New techniques in chest radiography.

Advances in film-screen radiography (e.g., InSight) and beam equalization radiography (e.g., AMBER) have improved the quality of standard chest radiographs. Despite the improved visibility of the mediastinum and retrocardiac and retrodiaphragmatic lung with AMBER, it is debatable whether this advantage outweighs its disadvantages, especially the increased cost of the unit and decreased reliability. The benefits of storage phosphor systems have largely been in the area of bedside radiography, where consistent image quality over a wide range of exposures and image processing compensate for the lower spatial resolution. More routine application of this technology to standard chest radiography is likely, especially as image processing techniques improve and digital units become more cost effective. Storage phosphor digital imaging may be the most appropriate technique for entry of images into a picture archiving and communication system in which images stored in image management systems can be displayed on high-resolution monitors in local or distant sites. Such systems have the potential of improving patient care by providing more rapid access to radiographic images, especially if the image is accompanied by an immediate report. Because of the significant expense of a picture archiving and communication system, their introduction is likely to be gradual, via networks in specific areas such as between intensive care units and radiology departments.