title: Clinical evaluation of twin screen-film chest radiography: cost effective lung and mediastinal imaging.
abstract: OBJECTIVE
  A new twin screen-film cassette system optimised for conventional chest radiography was evaluated by four thoracic radiologists.
  
  
  METHODS
  The twin screen-film cassette system produces two film images, the front film optimised for the mediastinal region of the chest, the rear for the lung region. Image degradation on either screen-film system due to internal photon scatter has been virtually eliminated due to the use of a dividing filter. Fifty patients were included in a trial that resulted in a set of chest images for each patient, taken on the same inspiration, by both the twin screen-film cassette and the conventional system. The resultant fifty sets of images were evaluated by four chest radiologists who scored 12 radiographic features of the chest and patient pathologies present, using a paired difference technique.
  
  
  RESULTS
  The image quality of the twin screen-film cassette system was judged to be significantly superior to the conventional screen-film system in nine of the 12 radiographic features scored (P < 0.003). In the three other regions and for the patient pathologies, no significant conclusions were drawn.
  
  
  CONCLUSIONS
  The new twin screen-film system showed improved visualisation of radiographic features, particularly in the mediastinal and retrocardiac lung regions. This new system shows promise in both standard and portable clinical applications.
authors.affiliation: School of Medical Radiation Technology, University of Sydney, Australia.
authors.forename: D
authors.initials: D
authors.lastname: McLean
authors.forename: J E
authors.initials: JE
authors.lastname: Gray
authors.forename: S J
authors.initials: SJ
authors.lastname: Swensen
authors.forename: T J
authors.initials: TJ
authors.lastname: Vrieze
mesh_terms: D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005374:Filtration / Q000295:instrumentation; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000000981:diagnostic imaging*; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008482:Mediastinum / Q000000981:diagnostic imaging*; D017785:Photons; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000191:economics / Q000295:instrumentation / Q000379:methods; D013902:Radiography, Thoracic / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D012272:Ribs / Q000000981:diagnostic imaging; D012542:Scattering, Radiation; D014963:X-Ray Intensifying Screens / Q000145:classification / Q000191:economics