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PubMed2006

Comparison between Scanora panoramic radiography and bitewing radiography in the assessment of marginal bone tissue.

OBJECTIVES: To compare panoramic radiographs made with the Scanora dental program and bitewing radiographs in the assessment of marginal bone tissue. MATERIALS AND METHODS: Panoramic and posterior bitewing radiographs were made for 96 consecutive patients. Six observers assessed marginal bone level, and five observers identified the presence or absence of vertical bone defects and furcation involvements. Observer agreement was calculated. RESULTS: Assessments of the marginal bone level with the two methods were identical for 57% of the sites. If a difference of one score was allowed, assessments for 95% of the sites were in agreement. Vertical bone defects and furcation involvement were detected with an agreement of 93%. Ranges of kappa indexes for intra-observer agreement on assessments of the marginal bone level were 0.37-0.46 in panoramic radiography and 0.31-0.55 in bitewing radiography. Ranges for agreement on detection of vertical bone defects were 0.52-0.63 and 0.47-0.56 and on detection of furcation involvements 0.64-0.79 and 0.66-0.77, respectively. The kappa index for inter-observer agreement on marginal bone level was 0.28 for panoramic and 0.29 for bitewing radiography. Corresponding figures for detection of vertical bone defects were 0.38 and 0.35 and for detection of furcation involvement 0.56 and 0.67. CONCLUSIONS: For those sites or teeth that are possible to assess, the diagnostic information available with Scanora panoramic radiography is comparable to that with bitewing radiography for marginal bone tissue. Therefore, Scanora dental panoramic radiography is a valuable diagnostic alternative in the primary examination of the periodontal status.

Adult↗
PubMed1999

Computed radiography versus screen-film radiography: detection of pulmonary edema in a rabbit model that simulates neonatal pulmonary infiltrates.

PURPOSE: To determine if computed radiography is equivalent to screen-film radiography in depicting pulmonary edema and to determine if radiation exposure can be reduced with computed radiography while maintaining equivalent diagnostic accuracy for pulmonary edema. MATERIALS AND METHODS: Oleic acid was intravenously injected into three rabbits at each of four doses: 0, 0.02, 0.04, and 0.06 mL/kg. Two hours later, chest computed radiographs and screen-film radiographs were obtained at 60 kVp and 1.1 mAs. Additional computed radiographs were obtained after reducing milliampere seconds or by reducing milliampere seconds and increasing the kilovolt peak, which reduced bone marrow exposure by up to 20%. The presence of pulmonary opacities, "truth," was established by the wet-dry weight ratio and by chest computed tomography (CT). The radiographs were masked and randomized. Four observers rated the images for the presence of parenchymal opacities with a dichotomous score and judged the quality of the radiographs on a scale from 1 (worst) to 6 (best). Cochran Q tests and McNemar tests were used to analyze the differences in paired comparisons. Image quality was evaluated with logistic regression analysis. RESULTS: There was no significant difference between truth and observer ability to detect opacity for either modality or for any exposure (P > .05). There was no significant difference between computed radiography and screen-film radiography for image quality (P > .05). CONCLUSION: Computed radiography is equivalent to screen-film radiography in the detection of pulmonary edema. Radiation exposure reduction of 20% can be achieved without affecting pulmonary edema detection or image quality.

Animals↗
PubMedDate not supplied

Visual-tactile examination compared with conventional radiography, digital radiography, and Diagnodent in the diagnosis of occlusal occult caries in extracted premolars.

PURPOSE: This laboratory study compared visual-tactile examination with conventional radiographs, digital radiographs, and laser fluorescence in the detection of occlusal occult caries on extracted premolar teeth. METHODS: Extracted premolars without obvious caries or restorations were collected from school dental clinics. Occlusal surfaces of 320 extracted premolars were examined visually with an explorer, then examined using the KaVo Diagnodent unit and scored using specific criteria. The teeth were exposed using conventional and digital radiography, respectively. The radiographs were assessed for dentin radiolucencies beneath the occlusal surface. RESULTS: Of the 320 teeth used in this study, 302 were scored as sound by visual-tactile examination. Of these, 57 (19%) demonstrated dentin radiolucency on conventional bite-wings, and 245 (81%) were scored as radiographically sound. Thus, the sensitivity and specificity values of the visual-tactile examination compared with conventional radiography were 81% and 44%, respectively. In contrast, Diagnodent produced results of 82% sensitivity and 36% specificity when compared with conventional radiography. When compared to digital radiography, the sensitivity and specificity values of the visual-tactile examination were 90% and 44%, respectively. In contrast, when compared to digital radiography, Diagnodent showed a very low specificity of only 32%, although sensitivity was still high at 91%. Differences in specificity among the techniques were statistically significant (P < .03), whereas differences in sensitivity were not (P > .01). CONCLUSIONS: Although the diagnosis of occult dentinal caries may be further enhanced by the Diagnodent, a combination of visual-tactile examination and either conventional or digital radiography should identify over 80% of lesions.

Adolescent↗
PubMed1998

Advanced multiple beam equalization radiography: receiver operating characteristic comparison with screen-film chest radiography.

OBJECTIVE: To test the hypothesis that the advanced multiple beam equalization radiography (AMBER) imaging system is superior to conventional chest radiography in the demonstration of diffuse infiltrative lung disease, emphysema, pulmonary nodules, calcification within nodules, and mediastinal or hilar masses and lymphadenopathy. MATERIAL AND METHODS: The study involved 115 patients, each of whom underwent chest computed tomography (CT), AMBER, posteroanterior chest radiography, and conventional posteroanterior stereoscopic chest radiography (two films). All radiographs were obtained with the InSight Thoracic Imaging System. Four chest radiologists independently analyzed the 115 AMBER studies, 115 unpaired single conventional radiographs (a single film from a stereoscopic pair), and 115 stereoscopic conventional radiographs (2 films) for the presence of diffuse infiltrative lung disease, emphysema, pulmonary nodules, calcification within nodules, and mediastinal or hilar masses and lymphadenopathy. For each abnormality detected, the radiologists described their level of confidence based on a scale of 1 to 5. The 115 CT examinations were interpreted by consensus among 3 of the chest radiologists. The CT results were considered the standard. Receiver operating characteristic (ROC) techniques were used for statistical analysis. RESULTS: No statistically significant differences were found with ROC techniques between the AMBER system and single or stereoscopic conventional screen-film radiography for the abnormalities studied. CONCLUSION: We noted no clinically significant difference between AMBER and either single or stereoscopic conventional screen-film radiography in this prospective study of 115 patients in which CT (performed within 1 week of both radiographic examinations) was the standard.

Humans↗
PubMed2001

Efficacy of daily bedside chest radiography as visualized by digital luminescence radiography.

To determine the diagnostic impact of daily bedside chest radiography in comparison with digital luminescence technique (DLR; storage phosphor radiography) and conventional film screen radiography, a prospective randomized study was completed in 210 mechanically ventilated patients with a total of 420 analysed radiographs. The patients were allocated to two groups: 150 patients underwent DLR, and 60 patients underwent conventional film screen radiography. Radiological analysis was performed consensually and therapeutic efficacy was assessed by the clinicians. There was no statistical significant difference between the frequency of abnormal findings seen on DLR and conventional film screen radiography. In total, 448 abnormal findings were present in 249 of 300 DLR and 97 of 120 conventional film screen radiographs. The most common findings were signs of overhydration (41%), pleural effusion (31%), partial collapse of the lung (11%) and pneumothorax (2%). One hundred and twenty-three of 448 (27%) of these abnormal findings were thought to have a considerable impact on patient management. The high rate of abnormal findings with significant impact on patient management suggests that the use of daily bedside chest radiography may be reasonable.

