Journal of Digital Imaging

, Volume 27, Issue 2, pp 248–254 | Cite as

Stereoscopic Interpretation of Low-Dose Breast Tomosynthesis Projection Images

  • Gautam S. Muralidhar
  • Mia K. Markey
  • Alan C. Bovik
  • Tamara Miner Haygood
  • Tanya W. Stephens
  • William R. Geiser
  • Naveen Garg
  • Beatriz E. Adrada
  • Basak E. Dogan
  • Selin Carkaci
  • Raunak Khisty
  • Gary J. Whitman
Article

Abstract

The purpose of this study was to evaluate stereoscopic perception of low-dose breast tomosynthesis projection images. In this Institutional Review Board exempt study, craniocaudal breast tomosynthesis cases (N = 47), consisting of 23 biopsy-proven malignant mass cases and 24 normal cases, were retrospectively reviewed. A stereoscopic pair comprised of two projection images that were ±4° apart from the zero angle projection was displayed on a Planar PL2010M stereoscopic display (Planar Systems, Inc., Beaverton, OR, USA). An experienced breast imager verified the truth for each case stereoscopically. A two-phase blinded observer study was conducted. In the first phase, two experienced breast imagers rated their ability to perceive 3D information using a scale of 1–3 and described the most suspicious lesion using the BI-RADS® descriptors. In the second phase, four experienced breast imagers were asked to make a binary decision on whether they saw a mass for which they would initiate a diagnostic workup or not and also report the location of the mass and provide a confidence score in the range of 0–100. The sensitivity and the specificity of the lesion detection task were evaluated. The results from our study suggest that radiologists who can perceive stereo can reliably interpret breast tomosynthesis projection images using stereoscopic viewing.

Keywords

Breast tomosynthesis Stereoscopic display 3D perception Low-dose projections 

Notes

Acknowledgments

The authors would like to acknowledge the support of Hologic, Inc. (Bedford, MA, USA) in this project. In particular, the authors would like to acknowledge Dr. Loren Niklason and Dr. Ashwini Kshirsagar at Hologic, Inc. for providing assistance with the breast tomosynthesis data.

References

  1. 1.
    Niklason LT, Christian BT, Niklason LE, et al: Digital tomosynthesis in breast imaging. Radiology 205:399–406, 1997Google Scholar
  2. 2.
    Dobbins JT III, Godfrey DJ: Digital x-ray tomosynthesis: Current state of the art and clinical potential. Phys Med Biol 48:R65–106, 2003Google Scholar
  3. 3.
    Ren B, Ruth C, Wu T, et al: A new generation FFDM / tomosynthesis fusion system with selenium detector. Proc. SPIE Medical Imaging: Physics of Medical Imaging 7622: 76220B-76220B-11, 2010Google Scholar
  4. 4.
    Karellas A, Vedantham S: Breast cancer imaging: A perspective for the next decade. Med Phys 35:4878–4897, 2008PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Getty DJ, D’Orsi CJ, Pickett RM: Stereoscopic digital mammography: Improved accuracy of lesion detection in breast cancer screening. Lect Notes Comput Sci 5116:74–79, 2008CrossRefGoogle Scholar
  6. 6.
    Prince JL, Links JM: Projection radiography. Medical imaging signals and systems. Pearson Prentice Hall, Upper Saddle River , NJ, 2006Google Scholar
  7. 7.
    Webb LJ, Samei E, Lo JY, et al: Comparative performance of multiview stereoscopic and mammographic display modalities for breast lesion detection. Med Phys 38:1972–1980, 2011Google Scholar
  8. 8.
    D’Orsi CJ, Bassett LW, Berg WA, et al: BI-RADS: Mammography, 4th edition in: D’Orsi CJ, Mendelson EB, Ikeda DM, et al: Breast Imaging Reporting and Data System: ACR BI-RADS - Breast Imaging Atlas. American College of Radiology, Reston, VA, 2003Google Scholar
  9. 9.
    Gur D, Bandos AI, King JL, et al: Binary and multi-category ratings in a laboratory observer performance study: A comparison. Med Phys 35:4404–4409, 2008Google Scholar
  10. 10.
    Richards W: Stereopsis and stereoblindness. Exp Brain Res 10:380–388, 1970PubMedCrossRefGoogle Scholar
  11. 11.
    Gwet KL: Computing inter-rater reliability and its variance in the presence of high agreement. Br J Math Stat Psychol 61:29–48, 2008PubMedCrossRefGoogle Scholar
  12. 12.
    Robin X, Turck N, Hainard A, et al: pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 12:77, 2011Google Scholar
  13. 13.
    Rafferty, E, Niklason, LT: Comparison of FFDM with breast tomosynthesis to FFDM alone: Performance in fatty and dense breasts. Proc. Tomosynthesis Imaging Symposium: Frontiers in Research and Clinical Applications, Duke University, Durham, NC, USA, 2009 (unpublished)Google Scholar
  14. 14.
    Poplack SP, Tosteson TD, Kogel CA, Nagy HM, et al: Digital breast tomosynthesis: Initial experience in 98 women with abnormal digital screening mammography. AJR Am J Roentgenol 189:616–623, 2007Google Scholar
  15. 15.
    Gur D, Abrams GS, Chough DM, et al: Digital breast tomosynthesis: Observer performance study. AJR Am J Roentgenol 193:586–591, 2009Google Scholar
  16. 16.
    Good WF, Abrams GS, Catullo VJ, et al: Digital breast tomosynthesis: A pilot observer study. Am J Roentgenol 190:865–869, 2008Google Scholar

Copyright information

© Society for Imaging Informatics in Medicine 2013

Authors and Affiliations

  • Gautam S. Muralidhar
    • 1
    • 9
  • Mia K. Markey
    • 2
    • 5
  • Alan C. Bovik
    • 3
  • Tamara Miner Haygood
    • 4
  • Tanya W. Stephens
    • 4
  • William R. Geiser
    • 5
  • Naveen Garg
    • 4
  • Beatriz E. Adrada
    • 4
  • Basak E. Dogan
    • 4
  • Selin Carkaci
    • 7
  • Raunak Khisty
    • 8
  • Gary J. Whitman
    • 4
    • 6
  1. 1.Department of Biomedical EngineeringThe University of Texas at AustinAustinUSA
  2. 2.Department of Biomedical EngineeringThe University of Texas at AustinAustinUSA
  3. 3.Department of Electrical and Computer EngineeringThe University of Texas at AustinAustinUSA
  4. 4.Department of Diagnostic RadiologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  5. 5.Department of Imaging PhysicsThe University of Texas MD Anderson Cancer CenterHoustonUSA
  6. 6.Department of Diagnostic RadiologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  7. 7.Department of RadiologyWexmer Medical Center at the Ohio State UniversityColumbusUSA
  8. 8.Department of PsychiatryWake Forest School of MedicineWinston-SalemUSA
  9. 9.VuCOMP, Inc.PlanoUSA

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