Radiology, Vol 206, 609-616, Copyright © 1998 by Radiological Society of North America

ARTICLES

Detection of subtle abnormalities on chest radiographs after irreversible compression

V Savcenko, BJ Erickson, PM Palisson, KR Persons, A Manduca, TE Hartman, GF Harms and LR Brown
Department of Diagnostic Radiology, Mayo Foundation, Rochester, MN 55905, USA.

PURPOSE: To assess the effect of wavelet-based compression of posteroanterior chest radiographs on detection of small uncalcified pulmonary nodules and fibrosis. MATERIALS AND METHODS: Computed tomography (CT) of the chest was used to identify 20 patients with normal posteroanterior chest radiographs, 20 with a solitary uncalcified pulmonary nodule 1-2 cm in diameter, and 20 with fibrotic disease. A double-blind protocol for readings of original images and images compressed at 40:1 and 80:1 was analyzed by using the nonparametric receiver operating characteristic to measure differences in diagnostic accuracy and their statistical significance. RESULTS: There was no substantial difference in the overall diagnostic accuracy (measured by the area under the curve index) for both nodules and fibrosis between images compressed at 40:1 and 80:1 and uncompressed images. Readers tended to perform better on images compressed at 40:1 compared with uncompressed images. The "high-sensitivity" portion of the 80:1 compression curve for nodules was below that for the uncompressed curve, although this was not statistically significant. CONCLUSION: Lossy compression of chest radiographs at 40:1 can be used without decreased diagnostic accuracy for detection of pulmonary nodules and fibrosis. There is no statistically significant difference in diagnostic accuracy at 80:1 compression, but detection ability is decreased.

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