title: Detection of CT-proved pulmonary nodules: comparison of selenium-based digital and conventional screen-film chest radiographs.
abstract: OBJECTIVE
  To compare hard-copy digital chest radiographs obtained with a selenium-based system with wide-latitude asymmetric screen-film radiographs for detection of pulmonary nodules.
  
  
  METHODS
  Fifty patients undergoing thoracic computed tomography (CT) for suspected pulmonary nodules were recruited to undergo both digital and screen-film posteroanterior (PA) and lateral chest radiography. Three chest radiologists blinded to the CT results independently reviewed each digital and screen-film radiograph, identified each nodule, and graded their confidence for its presence.
  
  
  RESULTS
  Seventy-eight pulmonary nodules (mean diameter, 1.5 cm; range, 0.5-3.5 cm; 62 soft tissue, 16 calcified) were identified with CT in 34 patients, while 16 patients had clear lungs. The mean sensitivity for the detection of all nodules by all readers (PA and lateral) was 66% (95% Cl, 54%, 76%) for digital radiographs and 64% (95% Cl, 52%, 74%) for screen-film radiographs. Differences between the two techniques were not statistically significant (P > .05, Student t test). There was no difference in mean false-positive-true-positive ratios (PA, 0.35; lateral, 0.53) or positive predictive values (PA, 74%; lateral, 65%), and no significant difference (P > .05) was seen in mean reader confidence rating.
  
  
  CONCLUSIONS
  In detecting pulmonary nodules, radiologists perform comparably with selenium-based digital and wide-latitude asymmetric screen-film radiographs.
authors.affiliation: Electronic Radiology Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Woodard
authors.forename: R M
authors.initials: RM
authors.lastname: Slone
authors.forename: S S
authors.initials: SS
authors.lastname: Sagel
authors.forename: M J
authors.initials: MJ
authors.lastname: Fleishman
authors.forename: F R
authors.initials: FR
authors.lastname: Gutierrez
authors.forename: G G
authors.initials: GG
authors.lastname: Reiker
authors.forename: T K
authors.initials: TK
authors.lastname: Pilgram
authors.forename: R G
authors.initials: RG
authors.lastname: Jost
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012643:Selenium; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014963:X-Ray Intensifying Screens
chemical_list: D012643:Selenium