title: Comparison of hard- and soft-copy digital chest images with different matrix sizes for managing coronary care unit patients.
abstract: OBJECTIVE
  This study was to determine whether different digital display formats for portable chest radiographs of coronary care unit patients would provide comparable information for clinical care. In particular, we tried to ascertain whether 1024 x 1024 pixel (1K) images on a picture archiving and communication system (PACS) workstation would be comparable to 1760 x 2140 pixel (2K) images on workstations or to digital films. If comparability could be proved, we hypothesized that 1K workstations could considerably lower equipment and film costs and facilitate image transmission from point to point.
  
  
  METHODS
  Four chest radiologists read a panel of chest studies assembled from 98 coronary care unit patients, comparing 1K and 2K soft-copy images with digital hard copies. For all three image types for the 98 patients, the readers evaluated nine image parameters that the cardiologists deemed essential for clinical decision making. Two other chest radiologists reviewed each patient's three image types, historical chest images, current and prior radiologic reports, and medical record to determine the consensus, or "truth findings."
  
  
  RESULTS
  With one exception (small pleural effusions), the receiver operating characteristic analysis showed no significant differences in the clinical information derived from the three image types.
  
  
  CONCLUSIONS
  For clinical management in a coronary care unit, comparable information can be obtained from digital radiologic chest studies using a 1K x 1K soft-copy format, a 2K x 2K soft-copy format, or a hard copy (film). Substantial savings in cost and time are therefore possible by using soft-copy images and lower resolution (1K x 1K) workstations and, when necessary, by transmitting images on regular telephone lines.
authors.affiliation: Department of Radiological Sciences, UCLA School of Medicine 90024-1721, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Steckel
authors.forename: P
authors.initials: P
authors.lastname: Batra
authors.forename: S
authors.initials: S
authors.lastname: Johnson
authors.forename: J
authors.initials: J
authors.lastname: Sayre
authors.forename: K
authors.initials: K
authors.lastname: Brown
authors.forename: K
authors.initials: K
authors.lastname: Haker
authors.forename: D
authors.initials: D
authors.lastname: Young
authors.forename: M
authors.initials: M
authors.lastname: Zucker
mesh_terms: D003325:Coronary Care Units; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging; D008168:Lung / Q000000981:diagnostic imaging; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D013902:Radiography, Thoracic; D011873:Radiology Information Systems; D012680:Sensitivity and Specificity