Craniosynostosis: Image quality, confidence, and correctness in diagnosis

T. K. Pilgram, M. W. Vannier, C. F. Hildebolt, J. L. Marsh, W. H. McAlister, G. D. Shackelford, C. J. Offutt, R. H. Knapp

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


The authors used the diagnosis of craniosynostosis to compare subjective evaluation of image quality with objective diagnostic utility. They studied in detail the responses of one observer, who read plain radiographs, computed tomographic (CT) scans, and three-dimensional reconstructions of CT scans (obtained with three different methods) for 82 patients with this diagnosis. The observer rated image quality and certainty in diagnosis made from each image. Subjective and objective performances were found to be strongly linked. High-quality images served as the basis for more accurate diagnoses than low-quality images. The increase in diagnostic performance results primarily from increased specificity, a fact that suggests that specificity and the concomitant diagnosis of normalcy are the focus of attention when image quality is evaluated.

Original languageEnglish
Pages (from-to)675-679
Number of pages5
Issue number3
StatePublished - 1989


  • Children, skeletal system
  • Computed tomography (CT), image display and recording
  • Computed tomography (CT), image quality
  • Diagnostic radiology, observer performance
  • Heat, CT
  • Infants, skeletal system
  • Skull, abnormalities


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