Chest radiography: new technological developments and their applications

Digital chest radiography is still the most common radiological examination. With the upcoming three-dimensional (3D) acquisition techniques the value of radiography seems to diminish. But because radiography is inexpensive, readily available, and requires very little dose, it is still being used for the first-line detection of many cardiothoracic diseases. In the last decades major technical developments of this 2D technique are being achieved. First, hardware developments of digital radiography have improved the contrast to noise, dose efficacy, throughput, and workflow. Dual energy acquisition techniques reduce anatomical noise by splitting a chest radiograph into a soft tissue image and a bone image. Second, advanced processing methods are developed to enable and improve detection of many kinds of disease. Digital bone subtraction by a software algorithm mimics the soft tissue image normally acquired with dedicated hardware. Temporal subtraction aims to rule out anatomical structures clotting the image, by subtracting a current radiograph with a previous radiograph. Finally, computer-aided detection systems help radiologists for the detection of various kinds of disease such as pulmonary nodules or tuberculosis.