[Diagnostic accuracy of teleradiology in thoracic and abdominal diseases]

For one year now, teleradiology has linked the "S. Marcello" Hospital to the Department of Radiology of "Del Ceppo." Hospital in Pistoia, 30 kilometers away. Plain films are digitized (Lumiscan 50, Philips), transmitted over a dedicated standard telephone line and displayed at 1024 x 1024 x 8 bits. To study the diagnostic accuracy of teleradiology in chest and abdominal conditions, we digitized and transmitted to the Pistoia Dept. of Radiology, a sample of 156 (96 chest and 60 abdominal) emergency examinations made in "S. Marcello" Hospital from January through November, 1995. The patients were 81 women (mean age: 69 years) and 75 men (mean age: 66 years); the age range was 17-93 years. Three radiologists independently reviewed the images in the Pistoia Dept. of Radiology on a digital workstation enabled to manipulate images. They filled in some given forms specific for chest and abdominal radiography, which were compared with the same forms filled in by the radiologist in "S. Marcello" Hospital who reviewed plain films. The differences were never clinically important; they concerned emphysema (4 false positives and 2 false negatives), congestion of the hila (2 false positives and 2 false negatives) and abnormal air in small bowel and colon (2 false positives and 2 false negatives). We believe these differences to be related to interobserver variability. The diagnostic accuracy of monitor image interpretation by the three radiologists who reviewed digitized radiographs exceeded 96% for both chest and abdominal examinations, which figure compares with literature data on high resolution workstations.