Digital chest radiography with a selenium-based flat-panel detector versus a storage phosphor system: comparison of soft-copy images

OBJECTIVE. We compared the soft-copy images produced by a digital chest radiography system that uses a flat-panel X-ray detector based on amorphous selenium with images produced by a storage phosphor radiography system for the visualization of anatomic regions of the chest. MATERIALS AND METHODS. Two chest radiologists and two residents analyzed 46 pairs of posteroanterior chest radiographs on high-resolution video monitors (2560 x 2048 x 8 bits). In each pair, one radiograph was obtained with a storage phosphor radiography system, and the other radiograph was obtained with a selenium-based flat-panel detector radiography system. Each pair of radiographs was obtained at the same exposure settings. The interpreter rated the visibility and radiographic quality of 11 different anatomic regions. Each pair of images was ranked on a five-point scale (1 = prefer image A, 3 = no preference, 5 = prefer image B) for preference of technique. Statistical significance of preference was determined using the Wilcoxon's signed rank test. RESULTS. The interpreters had a statistically significant preference for the selenium-based radiography system in six (unobscured lung, hilum, rib, minor fissure, heart border, and overall appearance) of 11 anatomic regions (p<0.001) and for the storage phosphor system in two regions (proximal airway and thoracic spine) (p<0.05). Chest radiologists strongly preferred selenium-based images in eight regions, and they did not prefer storage phosphor images in any region. CONCLUSION. The soft-copy images produced by the selenium-based radiography system were perceived as equal or superior to those produced by the storage phosphor system in most but not all anatomic regions.