Reliability and Validity of Soft Copy Images Based on Flat-panel Detector in Pneumoconiosis Classification: Comparison with the Analog Radiographs

Abstract

The aim of this study was to evaluate the reliability and validity of soft copy images based on flat-panel detector of digital radiography (DR-FPD soft copy images) compared to analog radiographs (ARs) in pneumoconiosis classification and diagnosis. DR-FPD soft copy images and ARs from 349 subjects were independently read by four-experienced readers according to the International Labor Organization 2000 guidelines. DR-FPD soft copy images were used to obtain consensus reading (CR) by all readers as the gold standard. Reliability and validity were evaluated by a κ and receiver operating characteristic analysis, respectively. In small opacity, overall interreader agreement of DR-FPD soft copy images was significantly higher than that of ARs, but it was not significantly different in large opacity and costophrenic angle obliteration. In small opacity, agreement of DR-FPD soft copy images with CR was significantly higher than that of ARs with CR. It was also higher than that of ARs with CR in pleural plaque and thickening. Receiver operating characteristic areas were not different significantly between DR-FPD soft copy images and ARs. DR-FPD soft copy images showed accurate and reliable results in pneumoconiosis classification and diagnosis compared to ARs.