Digital luminescence radiography

The introduction of picture archiving and communications systems requires primary digital image acquisition. In this paper the diagnostic value of digital luminescence radiography (10 pixels per millimeter, gray scale, 10 bits) in the investigation of the hand is compared with that of high-resolution screen-film radiography by means of receiver operating characteristic (ROC) curve methodology. Conventional (CR), digital (DR), and edge-enhanced digital (EDR) hand radiographs (100 each, 50% with arthritis or hyperparathyroidism) were read independently by five radiologists with no clinical information. Findings of four defined regions (carpus, metacarpus, proximal, and distal interphalanges) were scored on a five-point confidence scale, and a ROC analysis was performed. The gold standard was defined by consensus of three skeletral radiologists