Detection of masses and microcalcifications of breast cancer on digital mammograms: comparison among hard-copy film, 3-megapixel liquid crystal display (LCD) monitors and 5-megapixel LCD monitors: an observer performance study.

The purpose of the study was to compare observer performance in the detection of masses and microcalcifications of breast cancer among hard-copy reading and soft-copy readings using 3-megapixel (3M) and 5-megapixel (5M) liquid crystal display (LCD) monitors. For the microcalcification detection test, we prepared 100 mammograms: 40 surgically verified cancer cases and 60 normal cases. For the mass detection test, we prepared 100 mammograms: 50 cancer cases and 50 normal cases. After six readers assessed both microcalcifications and masses set for each modality, receiver operating characteristic (ROC) analysis was performed. The average A(z)s for mass detection using a hard copy and 3M and 5M LCD monitors were 0.923, 0.927 and 0.920, respectively; there were no significant differences. The average A(z) for microcalcification detection using hard copy, 3M and 5M LCD monitors was 0.977, 0.954 and 0.972, respectively. There were no significant differences, but the P-values between the hard copy and 3M LCD monitor and that between the 3M and 5M LCD monitor were 0.08 and 0.09, respectively. In conclusion, the observer performances for detecting masses of breast cancers were comparable among the hard copy and two LCD monitors; however, soft-copy reading with a 3M LCD monitor showed slightly lower observer performance for detecting microcalcifications of breast cancers than hard-copy or 5M LCD monitor reading.