Objective To evaluate technical key points and applicability of direct digital radiography(DR) images in identification of pneumoconiosis, we compared the shape/size and profusion of small opacities between film screen radiography (FSR)and DR technique.
Methods We enrolled 204 pneumoconiosis patients and 31 workers exposed to dust with FSR and DR images obtained, compared image quality, small opacity profusion and shape, large opacity identification between these two modalities.
Results Significantly more FSR images were unacceptable for classification purposes compared to DR images (P<0.001). The inter-modality agreement of small opacities was good with a weighted kappa (κ)of 0.77. The inter-modality agreement was high in the upper zones (κ=0.82), intermediate in the middle zones (κ=0.75) and low in the lower zones (κ=0.68). The identification of small opacities was close (93.2% FSR and 90.0% DR) and the distributions of shape between FSR and DR did not significantly differ(P>0.05). A complete agreement was achieved in the recognition of large opacities between modalities with 22.9% (44/192)of radiographs classified as having at least one large opacity in the same 44 subjects.
Conclusion DR im ages with soft copy display are equivalent or superior to FSR technique with respect to the image quality and the recognition/classification of small parenchymal lung opacities.
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