title: Digitizing pediatric chest radiographs: comparison of low-cost, commercial off-the-shelf technologies.
abstract: OBJECTIVE
  To compare low-cost, off-the-shelf technology for digitizing pediatric chest radiographs.
  
  
  METHODS
  Forty pediatric chest radiographs (hard copy), each with a single abnormality, were digitized using a commercial film digitizer and two low-cost
  
  
  METHODS
  a digital camera and a flatbed scanner. A stratified, randomized, block design was used where 20 readers evaluated 40 different images to determine the ability to accurately detect the abnormality. Readers then rated all 160 images (40 images x 4 methods) for conspicuity of the abnormality and overall image quality.
  
  
  RESULTS
  Abnormalities were correctly identified on 82.3 % of hard copy images, 82.9 % of flatbed scanner images, 74.3 % of film digitizer images, and 69.7 % of digital camera images (p < 0.05) when compared to hard copy or flatbed scanner images. Lesion conspicuity was rated higher on hard copy (p < 0.05) than all digitized images. Conspicuity ratings were similar for flatbed scanner and film digitizer images, but lower in digital camera images (p < 0.05). For overall image quality, all were rated significantly different from each other (p < 0.05), with hard copy > flatbed scanner > film digitizer > digital camera images.
  
  
  CONCLUSIONS
  A low-cost flatbed scanner yielded digital pediatric chest images which were significantly superior to digital camera images While flatbed scanner images were interpreted with the equivalent diagnostic accuracy of hard copy images, they were rated lower for image quality and lesion conspicuity.
authors.affiliation: Department of Radiology, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859-5000, USA. Lynne.Ruess@amedd.army.mil
authors.forename: L
authors.initials: L
authors.lastname: Ruess
authors.forename: C F
authors.initials: CF
authors.lastname: Uyehara
authors.forename: K C
authors.initials: KC
authors.lastname: Shiels
authors.forename: K H
authors.initials: KH
authors.lastname: Cho
authors.forename: S C
authors.initials: SC
authors.lastname: O'Connor
authors.forename: D A
authors.initials: DA
authors.lastname: Person
authors.forename: R K
authors.initials: RK
authors.lastname: Whitton
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003195:Computer Communication Networks; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011856:Radiographic Image Enhancement / Q000191:economics / Q000379:methods*; D011873:Radiology Information Systems / Q000191:economics; D019112:Teleradiology / Q000191:economics* / Q000295:instrumentation