Digitized radiographs in skeletal trauma: a performance comparison between a digital workstation and the original film images.

Abstract

To evaluate the diagnostic performance of a teleradiology system in skeletal trauma. Radiographs from 180 skeletal trauma patients were digitized (matrix, 2,000 x 2,500) and transmitted to a remote digital viewing console (1,200-line monitor). Four radiologists interpreted both the original film images and digital images. Each reader was asked to identify, locate, and characterize fractures and dislocations. Receiver operating characteristic curves were generated, and the results of the original and digitized film readings were compared. All readers performed better with the original film when interpreting fractures. Although the patterns varied between readers, all had statistically significant differences (P < .01) for the two image types. There was no statistically significant difference in performance with the two images when dislocations were diagnosed. The system tested is not a satisfactory alternative to the original radiograph for routine reading of fracture films.