Comparison of a new dual characteristic film–screen system (Insight) with a standard film–screen system for chest radiology

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Abstract
A new dual image receptor screen-film combination has been developed by Kodak with the objective of improving mediastinal and retro-cardiac detail whilst retaining good contrast and detail in the lung fields. This system was compared with our standard chest system. The study population was 36 patients with sarcoidosis. A postero-anterior (PA) chest film using our standard system was followed by a PA chest film using the new system--both using high kVp technique. The pairs of radiographs were assessed for (1) presence or absence of lymphadenopathy; (2) visibility of anterior and posterior mediastinal and azygo-esophageal lines; (3) visibility of vessels in the outer and inner thirds of the lungs and (4) visibility of infiltrates, if present. The new film-screen combination was judged to show the mediastinal structures better in almost all instances. However, our standard combination was preferred for lung detail visualization in most cases. No significant difference was found between the two systems in their ability to demonstrate lymphadenopathy. The results were almost unchanged when the observers were given the option to score the criteria as equally well demonstrated on both films as opposed to not having this option available. We feel the advantages of the Insight system do not compensate for the significant loss of parenchymal detail resulting from the use of this system.