Impact of resolution and noise characteristics of digital radiographic detectors on the detectability of lung nodules.

One of the unanswered questions in digital radiography is the connection between physical image quality metrics and clinical detection performance. In this paper, we examine the impact of two physical metrics, resolution and noise, on the detectability of nodules in a pulmonary background for specific digital radiographic detectors. A detection experiment was performed on a simulated image set using anatomical backgrounds from a high-quality lung radiograph and three different simulated nodule sizes (2-3.5 mm). The resolution and noise of the resulting images were modified using existing routines to simulate a selenium-based and a cesium iodide-based flat-panel detector at comparable exposures. A location-known-exactly (LKE) observer performance experiment was performed in which four experienced chest radiologists and three physicists specializing in chest radiology scored the images. The data from the observer experiment were analyzed by receiver operating characteristic (ROC) methodology. The detectability, as measured by the parameter Az, was higher for the selenium detector than the cesium iodide detector for all nodule sizes by an average of 8.5%. For one nodule size (2.75 mm), the difference between detectors was statistically significant (p < 0.01). The findings indicate that for the particular task studied, the superior resolution performance of the selenium-based detector provided better detectability of subtle lung nodules even though the images had greater noise than images obtained with the cesium iodide detector.