INTERPRETATION OF SUBTLE INTERSTITIAL LUNG ABNORMALITIES - CONVENTIONAL VERSUS STORAGE PHOSPHOR RADIOGRAPHY

To evaluate the reliability of storage phosphor radiography (SR) in di agnosis of subtle interstitial lung abnormalities, the differences amo ng radiologists in interpreting conventional screen-film radiographs a nd full-size and minified SR images obtained in 80 patients were studi ed. Forty patients had subtle interstitial lung abnormalities and 40 h ad no lung abnormalities. Seven chest radiologists and seven residents evaluated the images by using a five-point presence of abnormality sc ale. Results were evaluated with receiver operating characteristic tec hnique. For all observers, no significant differences were observed am ong the three image types. For the chest radiologists, significant dif ferences were observed between conventional radiographs and the two SR formats (P < .01). Furthermore, perceptual accuracy was best with con ventional radiographs evaluated by chest radiologists. Overall perform ance with SR and conventional radiography was identical for diagnosis of abnormalities, but detection performance was significantly dependen t on observer experience (P < .01 for chest radiologists and P > .01 f or residents). For chest radiologists, critically important informatio n may be lost with commercially available SR.