Comparison of film-screen combination and digital fluorography in gastrointestinal barium examinations in a clinical setting

Abstract

Objective: Digital fluoroscopy systems have been developed for gastrointestinal barium studies. We compare the performance of a commercially available digital fluoroscopy system with conventional film-screen combinations in gastrointestinal barium studies. Methods: Two consecutive groups of outpatients underwent diagnostic barium examinations of esophagus, stomach, or colon using either a film-screen technique ( n = 32) or a digital fluoroscopy system with an 8-bit gray scale ( n = 31). A standardized biphasic protocol was employed in all patients by the same set of investigators and scored subjectively for contrast performance in single-contrast and double-contrast mode and for spatial resolution. Results: For the whole group there were no significant differences between the two techniques. In the subgroup of esophagus studies, digital fluoroscopy performed better during the fullcolumn part of the examination. In the subgroup of colon studies, the film-screen technique performed better during the doublecontrast part of the examination. To reach sufficient spatial resolution with the digital system (884 2 matrix), the smallest input screen had to be used (23 cm), resulting in a higher number of exposures than with the film-screen combination ( P = 0.006). The average amount of film used was not significantly different. Conclusion: In a clinical setting the contrast performance and spatial resolution of digital fluoroscopy systems can be comparable with conventional film-screen combinations.