title: Hard-copy versus soft-copy with and without simple image manipulation for detection of pulmonary nodules and masses.
abstract: OBJECTIVE
  To compare interpretation performance on soft-copy presentations, with and without simple image manipulation, and on unmodified hard-copy presentations with regard to detection of pulmonary nodules and masses.
  
  
  METHODS
  Fifty chest digital radiograph combinations of patients with a total of 60 nodules, 32 of which were 2.0 cm in diameter, were selected for the study. Three readers evaluated three separate image formats: unmodified hard- and soft-copies, and soft-copies with simple image manipulation of lung and mediastinum window settings, and zooming. The screen display was 1600 x 1200 pixels with 8 bits/pixel.
  
  
  RESULTS
  The sensitivity, accuracy, detectability, and Az value of the soft-copy systems were clearly inferior to hard-copy evaluation. The mean Az values were 0.921 for unmodified hard-copy, 0.820 for image-manipulated soft-copy, and 0.781 for unmodified soft-copy.
  
  
  CONCLUSIONS
  Soft-copy interpretations were not as sensitive in detecting pulmonary nodules and masses as hard-copy evaluation.
authors.affiliation: Department of Radiology, National Defense Medical College, Tokorozawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kosuda
authors.forename: T
authors.initials: T
authors.lastname: Kaji
authors.forename: H
authors.initials: H
authors.lastname: Kobayashi
authors.forename: M
authors.initials: M
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: S
authors.initials: S
authors.lastname: Kusano
mesh_terms: D000328:Adult; D003199:Computer Systems; D003626:Data Display; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D016013:Likelihood Functions; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014963:X-Ray Intensifying Screens