title: Gray-scale inversion radiographic display for the detection of pulmonary nodules on chest radiographs.
abstract: The purpose of this study was to investigate gray-scale inversion in nodule detection on chest radiography. Simulated nodules were superimposed randomly onto normal chest radiographs. Six radiologists interpreted 144 chest radiographs during three reading sessions: traditional presentation, inverted gray-scale, and a choice session allowing use of traditional and gray-scale inverted views. Sensitivity and specificity were used to assess accuracy based on presence or absence of a nodule. Gray-scale inversion and choice display sessions resulted in significantly higher nodule detection specificity and decreased sensitivity compared to traditional display. Gray-scale inversion may decrease false-positive nodule findings during chest X-ray interpretation.
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, USA. matthew.lungren@duke.edu
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Lungren
authors.forename: Eshan
authors.initials: E
authors.lastname: Samei
authors.forename: Huiman
authors.initials: H
authors.lastname: Barnhart
authors.forename: H Page
authors.initials: HP
authors.lastname: McAdams
authors.forename: Richard A
authors.initials: RA
authors.lastname: Leder
authors.forename: Jared D
authors.initials: JD
authors.lastname: Christensen
authors.forename: John D
authors.initials: JD
authors.lastname: Wylie
authors.forename: Jin W
authors.initials: JW
authors.lastname: Tan
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Hurwitz
mesh_terms: D002983:Clinical Competence; D003937:Diagnosis, Differential; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology