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Digital Vs 35-Mm Photography to Convert Or Not to Convert?

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Digital Vs 35-Mm Photography to Convert Or Not to Convert? ORIGINAL ARTICLE Digital vs 35-mm Photography To Convert or Not to Convert? Mimi S. Kokoska, MD; John W. Currens, MD; Chris S. Hollenbeak, MA; J. Regan Thomas, MD; Brendan C. Stack, Jr, MD Objectives: To compare the quality of images gener- Results: The null hypothesis that there is no difference ated from a conventional 35-mm camera with those gen- between photographs taken with the various cameras was erated from various digital cameras; and to note the costs rejected (P,.001) for each of the image attributes. The im- of the cameras and ease of use. ages produced by the 35-mm camera (Nikon 6006) had the best overall quality, followed by the Olympus D600L, Design: A prospective, randomized, independent analy- Kodak DCS 315, and Olympus D320L digital cameras. Dif- sis of specific facial images taken with a 35-mm camera ferences in individual attributes between several of the cam- and 3 digital cameras by 3 facial plastic surgeons who eras in each category were statistically significant (P,.05). were blinded to camera type. Conclusions: The 35-mm camera produced the best over- Setting: An academic medical center. all image quality and ranked first for each of the indi- vidual attributes analyzed in this study. The Olympus Subjects: Thirteen volunteer subjects ranging from age D600L digital camera placed second in overall quality, 27 to 58 years. but there was no statistically significant difference in fo- cus, distortion, and resolution compared with the im- Main Outcome Measures: The overall quality, fo- ages generated by the 35-mm camera. The Olympus cus, distortion, trueness of color, resolution, contrast, and D600L digital camera also ranked second in color, con- presence of shadows were evaluated for each image. At- trast, and shadow. The Kodak DCS 315 and D320L digi- tributes were scored on an ordinal scale of 1 to 5. A 1-way tal cameras finished well behind the 35-mm camera in analysis of variance was used to test whether the aver- most categories. Although the 35-mm photographs were age scores across cameras were significantly different. Re- superior to the digital images, the surgeon should also sults using analysis of variance did not differ from the consider other factors before selecting a system for pho- results using a nonparametric Kruskal-Wallis test. When todocumentation of surgical results. significant differences were found, the Duncan multiple range test was used to group significantly different scores. Arch Facial Plast Surg. 1999;1:276-281 HOTOGRAPHIC documenta- images without significant distortion, tion has long been an inte- which is important in the documentation gral part of facial plastic sur- of aesthetic facial proportions.2 Most sur- gery. Photography allows geons process the film into 35-mm slides. the physician to compare The resolution of 35-mm film may vary de- Ppreoperative and postoperative images. It pending on film type and reference source. provides a means to assess surgical suc- If prints are required, for example, for cesses or failures long after the patient has submission to medical journals, the color left the office. It is often priceless in slides can easily be converted into black- academic and health insurance commu- and-white prints via an internegative pro- From the Department of nications as well as in medicolegal docu- cess. The images can also be converted Otolaryngology–Head and mentation. from a 35-mm slide to a Polaroid print in Neck Surgery, St Louis The 35-mm camera has been the the office with a slide printer. The archiv- University Health Sciences criterion standard for the facial plastic sur- ing of these slides can take up consider- Center (Drs Kokoska, Currens, 1 Thomas, and Stack); and the geon. In most practices where close-up able space if a practice is sizable. Department of Health images and views of the head and neck are Digital photography first became Administration, Washington needed, the camera is equipped with a 90- available in the 1970s. Since then, digital University School of Medicine to 105-mm lens with macro capability. cameras have become widely available. In- (Mr Hollenbeak), St Louis, Mo. These cameras consistently produce good stead of film, digital cameras capture im- ARCH FACIAL PLAST SURG/ VOL 1, OCT-DEC 1999 WWW.ARCHFACIAL.COM 276 ©1999 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 and process the image into print (which requires the use of a printer) or 35-mm slide format (which requires the SUBJECTS, MATERIALS, use of a slide processor). Conversely, a slide from a 35-mm AND METHODS camera can be converted into a digital image with a slide scanner. The digital camera can be used in conjunction Three