Highlights
- •Calcification cluster detection is related to image quality measured by CDMAM phantom.
- •CDMAM tests discriminate between clinically acceptable and unacceptable systems.
- •Image quality standards in European Guidelines need reviewing.
Abstract
Purpose
To investigate the relationship between image quality measurements and the clinical
performance of digital mammographic systems.
Methods
Mammograms containing subtle malignant non-calcification lesions and simulated malignant
calcification clusters were adapted to appear as if acquired by four types of detector.
Observers searched for suspicious lesions and gave these a malignancy score. Analysis
was undertaken using jackknife alternative free-response receiver operating characteristics
weighted figure of merit (FoM). Images of a CDMAM contrast-detail phantom were adapted
to appear as if acquired using the same four detectors as the clinical images. The
resultant threshold gold thicknesses were compared to the FoMs using a linear regression
model and an F-test was used to find if the gradient of the relationship was significantly non-zero.
Results
The detectors with the best image quality measurement also had the highest FoM values.
The gradient of the inverse relationship between FoMs and threshold gold thickness
for the 0.25 mm diameter disk was significantly different from zero for calcification clusters
(p = 0.027), but not for non-calcification lesions (p = 0.11). Systems performing just above the minimum image quality level set in the European
Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis resulted
in reduced cancer detection rates compared to systems performing at the achievable
level.
Conclusions
The clinical effectiveness of mammography for the task of detecting calcification
clusters was found to be linked to image quality assessment using the CDMAM phantom.
The European Guidelines should be reviewed as the current minimum image quality standards
may be too low.
Keywords
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Article info
Publication history
Published online: April 06, 2016
Accepted:
March 3,
2016
Received in revised form:
February 19,
2016
Received:
December 17,
2015
Identification
Copyright
© 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
