Computed radiography

In an effort to evaluate the feasibility of introducing computed radiography (FCR) into mass screening for lung cancer, the ability of FCR to detect nodules one cm in diameter was examined using a humanoid chest phantom. Based on the receiver operating characteristic (ROC) analysis, the detectability of FCR was compared with that of conventional radiography and photofluorography. The values of area under ROC curves were higher for FCR (0.963 for image similar to that with conventional film-intensifying screen system, image A; and 0.952 for processed image, image B) than the other two methods (0.774 for radiography and 0.789 for photofluorography). Degradation of image quality in FCR could be avoided by a wide latitude even if proper exposure techniques might not be employed. Images A and B in FCR yielded excellent delineation for nodules in the lung field and in the retrocardiac and subdiaphragmatic regions, respectively. This may have implications for the value of simultaneous interpretation of both images in increasing diagnostic accuracy. Structured noise of the ribs and blood vessels had scarcely an effect on nodule detectability in FCR. Radiation dose could be reduced to one third of the standard dose. It can thus be concluded that FCR is feasible in mass screening for lung cancer in terms of increased diagnostic ability and low radiation doses. (Namekawa, K.)