Evaluation of Three Pneumothorax Size Quantification Methods on Digitized Chest X-ray Films Using Medical-Grade Grayscale and Consumer-Grade Color Displays

This study focused on the effects of pneumothorax size quantification in digital radiology environments when a quantification method is selected according to the radiologist’s criteria. The objective of this study was to assess the effects of factors, including the radiologist (with different experience), displays (medical-grade and consumer-grade displays), or display calibration, on the Rhea, Collins, and Light quantification methods. This study used a factorial design with 76 cases, including 16 pneumothorax cases observed by six radiologists on three displays with and without the DICOM standard calibration. The gold standard was established by two radiologists by using computed tomography. Analysis of variance (ANOVA) was performed on the pneumothorax sizes. For the three quantifications methods, none of the evaluated factors were significant. We conclude that radiologists, displays, and calibration do not significantly affect the quantification of pneumothorax size in different digital radiology environments.