Rg. Swee et al., SCREEN-FILM VERSUS COMPUTED RADIOGRAPHY IMAGING OF THE HAND - A DIRECT COMPARISON, American journal of roentgenology, 168(2), 1997, pp. 539-542
OBJECTIVE. Computed radiography of the musculoskeletal system has the
potential to become a powerful tool in the practice of diagnostic radi
ology. It addresses many of the geographic and film-distribution conce
rns facing diagnostic imaging. We undertook this study to compare and
document the quality of computed radiographs and conventional screen-f
ilm images before widespread implementation. MATERIALS AND METHODS. We
evaluated clinical images using direct comparison. Bilateral hand ima
ges from 50 patients were scored independently by six musculoskeletal
radiologists. In each case one hand was imaged with a conventional scr
een-film technique and the other with computed radiography. Images wer
e masked to eliminate as much bias as possible. The numeric scores ass
igned to the images by the observers were analyzed using Student's t t
est. RESULTS. Computed radiographs were judged with statistical signif
icance to be better than conventional screen-film images in all featur
es judged by the observers, including bone cortex, bone trabeculae, co
rticomedullary junction, distal phalangeal tuft, soft tissues, fat pla
nes, bone-soft-tissue interface, and overall contrast and density. CON
CLUSION. The statistically significant determination that the image qu
ality of computed radiographs is at least as good as screen-film image
s allows confident use of computed radiography and enables radiologist
s to take advantage of its many other practical capabilities related t
o image distribution, storage, cost, and geographic coverage without s
acrificing image quality.