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The potential of digital luminescence radiography in replacing conventional myelography was analyzed using ROC methodology. 95 conventional (CR), digital (DR) and edge enhanced digital (EDR) myelograms (49 disk herniations, 46 normal) were read independently by 5 radiologists; and a ROC analysis was performed. Higher confidence levels were used in making both correct and incorrect diagnoses with DR and EDR than with CR. However, no statistically significant differences between AUC (area under the curve) values obtained with the different techniques, were noted. The separate analysis of cervical and lumbar myelograms showed no significant differences between the different techniques. With DR and EDR, the sensitivity of 4 of 5 readers was somewhat higher in the lumbar but lower in the cervical region than with CR. Replacement of conventional by digital luminescence myelography seems possible; however, some decrease of sensitivity in the cervical region must be accepted.
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