Comparison of observer performance on soft-copy reading of digital chest radiographs: high resolution liquid-crystal display monitors versus cathode-ray tube monitors

The purpose of this study is to compare observer performance for detection of abnormalities on chest radiographs with 5-megapixel resolution liquid-crystal displays (LCD) and 5-megapixel resolution cathode-ray tube (CRT) monitors under bright and subdued ambient light conditions. Six radiologists reviewed a total of 254 digital chest radiographs under four different conditions with a combination of two types of monitors (a 5-megapixel resolution LCD and a 5-megapixel resolution CRT monitor) and with two types of ambient light (460 and 50 lux). The abnormalities analyzed were nodules, pneumothorax and interstitial lung disease. For each reader, the detection performance using 5-megapixel LCD and 5-megapixel CRT monitors under bright and subdued ambient light conditions were compared using multi-case and multi-modality ROC analysis. For each type of ambient light, the average detection performance with the two types of monitors was also compared. For each reader, the observer performance of 5-megapixel LCD and 5-megapixel CRT monitors, under both bright and subdued ambient light conditions, showed no significant statistical differences for detecting nodules, pneumothorax and interstitial lung disease. In addition, there was no significant statistical difference in the average performance when the two monitor displays, under both bright and subdued ambient light conditions, were compared.