Hard- versus soft-copy interpretation

Clinic application of Epub of medical imaging film in CT workflow

OBJECTIVE

To investigate the clinical effects of the Epub of medical imaging film (EMIF) in CT workflow.

METHODS

All experiments were approved by the ethics committee of the local district. An EMIF application is fully implemented in PACS according to the DICOM 3.0 standard. For a statistical comparison in the effects of the EMIF in CT workflow, consecutive 50,000 CT hardcopy film prints have been randomly selected before and after the EMIF application in PACS, respectively. The role of the EMIF in the application of hardcopy films, the clinic practice, the integrality of the quality control data archived in PACS/RIS and so on is investigated.

RESULTS

For consecutive 50,000 CT hardcopy films before vs. after the EMIF application respectively, the counts of wasted films are 21 vs. 14 sheets due to the hardware problem, 28 vs. 0 sheets owing to operation errors, and 24 vs. 0 sheets caused by serious defects in image layout. Reissuing films for lost films and other special needs is 60 vs. 55 sheets. The average reissuing film time for each case is 16.97±6.14 vs. 4.36±1.26 min (t=5.94, p<0.01). The EMIF application has offered more convenience for medical viewing and reviewing, and has enhanced the integrality of the quality control data archived in PACS/RIS (χ2=320.835, P<0.01).

CONCLUSION

EMIF application in clinical healthcare can help enhance the function of PACS/RIS, and improve the quality and efficiency in CT routine work.

Comparison of Calcification Specificity in Digital Mammography Using Soft-Copy Display Versus Screen-Film Mammography

OBJECTIVE

The purpose of this study was to compare specificity in the interpretation of calcifications in soft-copy reviewing of digital mammograms versus hard-copy reviewing of screen-film mammograms.

MATERIALS AND METHODS

A total of 130 consecutive cases with calcifications (44 malignant and 86 benign) that had been evaluated with needle or surgical biopsy were collected. Both screen-film mammography and soft-copy digital mammography were obtained in the same patients under existing research protocols using Fischer Imaging's SenoScan (n = 71), Lorad's digital mammography system (n = 35), and GE Healthcare's Senographe 2000D (n = 24). Eight trained radiologists scored all lesions--cropped or masked to display just the region of interest--both on screen-film and soft-copy digital mammography with a month between reviews to reduce the effects of learning and memory. A 5-point malignancy scale was used, with 1 as definitely not, 2 as probably not, 3 as possibly, 4 as probably, and 5 as definitely. Reviewers were randomly assigned condition order, and images within each condition were randomly ordered. Repeated measures analysis of variance was used to test for differences between conditions in specificity computed via nonparametric receiver operating characteristic (ROC) study separately for each reviewer and condition.

RESULTS

Across all reviewers, the mean specificity for 1 or 2 versus 3, 4, or 5 was 0.803 for screen-film mammography (range, 0.413-0.938; SD +/- 0.166) and 0.833 for soft-copy image (range, 0.375-0.951; SD +/- 0.187). Although not statistically significant (Student's t test p values from 0.19 to 0.99 across all cut points), numeric values of specificity were consistently higher for soft-copy versus screen-film mammography. No statistical significance in specificity was seen using all possible cut points in the 5-point scale, although the primary analysis used the cutpoint for differentiation between benign and malignant cases as 1 or 2 versus 3, 4, or 5.

CONCLUSION

No statistically significant difference was shown in specificity achievable using soft-copy digital versus screen-film mammography in this study.

The Electronic Viewbox

OBJECTIVE

We describe an effective, resource-free method for facilitating the comparison of film-based and PACS-based radiographic studies.

CONCLUSION

Side-by-side comparison of film-based and PACS-based radiographic studies is often inconvenient because of the absence of an ergonomically satisfactory viewbox near the workstation. With a simple maneuver, any PACS display monitor can be used as a rudimentary viewbox, providing a convenient and ergonomically effective alternative.