title: Comparison of full-field digital mammography to screen-film mammography with respect to contrast and spatial resolution in tissue equivalent breast phantoms.
abstract: To determine if the improved contrast resolution of full-field digital mammography (FFDM) with reduced spatial resolution allows for superior or equal phantom object detection compared with screen-film mammography (SFM). Tissue equivalent breast phantoms simulating an adipose to glandular ratio of 50/50,30/70, and 20/80 were imaged according to each manufacturers' recommendation with four full-field digital mammography units (Fuji, Sectra, Fischer, and General Electric) and a screen-film mammography unit (MammoMatII 2000, Siemens, Munich, Germany). A total of 20 images were obtained in both hard- and soft-copy formats. For the purpose of soft-copy display, the screen-film hard-copy images were digitized with a 50 microm micron scanner. Six radiologists, experts in breast imaging, and three physicists, experts in scoring mammography phantoms, participated in a reader study where each reader scored each phantom for visibility of line-pairs and for 24 objects (fibers, clusters of specks, and masses). The data were recorded, entered into a database, and analyzed by a mixed-effect model. The limiting spatial resolution in line-pairs per millimeter visible with the digital units was less, regardless of display modality used, than that provided by the screen-film unit. The difference was statistically significant for the General Electric (p < 0.01) and Fuji digital mammography units (p = 0.03). With respect to the number of visible objects, a statistically significant higher number could be detected with the screen-film unit as compared to the Fischer (p < 0.01) and Sectra (p < 0.01) digital mammography units, but there was no significant difference between the other digital units and screen film. Overall, there was significantly better performance on the 50/50 phantom than with the 30/70 and 20/80 phantoms (p = 0.01, p < 0.01) for object visibility. For the digital mammography units, soft-copy display performed better than hard-copy display for the Fischer and Sectra images, but worse for Fuji and General Electric. In addition, soft-copy display of digitized screen-film images was significantly better than hard-copy display (p =0.02) of the original screen films for object visibility, but worse for spatial resolution. The higher contrast resolution of the FFDM units tested did not result in improved detection of line-pair resolution or objects in the phantoms tested versus screen-film mammography. The phantom performance of a digital mammography unit seems to be influenced by the type of detection task (line-pair resolution versus object visibility), the display modality (soft-copy versus hard-copy) chosen to score the phantoms, and the parenchymal pattern composition of the phantom.
authors.affiliation: Department of Radiology, University of North Carolina at Chapel Hill, Old Infirmary Builiding, Room 513, CB#7510, Chapel Hill, North Carolina 27599, USA.
authors.forename: Cherie M
authors.initials: CM
authors.lastname: Kuzmiak
authors.forename: Etta D
authors.initials: ED
authors.lastname: Pisano
authors.forename: Elodia B
authors.initials: EB
authors.lastname: Cole
authors.forename: Donglin
authors.initials: D
authors.lastname: Zeng
authors.forename: Charles B
authors.initials: CB
authors.lastname: Burns
authors.forename: Craig
authors.initials: C
authors.lastname: Roberto
authors.forename: Dag
authors.initials: D
authors.lastname: Pavic
authors.forename: Yeonhee
authors.initials: Y
authors.lastname: Lee
authors.forename: Bo Kyoung
authors.initials: BK
authors.lastname: Seo
authors.forename: Marcia
authors.initials: M
authors.lastname: Koomen
authors.forename: David
authors.initials: D
authors.lastname: Washburn
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D019544:Equipment Failure Analysis; D008327:Mammography / Q000379:methods*; D019047:Phantoms, Imaging; D011856:Radiographic Image Enhancement / Q000295:instrumentation* / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014963:X-Ray Intensifying Screens