Detection of simulated chest lesions: comparison of a conventional screen-film combination, an asymmetric screen-film system, and storage phosphor radiography

To compare a high-contrast asymmetric screen-film system with a conventional screen-film combination and storage phosphor radiographs for detection of simulated chest lesions.To test the diagnostic performance of these three systems, the authors used three types of simulated lesions that were superimposed over the chests of 10 patients and an anthropomorphic phantom. In the patient and phantom study, a total of 1,350 observations by each of the eight radiologists were analyzed by means of receiver operating characteristics.In the patient study, mediastinal nodules were better visualized with high-contrast asymmetric screen-film and storage phosphor radiographs compared with the conventional screen-film system. For visualization of pulmonary nodules, the high-contrast asymmetric screen-film system was best. Micronodules were poorly visualized on high-contrast asymmetric screen-film and storage phosphor radiographs, but only in the phantom study.The high-contrast asymmetric screen-film system combines the advantages of conventional screen-film radiographs with improved visualization of the mediastinum.