title: The effects of gray scale image processing on digital mammography interpretation performance.
abstract: OBJECTIVE
  To determine the effects of three image-processing algorithms on diagnostic accuracy of digital mammography in comparison with conventional screen-film mammography.
  
  
  METHODS
  A total of 201 cases consisting of nonprocessed soft copy versions of the digital mammograms acquired from GE, Fischer, and Trex digital mammography systems (1997-1999) and conventional screen-film mammograms of the same patients were interpreted by nine radiologists. The raw digital data were processed with each of three different image-processing algorithms creating three presentations-manufacturer's default (applied and laser printed to film by each of the manufacturers), MUSICA, and PLAHE-were presented in soft copy display. There were three radiologists per presentation.
  
  
  RESULTS
  Area under the receiver operating characteristic curve for GE digital mass cases was worse than screen-film for all digital presentations. The area under the receiver operating characteristic for Trex digital mass cases was better, but only with images processed with the manufacturer's default algorithm. Sensitivity for GE digital mass cases was worse than screen film for all digital presentations. Specificity for Fischer digital calcifications cases was worse than screen film for images processed in default and PLAHE algorithms. Specificity for Trex digital calcifications cases was worse than screen film for images processed with MUSICA.
  
  
  CONCLUSIONS
  Specific image-processing algorithms may be necessary for optimal presentation for interpretation based on machine and lesion type.
authors.affiliation: Department of Radiology and Lineberger Comprehensive Cancer Center, University of North Carolina, CB#7515, Radiology Research Labs, 106 Mason Farm Road, Chapel Hill, NC 27599, USA.
authors.forename: Elodia B
authors.initials: EB
authors.lastname: Cole
authors.forename: Etta D
authors.initials: ED
authors.lastname: Pisano
authors.forename: Donglin
authors.initials: D
authors.lastname: Zeng
authors.forename: Keith
authors.initials: K
authors.lastname: Muller
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Aylward
authors.forename: Sungwook
authors.initials: S
authors.lastname: Park
authors.forename: Cherie
authors.initials: C
authors.lastname: Kuzmiak
authors.forename: Marcia
authors.initials: M
authors.lastname: Koomen
authors.forename: Dag
authors.initials: D
authors.lastname: Pavic
authors.forename: Ruth
authors.initials: R
authors.lastname: Walsh
authors.forename: Jay
authors.initials: J
authors.lastname: Baker
authors.forename: Edgardo I
authors.initials: EI
authors.lastname: Gimenez
authors.forename: Rita
authors.initials: R
authors.lastname: Freimanis
mesh_terms: D000465:Algorithms; D001941:Breast Diseases / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D016014:Linear Models; D008327:Mammography / Q000295:instrumentation*; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity