Comparison of 2048-line digital display formats and conventional radiographs: an ROC study

Observer performance tests were conducted to compare the effects on diagnostic accuracy of digital hard copy and video display formats versus conventional radiographic film. Digital images were obtained by digitizing conventional chest radiographs to a 2048 x 2048 matrix with a laser film scanner. Three digital display formats were used: laser-printed digital film, a 2048-line video monitor without user interaction, and a 2048-line video monitor with user interaction. Thirty-one posteroanterior chest radiographs, determined by consensus of four thoracic radiologists to contain septal lines (n = 11), parenchymal nodules (n = 7), nodules and septal lines (n = 7), or neither abnormality (n = 6), were used for the study. Images were interpreted by four radiologists in four separate viewing sessions. Diagnostic accuracy was determined by receiver-operating characteristic analysis for each observer with each viewing technique. No statistical differences in diagnostic accuracy, determined by the area under the receiver-operating-characteristic curve, were found between the analog film, the digital film, and the two video digital display formats. This preliminary study suggests that 2048-line digital displays may be an acceptable alternative to the traditional lightbox viewing method for the perception of these two abnormalities commonly seen on chest radiographs.