Liver and bone window settings for soft-copy interpretation of chest and abdominal CT

OBJECTIVE. We evaluated whether the use of multiple window and level settin gs on a soft-copy workstation improves diagnostic accuracy on chest and abd ominal CT. We hypothesized that routinely using window and level settings d uring soft-copy interpretation would beneficially affect the final diagnosi s without compromising efficiency. MATERIALS AND METHODS, Two hundred three randomly selected abdominal and ch est CT scans were interpreted by three radiologists using a four-monitor so ft-copy workstation (images per screen, nine; resolution, 2K). After the in itial interpretations, all scans were reevaluated by the same radiologists using additional liver and bone window and level settings. Differences in c onspicuity and characterization of abnormalities were graded on a three-poi nt scale. RESULTS. Conspicuity and characterization of abnormalities were improved in 67% of abnormal findings (81/121; p = 0.01). Improvement (a finding that s ubstantially affected the final diagnosis) was present in 18% of abnormal f indings (22/121; p = 0.04). On average, the evaluation of images at multipl e window and level settings required an additional 40 sec per case. CONCLUSION. The use of multiple window and level settings during soft-copy interpretation resulted in improved lesion detectability and characterizati on with greater diagnostic efficacy. Using soft-copy workstations, radiolog ists can evaluate images using multiple settings without compromising effic iency.