Purpose: To compare radiologist detection performance under clinical conditions for assessment of conventional radiographs and digital chest images obtained with a selenium detector.

Materials And Methods: One hundred four patients were examined with the digital and conventional systems under near identical technical conditions. The digital images were acquired without an antiscatter grid. Two hundred eight images were analyzed by three radiologists for detection of pulmonary, mediastinal, and pleural abnormalities; computed tomography was used as the reference standard. The diagnostic value of both techniques for the detection of these chest abnormalities was analyzed with receiver operating characteristic (ROC) methods.

Results: For detection of the various abnormalities by all radiologists, the areas under the ROC curves with conventional imaging versus digital imaging, respectively, were as follows: pulmonary opacities, 0.81 versus 0.79; interstitial disease, 0.69 versus 0.73; mediastinal disease, 0.79 versus 0.74; and pleural abnormalities, 0.73 versus 0.68.

Conclusion: There was no statistically significant difference between the radiologists' performance in detecting pulmonary, mediastinal, and pleural abnormalities with conventional radiography versus that with digital selenium chest radiography.

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