Contrast- and edge-enhanced digital monitor images from an image intensifier system for chest radiography were compared to conventional radiograms using visual grading analysis. Eleven observers graded the visibility of rounded opacities, the carinal region, fine line structures, and also compared the overall quality of images from 20 patients. The results showed significantly better visibility on the digital monitor for the rounded opacities and the mediastinum compared to the conventional radiograms. The overall quality of the digital images was also considered better. However, the digital images showed significantly inferior visibility for the line structures in comparison with the conventional radiograms. Our study indicates that the present contrast- and edge-enhanced digital images, with a spatial resolution of 1,024 x 1,024 pixels and a contrast resolution of 8 bits, are superior to conventional radiograms for the visualization of mediastinal anatomy and rounded opacities. The clinical importance of the inferior visibility of fine line structures is not clear.