title: Digital radiography versus conventional radiography in chest imaging: diagnostic performance of a large-area silicon flat-panel detector in a clinical CT-controlled study.
abstract: OBJECTIVE
  The objective of this study was to compare the diagnostic performance of a digital large-area silicon flat-panel detector with that of a conventional screen-film system in clinical chest imaging using abnormal findings documented by CT as the reference standard.
  
  
  METHODS
  Eighty patients (46 men and 34 women; age range,18-91 years; mean age, 63 years) who underwent CT of the chest were examined with the new digital radiography system, which is based on a 43 x 43 cm silicon flat-panel detector, and with a conventional screen-film system, which is used routinely in clinical practice. Posteroanterior and lateral radiographs were obtained. Four radiologists analyzed the digital and conventional images separately for chest abnormalities and rated the images using a five-level scale of confidence; CT was used as the reference standard. Diagnostic value was assessed using receiver operating characteristic curves for each abnormality.
  
  
  RESULTS
  No significant differences were found between the area under the receiver operating characteristic curve of the digital and that of the conventional radiography method for almost all investigated criteria. The only exception was mediastinal abnormalities, for which the digital method provided better results than the conventional method (p < 0.05).
  
  
  CONCLUSIONS
  The diagnostic performance of the new large-area silicon flat-panel detector is equivalent or superior to that of the conventional screen-film system for clinical chest imaging and can replace conventional radiography systems. This new technology offers transmission and storage possibilities inherent to digital radiology that would facilitate daily practice and reduce the initial high costs in the long-term.
authors.affiliation: Department of Clinical Radiology, Staedtische Kliniken Dortmund, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Garmer
authors.forename: S P
authors.initials: SP
authors.lastname: Hennigs
authors.forename: H J
authors.initials: HJ
authors.lastname: Jäger
authors.forename: F
authors.initials: F
authors.lastname: Schrick
authors.forename: T
authors.initials: T
authors.lastname: van de Loo
authors.forename: A
authors.initials: A
authors.lastname: Jacobs
authors.forename: A
authors.initials: A
authors.lastname: Hanusch
authors.forename: A
authors.initials: A
authors.lastname: Christmann
authors.forename: K
authors.initials: K
authors.lastname: Mathias
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000295:instrumentation*; D013902:Radiography, Thoracic; D012825:Silicon; D014057:Tomography, X-Ray Computed; D014963:X-Ray Intensifying Screens
chemical_list: D012825:Silicon