COMPARISON OF DIRECT MAGNIFICATION RADIOG RAPHY AND MAMMOGRAPHIC FILM-SCREEN SYSTEMS IN THE DETECTION OF SUBPERIOSTEAL, INTRACORTICAL AND ENDOSTEAL BONE-RESORPTION

Purpose: To compare direct magnification radiography and mammographic film-screen systems in osseous changes of the hand in hyperparathyroid ism. Materials and methods: The hands of 60 patients who were suspecte d to have primary (5), secondary or tertiary (both 55) hyperparathyroi dism were evaluated with direct magnification radiography and a mammog raphic film-screen system (S12.5). Posterior-anterior views of each ha nd were obtained with both techniques. The magnification radiographs w ere made with a focal spot size of 40 or 60 mu m, digital luminescence radiography (S600/1200), and a x 6 or 8 magnification. The 240 films were evaluated for subperiosteal, intracortical and endosteal resorpti ve changes by five radiologists using a grading according to five leve ls of confidence. Results: A significant improvement (p < 0.05) in the diagnosis of periosteal and intracortical bone resorption was shown, but no significant changes in endosteal resorption with direct magnifi cation radiography. As compared to mammographic film-screen systems, m agnification radiography improved the diagnostic accuracy (24%). The t ime needed for the evaluation of periosteal and intracortical bone res orption was shortened with direct magnification radiography (-4 %/-15 %), and the time for giving the diagnosis decreased (-10 %).