Comparison of Digital Radiographs with Film Radiographs for the Classification of Pneumoconiosis 1

Abstract

Digital chest imaging has replaced film chest radiographs in many centers, but the International Labour Organization classification system, which is the most widely used system for recognition and classification of dust-related abnormalities, is predicated on film chest radiographs. The purpose of this study was to evaluate the equivalency of digital chest radiographs (including both hard copy and soft copy) with film radiographs for the recognition and quantification of abnormalities consistent with pneumoconiosis using the International Labour Organization classification system. Digital chest images and film images, obtained from 107 subjects with a range of parenchymal and pleural abnormalities, were classified in random order by six B readers. Readings of film and soft copy images were equivalent for small opacity profusion; readings of hard copy images had significantly greater prevalence of small opacities compared to film and soft copy. The prevalence of large opacities differed significantly among all three image formats: hard copy greater than film greater than soft copy. However, film and soft copy readings for large opacities did not differ significantly when images demonstrating the coalescence of small opacities that had not yet become a large opacity were grouped with large opacities. The prevalence of pleural abnormalities differed significantly among all three image formats: film greater than hard copy greater than soft copy. Film and soft copy images can be recommended for the recognition and classification of dust-related parenchymal abnormalities using International Labour Organization classifications. The role of digital radiography in reading for pleural abnormalities requires additional investigation.