Storage phosphor radiographs vs conventional films: interpreters' perceptions of diagnostic quality

We compared storage phosphor images with high-quality conventional film-screen images by evaluating physicians' perceptions of image quality and their levels of confidence in making diagnostic interpretations. Eight physicians each examined 11 posteroanterior storage phosphor chest images (obtained with an experimental high-resolution storage phosphor system) side by side with conventional film images of the same patients. The storage phosphor images were obtained only minutes after the conventional radiographs were obtained. Storage phosphor images were digitally printed onto films in two different formats: a full-size (12 X 14 in. [30.5 X 35.6 cm]) and a half-size format of four computer-processed, minified images (6 X 7 in. [15.2 X 17.8 cm] each). Most of the responses rated the quality and resolution/sharpness of conventional images, as well as their ability to display the complete lung field, as either "excellent" or "good"; however, the storage phosphor images received significantly better ratings (p less than .05). Computer-processed minified versions of the storage phosphor images also received better ratings than did the conventional images. When the physicians were asked to rate their confidence level in making diagnoses with each of the two techniques, in 74 of 88 cases they indicated that their level of confidence would be at least as high when using the storage phosphor images as when using the conventional images.