title: How Does the Display Luminance Level Affect Detectability of Breast Microcalcifications and Spiculated Lesions in Digital Breast Tomosynthesis (DBT) Images?
abstract: This study evaluates the influence of the calibrated luminance level of medical displays in the detectability of microcalcifications and spiculated lesions in digital breast tomosynthesis images.
  
  
  
  Four models of medical displays with calibrated maximum and minimum luminance, respectively, ranging from 500 to 1000 cd/m2and from 0.5 to 1.0 cd/m2, were investigated. Forty-eight studies were selected by a senior radiologist: 16 with microcalcifications, 16 with spiculated lesions, and 16 without lesions. All images were anonymized and blindly evaluated by one senior and two junior radiologists. For each study, lesion presence or absence and localization statements, interpretative difficulty level, and overall quality were reported. Cohen's kappa statistic was computed between monitors and within or between radiologists to estimate the reproducibility in correctly identifying lesions; for multireader-multicase analysis, the weighted jackknife alternative free-response receiver operating characteristic statistical tool was applied.
  
  
  
  Intraradiologist reproducibility ranged from 0.75 to 1.00. Interreader as well as reader-truth agreement values were >0.80 and higher with the two 1000 cd/m2luminance displays than with the lower luminance displays for each radiologist. Performances in the detectability of breast lesions were significantly greater with the 1000 cd/m2luminance displays when compared to the display with the lowest luminance value (P value <0.001).
  
  
  
  Our findings highlight the role of display luminance level on the accuracy of detecting breast lesions.
authors.affiliation: Breast Imaging Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ferranti
authors.affiliation: Breast Imaging Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Primolevo
authors.affiliation: Breast Imaging Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cartia
authors.affiliation: Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cavatorta
authors.affiliation: Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Chiara Maura
authors.initials: CM
authors.lastname: Ciniselli
authors.affiliation: Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy. Electronic address: manuela.lualdi@istitutotumori.mi.it.
authors.forename: Manuela
authors.initials: M
authors.lastname: Lualdi
authors.affiliation: Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Meroni
authors.affiliation: Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pignoli
authors.affiliation: Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Plebani
authors.affiliation: Information and Communication Technology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Siciliano
authors.affiliation: Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Verderio
authors.affiliation: Breast Imaging Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milano, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Scaperrotta
mesh_terms: D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D003626:Data Display; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results
keywords: Digital breast tomosynthesis; ROC curve; breast neoplasm; display device; liquid crystal display; luminance; radiographic image interpretation