Image quality for five modern chest radiography techniques: a modified FROC study with an anthropomorphic chest phantom

The purpose of the study was to compare the image quality for one conventio nal and four digital chest radiography techniques. Three storage phosphor s ystems, one selenium drum system, and one film-screen system were compared using a modified receiver-operating-characteristics method. Simulated patho logy was randomly positioned over the parenchymal regions and the mediastin um of an anthropomorphic phantom. Eight observers (four chest radiologists, one specialist in general radiology, one hospital physicist, and two radio graphers) evaluated 60 images for each technique. The selenium drum system (Philips, Eindhoven, The Netherlands) rate best for the detection of parenc hymal nodules. Together with the storage phosphor system of generation IIIN (Philips/Fuji), the selenium drug system also rated best for detection of thin linear structures. The storage phosphor system of generation V (Fuji) rated best for the detection of mediastinal nodules. The first generation o f the storage phosphor system from Agfa (Mortsel, Belgium) rated worst for the detection of parenchymal nodules and thin linear structures. These diff erences were significant (p < 0.0001). Averaging the results for all test o bjects, the selenium drum system and storage phosphor system of generation V were significantly better than the other systems tested. The film/screen system performed significantly better than the first-generation storage pho sphor system from Agfa, equal tot he generation IIIN storage phosphor syste m (Philips/Fuji) and significantly worse than the selenium drum system (Phi lips) and the generation-V storage phosphor system (Fuji). The conclusion i s therefore that the image quality of selenium-based digital technique and of the more recent generations of storage phosphor systems is superior to b oth conventional technique and storage phosphor systems using image plates of older types.