Soft-copy reading in digital mammography of microcalcifications: diagnostic performance of a 5-megapixel cathode ray tube monitor versus a 3-megapixel liquid crystal display monitor in a clinical setting.
BACKGROUND
A recent study using dedicated contrast-detail phantoms showed that the image quality of a 3-megapixel (M) monitor can approach that of a 5M monitor in digital mammography.


OBJECTIVE
To compare a 5M cathode ray tube (CRT) monitor with a 3M liquid crystal display (LCD) monitor for soft-copy reading of digital mammography of microcalcifications in a clinical setting.


METHODS
100 screen-detected microcalcification lesions (34 malignant and 66 benign) without mass that had been evaluated with 11-gauge stereotactic vacuum-assisted breast biopsy or definitive surgery were recruited into the study. One radiologist analyzed the soft-copy mammograms on a 5M CRT monitor and a 3M LCD monitor with 5 months between interpretations and scored the likelihood of malignancy and calcification distribution on a five-point scale. Calcification morphology and breast density were scored on a four-point scale. Positive predictive value (PPV) and negative predictive value (NPV) were calculated on the basis of a Breast Imaging Reporting and Data System. The interpretation time was also measured.


RESULTS
There was no significant difference in the likelihood of malignancy (P = 0.655), calcification morphology (P = 0.168), calcification distribution (P = 0.11), and breast density (P = 0.0608). The PPV and NPV of soft-copy reading on the 5M CRT monitor was 57% (30/53) and 91% (43/47), respectively, identical to the results using the 3M LCD monitor. The total interpretation time averaged 88 s for the 5M CRT monitor and 67 s for the 3M LCD monitor (P<0.0001).


CONCLUSIONS
Soft-copy reading of a digital mammography of microcalcifications with a 3M LCD monitor was similar in diagnostic performance to a 5M CRT monitor in this study.
Uematsu
T
T
Department of Diagnostic Radiology, Shizuoka Cancer Center Hospital, Naga-isumi, Shizuoka 411-8777, Japan. t.uematsu@scchr.jp
Kasami
M
M
Uchida
Y
Y
D001941:Breast Diseases / Q000175:diagnosis* / Q000473:pathology; D002114:Calcinosis / Q000175:diagnosis* / Q000473:pathology; D016288:Computer Terminals; D003626:Data Display; D004867:Equipment Design; D005260:Female; D006801:Humans; D050866:Liquid Crystals; D008327:Mammography / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation*; D014584:User-Computer Interface