@article{ref1,
title="Detection of rib fractures in an abused infant using digital radiography: a laboratory study",
journal="Pediatric radiology",
year="2002",
author="Kleinman, Paul K. and O'Connor, Brian and Nimkin, Katherine and Rayder, Shawn M. and Spevak, Melissa R. and Belanger, Patricia L. and Getty, David J. and Karellas, Andrew",
volume="32",
number="12",
pages="896-901",
abstract="PURPOSE: To assess the diagnostic performance of digital radiography using charge-coupled device (CCD) technology in the detection of rib fracture in infant abuse. MATERIALS AND METHODS: Four fractured posterior rib arcs and eight normal ribs removed at autopsy from a 10-month-old abused infant were radiographed using a CCD prototype, four clinical film-screen systems, and direct-exposure film. Each rib was viewed with these six systems in nine different projections. The resultant 648 images were assessed for probability of fracture (0-100%) by four pediatric radiologists. The calculated area under the resultant ROC curves (A(z)) for the CCD was compared with those obtained with direct-exposure, high-detail, medium and fast film-screen radiographic systems. RESULTS: The mean A(z) for the CCD (0.937) fell within the range of the high-detail systems (0.934-0.940) and was significantly higher (p < 0.05) than the medium and fast system (0.861 and 0.858, respectively). Despite a lower spatial resolution than direct-exposure film (7 line pairs per millimeter vs. > 20 line pairs per millimeter) the CCD performance was comparable (A(z) = 0.944 vs. 0.937). The similar performance can be explained by the higher contrast resolution of the digital technology. CONCLUSION: This study indicates that in the ex vivo setting, digital radiology can perform comparably to high-detail film-screen imaging. The findings suggest that digital radiography has the potential to replace film-screen imaging in the evaluation of inflicted skeletal injury in infants.<p /><p>Language: en</p>",
language="en",
issn="0301-0449",
doi="10.1007/s00247-002-0778-4",
url="http://dx.doi.org/10.1007/s00247-002-0778-4"
}