Improved imaging of bone with scan equalization radiography

Use of scan equalization radiography (SER) for imaging bone in the head, face, neck, and shoulder was evaluated in a clinical comparison study with conventional radiographs of randomly selected patients. Two hundred nine pairs of normal and abnormal SER images and conventional radiographs were compared by four radiologists in a side-by-side viewing situation. The radiologists compared the visibility of specific anatomic features and rated the SER images as better than, equal to, or worse than the conventional radiographs. In the evaluation of the images of the cervical spine, the radiologists much preferred the SER images 63% of the time because of slight improvement in bone detail and marked improvement in detail of the soft tissues. In the evaluation of the images of the shoulder, the radiologists preferred the SER image 58% of the time and preferred the conventional radiograph only 5% of the time (p less than .05). In the evaluation of the images of the skull, face, and mandible, the radiologists preferred the SER images 62% of the time and the conventional images 4% of the time (p less than .05). The superior image quality with the SER technique was recognized by all radiologists in the study and was the overwhelmingly preferred way of imaging the shoulder, neck, head, and face.