SCREEN-FILM VERSUS COMPUTED RADIOGRAPHY IMAGING OF THE HAND - A DIRECT COMPARISON

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.