title: Radiologists' preferences for digital mammographic display. The International Digital Mammography Development Group.
abstract: OBJECTIVE
  To determine the preferences of radiologists among eight different image processing algorithms applied to digital mammograms obtained for screening and diagnostic imaging tasks.
  
  
  METHODS
  Twenty-eight images representing histologically proved masses or calcifications were obtained by using three clinically available digital mammographic units. Images were processed and printed on film by using manual intensity windowing, histogram-based intensity windowing, mixture model intensity windowing, peripheral equalization, multiscale image contrast amplification (MUSICA), contrast-limited adaptive histogram equalization, Trex processing, and unsharp masking. Twelve radiologists compared the processed digital images with screen-film mammograms obtained in the same patient for breast cancer screening and breast lesion diagnosis.
  
  
  RESULTS
  For the screening task, screen-film mammograms were preferred to all digital presentations, but the acceptability of images processed with Trex and MUSICA algorithms were not significantly different. All printed digital images were preferred to screen-film radiographs in the diagnosis of masses; mammograms processed with unsharp masking were significantly preferred. For the diagnosis of calcifications, no processed digital mammogram was preferred to screen-film mammograms.
  
  
  CONCLUSIONS
  When digital mammograms were preferred to screen-film mammograms, radiologists selected different digital processing algorithms for each of three mammographic reading tasks and for different lesion types. Soft-copy display will eventually allow radiologists to select among these options more easily.
authors.affiliation: Dept of Radiology, University of North Carolina CB7510, Chapel Hill, NC 27599-7510, USA. Etta_Pisano@med.unc.edu
authors.forename: E D
authors.initials: ED
authors.lastname: Pisano
authors.forename: E B
authors.initials: EB
authors.lastname: Cole
authors.forename: S
authors.initials: S
authors.lastname: Major
authors.forename: S
authors.initials: S
authors.lastname: Zong
authors.forename: B M
authors.initials: BM
authors.lastname: Hemminger
authors.forename: K E
authors.initials: KE
authors.lastname: Muller
authors.forename: R E
authors.initials: RE
authors.lastname: Johnston
authors.forename: R
authors.initials: R
authors.lastname: Walsh
authors.forename: E
authors.initials: E
authors.lastname: Conant
authors.forename: L L
authors.initials: LL
authors.lastname: Fajardo
authors.forename: S A
authors.initials: SA
authors.lastname: Feig
authors.forename: R M
authors.initials: RM
authors.lastname: Nishikawa
authors.forename: M J
authors.initials: MJ
authors.lastname: Yaffe
authors.forename: M B
authors.initials: MB
authors.lastname: Williams
authors.forename: S R
authors.initials: SR
authors.lastname: Aylward
mesh_terms: D000465:Algorithms; D001291:Attitude of Health Personnel; D001941:Breast Diseases / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity