dominik Deniffel, Andreas P. Sauter, Bernhard Haller, Daniela Pfeiffer, Ernst J. Rummeny, Julia HerzenFranz Pfeiffer

Publikation: Beitrag in FachzeitschriftArtikelBegutachtung

19 Zitate (Scopus)


BACKGROUND: Although x-ray dark-field imaging has been intensively investigated for lung imaging in different animal models, there is very limited data about imaging features in the human lungs. Therefore, in this work, a reader study on nine post-mortem human chest x-ray dark-field radiographs was performed to evaluate dark-field signal strength in the lungs, intraobserver and interobserver agreement, and image quality and to correlate with findings of conventional x-ray and CT. METHODS: In this prospective work, chest x-ray dark-field radiography with a tube voltage of 70 kVp was performed post-mortem on nine humans (3 females, 6 males, age range 52-88 years). Visual quantification of dark-field and transmission signals in the lungs was performed by three radiologists. Results were compared to findings on conventional x-rays and 256-slice computed tomography. Image quality was evaluated. For ordinal data, median, range, and dot plots with medians and 95% confidence intervals are presented; intraobserver and interobserver agreement were determined using weighted Cohen κ. RESULTS: Dark-field signal grading showed significant differences between upper and middle (p = 0.004-0.016, readers 1-3) as well as upper and lower zones (p = 0.004-0.016, readers 1-2). Median transmission grading was indifferent between all lung regions. Intraobserver and interobserver agreements were substantial to almost perfect for grading of both dark-field (κ = 0.793-0.971 and κ = 0.828-0.893) and transmission images (κ = 0.790-0.918 and κ = 0.700-0.772). Pulmonary infiltrates correlated with areas of reduced dark-field signal. Image quality was rated good for dark-field images. CONCLUSIONS: Chest x-ray dark-field images provide information of the lungs complementary to conventional x-ray and allow reliable visual quantification of dark-field signal strength.

Seiten (von - bis)25
FachzeitschriftEuropean Radiology Experimental
PublikationsstatusVeröffentlicht - 11 Juli 2019


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