THE VALUE OF SUPINE CHEST RADIOGRAPHS USI NG DIGITAL LUMINESCENCE RADIOGRAPHY (DLR) IN RELATION TO OBSERVER EXPERIENCE - ROC ANALYSIS IN CT-VALIDATED CASES

The aim of the present study was to evaluate supine chest radiographs obtained by DLR for the diagnosis of pleural and parenchymatous change s and to compare the accuracy of observers in relation to their experi ence. 50 examinations, which had been checked by CT, were chosen. The images were examined by 7 doctors (2 non-radiologists, 5 radiologists) . Our experience indicates that DLR has high specificity but low sensi tivity for the diagnosis of a pneumothorax but relatively high sensiti vity and low specificity for other changes (pleural effusions, atelect ases and other intrapulmonary opacities). The area under the ROC-curve averaged over the 7 rater was similar for these 4 entities. There wer e marked differences between the observers; the radiologists were cons iderably better than the non-radiologists. Altogether, the diagnostic value of single DLR examinations was relatively low. In indeterminate cases, additional diagnostic methods should, therefore, be used.