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Detection of Subtle Undisplaced Rib Fractures in a Porcine Model: Radiation Dose Requirement—Digital Flat-Panel versus Screen-Film and Storage-Phosphor Systems¹

¹ From the Department of Clinical Radiology (K.L., C.S., S.D., D.W., H.L., T.M.B., W.H.) and Institute of Experimental Biomechanics (P.B.), University of Munster, Albert-Schweitzer-Strasse 33, D-48129 Munster, Germany. Received April 1, 2002; revision requested June 11; revision received July 9; accepted August 16. Address correspondence to K.L. (e-mail: lud@uni-muenster.de).

View larger version (11K): [in a new window]   Figure 1a. Schematic drawings of the method of rib fracturing. (a) A rib (shaded in gray) is positioned in a frame with clamps. (b) A fracture is produced by temporarily applying a controlled force (arrow) to the rib with a materials-testing device. (c) The rib is then brought back to its original shape by applying tension forces (arrows) to the frame.

View larger version (12K): [in a new window]   Figure 1b. Schematic drawings of the method of rib fracturing. (a) A rib (shaded in gray) is positioned in a frame with clamps. (b) A fracture is produced by temporarily applying a controlled force (arrow) to the rib with a materials-testing device. (c) The rib is then brought back to its original shape by applying tension forces (arrows) to the frame.

View larger version (13K): [in a new window]   Figure 1c. Schematic drawings of the method of rib fracturing. (a) A rib (shaded in gray) is positioned in a frame with clamps. (b) A fracture is produced by temporarily applying a controlled force (arrow) to the rib with a materials-testing device. (c) The rib is then brought back to its original shape by applying tension forces (arrows) to the frame.

View larger version (33K): [in a new window]   Figure 2. Bar graph of Az values for the different imaging modalities and exposure levels shows that the diagnostic performance of the flat-panel and storage-phosphor systems is dependent on exposure level. With an exposure level equivalent to speed class 400, the flat-panel system outperforms the other imaging systems evaluated. With an exposure level equivalent to speed class 800, the diagnostic performance of the flat-panel system is not significantly different (P > .05) from that of the speed class 400 screen-film system. SFS = screen-film system, FPD = flat-panel detector system, SPS = storage-phosphor system.

View larger version (27K): [in a new window]   Figure 3. Graph shows ROC curves for the combination of the three readers’ results with the flat-panel (solid line), storage-phosphor (dashed line), and screen-film (dotted line) systems at an exposure level equivalent to speed class 400. The flat-panel system is superior to the screen-film and storage-phosphor systems.

View larger version (85K): [in a new window]   Figure 4a. Anteroposterior radiographs of a fractured porcine rib specimen obtained (a) with the flat-panel system, (b) with the storage-phosphor system, and (c) with the screen-film system at an exposure level equivalent to speed class 400. The image obtained with the flat-panel system is superior to those obtained with the other systems. The fracture site is depicted.

View larger version (100K): [in a new window]   Figure 4b. Anteroposterior radiographs of a fractured porcine rib specimen obtained (a) with the flat-panel system, (b) with the storage-phosphor system, and (c) with the screen-film system at an exposure level equivalent to speed class 400. The image obtained with the flat-panel system is superior to those obtained with the other systems. The fracture site is depicted.

View larger version (100K): [in a new window]   Figure 4c. Anteroposterior radiographs of a fractured porcine rib specimen obtained (a) with the flat-panel system, (b) with the storage-phosphor system, and (c) with the screen-film system at an exposure level equivalent to speed class 400. The image obtained with the flat-panel system is superior to those obtained with the other systems. The fracture site is depicted.

View larger version (80K): [in a new window]   Figure 5a. Anteroposterior images of a fractured porcine rib specimen obtained with the flat-panel system at exposure levels equivalent to speed classes (a) 400, (b) 800, (c) 1,600, and (d) 6,400 show that fracture depiction deteriorates with decreasing exposure level. Fracture depiction in b is comparable to that in (e) an image obtained with the speed class 400 screen-film system. The fracture site is depicted.

View larger version (80K): [in a new window]   Figure 5b. Anteroposterior images of a fractured porcine rib specimen obtained with the flat-panel system at exposure levels equivalent to speed classes (a) 400, (b) 800, (c) 1,600, and (d) 6,400 show that fracture depiction deteriorates with decreasing exposure level. Fracture depiction in b is comparable to that in (e) an image obtained with the speed class 400 screen-film system. The fracture site is depicted.

View larger version (93K): [in a new window]   Figure 5c. Anteroposterior images of a fractured porcine rib specimen obtained with the flat-panel system at exposure levels equivalent to speed classes (a) 400, (b) 800, (c) 1,600, and (d) 6,400 show that fracture depiction deteriorates with decreasing exposure level. Fracture depiction in b is comparable to that in (e) an image obtained with the speed class 400 screen-film system. The fracture site is depicted.

View larger version (96K): [in a new window]   Figure 5d. Anteroposterior images of a fractured porcine rib specimen obtained with the flat-panel system at exposure levels equivalent to speed classes (a) 400, (b) 800, (c) 1,600, and (d) 6,400 show that fracture depiction deteriorates with decreasing exposure level. Fracture depiction in b is comparable to that in (e) an image obtained with the speed class 400 screen-film system. The fracture site is depicted.

View larger version (91K): [in a new window]   Figure 5e. Anteroposterior images of a fractured porcine rib specimen obtained with the flat-panel system at exposure levels equivalent to speed classes (a) 400, (b) 800, (c) 1,600, and (d) 6,400 show that fracture depiction deteriorates with decreasing exposure level. Fracture depiction in b is comparable to that in (e) an image obtained with the speed class 400 screen-film system. The fracture site is depicted.