{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:29:22Z","timestamp":1792189762573,"version":"4.4.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006431","name":"Carestream Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006431","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Howard Holderness Distinguished Medical Scholar grant"},{"name":"The National Institute of Health","award":["T32HL1661411A1"],"award-info":[{"award-number":["T32HL1661411A1"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Portable chest radiographs are a vital tool for clinical evaluation. However, their value remains limited due to overlapping anatomical structures obscuring underlying pathologies. Chest tomosynthesis has been proposed as an alternative to CT for high resolution chest imaging; however, a portable tomosynthesis unit is currently lacking in the standard of care. Utilizing a carbon nanotube linear x-ray source array, our team has developed a stationary digital chest tomosynthesis (s-DCT) unit that enables tomosynthesis imaging without need for a moving x-ray source during image acquisition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The goal of our study was to evaluate the performance of portable s-DCT in patients with concurrent portable radiographs and recent cross-sectional chest CT imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study recruited twenty-seven outpatients with recent chest CT images. Twenty-two patients were imaged with a conventional radiograph unit and the s-DCT system. Three board-certified thoracic radiologists rated their confidence in evaluating ten criteria: nine anatomic criteria and one on indwelling hardware. Readers were asked if information was gained from chest tomosynthesis, and if a follow-up CT was recommended. Random effects modeling was performed to assess factors contributing to reader confidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-two adult patients were successfully imaged. Overall, reader confidence with s-DCT was significantly higher than CXR (p =\u2009&lt;\u20090.001). Higher confidence in tomosynthesis was associated with perception that tomosynthesis gave additional information over CXR (p\u2009=\u20090.05). There was no significant trend toward not recommending a CT (p\u2009=\u20090.47).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Stationary digital chest tomosynthesis is a superior alternative to portable chest x-ray for patients that cannot undergo CT examination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0344178","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:29:03Z","timestamp":1775150943000},"page":"e0344178","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of stationary digital chest tomosynthesis to portable chest radiographs: A patient study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5436-9907","authenticated-orcid":true,"given":"Courtney","family":"Wing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6979-0555","authenticated-orcid":true,"given":"Elias Taylor","family":"Gunnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Billingsley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umer","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Inscoe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6257-884X","authenticated-orcid":true,"given":"Muthu","family":"Sakthivel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Hoag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ertan","family":"Pamuklar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thad","family":"Benefield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otto","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueh Z.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"issue":"3","key":"pone.0344178.ref001","doi-asserted-by":"crossref","first-page":"572","DOI":"10.2214\/AJR.11.8124","article-title":"Chest radiography in the ICU: Part 2, Evaluation of cardiovascular lines and other devices","volume":"198","author":"MCB Godoy","year":"2012","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"pone.0344178.ref002","doi-asserted-by":"crossref","first-page":"563","DOI":"10.2214\/AJR.10.7226","article-title":"Chest radiography in the ICU: Part 1, Evaluation of airway, enteric, and pleural tubes","volume":"198","author":"MCB Godoy","year":"2012","journal-title":"AJR Am J Roentgenol"},{"issue":"1068","key":"pone.0344178.ref003","doi-asserted-by":"crossref","first-page":"20160421","DOI":"10.1259\/bjr.20160421","article-title":"Comparison of digital tomosynthesis and chest radiography for the detection of pulmonary nodules: systematic review and meta-analysis","volume":"89","author":"JH Kim","year":"2016","journal-title":"Br J