Radiologists' preferences for digital mammographic display

PURPOSE: To determine the preferences of radiologists among eight different image processing algorithms applied to digital mammograms obtained for scr eening and diagnostic imaging tasks. MATERIALS AND METHODS: Twenty-eight images representing histologically prov ed masses or calcifications were obtained by using three clinically availab le digital mammographic units. Images were processed and printed on film by using manual intensity windowing, histogram-based intensity windowing, mix ture model intensity windowing, peripheral equalization, multiscale image c ontrast amplification (MUSICA), contrast-limited adaptive histogram equaliz ation, Trex processing, and unsharp masking. Twelve radiologists compared t he processed digital images with screen-film mammograms obtained in the sam e patient for breast cancer screening and breast lesion diagnosis. RESULTS: For the screening task, screen-film mammograms were preferred to a ll digital presentations, but the acceptability of images processed with Tr ex and MUSICA algorithms were not significantly different. All printed digi tal images were preferred to screen-film radiographs in the diagnosis of ma sses; mammograms processed with unsharp masking were significantly preferre d. For the diagnosis of calcifications, no processed digital mammogram was preferred to screen-film mammograms. CONCLUSION: When digital mammograms were preferred to screen-firm mammogram s, radiologists selected different digital processing algorithms for each o f three mammographic reading tasks and for different lesion types. Soft-cop y display will eventually allow radiologists to select among these options more easily.