We are evaluating the usefulness of stereomammography in improving breast c
ancer diagnosis. One area that we are investigating is whether the improved
depth perception associated with stereomammography might be significantly
enhanced with the use of a virtual 3D cursor. A study was performed to eval
uate the accuracy of absolute depth measurements made in stereomammograms w
ith such a cursor. A biopsy unit was used to produce digital stereo images
of a phantom containing 50 low contrast fibrils (0.5 mm diam monofilaments)
at depths ranging from 1 to 11 mm, with a minimum spacing of 2 mrn. Half o
f the fibrils were oriented perpendicular (vertical) and half parallel (hor
izontal) to the stereo shift direction. The depth and orientation of each f
ibril were randomized, and the horizontal and vertical fibrils crossed, sim
ulating overlapping structures in a breast image. Left and right eye images
were generated by shifting the x-ray tube from +2.5 degrees to -2.5 degree
s relative to the image receptor. Three observers viewed these images on a
computer display with stereo glasses and adjusted the position of a cross-s
haped virtual cursor to best match the perceived location of each fibril. T
he x, y, and z positions of the cursor were indicated on the display. The,z
(depth) coordinate was separately calibrated using known positions of fibr
ils in the phantom. The observers analyzed images of two configurations of
the phantom. Thus, each observer made 50 vertical filament depth measuremen
ts and 50 horizontal filament depth measurements. These measurements were c
ompared with the true depths. The correlation coefficients between the meas
ured and true depths of the vertically oriented fibrils for the three obser
vers were 0.99, 0.97, and 0.89 with standard errors of the estimates of 0.3
9 mm, 0.83 mm, and 1.33 mm, respectively. Corresponding values for the hori
zontally oriented fibrils were 0.91, 0.28, and 0.08, and 1.87 mm, 4.19 mm,
and 3.13 mm. All observers could estimate the absolute depths of vertically
oriented objects fairly accurately in digital stereomammograms; however, o
nly one observer was able to accurately estimate the depths of horizontally
oriented objects. This may relate to different aptitudes for stereoscopic
visualization. The orientations of most objects in actual mammograms are co
mbinations of horizontal and vertical. Further studies are planned to evalu
ate absolute depth measurements of fibrils oriented at various intermediate
angles and of objects of different shapes. The effects of the shape and co
ntrast of the virtual cursor and the stereo shift angle on the accuracy of
the depth measurements will also be investigated. (C) 2000 American Associa
tion of Physicists in Medicine. [S0094-2405(00)01406-1].