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Clinical comparison of a new digital x-ray detector system with a conventional screen film system

Twenty-five paired chest images (twenty Posterior-Anterior views and five Lateral views) were obtained under identical x- ray exposure conditions with both an amorphous silicon digital detector system and a thoracic film-screen system (InSight HC screen and InSight IT film; Kodak, Rochester, NY). The digital image data was transformed using non-linear algorithms to obtain a gray-scale appearance comparable to conventional film images. The digital images were printed at full resolution onto laser film (3M, 969). Each hard copy clinical image pair was evaluated by six radiologist experts in a blinded study. Two thirds of the radiologists' ratings showed the digital detector images 'Better' or 'Much Better' than screen-film images (p less than 0.05); Ninety-eight percent of the radiologists' ratings indicated the digital 'Equivalent,' 'Better' or 'Much Better' (p equals 0.0004) than analog film. The digital image system improvement can be explained by significantly higher DQE and an extended dynamic range. The study clearly demonstrates that clinically the new digital x- ray detector radiographic system can produce diagnostic images equivalent or superior to conventional screen film system.