Detection of pulmonary edema in pigs: storage phosphor versus amorphous selenium-based flat-panel-detector radiography.

Abstract

To compare diagnostic accuracy of soft-copy selenium-based digital radiographic images and soft-copy computed radiographic images obtained for detection of pulmonary edema in pigs. Oleic acid was injected intraatrially into three pigs (weight, 20-25 kg) at doses of 0.04, 0.05, and 0.06 mL/kg to induce pulmonary edema. Thirty-seven sets of computed radiographic, digital radiographic, and thin-section computed tomographic (CT) scans were obtained every 20-30 minutes in three pigs over 4-6 hours. Images were masked for identity, randomly sorted, and displayed on a monitor. Four radiologists rated each image for presence of parenchymal opacities by using a dichotomous scoring system in two sessions. Presence of pulmonary edema was determined with thin-section CT and a severity scale. Intra- and interobserver variations were determined with the kappa statistic and the Z test and with the Cochran Q test and the McNemar test, respectively. True-positive, true-negative, false-positive, and false-negative rates were determined. McNemar test was used to determine statistical significance of differences in detection between computed and digital radiographic images. There was no significant intra- or interobserver variation, except for one pair of observers during the first interpretative session with computed radiographic images (P =.016, McNemar test). Overall sensitivity (92.1%) and diagnostic accuracy (90.2%) of digital radiography were significantly higher than those of computed radiography (79.6% and 83.4%, respectively) (P <.001 for sensitivity, P =.01 for diagnostic accuracy, McNemar test). In detection of minimal and mild pulmonary edema, sensitivity of digital radiography (84%) was significantly higher than that of computed radiography (58%) (P <.001). Soft-copy digital radiographic images are superior to soft-copy computed radiographic images obtained for detection of mild pulmonary edema in pigs.