title: Preliminary clinical evaluation of a high-resolution telemammography system.
abstract: OBJECTIVE
  The authors designed, assembled, tested, and clinically evaluated a high-quality, fast, and relatively inexpensive telemammography system.
  
  
  METHODS
  The authors designed a telemammography system that uses a high-resolution film digitizer and high data compression (> or = 40:1) to send images over regular telephone lines to a high-resolution laser printer that produces images with the look and feel of the original image and can operate in a hub and spokes mode. The authors then evaluated the system's performance. In a preliminary clinical study, interpretations of the laser-printed system's output of 119 cases were compared with the original interpretations, followed by a review of any clinically significant differences.
  
  
  RESULTS
  With the exception of the laser printer, which is a modified off-the-shelf product, all hardware components of the system are commercially available products. The system digitizes (50 microns pixel size), compresses, transmits, receives, decompresses, and prints a 30 MB mammography file in less than 4 minutes. In the clinical study, there were 13 differences (in 13 cases) in the level of concern or recommendations. Seven were found to be clinically insignificant by a third-party review. The remaining six were reviewed by the original interpreter, and three were determined to be significant enough for further action. All were found to result from intra-reader variability rather than differences in visualization of possible abnormalities.
  
  
  CONCLUSIONS
  Almost real-time, high-quality telemammography without geographic boundaries is possible with the use of high-level data compression. Telemammography with laser-printed film as the display may make it possible to offer mammographic services in remote locations while using commercially available technology.
authors.affiliation: Department of Radiology, University of Pittsburgh, PA 15261-0001, USA. maitz@rad.arad.upmc.edu
authors.forename: G S
authors.initials: GS
authors.lastname: Maitz
authors.forename: T S
authors.initials: TS
authors.lastname: Chang
authors.forename: J H
authors.initials: JH
authors.lastname: Sumkin
authors.forename: P W
authors.initials: PW
authors.lastname: Wintz
authors.forename: C M
authors.initials: CM
authors.lastname: Johns
authors.forename: M
authors.initials: M
authors.lastname: Ganott
authors.forename: B L
authors.initials: BL
authors.lastname: Holbert
authors.forename: C M
authors.initials: CM
authors.lastname: Hakim
authors.forename: K M
authors.initials: KM
authors.lastname: Harris
authors.forename: D
authors.initials: D
authors.lastname: Gur
authors.forename: J M
authors.initials: JM
authors.lastname: Herron
mesh_terms: D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D008327:Mammography / Q000295:instrumentation* / Q000379:methods; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods; D019112:Teleradiology / Q000295:instrumentation* / Q000379:methods