Effect of image processing on diagnostic decisions in chest radiography

Elizabeth Krupinski, Michael Evanoff

Research output: Contribution to journalConference articlepeer-review

1 Scopus citations


The goal of this study was to determine what the influence of image processing functions was on decisions and decision changes made while reading chest radiographs displayed on a monitor. Six radiologists read 168 computed radiography chest images first without then with the use of six image processing functions. Diagnostic performance was measured using Receiver Operating Characteristic analysis, and decision changes made without and with processing use were analyzed. Diagnostic performance did not differ statistically for readings without and with image processing. The decision change analysis showed that readers were just as likely to change decisions from tree-positive to false-negative as they were from false-negative to true-positive. With image processing, there were significantly more changes from true-negative to false-positive than from false-positive to true-negative. 93% of all decisions did not change with the use of image processing. No significant correlations were found between the type of lesions present on the radiograph and the type of image processing function used. Positive decision changes made with the use of image processing are offset by equivalent numbers of negative decision changes. The use of image processing does not affect significantly diagnostic performance in chest radiography.

Original languageEnglish (US)
Pages (from-to)92-98
Number of pages7
JournalProceedings of SPIE - The International Society for Optical Engineering
StatePublished - 1998
Externally publishedYes
EventMedical Imaging 1998: Image Perception - San Diego, CA, United States
Duration: Feb 25 1998Feb 25 1998


  • Decision changes
  • Image processing
  • Observer performance
  • ROC analysis

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Condensed Matter Physics
  • Computer Science Applications
  • Applied Mathematics
  • Electrical and Electronic Engineering


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