Adolescent↗
PubMed2002

Comparison of panoramic radiography and panoramic digital subtraction radiography in the detection of simulated osteophytic lesions of the mandibular condyle.

OBJECTIVE: The aim of this study was to compare panoramic temporomandibular joint radiography, unenhanced and color-enhanced digital-subtraction radiography with respect to detectability of simulated osteophytic lesions of the mandibular condyle. METHODS: Three dry human skulls with no obvious temporomandibular joint pathology were selected. Four sizes of bone chips were placed on the anterior aspect of the condyle at medial, central, and lateral locations. Panoramic radiographs were made with and without the chips in place. These paired radiographs were digitized, and unenhanced and color-enhanced digital-subtraction images of the original panoramic images were obtained. Eight observers evaluated 72 randomized images of each modality for the presence or absence of simulated osteophytic lesions of the mandibular condyle, grading the images on a 100-point scale. RESULTS: A(z) values for overall diagnostic accuracy of the three imaging modalities were 0.5376 for panoramic radiography, 0.7861 for unenhanced digital subtraction radiography, and 0.7923 for color-enhanced digital-subtraction radiography. Digital-subtraction radiography improved the detection accuracy of the original panoramic films. CONCLUSION: Panoramic radiographs were significantly less accurate in the detection of simulated osteophytic lesions of the mandibular condyle than the two digital-subtraction techniques.

Analysis of Variance↗
PubMed1989

The detection of in vitro produced periodontal bone lesions by conventional radiography and photographic subtraction radiography using observers and quantitative digital subtraction radiography.

Changes in the periodontium produced by removal of bone cylinders at one interdental site of a dry human mandible, were recorded radiographically. These artificial lesions had diameters of 0.3 mm increasing to 1.4 mm in steps of 0.1 mm. Radiographs were obtained using 3 different X-ray tube potentials and 3 different amounts of radiation. These 9 exposure variables resulted in 9 series of radiographs from the artificial lesions. Observers were asked to determine the presence or absence of these periodontal bone lesions on conventional radiographs and on photographically subtracted images. The images were also evaluated by a quantitative digital subtraction technique. This study showed that the smallest periodontal bone changes were detected with the quantitative digital subtraction technique compared to the other methods using observers. On photographically subtracted images, smaller bone changes were detected by the observers than on conventional radiographs. Only the detection threshold of the quantitative digital subtraction technique was influenced by the 2 exposure factors: kVp and mAs.

Alveolar Process↗
PubMed2001

Digital chest radiography with a large-area flat-panel silicon X-ray detector: clinical comparison with conventional radiography.

This was a radiologists' preference study to compare a digital chest radiography system that utilizes a large-area silicon flat-panel detector with conventional radiography for visualizing anatomic regions of the chest. Conventional and digital posteroanterior (PA) and lateral chest radiographs were obtained in 115 patients. The PA and lateral image pairs were compared independently by three radiologists rating the overall appearance, 11 anatomic regions in the PA, and 9 in the lateral views. Statistical analysis was performed with the Wilcoxon signed-rank test with Bonferroni-Holm adjustment (p=0.05). For the PA view, the digital system performed significantly better for the overall appearance and for all anatomic regions except for the peripheral pulmonary vasculature and hilum, where no significant difference was found. For the lateral digital images, the regions trachea, costodiaphragmatic recess, and hilum were rated significantly worse. The regions retrosternal and retrocardiac lung were rated significantly better. The other regions and the overall appearance showed no significant differences. The described digital chest radiography system showed statistically superior visualization of anatomic regions for PA and an ambiguous performance for lateral images as compared with conventional radiography. After changing some image processing parameters for the lateral view, this system may be suitable for digitalization of chest radiography.

Adult↗
PubMed1990

[Can digital luminescent radiography substitute for conventional x-ray technics in chest radiography?].

