Diagnostic accuracy of fracture detection in suspected non-accidental injury: the effect of edge enhancement and digital display on observer performance

To compare the effect of varying degrees of edge enhancement and method of digital image display on fracture detection in suspected non-accidental injury (NAI). Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000...

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Bibliographic Details
Published in:Clinical radiology 2006-02, Vol.61 (2), p.163-173
Main Authors: Offiah, A.C., Moon, L., Hall, C.M., Todd-Pokropek, A.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child Abuse - diagnosis
Child, Preschool
Data Display - standards
Fractures, Bone - diagnostic imaging
Humans
Infant
Injuries of the limb. Injuries of the spine
Medical sciences
Observer Variation
Radiographic Image Enhancement - standards
Sensitivity and Specificity
Traumas. Diseases due to physical agents
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Summary:To compare the effect of varying degrees of edge enhancement and method of digital image display on fracture detection in suspected non-accidental injury (NAI). Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000R computed radiography system. Hard copies were printed with edge enhancement factors 0, 0.5 and 1.2. Images (edge enhancement 0.5) were also displayed on a 1K 2 monitor. Six observers independently evaluated all 200 images for the presence of abnormality. Observers also scored each image for visualization of soft tissues, visualization of trabecular markings and overall image quality. The paired Student's t-test and location receiver operating curve (ROC) analysis were used to compare quality scores and diagnostic accuracy of each display method. Individual and pooled true-positive rates (sensitivity) were determined. For the purposes of ROC analysis, histology was taken as the gold standard. There was no difference in duration of hard and soft-copy reading sessions ( p=0.76). After image manipulation soft-copy radiographs scored significantly better for image quality than hard copy ( p
ISSN:0009-9260
1365-229X
DOI:10.1016/j.crad.2005.09.004