Evaluation of a two-image technique consisting of an axial and a coronal image generated by using the rib-flattening application: effect on reading time and diagnostic validity

Abstract

Background/aim: When reading a chest CT, a radiologist needs to evaluate each rib one by one due to complex curvy shape, whichmakes reporting a tiresome and time-consuming task. A new curved planar reformat application that flattens ribs on a single plane mayfind a place in the radiology reporting room. This study aimed to evaluate the effect of a two-image set created by using the rib-flatteningapplication on the performance of a radiologist in detecting sclerotic rib lesions in cancer patients.Materials and methods: The local Institutional Review Board approved this retrospective study. Two radiologists with differentexperience levels reviewed chest CT examinations of 106 patients (76 men, 30 women). We divided the patients into group A (n =54), reviewed by a standard method, and group B (n = 52), reviewed by a standard method and the two-image set created on the ribflatteningapplication. Reading times, validity indices, and agreement levels with reference data were evaluated for both readers.Results: The median reading time of the junior examiner significantly decreased with the rib-flattening method (160.5 s vs. 70.0 s; P