The image quality of digital luminescent radiography (DLR) is sufficient for routine biplane chest radiography and for follow-up studies of heart size, pulmonary congestion, coin lesions, infiltrations, atelectasis, pleural effusions, and mediastinal and hilar lymph node enlargement. Chest radiography in the intensive care unit may in most cases be performed using the DLR technique. There is no need for repeat shots because of incorrect exposure, and the position of catheters, tubes, pacemakers, drains and artificial heart valves, the mediastinum, and the retrocardiac areas of the left lung are more confidently assessed on the edge-enhanced DLR films than on conventional films. Nevertheless, DLR is somewhat inferior to conventional film-screen radiography of the chest as it can demonstrate or rule out subtle pulmonary interstitial disease less confidently. There is no reduction of radiation exposure of the chest in DLR compared with modern film-screen systems. As a consequence, DLR is presently not in a position to replace traditional film-screen radiography of the chest completely.

Humans↗
PubMed2001

Comparison of an amorphous silicon/cesium iodide flat-panel digital chest radiography system with screen/film and computed radiography systems--a contrast-detail phantom study.

Flat-panel (FP) based digital radiography systems have recently been introduced as a new and improved digital radiography technology; it is important to evaluate and compare this new technology with currently widely used conventional screen/film (SF) and computed radiography (CR) techniques. In this study, the low-contrast performance of an amorphous silicon/cesium iodide (aSi/Csl)-based flat-panel digital chest radiography system is compared to those of a screen/film and a computed radiography system by measuring their contrast-detail curves. Also studied were the effects of image enhancement in printing the digital images and dependence on kVp and incident exposure. It was found that the FP system demonstrated significantly better low-contrast performance than the SF or CR systems. It was estimated that a dose savings of 70%-90% could be achieved to match the low-contrast performance of the FP images to that of the SF images. This dose saving was also found to increase with the object size. No significant difference was observed in low-contrast performances between the SF and CR systems. The use of clinical enhancement protocols for printing digital images was found to be essential and result in better low-contrast performance. No significant effects were observed for different kVps. From the results of this contrast-detail phantom study, the aSi/CsI-based flat-panel digital chest system should perform better under clinical situations for detection of low-contrast objects such as lung nodules. However, proper processing prior to printing would be essential to realizing this better performance.

Cesium↗
PubMed1983

Scanned projection radiography of the chest versus standard film radiography: a comparison of 250 cases.

Two hundred fifty patients who had 240 pathological changes of the lungs or mediastinum were examined using both scanned projection radiography (SPR) and standard film radiography, and the diagnostic accuracy of the procedures was compared. The use of standard film radiography led to diagnostic findings in 90.1% of the cases, while 94% of the images obtained at SPR provided diagnostic findings. The equivalent performance and, in part, the slight superiority obtained with the digital technique is a result of the better contrast resolution for objects with diameters greater than 2 mm. A further improvement in the diagnosis of thoracic disease with digital radiography may occur because of the use of special mathematical algorithms for image reconstruction and with the use of dual-energy subtraction radiography rather than by an increase of spatial resolution.

Humans↗
PubMed1992

Problems associated with digital luminescence radiography in the neonate and young infant. Problems with digital radiography.

An evaluation of the Siemens Digiscan has been undertaken to determine whether digital luminescence radiography (DLR) could replace conventional radiography in the examination of the neonate and young infant. Whilst the overall image quality of the digital radiograph was consistently higher than for conventional radiography the difference was less marked than we had expected. Furthermore, the potential for reduction in radiation dose by reducing the repeat rate due to incorrect exposure was limited. The potential advantages of DLR have been critically examined in relationship to neonatal radiography and a number of problems encountered during the evaluation have been highlighted.

Absorptiometry, Photon↗
PubMed1982

Radiation-absorbed doses and energy imparted from panoramic tomography, cephalometric radiography, and occlusal film radiography in children.

