• Ling Mao, A Scott Laney, Mei Lin Wang, Xiwen Sun, Shaowei Zhou, Jin Shi, and Haiyan Shi.
• Department of Pneumoconiosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China. maoling113@sina.com
• J Occup Health. 2011 Jan 1;53(5):320-6.

ObjectivesPneumoconiosis in China remains a disease with substantial public health significance. Diagnostic standards for the pneumoconioses are based on traditional film-screen radiography (FSR). However, FSR is increasingly being replaced with digital radiographic imaging, which has become the predominant technology available in Chinese clinical practice. To evaluate the applicability of digital direct readout radiography (DR) images in the recognition of pneumoconioses, we compared the profusion of small opacities and large opacities between FSR and DR radiographs.MethodsWe enrolled 161 pneumoconioses patients and 31 dust-exposed workers during the course of the study, with FSR and DR images obtained from all participants. Each chest film was interpreted by five readers using the Chinese Diagnostic Criteria classification of radiographs of pneumoconiosis, as were DR images displayed on medical-grade computer monitors.ResultsNo statistically significant differences were observed when the data were analyzed by small opacity profusion subcategory except for 1/1. The overall intermodality agreement of small opacities was good, with a weighted kappa (κ) of 0.77.ConclusionsDR images with soft copy display are equivalent with respect to image quality and the recognition and classification of small parenchymal lung opacities. Additionally, we observed likeness between modalities with respect to the classification of large opacities. Overall, our study findings demonstrate that in a population of Chinese workers with pneumoconiosis, direct readout digital systems are equivalent to traditional film-screen radiography in the recognition and classification of small pneumoconiotic opacities.

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