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Digital Chest Radiography

Schaefer-Prokop, Cornelia MD

Section Editor(s): Klein, Jeffrey S. MD

Journal of Thoracic Imaging: July 2003 - Volume 18 - Issue 3 - p 123

Editor-in-Chief, Journal of Thoracic Imaging

University of Vermont College of Medicine

Burlington, VT, USA

University of Vienna

Vienna General Hospital Austria

I would like to thank Dr. Schaefer-Prokop for her terrific work in guest editing and contributing to this issue of the JTI on digital chest radiography. I would also like to extend my gratitude to the officers of the Fleischner Society and European Society of Thoracic Imaging who have allowed the journal to publish this material drawn in large part from the session on Digital Chest Radiography chaired by Dr. Schaefer-Prokop at their combined meeting in Leuven, Belgium, in May 2002.

    Changing healthcare needs require tomorrow's diagnostic imaging service provider to rapidly produce high quality images, transmit them broadly, display them in alternative ways, and then archive and retrieve them efficiently. To accomplish this, new digital radiography image capture systems will play a critical role. While image quality and handling of storage phosphor radiography remain similar to conventional film-screen systems, the most recently introduced large area direct detector units promise to be the “missing link” in the fully digital radiology department.

    Optimum use of the advantages of digital radiography requires moving from conventional habits towards procedures that are better adapted to the new technology with regard to appropriate acquisition techniques, optimized processing parameters, and adjustment of workflow habits. The decoupling of image acquisition and display parameters allows their separate optimization. On the other hand, suboptimal acquisition and processing parameters may have a deleterious effect on image quality and the diagnostic performance of digital radiography systems. Since the exposure level in digital systems determines the signal-to-noise ratio rather than the optical density on a film, the exposure level can be chosen more freely. However, the overall potential for dose reduction depends on the detector properties.

    Picture archiving and communication systems (PACS) and digital speech recognition offer a tremendous potential for stratification of workflow and efficiency. However, they represent pain and pleasure especially in the implementation phase. The concept of “quality assurance” is even more mandatory in a digital environment where there is a continuous and complex interaction between the imaging system and the radiology and hospital information systems. Quality assurance should not only focus on equipment performance and resultant image quality but also include an appreciation of each individual step within the chain from the request to the moment when image and report are available to the referring physician.

    The articles in the following issue summarize contributions made at a recent international meeting of chest radiologists (Fleischner and European Society of Thoracic Imaging). They address a variety of aspects of digital radiography from a rather practical point of view. The articles aim to help colleagues dealing with digital radiographic chest units use the numerous and wide-ranging capabilities of digital radiology to their full advantage with regard to patient care, public health, and health economics.

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    Guest Editor: Cornelia Schaefer-Prokop, MD

    © 2003 Lippincott Williams & Wilkins, Inc.