Teleradiology: Detectability of Pneumothorax and Miliary Tuberculosis

Park, No Hyuck; Bae, Kyung Su; Shin, Hyun Woong; Yang, Geun Seock; Ryum, Hun Kyu; Suh, Kyung Jin; Rheu, Chun Woock; Kim, Yong Kil; Kang, Duk Sik

Abstract

PURPOSE
To evaluate the clinical utility of the teleradiology system using the information super highway communication network.
MATERIALS AND METHODS
Two radiologists selected 101 cases of pneumothorax and 20 cases ofmiliary tuberculosis. There were scanned and transmitted to our hospital at a speed of 640 Kbps and displayed on avideo monitor with a resolution of 1280 pixels/line x 1024 lines. Four radiologists divided into three groups :read the images group A read the images without image processing ; group B read the images with image processing, group C read the radiographic films on the view box. The authors compared sensitivity and specificity between thegroups and checked their statistical significance using the Chi-square test. According to the location of thepleural line, we divided the pneumothorax into four types : continve on this live type 1, pleural line confined tothe apex ; type 2, to the upper half ; type 3, to the lower half ; type 4, to the upper through lower half. We then compared sensitivity between the Three groups.
RESULTS
In the pneumothorax group, the average sensitivity of group A, B and C was 79%, 90% and 96%, and average specificity was 99%, 99% and 94%, respectively. There were statistically significant differences in seasitivity between group A and B and between group B and C (p<0.017). There were no statistically significant difference in specificity between group A and B or between group B and C.In the miliary tuberculosis group, the average sensitivity of group A, B and C was 73%, 78% and 90%, and average specificity was 95%, 95% and 100%, respectively. With regard to sensitivity and specificity, there was no statistically significant difference between group A and B or between group B and C but there was a statistically significant difference between group A and C (p<0.017). According to the location of the pneumothorax, for alltypes, the sensitivity of group A was less than that of group B and group B was less than that of group C.
CONCLUSION
All groups showed reduced observer performance in the detection of pneumothorax and miliary tuberculosis when reading a transmitted image on the monitor-workstation compared with reading conventional radiographs on the view box. To improve the clinical utility of the teleradiology system, a higher resolution workstation and adequate image processing are required.