title: Computed radiography versus screen-film mammography in detection of simulated microcalcifications: a receiver operating characteristic study based on phantom images.
abstract: OBJECTIVE
  The authors compare a 43-micron computed radiographic system with a mammographic screen-film system for detection of simulated microcalcifications in an observer-performance study.
  
  
  METHODS
  The task of detecting microcalcifications was simulated by imaging aluminum wire segments (200-500 microns in length; 100, 125, or 150 microns in diameter) that overlapped with tissue background structures produced by beef brisket. A total of 288 such simulations were generated and examined with both computed radiography and conventional screen-film mammography techniques. Computed radiography was performed with high-resolution plates, a 43-micron image reader, and a 43-micron laser film printer. Computed radiographic images were printed with simple contrast enhancement and compared with screen-film images in a receiver operating characteristic study in which experienced readers detected and scored the simulated microcalcifications. Observer performance was quantitated and compared by computing the area under the receiver operating characteristic curve.
  
  
  RESULTS
  Although the resolution of the computed radiography system was better than that of commercial systems, it fell short of that of screen-film systems. For the 100-micron microcalcifications, the difference in the average area under the curve was not statistically significant, but it was significant for the larger simulated microcalcifications: the average area under the curve was 0.58 for computed radiography versus 0.76 for screen-film imaging for the 125-micron microcalcifications and 0.83 versus 1.00, respectively, for the 150-micron microcalcifications.
  
  
  CONCLUSIONS
  Observer performance in the detection of small simulated microcalcifications (100-150 microns in diameter) is better with screen-film images than with high-resolution computed radiographic images.
authors.affiliation: Department of Radiology, University of Pittsburgh, PA 15261-0001, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Shaw
authors.forename: T
authors.initials: T
authors.lastname: Wang
authors.forename: J L
authors.initials: JL
authors.lastname: King
authors.forename: D S
authors.initials: DS
authors.lastname: Breitenstein
authors.forename: T S
authors.initials: TS
authors.lastname: Chang
authors.forename: K M
authors.initials: KM
authors.lastname: Harris
authors.forename: A B
authors.initials: AB
authors.lastname: Baratz
authors.forename: M A
authors.initials: MA
authors.lastname: Ganott
authors.forename: R
authors.initials: R
authors.lastname: Reginella
authors.forename: J H
authors.initials: JH
authors.lastname: Sumkin
authors.forename: D
authors.initials: D
authors.lastname: Gur
mesh_terms: D001941:Breast Diseases / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008327:Mammography; D019047:Phantoms, Imaging; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D014963:X-Ray Intensifying Screens