Improved sensitivity and specificity of mammograms by producing uniform luminance from viewboxes

Effect of room illuminance on monitor black level luminance and monitor calibration

In this article we demonstrate the effect of room illuminance and surrounding monitor black level luminance on image quality for soft copy interpretation. Luminance values of a 10% central target and image quality evaluations and observer performance using a contrast-detail mammography (CDMAM) phantom demonstrate these effects. Our results indicate that high room illuminance has a more damaging effect on image quality when the surrounding monitor luminance is 0% to 5% of the maximum monitor luminance. The effect of room illuminance is less obvious when the surrounding monitor luminance is 20% of the maximum.

Influence of film and monitor display luminance on observer performance and visual search

RATIONALE AND OBJECTIVES

The purpose of this study was to measure the influence of display luminance on detection performance and visual search behavior. The results of the study should be helpful in establishing minimally acceptable display conditions for viewing radiographs on cathode-ray tube (CRT) monitors.

MATERIALS AND METHODS

Two groups of six radiologists each viewed 50 pairs of mammograms. One group viewed film images on a standard mammographic view box; the other viewed images on a high-resolution CRT monitor. Two luminance levels were studied for each display type. Observers reported on the presence or absence of masses or microcalcification clusters and on their confidence in that decision. Confidence data were analyzed by using alternative free-response receiver operating characteristic (AFROC) techniques. Eye position also was recorded as observers viewed the images.

RESULTS

For both the film and monitor studies, detection performance (AFROC area under the curve) was not affected significantly by display luminance, but search behavior was. Total viewing and decision dwell times were shorter with the higher-luminance displays, especially for true-negative decisions. Significantly more fixation clusters were generated during the search of lesion-free than of lesion-containing images with the lower-luminance displays.

CONCLUSION

Display luminance affects visual search performance with both film and monitor displays without affecting detection performance significantly. Higher-luminance displays yield more efficient search performance. The true-negative dwell times and number of clusters are suggestive that lower-luminance levels prolong the search and recognition of normal, lesion-free areas compared with lesion-containing areas.

Testing optimum viewing conditions for mammographic image displays

The viewbox luminance and viewing room light level are important parameters in a medical film display, but these parameters have not had much attention. Spatial variations and too much room illumination can mask real signal or create the false perception of a signal. This presentation looks at how scotopic light sources and dark-adapted radiologists may identify more real diseases.