Digital videofluorography for direct digital spot filming of gastrointestinal studies

Digital videofluorography (DVF) refers to a new computer-aided televised fluoroscopy technique that uses short (10-20 ms) intense pulses of radiation to produce a motion-free latent image, which is then transferred into digital storage. Because gastrointestinal imaging has lagged behind other body systems in the evaluation of digital acquisition, we investigated the potential utility of this technique for direct digital fluoroscopic spot filming of gastrointestinal examinations. In order to assess the level of clinical image quality achieved by this technique, we conducted an observer performance comparison study of digitally acquired and conventional analog 100 mm spot films. Sequentially acquired spot films and digital radiographs of 111 anatomic regions in 60 patients undergoing routine barium and cholangiographic examinations were compared. Evaluation was made of on-line interactive performance as well as side-by-side analysis of digital and analog hard copy images. Parameters evaluated include detection of normal and pathologic features, image contrast, image resolution, and image sharpness. Direct digital and analog spot films were of comparable diagnostic quality in all parameters studied. Added benefits of the digital mode included postprocessing to enhance detail in regions of low contrast and accommodation of a large field of view (14 inch) image intensifier format.