standard facial views were taken of 13 sub- with computer software to manipulate the image to pro- jects (age range, 27-58 years) by one amateur pho- vide patients with a better idea of the possible aesthetic tographer (J.W.C.). Informed consent was obtained outcome of a proposed surgery (ie, surgical simula- from all subjects (10 women and 3 men). There were tion). The archiving of digital images requires substan- 10 white patients, 2 African American patients, and tially less physical storage space than 35-mm images. Cur- one Asian patient. The frames included frontal full rently, hundreds of high-resolution images can be stored face, lateral profile, and animated forehead views, with on a compact disk. Many software programs also record the subject sitting upright in a Frankfort horizontal plane. Each subject had his or her images taken at patient demographic characteristics, such as age, race, sex, one sitting in a room with one overhead fluorescent diagnosis, date, and type of procedure, along with the im- light and no windows. A tripod was used to steady age. This provides the user with instant access to a se- each camera and the backdrop was a blue canvas. ries of photographs based on any of the data collected. The 3 views were taken with each of the 4 cam- Most digital cameras also have a liquid crystal display eras. The 35-mm camera was a Nikon 6006 (Nikon (LCD) screen so that images can be viewed and evalu- Corp, Tokyo, Japan), with a Nikon 105-mm f/2.8 macro ated immediately. lens and a Sunpak automatic DX-12R ring flash (Osaka, Almost all digital cameras store the image using some Japan). A broad spectrum of digital cameras, ranging form of compression. Compression makes an image file from an inexpensive low-resolution consumer- smaller and more manageable so that it can be manipu- oriented camera to a high-resolution professional se- ries camera, was examined. The digital cameras in- lated more quickly. The JPEG (Joint Photographic Ex- cluded the Olympus D320L, with an f/2.8 autofocus perts Group) method is one popular form of compres- lens (Olympus Co, Tokyo, Japan); Olympus D600L, sion. Compression can reduce the quality of an image with a 36- to 110-mm, 3 3 zoom f/2.8 TTL autofocus compared with the original source. An image can be di- lens; and Kodak DCS 315 (Eastman Kodak Co, Roch- vided into grids that are composed of picture elements ester, NY), with an IX Nikkor 24- to 70-mm f/3.5-5.6 in the form of small dots or pixels. The resolution of a lens and a Nikon SB-21 ring flash. The individual cam- camera or an image is commonly expressed by its di- era flash systems and the overhead fluorescent light were mensions in pixels, pixels or dots per inch, or total pixels. the sole sources of lighting. The cost and resolution of The requirements for photodocumentation are some- each camera are shown in Table 1. what different for the aesthetic facial surgeon than for The 35-mm slide film (Ektachrome ISO 100; East- man Kodak Co) used in the Nikon camera was sub- the average consumer. The goal of this study was to com- mitted for processing. The digital images were saved pare the print images derived from a 35-mm camera out- as JPEG files on a zip disk. These digital and 35-mm fitted for facial portraits with those generated from a images were then processed into slides at a professional variety of digital cameras. laboratory, assuring that the resolution of the slides would be no less than that of the camera with the high- RESULTS est resolution. The professional laboratory converted 3 alltheslidestoglossy5 7-incolorprints,similartothose The data were tabulated and statistical analysis was per- required for publication in many medical journals. formed using the Statistical Analysis System (version Each color print was assigned a unique ran- dom identifying code, which was logged into our data- 6.12; SAS Institute, Cary, NC). Since the sample size was collection sheet. To our knowledge, there is no vali- large, we used 1-way analysis of variance to test whether dated survey instrument for the analysis of aesthetic average scores across cameras were significantly different facial photographs; consequently, a data-collection (Table 2). These results did not differ from the results us- sheet was specifically designed for this study ing a nonparametric Kruskal-Wallis test. When signifi- (Figure 1). Three facial plastic and reconstructive cant differences were found, the Duncan multiple range test surgeons who were blinded to the origin of photo- was used to group significantly different scores (Table 3). graphs evaluated the prints in a random fashion. At The 35-mm camera had the best overall quality and no time were the prints evaluated side by side. ranked first for each print feature analyzed in this study Theprintswereevaluatedforfocus,distortion,color, (P,.001).
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