Background: It is not well known how specific experience in paediatric radiology and the radiological technique influence the diagnostic yield of a plain radiograph of the chest when a paediatric foreign body aspiration (FB) is suspected.
Methods and patients: 319 radiographs were retrospectively evaluated by a paediatric radiologist, a radiologist in paediatric radiology training and an experienced paediatrician with respect to the probability of a tracheobronchial FB (216 children with proven FB, 103 children without FB but with symptoms compatible with FB).
Results: 1) Sensitivity was highest for the radiologist compared to the two other subspecialists (70.8 vs. 59.5 % paediatric radiologist; 56.8 % paediatrician). The specifity was highest for the paediatrician and the paediatric radiologist (77.7 and 73.8 %; 62.2 % radiologist). Correctness as well as positive and negative predictive value were not significantly different. 2) The impact of technical quality correlated with the degree of radiological experience, but use of the expiratory phase in general did not increase the sensitivity.
Conclusions: Even profound experience in paediatric radiology does not improve the limited diagnostic value of a plain radiograph of the chest in case of a suspected FB. Radiological training compensates for incorrect patient alignment. An expiratory phase image is not necessary.