Tom Kimpe PhD, Presenter: Employee, Barco nv

Albert Xthona, Abstract Co-Author: Employee, Barco NV

Cédric Marchessoux, Abstract Co-Author: Employee, Barco NV

Early clinical results with Digital Breast Tomosynthesis (DBT) are very promising. Researchers believe that DBT will make breast cancers easier to see in dense breast tissue, and will make breast screening more comfortable. However an important aspect, that has insufficiently been studied so far, is the influence of the Medical Display when reading DBT datasets.

This work studies clinical performance of a new Medical display optimized for DBT. Medical displays have slow response time. This means that it takes time for a display pixel to go from one gray level to another gray level. In case of FFDM images this is not important since image content is mostly static. While reading DBT datasets radiologists quickly browse through slices and therefore slow response of the Medical Display may become a limiting factor for detection performance. The new DBT display contains a real-time medical grade algorithm that solves the problem of slow response time. DBT images are sharper and structures are smaller compared to FFDM. A very high quality display is necessary to be able to detect these subtle details. Optical characteristics of LCDs need to be improved to optimize use of the new DBT technology. The new DBT display introduces various optical improvements that increase image quality.

A pilot study was performed with three radiologists who were presented 100 reconstructed DBT sets (50 with and 50 without microcalcifications) at a speed of 25 slices per second. The task was detection of microcalcifications. The radiologists read these cases on the new DBT display and on a FFDM medical display. The new DBT display achieved an AUC value of 0.896, compared to 0.797 for the FFDM display. The AUC difference is statistically significant at a confidence level of 95%.

This work studied the effect that the medical display can have on the overall clinical performance of DBT reading. DBT inherently differs from FFDM because images are no longer read in a static way and because DBT image characteristics are different as well. A pilot study shows that clinical performance for detection of microcalcifications can be improved by almost 10% if a medical display is optimized for DBT.

This work shows that medical displays can have a largeinfluence on the overall clinical performance of DBT reading and that displays optimized for DBT can offer significant clinical benefits.

Kimpe, T, Xthona, A, Marchessoux, C, Medical Display Optimized for Digital Breast Tomosynthesis.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005219.html