The absorbed doses and energy imparted from radiographic examinations of children, using panoramic tomography (PTG), cephalometric radiography (CPR), and maxillary frontal occlusal overview (FOO), were examined. The absorbed dose at various sites of the head were measured with TL dosimeters in a phantom and in patients. The energy imparted was calculated from measurements of areal exposure using a planparallel ionization chamber. The maximum absorbed doses for panoramic tomography were located around the lateral rotation center, for cephalometric radiography in the left (tube side) parotid region, and for frontal occlusal radiography in the nose. The absorbed doses in the eyes, thyroid gland, and skin are discussed and compared with previous reports and, for the most part, are found to be in agreement. The mean energy imparted from all three examination methods is 5 mJ with about 57 percent from panoramic, 33 percent from cephalometric, and 10 percent from frontal occlusal examinations. The energy imparted from cephalometric radiography can be reduced to about 10 percent with the use of an improved examination technique, leaving panoramic tomography responsible for contributing about 80 percent of the total energy imparted.

Cephalometry↗
PubMed1998

[Panoramic radiography using an intraoral tube. Method, anatomy, radiography and dosimetry].

BACKGROUND: There are two techniques giving a panoramic view of the dental arch: orthopantomography and intraoral tube panoramic radiography. The last one is not very well known because images, with a characteristic and variable deformity if compared with orthopantomography are not useful for routinary use in dentistry. The poor radiographic and pathologic anatomy knowledge of intraoral tube panoramic radiography, and the slight improvements brought to the method particularly in order to reduce the dose, partly depend on the scant attention given to the method by investigators, and partly on the dyshomogeneous anatomic sites enlargement and overlapping with consequent deformity of all of them. With intraoral tube panoramic radiography, X-ray exposition is emitted using a miniaturized cylindrical source placed inside the oral cavity and the radiographic film is in contact with the skin of the face. Based on the orientation of the collimator and the inclination of the tube major axis in the oral cavity, a central technique (exposition of either superior or inferior dental arch) and a lateral technique (simultaneous exposition of the two hemiarches of the same side) are recognized. The aim of this study is to give a significative contribution to maxillo-facial characteristic appearance and dosimetry knowledge in intraoral tube panoramic radiography. METHODS: It consists of: a) a "laboratory" part concerning the evaluation of the enlargement, deformation and visibility of different structures, obtained by positioning about fifty different markers in different maxillary and mandibular anatomic sites, and b) an in vivo dosimetry part obtained with intraoral and extraoral termoluminiscent dosimeters. An original dispositive allowed the right positioning of the film and its adherence to the screen. Deformity characteristics are analitically described and discussed in relation with the different sites. RESULTS AND CONCLUSIONS: The use of intensifying screens allowed a good reduction of dose, (mean absorbed doses ranging from 25 microGy in the intraoral sites to 1936 microGy in the extraoral sites) without reducing the image quality thanks to the device performed "ad hoc".

Dose-Response Relationship, Radiation↗
PubMed2002

Clinical evaluation of digital radiography based on a large-area cesium iodide-amorphous silicon flat-panel detector compared with screen-film radiography for skeletal system and abdomen.

The aim of this clinical study was to compare the image quality of digital radiography using the new digital Bucky system based on a flat-panel detector with that of a conventional screen-film system for the skeletal structure and the abdomen. Fifty patients were examined using digital radiography with a flat-panel detector and screen-film systems, 25 for the skeletal structures and 25 for the abdomen. Six radiologists judged each paired image acquired under the same exposure parameters concerning three observation items for the bone and six items for the abdomen. Digital radiographic images for the bone were evaluated to be similar to screen-film images at the mean of 42.2%, to be superior at 50.2%, and to be inferior at 7.6%. Digital radiographic images for the abdomen were judged to be similar to screen-film images at the mean of 43.4%, superior at 52.4%, and inferior at 4.2%; thus, digital radiographic images were estimated to be either similar as or superior to screen-film images at over 92% for the bone and abdomen. On the statistical analysis, digital radiographic images were also judged to be preferred significantly in the most items for the bone and abdomen. In conclusion, the image quality of digital radiography with a flat-panel detector was superior to that of a screen-film system under the same exposure parameters, suggesting that dose reduction is possible with digital radiography.

