title: Picture archive and communication system (PACS) in the detection of fish bone: an animal study.
abstract: OBJECTIVE
  We have developed an animal model to investigate the feasibility of using a digital radiography picture archive and communication system (PACS) to identify fish bones.
  
  
  METHODS
  Bones from 21 species of freshwater and seawater fish were placed in the upper esophagus of a test pig. Digital radiographic images of the lateral neck were taken (60 kV, 200 mA, and 20 ms, 100 cm in distance). The images were interpreted by three radiologists. The chi(2) test, Kendall's coefficient of concordance, and the logistic regression model were applied for statistical analyses.
  
  
  RESULTS
  Milkfish had the lowest visibility (33.3%) in PACS. There was a significant variation in the ratings of visibility among three radiologists (P < 0.01, Kendall's coefficient 0.75). Seawater vs freshwater category, bone length, and radiologist were significant factors that affected visibility.
  
  
  CONCLUSIONS
  The sensitivity is 0.89. Images from seawater fish with long bones have better visibility. PACS is feasible in diagnosing upper esophagus fish bones, but the physician's knowledge of local varieties of fish prior to image study is equally important.
authors.affiliation: Department of Radiology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Yung-Cheng
authors.initials: YC
authors.lastname: Wang
authors.forename: Yung-Chien
authors.initials: YC
authors.lastname: Huang
authors.forename: Hsio-Yun
authors.initials: HY
authors.lastname: Chang
authors.forename: Yen-Liang
authors.initials: YL
authors.lastname: Chang
authors.forename: Chi-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Pa-Chun
authors.initials: PC
authors.lastname: Wang
mesh_terms: D000818:Animals; D001842:Bone and Bones; D004195:Disease Models, Animal; D004947:Esophagus; D005240:Feasibility Studies; D005399:Fishes; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011859:Radiography; D011873:Radiology Information Systems; D015203:Reproducibility of Results; D017747:Seafood; D013552:Swine; D013624:Taiwan