ACCURACY OF DIAGNOSIS OF SUBTLE CHEST DISEASE AND SUBTLE FRACTURES WITH A TELERADIOLOGY SYSTEM

OBJECTIVE. This study compared conventional thoracic and skeletal radi ographs with 12-bit digitized images of the same radiographs in terms of subjective image quality and accuracy of diagnosis of subtle diseas e. MATERIALS AND METHODS. Thirty-six chest radiographs with normal fin dings, 48 chest radiographs with abnormal findings, 29 skeletal radiog raphs with normal findings, and 26 skeletal radiographs with abnormal findings were included in this study. The images were chosen for the s ubtlety of their findings (nodules, pneumothoraces, interstitial lung disease, fractures). Each set of images was laser-digitized and viewed independently by three radiologists at a teleradiology workstation wi th a 1280 x 1024 pixel matrix monitor equipped with an eight-bit-per-p ixel gray-scale display. All images were viewed at maximum resolution. After review of the digitized images for image quality and for the pr esence of abnormalities, each radiologist analyzed the analog images i n a similar way. RESULTS. Sensitivities for detecting nodules, pneumot horaces, and interstitial lung disease on digitized chest radiographs were 58%, 75%, and 90%, respectively, compared with 62%, 79%, and 92%, respectively, on the original radiographs. Sensitivity for fracture d etection on digitized bone radiographs was 87% compared with 88% on an alog radiographs. None of these differences was statistically signific ant. CONCLUSION. Digitization of radiographs for primary diagnosis by teleradiology results in a slight decrease in sensitivity for detectio n of subtle abnormalities, provided that the images are viewed at maxi mum resolution.