Concordance of chest x-ray with chest CT by body mass index.

Content Provider	Europe PMC
Author	Heston, Thomas F. Jiang, John Y.
Editor	Nuhmani, Shibili
Copyright Year	2023
Abstract	IntroductionPatients with suspected thoracic pathology frequently get imaging with conventional radiography or chest x-rays (CXR) and computed tomography (CT). CXR include one or two planar views, compared to the three-dimensional images generated by chest CT. CXR imaging has the advantage of lower costs and lower radiation exposure at the expense of lower diagnostic accuracy, especially in patients with large body habitus.ObjectivesTo determine whether CXR imaging could achieve acceptable diagnostic accuracy in patients with a low body mass index (BMI).MethodsThis retrospective study evaluated 50 patients with age of 63 ± 12 years old, 92% male, BMI 31.7 ± 7.9, presenting with acute, nontraumatic cardiopulmonary complaints who underwent CXR followed by CT within 1 day. Diagnostic accuracy was determined by comparing scan interpretation with the final clinical diagnosis of the referring clinician.ResultsCT results were significantly correlated with CXR results (r = 0.284, p = 0.046). Correcting for BMI did not improve this correlation (r = 0.285, p = 0.047). Correcting for BMI and age also did not improve the correlation (r = 0.283, p = 0.052), nor did correcting for BMI, age, and sex (r = 0.270, p = 0.067). Correcting for height alone slightly improved the correlation (r = 0.290, p = 0.043), as did correcting for weight alone (r = 0.288, p = 0.045). CT accuracy was 92% (SE = 0.039) vs. 60% for CXR (SE = 0.070, p < 0.01).ConclusionAccounting for patient body habitus as determined by either BMI, height, or weight did not improve the correlation between CXR accuracy and chest CT accuracy. CXR is significantly less accurate than CT even in patients with a low BMI.
Journal	Peerj
Volume Number	11
PubMed Central reference number	PMC10024896
PubMed reference number	36945358
e-ISSN	21678359
DOI	10.7717/peerj.15090
Language	English
Publisher	PeerJ Inc.
Publisher Date	2023-03-16
Publisher Place	San Diego, USA
Access Restriction	Open
Rights License	This is an open access article, free of all copyright, made available under the Creative Commons Public Domain Dedication. This work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
Subject Keyword	Diagnostic imaging Chest x-ray Computed tomography Body mass index
Content Type	Text
Resource Type	Article
Subject	Neuroscience Medicine Agricultural and Biological Sciences Biochemistry, Genetics and Molecular Biology