The aim of this study was comparative analysis of rejected radiographs in conventional and digital radiology under the aspects number of rejected images and reasons for rejection. During 2 months waste films of conventional radiography were collected; in digital radiography each image-delete command at the postprocessing workstation was documented. Rejected images were analysed and assigned to four categories. The overall reject rate was 27.6% in the conventional and 2.3% in the digital department. Whereas in the conventional department the main reason for rejection was "exposure" and "others" (i.e. problems related to film handling), the main reason in the digital environment was "positioning". The high exposure tolerance of digital systems markedly reduces the amount of faulty images. This is not only economically rewarding, but may also reduce unnecessary X-ray exposure of patients due to image retake.

The purpose of this work was to gather information about the benefits in patient care caused by the introduction of digital radiography. In particular, the possibility of reducing the number of image repeats and thus unnecessary patient radiation was sought. Waste films of conventional radiography were collected--in digital radiography each image delete command at the post-processing workstation was documented. Rejected images were analysed retrospectively. The overall reject rate was 27.6% in the conventional and 2.3% in the digital department. While in the conventional department the main reason for rejection was 'exposure' and 'others' (i.e. problems related to film handling), the main reason in the digital environment was 'positioning'. Reject analysis yields representative data about the current performance of a radiology department. A marked reduction of repeated X rays and consequently reduced radiation exposure of the patient was clearly shown in this study comparing two differently working radiology departments. This is one of several benefits of digital radiography in patient care.

Extracorporeal membrane oxygenation (ECMO) can be a last resort treatment in acute respiratory distress syndrome after thoracic trauma. However, co-existent brain trauma is considered to be a contra-indication for ECMO. This is the first report on successful craniotomy under ECMO treatment in a multiply traumatized patient with severe thoracic and brain injuries. This successful treatment with beneficial neurological outcome suggests that ECMO therapy should not be withheld from severely injured patients with combined brain and thoracic trauma presenting with life-threatening hypoxemia. Moreover, even craniotomy may be performed during ECMO therapy without major bleeding and adverse effects on neurological function.

A contrast detail analysis was performed to compare perception of low-contrast details on X-ray images derived from digital storage phosphor radiography and from a flat panel detector system based on a cesium iodide/amorphous silicon matrix. The CDRAD 2.0 phantom was used to perform a comparative contrast detail analysis of a clinical storage phosphor radiography system and an indirect type digital flat panel detector unit. Images were acquired at exposure levels comparable to film speeds of 50/100/200/400 and 800. Four observers evaluated a total of 50 films with respect to the threshold contrast for each detail size. The numbers of correctly identified objects were determined for all image subsets. The overall results show that low-contrast detail perception with digital flat panel detector images is better than with state of the art storage phosphor screens. This is especially true for the low-exposure setting, where a nearly 10% higher correct observation ratio is reached. Given its high detective quantum efficiency the digital flat panel technology based on the cesium iodide scintillator/amorphous silicon matrix is best suited for detection of low-contrast detail structures, which shows its high potential for clinical imaging.