Are digital images good enough? A comparative study of conventional film-screen vs digital radiographs on printed images of total hip replacement.
The aim of this study was to evaluate the inter- and intra-observer variability and to find differences in diagnostic safety between digital and analog technique in diagnostic zones around hip prostheses. In 80 patients who had had a total hip replacement (THR) for more than 2 years, a conventional image and a digital image were taken. Gruen's model of seven distinct regions of interest was used for evaluations. Five experienced radiologists observed the seven regions and noted in a protocol the following distances: stem-cement; cement-bone; and stem-bone. All images were printed on hard copies and were read twice. Weighted kappa, kappa(w), analyses were used. The two most frequently loosening regions, stem-cement region 1 and cement-bone region 7, were closely analyzed. In region 1 the five observers had an agreement of 86.75-97.92% between analog and digital images in stem-cement, which is a varied kappa(w) 0.29-0.71. For cement-bone region 7 an agreement of 87.21-90.45% was found, which is a varied kappa(w) of 0.48-0.58. All the kappa values differ significantly from nil. The result shows that digital technique is as good as analog radiographs for diagnosing possible loosening of hip prostheses.
Eklund
K
K
Department of Radiology, Center for Medical Imaging and Physiology, Lund University Hospital, 22185 Lund, Sweden. Karin.eklund@skane.se
Jonsson
K
K
Lindblom
G
G
Lundin
B
B
Sanfridsson
J
J
Sloth
M
M
Sivberg
B
B
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis; D006801:Humans; D015588:Observer Variation; D011183:Postoperative Complications / Q000175:diagnosis; D011856:Radiographic Image Enhancement / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D014962:X-Ray Film / Q000706:statistics & numerical data