Background: Recent studies have reported the clinical usefulness of the soft-copy reading of mammograms. However, image-processing parameters for soft-copy reading of digital mammograms have not been established. Purpose: To compare observer performance in detecting breast cancer by soft-copy reading of digital mammograms using a routine image-processing parameter versus each of several high-contrast parameters. Material and Methods: The mammograms of 154 breasts, including 48 abnormal breasts with breast cancer and 106 normal breasts, were examined. Cancers were classified into 34 mass-dominant cancers, 11 microcalcification-dominant cancers, two cancers showing only architectural distortion, and one cancer without abnormal findings. All mammograms were performed using a computed radiography (CR) system. Each image was processed using GA (1.2), which was the contrast parameter recommended by the manufacturer for hard-copy film, GA (1.4), GA (1.6), and GA (1.8). These images were displayed on 5-megapixel (M) liquid-crystal display monitors. Five experienced radiologists classified them into BI-RADS category 1-2 or 3-5, and were also asked to rate the images on a scale of 0 to 100 for the likelihood of the presence of masses and microcalcifications in each breast. Results: In mass-dominant cancers of dense breast tissue, the mean sensitivities of GA (1.2), GA (1.4), GA (1.6), and GA (1.8) were 32.7, 38.2, 36.4, and 40.0, and the AZ values were 0.67, 0.73, 0.71, and 0.73, respectively; in microcalcification-dominant cancers, the mean sensitivities were 80.0, 74.5, 80.0, and 78.2, respectively; however, there were no significant differences among them. Conclusion: High-contrast parameters tended to show relatively high sensitivity and AZ values in the detection of masses in dense breast tissue, but relatively low sensitivity for microcalcifications.
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