title: Liver and bone window settings for soft-copy interpretation of chest and abdominal CT.
abstract: OBJECTIVE
  We evaluated whether the use of multiple window and level settings on a soft-copy workstation improves diagnostic accuracy on chest and abdominal CT. We hypothesized that routinely using window and level settings during soft-copy interpretation would beneficially affect the final diagnosis without compromising efficiency.
  
  
  METHODS
  Two hundred three randomly selected abdominal and chest CT scans were interpreted by three radiologists using a four-monitor soft-copy workstation (images per screen, nine; resolution, 2K). After the initial interpretations, all scans were reevaluated by the same radiologists using additional liver and bone window and level settings. Differences in conspicuity and characterization of abnormalities were graded on a three-point scale.
  
  
  RESULTS
  Conspicuity and characterization of abnormalities were improved in 67% of abnormal findings (81/121; p = 0.01). Improvement (a finding that substantially affected the final diagnosis) was present in 18% of abnormal findings (22/121; p = 0.04). On average, the evaluation of images at multiple window and level settings required an additional 40 sec per case.
  
  
  CONCLUSIONS
  The use of multiple window and level settings during soft-copy interpretation resulted in improved lesion detectability and characterization with greater diagnostic efficacy. Using soft-copy workstations, radiologists can evaluate images using multiple settings without compromising efficiency.
authors.affiliation: Department of Diagnostic Imaging, University of Maryland Medical System, Baltimore 21201, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Pomerantz
authors.forename: C S
authors.initials: CS
authors.lastname: White
authors.forename: T L
authors.initials: TL
authors.lastname: Krebs
authors.forename: B
authors.initials: B
authors.lastname: Daly
authors.forename: S A
authors.initials: SA
authors.lastname: Sukumar
authors.forename: F
authors.initials: F
authors.lastname: Hooper
authors.forename: E L
authors.initials: EL
authors.lastname: Siegel
mesh_terms: D001847:Bone Diseases / Q000000981:diagnostic imaging; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging; D011860:Radiography, Abdominal / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*