Can chest X-rays and ventilation/perfusion scans be interpreted reliably from personal computer screens?

Area of Science:

• Radiology
• Nuclear Medicine
• Medical Imaging

Background:

• Home reporting of nuclear medicine scans is increasingly common.
• Accurate interpretation of ventilation/perfusion (V/Q) scans requires both V/Q imaging and chest radiographs.

Purpose of the Study:

• To evaluate the reliability of reporting V/Q scans using computer screen images.
• To assess the impact of digitized chest X-rays on V/Q scan interpretation.

Main Methods:

• One hundred consecutive V/Q scans and their corresponding chest X-rays were analyzed.
• Two radiologists and two nuclear physicians reported scans using both personal computers and traditional lightboxes.
• Chest X-rays were digitized to a 512 x 512 matrix for computer reporting.

Main Results:

• V/Q scans were reliably reported from computer screen images.
• Digitization of chest X-rays resulted in significant data loss.
• Digitized chest X-rays led to misinterpretations and potentially incorrect V/Q scan reports.

Conclusions:

• Computer-based reporting of V/Q scans is feasible and reliable.
• Digitizing chest X-rays for V/Q scan interpretation introduces significant risks of error.
• Current digitization methods for chest X-rays are inadequate for accurate V/Q scan reporting.