title: Comparison between differently priced devices for digital capture of X-ray films using computed tomography as a gold standard: a multireader-multicase receiver operating characteristic curve study.
abstract: OBJECTIVE
  Film digitizers are a specialized technology that is available for scanning X-ray radiographs; however, their cost makes them unaffordable for developing countries. Thus, less expensive alternatives are used. The purpose of this study was to compare three devices for digital capture of X-ray films: a film digitizer (US $15,000), a flatbed scanner (US $1800), and a 10-megapixel digital camera (US $450), in terms of diagnostic accuracy, defined as the area under the receiver operating characteristic curves and computed tomography as the gold standard.
  
  
  METHODS
  The sample included 136 chest X-ray cases with computed tomography confirmation of the presence or absence of pneumothorax, interstitial opacities, or nodules. The readers were six radiologists who made observations of eight variables for each digital capture of the X-ray films: three main variables to determine the accuracy in the detection of the above-mentioned pathologies, four secondary variables to categorize other pathological classifications, and one variable regarding digital image quality.
  
  
  RESULTS
  The receiver operating characteristic curves for each device and pathology were very similar. For the main variables, there was no significant statistical difference in diagnostic accuracy between the devices. For the secondary variables, >84% of cases were correctly classified, even those that were classified with the lowest image quality. High accuracy was determined for the three main variables (0.75 to 0.96), indicating good performance for all tested devices, despite their very different prices.
  
  
  CONCLUSIONS
  Choosing a device for a teleradiology service should involve additional factors, such as capture time, maintenance concerns, and training requirements.
authors: Department of Electrical and Electronic Engineering, University of Los Andes, Bogotá, Colombia. ant-sala@uniandes.edu.co
authors: Antonio J
authors: AJ
authors: Salazar
authors: Juan Camilo
authors: JC
authors: Camacho
authors: Diego Andrés
authors: DA
authors: Aguirre
mesh_terms: D000704:Analysis of Variance; D003105:Colombia; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000191:economics / Q000295:instrumentation / Q000379:methods; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000191:economics* / Q000295:instrumentation / Q000706:statistics & numerical data; D014963:X-Ray Intensifying Screens / Q000191:economics* / Q000706:statistics & numerical data