Radiol"},{"issue":"7","key":"pone.0344178.ref004","doi-asserted-by":"crossref","DOI":"10.1097\/CCM.0000000000003129","article-title":"Diagnostic Accuracy of Chest Radiograph, and When Concomitantly Studied Lung Ultrasound, in Critically Ill Patients With Respiratory Symptoms: A Systematic Review and Meta-Analysis","volume":"46","author":"MH Winkler","year":"2018","journal-title":"Crit Care Med"},{"key":"pone.0344178.ref005","article-title":"ACR Appropriateness Criteria\u00ae Intensive Care Unit Patients","volume":"18","author":"Expert Panel on Thoracic Imaging","year":"2021","journal-title":"J Am Coll Radiol"},{"key":"pone.0344178.ref006","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ajem.2021.11.021","article-title":"Adverse events during intrahospital transport of critically ill patients: A systematic review and meta-analysis","volume":"52","author":"M Murata","year":"2022","journal-title":"Am J Emerg Med"},{"issue":"4","key":"pone.0344178.ref007","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/s00068-009-9127-8","article-title":"A Portable CT Scanner in the Pediatric Intensive Care Unit Decreases Transfer-Associated Adverse Events and Staff Disruption","volume":"36","author":"S Agrawal","year":"2010","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"01","key":"pone.0344178.ref008","doi-asserted-by":"crossref","first-page":"017","DOI":"10.1055\/s-0033-1363448","article-title":"Chest tomosynthesis: technical and clinical perspectives","volume":"35","author":"A Johnsson","year":"2014","journal-title":"Semin Respir Crit Care Med"},{"issue":"2","key":"pone.0344178.ref009","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1148\/rg.342135057","article-title":"Digital tomosynthesis of the chest: current and emerging applications","volume":"34","author":"S-HS Chou","year":"2014","journal-title":"Radiographics"},{"issue":"5","key":"pone.0344178.ref010","doi-asserted-by":"crossref","first-page":"91","DOI":"10.21037\/atm.2017.08.18","article-title":"Digital chest tomosynthesis: the 2017 updated review of an emerging application","volume":"6","author":"A Ferrari","year":"2018","journal-title":"Ann Transl Med"},{"issue":"1","key":"pone.0344178.ref011","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1186\/s12885-018-4263-3","article-title":"Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis","volume":"18","author":"X-A Phi","year":"2018","journal-title":"BMC Cancer"},{"issue":"2","key":"pone.0344178.ref012","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1148\/rg.2021200101","article-title":"Digital breast tomosynthesis: update on technology, evidence, and clinical practice","volume":"41","author":"Y Gao","year":"2021","journal-title":"Radiographics"},{"issue":"7","key":"pone.0344178.ref013","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1007\/s00256-010-1049-3","article-title":"Clinical utility of tomosynthesis in suspected scaphoid fracture. A pilot study","volume":"40","author":"M Geijer","year":"2011","journal-title":"Skeletal Radiol"},{"issue":"1","key":"pone.0344178.ref014","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1258\/ar.2011.110347","article-title":"Digital tomosynthesis for aortic arch calcification evaluation: performance comparison with chest radiography with CT as the reference standard","volume":"53","author":"EY Kim","year":"2012","journal-title":"Acta Radiol"},{"issue":"4","key":"pone.0344178.ref015","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1159\/000381471","article-title":"Localization of the Patency Capsule by Abdominal Tomosynthesis","volume":"91","author":"T Omori","year":"2015","journal-title":"Digestion"},{"issue":"4","key":"pone.0344178.ref016","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1007\/s00330-018-5703-9","article-title":"Initial clinical evaluation of stationary digital chest tomosynthesis in adult patients with cystic fibrosis","volume":"29","author":"ET Gunnell","year":"2019","journal-title":"Eur Radiol"},{"issue":"1","key":"pone.0344178.ref017","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s13244-011-0137-9","article-title":"Tomosynthesis in pulmonary cystic fibrosis with comparison to radiography and computed tomography: a pictorial review","volume":"3","author":"K Vult von Steyern","year":"2011","journal-title":"Insights Imaging"},{"issue":"2","key":"pone.0344178.ref018","doi-asserted-by":"crossref","first-page":"257","DOI":"10.21037\/jtd-21-1381","article-title":"Feasibility of a prototype carbon nanotube enabled stationary digital chest tomosynthesis system for identification of pulmonary nodules by pulmonologists","volume":"14","author":"AC Burks","year":"2022","journal-title":"J Thorac