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Soft Copy Display Requirements for Digital Mammography

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Abstract

One of the advantages of digital mammography is to display mammograms on softcopy (electronic displays). Softcopy display of mammography is challenging because of the spatial and contrast resolution demands present in mammograms. We have designed and developed a softcopy mammography display application, Mammoview, which is capable of allowing radiologists to read mammograms as quickly and as accurately as they can on film alternators. We review the studies using Mammoview to elucidate the requirements of a successful softcopy display station. The design and development of the Mammoview softcopy display station are described in this article, and results of several studies using Mammoview are reported, including subjective feedback from Radiological Society of North America (RSNA) conference demonstrations, and clinical studies measuring performance in terms of speed and accuracy. Additional analysis of user interactions and user feedback is used to study the successes and shortcomings of mammography display stations like Mammoview. Overall, radiologist readings using Mammoview have been shown to be as fast and as accurate as readings using mammography film alternators. However, certain parts of the softcopy interface were more successful than their film counterparts, whereas others were less successful. Data analysis of the recorded human–computer interactions for the softcopy component of the clinical trial indicate statistically significant correlations between the difference in review time of softcopy versus alternator readings and three factors: the number of interactions, the reader, and the size of the image being reviewed. The first factor (number of interactions) suggests that simpler interfaces require less time to use; the second factor, the reader, supports previous findings that radiologists vary in how fast they read screening mammography studies; the third, size of image, suggests that the speed of softcopy review is increased relative to film readings when images are significantly larger than the display size. Feedback from radiologists using the system in clinical trials and at demonstration exhibits at RSNA indicated good acceptance of the interface and easy adaptation. Radiologists indicated that they felt comfortable using the interface, and that they would use such a softcopy interface in clinical practice. Finally, preliminary work suggests that the addition of a simple interaction to incorporate computer-aided detection (CAD) results would improve reading accuracy without significantly increasing reader times.

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Acknowledgements

The clinical trial evaluating Mammoview versus film display was conducting in the Radiology Research Laboratory and supported by the mammography research group in the Department of Radiology at UNC-CH, directed by Dr. Etta Pisano. Original acquisition of the Fischer digital mammography cases was supported by a grant from Fischer Digital Imaging. Work evaluating the incorporation of CAD results into softcopy display was supported by and done in collaboration with Qualia Computing, developers of the CADx computer-aided detection product for digital mammography. Printing of hard copy films was made possible by the Eastman Kodak Corporation. Anne Bauers helped with the secondary analyses. The Odum Institute for Research in Social Sciences at UNC-CH, especially Jun Koo and Chris Wiesen, aided us in performing the statistical regression analysis. A preliminary version of this work was published in the SPIE Medical Imaging Conference Proceedings.8 In addition, the following grants partially supported this work: Grey Scale Image Processing for Digital Mammography, National Cancer Institute, National Institutes of Health, grant RO1 CA60193-05, and Evaluation of Digital Mammography Display, U.S. Army Medical Research and Material Command, grant DAMD 17-94-J-4345.

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  1. School of Information and Library Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-3360, USA

    Bradley M. Hemminger Ph.D.

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  1. Bradley M. Hemminger Ph.D.
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Hemminger, B.M. Soft Copy Display Requirements for Digital Mammography . J Digit Imaging 16, 292–305 (2003). https://doi.org/10.1007/s10278-003-1659-6

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