title: Interpretation of calcifications in screen/film, digitized, and wavelet-enhanced monitor-displayed mammograms: a receiver operating characteristic study.
abstract: OBJECTIVE
  The acceptance of filmless digital mammography is currently limited by digitization and display drawbacks, as well as bias toward hard-copy interpretation. In the current study, we evaluated a wavelet-based image enhancement method for the filmless interpretation of breast calcifications.
  
  
  METHODS
  A set of 100 mammograms (58 with calcification clusters) was digitized at 105 microns and 4,096 gray levels per pixel and was processed with nonlinear filters and wavelets. Standard receiver operating characteristic analysis was performed by four radiologists, who independently read the films, the unprocessed digital images, and unprocessed and wavelet-enhanced digital images presented simultaneously.
  
  
  RESULTS
  Statistical differences were observed between screen/film and unprocessed digitized mammography displayed on monitors. Differences were not significant when wavelet enhancement was included in the monitor display. Interobserver variation in the digitized reading was greater than in film reading, but the wavelet enhancement reduced the difference.
  
  
  CONCLUSIONS
  Wavelet-enhanced digital mammograms may assist radiologists in diagnosing calcifications directly from computer monitors and may compensate for current technologic limitations. A study with a larger data-base is needed before this method is accepted for clinical use.
authors.affiliation: Department of Radiology, College of Medicine, University of South Florida, Tampa 33612-4799, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kallergi
authors.forename: L P
authors.initials: LP
authors.lastname: Clarke
authors.forename: W
authors.initials: W
authors.lastname: Qian
authors.forename: M
authors.initials: M
authors.lastname: Gavrielides
authors.forename: P
authors.initials: P
authors.lastname: Venugopal
authors.forename: C G
authors.initials: CG
authors.lastname: Berman
authors.forename: S D
authors.initials: SD
authors.lastname: Holman-Ferris
authors.forename: M S
authors.initials: MS
authors.lastname: Miller
authors.forename: R A
authors.initials: RA
authors.lastname: Clark
mesh_terms: D001941:Breast Diseases / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008327:Mammography; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D014963:X-Ray Intensifying Screens