Gray-scale inversion radiographic display for the detection of pulmonary nodules on chest radiographs

Clin Imaging. Sep-Oct 2012;36(5):515-21. doi: 10.1016/j.clinimag.2012.01.009. Epub 2012 Jun 8.


The purpose of this study was to investigate gray-scale inversion in nodule detection on chest radiography. Simulated nodules were superimposed randomly onto normal chest radiographs. Six radiologists interpreted 144 chest radiographs during three reading sessions: traditional presentation, inverted gray-scale, and a choice session allowing use of traditional and gray-scale inverted views. Sensitivity and specificity were used to assess accuracy based on presence or absence of a nodule. Gray-scale inversion and choice display sessions resulted in significantly higher nodule detection specificity and decreased sensitivity compared to traditional display. Gray-scale inversion may decrease false-positive nodule findings during chest X-ray interpretation.

MeSH terms

  • Clinical Competence
  • Diagnosis, Differential
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • ROC Curve
  • Radiographic Image Enhancement / methods*
  • Radiography, Thoracic / methods*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Solitary Pulmonary Nodule / diagnostic imaging*
  • Solitary Pulmonary Nodule / pathology