CHICAGO – Researchers from University of Massachusetts Memorial Health Care in Worcester, MA Monday presented data at the RSNA suggesting that digital radiography has the potential to replace screen-film imaging for evaluation of inflicted pediatric skeletal injury.
The authors attempted to assess the diagnostic performance of digital radiography using charge-coupled device (CCD) technology in the detection of rib fractures in infant abuse. The study was conducted by utilizing four fractured posterior rib arcs and eight normal ribs removed at autopsy from an abused infant.
The ribs were imaged using a CCD lab prototype developed by A. Karellas, Ph.D., one of the study’s authors. Each rib was viewed in nine projections, to simulate the clinical setting. The images were then assessed for probability of fracture (using a scale of 0=no fracture to 100=definite fracture) by four pediatric radiologists. The calculated areas under the resultant receiver operator characteristics (ROC) curves (Az) were compared with those obtained with direct exposure, high-detail, medium and fast screen-film radiographic systems.
The research determined that the mean Az for the CCD (.937) fell within the range of the high-detail systems (.934 to .940) and was significantly higher (p < .05) than the medium and fast system (.861 and .858 respectively). Despite a lower spatial resolution than direct exposure film (7 line pairs per millimeter vs. >20 line pairs per millimeter) the CCD performance was comparable (Az = .944 vs. .937). The authors concluded that the similar performance could be explained by the higher contrast resolution of the digital technology.
Dr. Paul Kleinman, presenter of the paper, noted: “As we move from film-screen radiography to digital radiography we have to be careful that we do not diminish our diagnostic accuracy. And there is no area where this is more important than in the area of suspected child abuse.”
By Jonathan S. Batchelor
AuntMinnie.com staff writer
November 28, 2000
The authors attempted to assess the diagnostic performance of digital radiography using charge-coupled device (CCD) technology in the detection of rib fractures in infant abuse. The study was conducted by utilizing four fractured posterior rib arcs and eight normal ribs removed at autopsy from an abused infant.
The ribs were imaged using a CCD lab prototype developed by A. Karellas, Ph.D., one of the study’s authors. Each rib was viewed in nine projections, to simulate the clinical setting. The images were then assessed for probability of fracture (using a scale of 0=no fracture to 100=definite fracture) by four pediatric radiologists. The calculated areas under the resultant receiver operator characteristics (ROC) curves (Az) were compared with those obtained with direct exposure, high-detail, medium and fast screen-film radiographic systems.
The research determined that the mean Az for the CCD (.937) fell within the range of the high-detail systems (.934 to .940) and was significantly higher (p < .05) than the medium and fast system (.861 and .858 respectively). Despite a lower spatial resolution than direct exposure film (7 line pairs per millimeter vs. >20 line pairs per millimeter) the CCD performance was comparable (Az = .944 vs. .937). The authors concluded that the similar performance could be explained by the higher contrast resolution of the digital technology.
Dr. Paul Kleinman, presenter of the paper, noted: “As we move from film-screen radiography to digital radiography we have to be careful that we do not diminish our diagnostic accuracy. And there is no area where this is more important than in the area of suspected child abuse.”
By Jonathan S. Batchelor
AuntMinnie.com staff writer
November 28, 2000
Copyright © 2000 AuntMinnie.com
Click here to view the rest of AuntMinnie’s coverage of the 2000 RSNA conference.
Click here to post your comments about this story.
