DETECTION OF INTERSTITIAL LUNG ABNORMALITIES ON PICTURE ARCHIVE AND COMMUNICATION-SYSTEM VIDEO MONITORS

The purpose of this study was to compare the detection of interstitial lung abnormalities on video display workstation monitors between radi ologists experienced with video image interpretation and radiologists who lack this experience. Twenty-four patients with interstitial lung abnormalities documented by high-resolution computed tomagraphy (HRCT) and lung biopsy, and 26 control patients with no history of pulmonary disease or a normal HRCT and normal chest radiographs were studied, I mages were acquired using storage phosphor digital radiography and dis played on 1.645-2,0498 pixel resolution video monitors, Five board-cer tified radiologists evaluated the images in a blinded and randomized m anner by using a six-point presence of abnormality grading scale. Thre e radiologists were from 1 to 4 years out of residency and considered to be experienced workstation monitor readers with between 1 to 3 year s of video monitor image interpretation. For the inexperienced readers , one radiologist bad no prior experience with reading images front a video monitor and was direct out of residency, and ti-re other radiolo gist had less than 4 months of intermittent exposure and was 1 year ou t of residency. Sensitivity and specificity were determined for indivi dual readers. Positive predictive values, negative predictive values, accuracy, and receiver-operating curves were also generated. A compari son was made between experienced and inexperienced readers, Far reader s experienced with video monitor image interpretation, the sensitivity ranged from 87.5% to 92%, specificity from 69% to 92%, positive predi ctive value (PPV) from 73% to 87.5%, negative predictive value (NPV) f rom 87% to 90%, and accuracy from 80% to 88%. For inexperienced reader s, these values were sensitivity 58%, specificity 50% to 65%, PPV 52% to 61%, NPV 56.5% to 63% and accuracy 54% to 62%. Comparing image inte rpretation between experienced and inexperienced readers, there were s tatistically significant differences far sensitivity (P <.01), specifi city (P <.01), PPV (P <.05), NPV (P <05), accuracy (P <.05), and area under the receiver operator curve (Az) (P <.01). Within the respective experienced and inexperienced groups, no statistical significant diff erences were present. Our results show that digitally acquired chest r adiographs displayed on high-resolution workstation monitors are adequ ate for the detection of interstitial lung abnormalities when the imag es are interpreted by radiologists experienced with Yideo image interp retation. Radiologists inexperienced with video monitor image interpre tation, however, cannot reliably interpret images for the detection of interstitial lung abnormalities. Copyright (C) 1937 by W.B. Saunders Company.