COMPUTED RADIOGRAPHY IN NEONATAL AND PEDIATRIC INTENSIVE-CARE UNITS -A COMPARISON OF 2.5KX2K SOFT-COPY IMAGES VS DIGITAL HARD-COPY FILM

Objective. The goal of the study was to determine whether soft-copy im ages on high-resolution monitors (2.5 K x 2 K) are suitable for primar y interpretation of images from pediatric and neonatal intensive care units. The hypotheses were that hard and soft images yield similar dia gnostic information, and that both residents and faculty radiologists can use monitors effectively. Previous reports have produced conflicti ng results; the need for larger sample sizes has been empha sized. Mat erials and methods. One thousand one hundred and four images produced by computed radiography using the Kodak Ectascan Imagelink system were prospectively analyzed by two pediatric radiologists, one reading har d copy and the other soft copy of the same images. Bias was controlled by equal distribution of modalities between observers and by daily al ternation of modality. Hard- and soft-copy observations of presence or absence of nine specific tubes and nine specific diagnostic findings were compared. Interobserver differences between pediatric radiologist s and radiology residents were studied on additional images. The kappa statistic was used to evaluate the level of agreement for all observa tions. Results. There was excellent agreement between hard and soft co py interpretation for each tube and diagnostic finding (kappa values 0 .93-1.0) and excellent interobserver agreement between two pediatric r adiologists (kappa values 0.84-1.0), The level of agreement between ra diology residents and pediatric radiologist was excellent for the most objective findings. All results were statistically significant (p < 0 .001). Conclusion. High resolution soft-copy images are suitable for p rimary interpretation in patients in pediatric and neonatal intensive care units.