Improving the cervical spine X-ray in trauma patients utilizing dynamic range compression (DRC) modified digital radiography

Purpose: Inadequate cervical spine X-rays delay diagnosis and treatment and add radiation exposure to trauma patients with suspected cervical spine injury. Digital radiography (DR) with dynamic range compression (DRC) modification can improve the visualization of abnormalities in the cervical spine X-ray. Methods: Two digital hard copy cervical spine X-rays from each of 65 trauma patients were used, both with standard DR processing, and with the second image having the DRC algorithm applied. Blinded readers from emergency medicine, surgery, radiology, and critical care specialties evaluated the films with data analyzed by Student's t-test and ϰ²; P < 0.05. Results: Readers cleared more of the DRC than of the non-DRC images: 41 % vs 30 %, P < 0.001. More vertebral bodies were visualized on DRC than on non-DRC images: 65 % vs 53 % showing C7, P < 0.001. For overall impression of the image quality, DRC images rated higher on a 10-cm visual analog scale than non-DRC: 6.7 vs 4.2, P < 0.001. Conclusions: DRC modification of DR images enabled physicians to evaluate cervical spine X-rays more rapidly and accurately after trauma, requiring fewer repeat films.