Comparison of a PACS workstation with conventional film for interpretation of neonatal examinations: a paired comparison study

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Abstract
The diagnostic value of neonatal examinations using picture archiving and communication systems (PACS) was compared with that of conventional radiographs. A total of 202 consecutive chest or abdominal radiographs from the newborn intensive care unit were digitized for display on a commercially available PACS console. Experimental design was a paired comparison study. Plain films and PACS images were reviewed alternately in unbiased fashion. After the examination was evaluated using the second modality, any change in diagnosis or confidence in diagnosis was noted. Overall evaluation showed slight preference for the PACS modality. Change of diagnosis or in confidence of diagnosis was more than twice as likely to occur with evaluation of PACS (35%) after hadcopy than with evaluation of conventional radiographs (14%) after PACS. Of the variety of image processing features available on PACS, only window and leveling were judged to be of significant value. These results indicate that PACS and conventional radiographs of the neonatal chest and abdomen are of similar diagnostic value.