We compared the soft-copy images produced by an amorphous silicon flat-panel-detector system with the images produced by a storage-phosphor radiography system for their ability to visualize anatomic regions of the chest.

Two chest radiologists independently analyzed 234 posteroanterior chest radiographs obtained from 78 patients on high-resolution liquid crystal display monitors (2560x2048x8 bits). In each patient, one radiograph was obtained with a storage-phosphor system, and two radiographs were obtained via amorphous silicon flat-panel-detector radiography with and without spatial frequency filtering. After randomizing the 234 images, the interpreters rated the visibility and radiographic quality of 11 different anatomic regions. Each image was ranked on a five-point scale (1 = not visualized, 2 = poor visualization, 3 = fair visualization, 4 = good visualization, and 5 = excellent visualization). The statistical difference between each system was determined using the Wilcoxon's signed rank test.

The visibility of three anatomic regions (hilum, heart border and ribs), as determined by the chest radiologist with 14 years experience (p<0.05) and the visibility of the thoracic spine, as determined by the chest radiologist with 8 years experience (p=0.036), on the amorphous silicon flat-panel-detector radiography prior to spatial frequency filtering were significantly superior to that on the storage-phosphor radiography. The visibility of 11 anatomic regions, as determined by the chest radiologist with 14 years experience (p<0.0001) and the visibility of five anatomic regions (unobscured lung, rib, proximal airway, thoracic spine and overall appearance), as determined by the chest radiologist with 8 years experience (p<0.05), on the amorphous silicon flat-panel-detector radiography after spatial frequency filtering were significantly superior to that on the storage-phosphor radiography.

The amorphous silicon flat-panel-detector system depicted the anatomic structures on chest radiographs comparably or significantly better as compared to the storage-phosphor system. The superiority of the amorphous silicon flat-panel-detector system compared to the storage-phosphor system was more obvious after performing spatial frequency filtering.