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Detection of Pulmonary Edema in Pigs: Storage Phosphor versus Amorphous Selenium-based Flat-Panel-Detector Radiography¹

¹ From the Dept of Radiology, Samsung Med Ctr, Sungkyunkwan Univ School of Med, Seoul, Korea (T.S.K.); Dept of Radiology, Seoul National Univ Coll of Med and Institute of Radiation Med, Seoul National University Med Research Ctr, 28 Yongon-dong, Chongro-gu, Seoul 110-744, Korea (J.G.I., J.M.G., K.H.L., Y.J.L., S.H.K.); and Samsung Biomedical Research Institute, Samsung Med Ctr, Seoul, Korea (S.K.). Received Jun 20, 2001; revision requested Aug 13; revision received Sep 19; accepted Oct 16. Supported in part by grant HMP-98-G-1-014 of the Highly Advanced National Project, Ministry of Health and Welfare, Republic of Korea. Address correspondence to J.G.I. (e-mail: imjg@radcom.snu.ac.kr).

PURPOSE: To compare diagnostic accuracy of soft-copy selenium-based digital radiographic images and soft-copy computed radiographic images obtained for detection of pulmonary edema in pigs.

MATERIALS AND METHODS: Oleic acid was injected intraatrially into three pigs (weight, 20–25 kg) at doses of 0.04, 0.05, and 0.06 mL/kg to induce pulmonary edema. Thirty-seven sets of computed radiographic, digital radiographic, and thin-section computed tomographic (CT) scans were obtained every 20–30 minutes in three pigs over 4–6 hours. Images were masked for identity, randomly sorted, and displayed on a monitor. Four radiologists rated each image for presence of parenchymal opacities by using a dichotomous scoring system in two sessions. Presence of pulmonary edema was determined with thin-section CT and a severity scale. Intra- and interobserver variations were determined with the statistic and the Z test and with the Cochran Q test and the McNemar test, respectively. True-positive, true-negative, false-positive, and false-negative rates were determined. McNemar test was used to determine statistical significance of differences in detection between computed and digital radiographic images.

RESULTS: There was no significant intra- or interobserver variation, except for one pair of observers during the first interpretative session with computed radiographic images (P = .016, McNemar test). Overall sensitivity (92.1%) and diagnostic accuracy (90.2%) of digital radiography were significantly higher than those of computed radiography (79.6% and 83.4%, respectively) (P < .001 for sensitivity, P = .01 for diagnostic accuracy, McNemar test). In detection of minimal and mild pulmonary edema, sensitivity of digital radiography (84%) was significantly higher than that of computed radiography (58%) (P < .001).

CONCLUSION: Soft-copy digital radiographic images are superior to soft-copy computed radiographic images obtained for detection of mild pulmonary edema in pigs.

© RSNA, 2002

Index terms: Animals • Computed tomography (CT), high-resolution, 60.12118 • Experimental study • Lung, edema, 60.71 • Radiography, comparative studies • Radiography, digital, 60.1215 • Radiography, selenium detector, 60.1215 • Radiography, storage phosphor, 60.1215

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