Dis"},{"issue":"9","key":"pone.0344178.ref019","doi-asserted-by":"crossref","first-page":"3147","DOI":"10.1007\/s00330-015-4127-z","article-title":"A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference","volume":"26","author":"JY Choo","year":"2016","journal-title":"Eur Radiol"},{"issue":"4","key":"pone.0344178.ref020","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.crad.2012.05.022","article-title":"Comparison of chest digital tomosynthesis and chest radiography for detection of asbestos-related pleuropulmonary disease","volume":"68","author":"G Lee","year":"2013","journal-title":"Clin Radiol"},{"key":"pone.0344178.ref021","volume-title":"Initial clinical evaluation of stationary digital chest tomosynthesis. Medical Imaging 2016: Physics of Medical Imaging","author":"AE Hartman","year":"2016"},{"key":"pone.0344178.ref022","article-title":"Stationary chest tomosynthesis using a CNT x-ray source array","volume-title":"Medical Imaging","author":"J Shan","year":"2013"},{"issue":"5","key":"pone.0344178.ref023","doi-asserted-by":"crossref","first-page":"202","DOI":"10.5539\/gjhs.v7n5p202","article-title":"Measurement of Entrance Skin Dose and Calculation of Effective Dose for Common Diagnostic X-Ray Examinations in Kashan, Iran","volume":"7","author":"A Aliasgharzadeh","year":"2015","journal-title":"Glob J Health Sci"},{"issue":"3","key":"pone.0344178.ref024","doi-asserted-by":"crossref","first-page":"525","DOI":"10.3348\/kjr.2013.14.3.525","article-title":"Digital tomosynthesis of the chest: comparison of patient exposure dose and image quality between standard default setting and low dose setting","volume":"14","author":"HS Hwang","year":"2013","journal-title":"Korean J Radiol"},{"key":"pone.0344178.ref025","article-title":"Adapted fan-beam volume reconstruction for stationary digital breast tomosynthesis","volume-title":"Medical Imaging","author":"G Wu","year":"2015"},{"issue":"3","key":"pone.0344178.ref026","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1007\/s00134-014-3592-1","article-title":"Diagnostic yield and safety of CT scans in ICU","volume":"41","author":"M Aliaga","year":"2015","journal-title":"Intensive Care Med"},{"issue":"1","key":"pone.0344178.ref027","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s41747-017-0021-6","article-title":"Can portable tomosynthesis improve the diagnostic value of bedside chest X-ray in the intensive care unit? A proof of concept study","volume":"1","author":"J Cant","year":"2017","journal-title":"Eur Radiol Exp"},{"key":"pone.0344178.ref028","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1117\/12.2293713","article-title":"Initial clinical evaluation of gated stationary digital chest tomosynthesis.","volume-title":"Medical Imaging 2018: Physics of Medical Imaging","author":"YZ Lee","year":"2018"},{"issue":"16","key":"pone.0344178.ref029","doi-asserted-by":"crossref","DOI":"10.1088\/1361-6560\/ad62d1","article-title":"Stationary prospective cardiac gated computed tomography-dynamic study in phantoms and in vivo","volume":"69","author":"A Billingsley","year":"2024","journal-title":"Phys Med Biol"},{"issue":"1","key":"pone.0344178.ref030","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/RCT.0000000000000780","article-title":"Accuracy of Digital Tomosynthesis of the Chest in Detection of Interstitial Lung Disease Comparison With Digital Chest Radiography","volume":"43","author":"T Kruamak","year":"2019","journal-title":"J Comput Assist Tomogr"},{"issue":"10","key":"pone.0344178.ref031","doi-asserted-by":"crossref","first-page":"5627","DOI":"10.21037\/jtd-21-1032","article-title":"Diagnostic performance of digital tomosynthesis to evaluate silicone airway stents and related complications","volume":"13","author":"B-G Kim","year":"2021","journal-title":"J Thorac Dis"},{"issue":"3","key":"pone.0344178.ref032","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1002\/mp.14696","article-title":"Evaluation of carbon nanotube x-ray source array for stationary head computed tomography","volume":"48","author":"D Spronk","year":"2021","journal-title":"Med Phys"},{"issue":"1","key":"pone.0344178.ref033","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1002\/mp.17460","article-title":"Second generation stationary chest tomosynthesis with faster scan time and wider angular span","volume":"52","author":"A Billingsley","year":"2025","journal-title":"Med Phys"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0344178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:29:08Z","timestamp":1775150948000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0344178"}},"subtitle":[],"editor":[{"given":"Kartikeya","family":"Rajdev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0344178","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]}}}