<title>Clinical comparison of CR and screen film for imaging the critically ill neonate</title>

Abstract

A clinical comparison of computed radiography (CR) versus screen-film for imaging the critically-ill neonate is performed, utilizing a modified (hybrid) film cassette containing a CR (standard ST-V) imaging plate, a conventional screen and film, allowing simultaneous acquisition of perfectly matched CR and plain film images. For 100 portable neonatal chest and abdominal projection radiographs, plain film was subjectively compared to CR hardcopy. Three pediatric radiologists graded overall image quality on a scale of one (poor) to five (excellent), as well as visualization of various anatomic structures (i.e., lung parenchyma, pulmonary vasculature, tubes/lines) and pathological findings (i.e., pulmonary interstitial emphysema, pleural effusion, pneumothorax). Results analyzed using a combined kappa statistic of the differences between scores from each matched set, combined over the three readers showed no statistically significant difference in overall image quality between screen- film and CR (p equals 0.19). Similarly, no statistically significant difference was seen between screen-film and CR for anatomic structure visualization and for visualization of pathological findings. These results indicate that the image quality of CR is comparable to plain film, and that CR may be a suitable alternative to screen-film imaging for portable neonatal chest and abdominal examinations.