Evaluation of digital chest computed radiology (CR) unit and image distribution system at the Prince Charles Hospital Brisbane, Australia

In March 1998, The Prince Charles Hospital (TPCH), Brisbane, Australia, installed a computed radiography (CR) acquisition and image distribution system for the management of chest images. TPCH is the major cardiothoracic hospital for the State of Queensland (population 3.3 million), and the Medical Imaging Department performs some 140 chest examinations and 50 mobile examinations a day. The CR installation has been installed to facilitate the transmission of digital chest images to the intensive care and coronary care wards and enables images to be reported on computer workstations. As well as installing two Kodak KESPR400 CR readers, a world first for the TPCH image acquisition system is the installation of a Fuji 9501ES unit with DICOM connection to a Kodak image display network. The Fuji CR unit performs energy subtraction (ES) of chest images which permits digital chest images to be viewed without bones, if required, to facilitate the interpretation and reporting of chest images. A two-phase evaluation study of the diagnostic capability of chest CR, including ES and transmission of images to computer screens in the wards, has been commenced. As chest films are printed on a laser imager for long-term archive purposes, a prospective evaluation is being undertaken to compare the diagnostic accuracy of hard-copy chest films with soft-copy ES images. Phase one involves a three-month subjective comparison of images by experienced radiologists. Phase two involves a twelve month blinded study of 150 selected examinations from both film and computer screens, with the ES image also available on screen