Diagnostic accuracy on detection of proximal enamel lesions in nonscreen radiographic performance

The effect of differences in image contrast and mean density associated with Kodak Ektaspeed and Ultraspeed films was examined in association with systematic variations in exposure geometry and beam characteristics. Performance was expressed in terms of diagnostic accuracy obtainable by eight dentists who attempted to detect a known distribution of induced proximal enamel lesions in a radiographic phantom. Differences associated with the two types of film and x-ray beam quality were found to have small but statistically significant effects on diagnostic performance. The other factors of film density and projection geometry influenced diagnostic accuracy much more. The largest source of variation was observed among the individual dentists serving as observers.