Adult↗
PubMed1992

Threshold perception performance with computed and screen-film radiography: implications for chest radiography.

Images of a phantom obtained with computed radiography and standard screen-film imaging were compared to evaluate observer threshold perception performance with a modified contrast-detail technique. Optimum exposure necessary for performance with the imaging plate technique to match that with screen-film techniques was determined, as was comparative performance with variation in kilovoltages, plate type, spatial enhancement, and hard-copy interpolation method. It was found that computed radiography necessitates about 75%-100% more exposure than screen-film radiography to optimally match performance with Ortho-C film with Lanex regular or medium screens (Eastman Kodak, Rochester, NY) for detection of objects 0.05-2.0 cm in diameter. However, only minimal loss of detection performance (approximately 10% overall) was experienced if standard screen-film exposures were used with computed radiography. Little change in observer performance was found with variation in plate type, spatial enhancement, or method of hard-copy interpolation. However, perception performance with computed radiographic images was better at lower kilovoltages.

Humans↗
PubMed1996

Selenium radiography versus storage phosphor and conventional radiography in the detection of simulated chest lesions.

PURPOSE: To compare selenium detectors with three conventional and digital detector systems for the detection of simulated pulmonary lesions. MATERIALS AND METHODS: Templates containing nodules, linear structures, and micronodular opacities were superimposed over an anthropomorphic chest phantom. The authors compared lesion detection with use of storage phosphor radiography (250 speed), selenium radiography (250 speed) with an antiscatter grid, selenium radiography (450 speed) without an antiscatter grid, an asymmetric screen-film system (400 speed), and a conventional screen-film system (250 speed). Detection performance of 10 radiologists was compared by using a multireader-multicase receiver operating characteristic analysis of variance. RESULTS: For the detection of nodules, no statistically significant differences between imaging modes were seen. For the detection of micronodules and linear lesions, both selenium techniques were superior to all other modes (P < .05). In addition, the asymmetric screen-film radiographs were inferior (P < .05) to the conventional screen-film radiographs and to storage phosphor radiographs for the detection of micronodules. CONCLUSION: The selenium detector improves detection of simulated fine linear and low-contrast micronodular details and appears to be superior to other detector systems for chest radiography.

Humans↗
PubMed2001

Abdominal radiography after CT reveals urinary calculi: a method to predict usefulness of abdominal radiography on the basis of size and CT attenuation of calculi.

OBJECTIVE: The purpose of this study was to determine if the radiographic visibility of urinary tract calculi could be predicted on the basis of CT features. MATERIALS AND METHODS: The images of 26 patients whose urinary tract calculi were revealed on unenhanced helical CT and who also underwent digital abdominal radiography were retrospectively reviewed. CT features studied included size and CT attenuation of the calculi. These CT findings were correlated with the ability to detect the same calculi with radiography. RESULTS: Forty-nine urinary tract calculi were detected with unenhanced helical CT in 26 patients. Twenty-six (53%) calculi were visible on radiography. Most (79%) calculi larger than 5 mm were detectable with radiography (p < 0.01). One (8%) of 13 calculi with CT attenuation below 200 H was detectable on radiographs. Ninety-five percent (21/22) of calculi with CT attenuation exceeding 300 H were visible on radiographs (p < 0.0001). The one remaining calculus was obscured by overlying anatomy. CONCLUSION: Radiographic surveillance of urinary tract calculi detected with CT may not be useful if the calculi have a CT attenuation below 200 H. Most calculi larger than 5 mm and nearly all calculi with a CT attenuation exceeding 300 H can be seen on abdominal radiographs.

Adult↗