Comparison of LCD and CRT Monitors for Detection of Pulmonary Nodules and Interstitial Lung Diseases on Digital Chest Radiographs by Using Receiver Operating Characteristic Analysis

Abstract

Soft copy reading of digital images has been practiced commonly in the PACS environment. In this study, we compared liquid-crystal display (LCD) and cathode-ray tube (CRT) monitors for detection of pulmonary nodules and interstitial lung diseases on digital chest radiographs by using receiver operating characteristic (ROC) analysis. Digital chest images with a 1000x1000 matrix size and a 8 bit grayscale were displayed on LCD/CRT monitor with 2M pixels in each observer test. Eight and ten radiologists participated in the observer tests for detection of nodules and interstitial diseases, respectively. In each observer test, radiologists marked their confidence levels for diagnosis of pulmonary nodules or interstitial diseases. The detection performance of radiologists was evaluated by ROC analyses. The average Az values (area under the ROC curve) in detecting pulmonary nodules with LCD and CRT monitors were 0.792 and 0.814, respectively. In addition, the average Az values in detecting interstitial diseases with LCD and CRT monitors were 0.951 and 0.953, respectively. There was no statistically significant difference between LCD and CRT for both detection of pulmonary nodules (P=0.522) and interstitial lung diseases (P=0.869). Therefore, we believe that the LCD monitor instead of the CRT monitor can be used for the diagnosis of pulmonary nodules and interstitial lung diseases in digital chest images.

Effect of greyscale liquid crystal displays of different resolutions on observer performance during detection of small solitary pulmonary nodules

“…Furthermore, Uematsu and Kasami [21] showed that soft-copy reading of a digital mammography of mass with 3 megapixel LCD monitors was similar in diagnostic performance to 5 megapixel CRT monitors and 3 megapixel LCD monitors can replace 5 megapixel CRT monitors without any loss in the ability to diagnose digital mammograms. Some other reports are also congruent with the above results of our study [6,[17][18][19][20][21][22][23][24][25]. Therefore, we believe that the results are generally applicable.…”

“…Recently, many studies have attempted to determine the applicability of new display devices in digital imagereading practice as compared with legacy display devices, such as screen-film systems vs CRT monitors, CRT monitors vs LCDs, and monochrome vs colour monitors [1,2,4,9,10,[17][18][19]. However, to date, no studies have reported any significant differences between the different types of display devices used in diagnostic imaging practices.…”

Comparison of detectability of a simple object with low contrast displayed on a high-brightness color LCD and a monochrome LCD

“…Ikeda et al [10] suggested that the detectability of pulmonary nodules and interstitial lung diseases in chest images displayed on a CRT and LCD was almost comparable. Krupinski et al [11] concluded that maximum-luminance LCDs with as high as 450 cd/m 2 may have an advantage in terms of diagnostic accuracy and visual search efficiency for detecting lung nodules in chest images, compared to lowermaximum-luminance monochrome and color LCDs, although these differences may have little clinical impact because they are relatively small.…”

Influence of liquid crystal display monitors on observer performance for detection of diffuse pulmonary disease on chest radiographs

“…4,[8][9][10][11] More recently, Ikeda et al reported that there was no signifi cant difference between LCD and CRT monitors with 2M pixels for both detection performance of pulmonary nodules and interstitial lung diseases on digitized chest radiographs. 19 Furthermore, Araki et al showed that no signifi cant differences in the nodule detection performance on chest radiographs were detected among the monochrome LCD monitors with 3M and 5M pixels and the color LCD monitors with 3M pixels. 20 Their reports are also congruent with the above results of our present study.…”