PURPOSE-To evaluate the effect of pixel size on the detection of simulated microcalcifications in digital mammography using a phantom.MATERIALS AND METHODS-A high-resolution prototype imager with variable pixel size of 39 and 78 μm, and a clinical full-field digital mammography (FFDM) system with pixel size of 100 μm were used. X-ray images of a contrast-detail (CD) phantom were obtained to perform alternative forced choice (AFC) observer experiments. Polymethyl-methacrylate (PMMA) was added to obtain phantom thickness of 45 and 58 mm which are typical breast thickness conditions encountered in mammography. Phantom images were acquired with both systems under nearly identical exposure conditions using an anti-scatter grid. Twelve images were acquired for each phantom thickness and pixel size (total of 72 images) and six observers participated in this study. Observer responses were used to compute the fraction of correctly detected disks. A signal detection model was used to fit the recorded data from which CD characteristics were obtained. Repeated-measures analyses using mixed effects linear models were performed for each of the 6 observers. All statistical tests were 2-sided and unadjusted for multiple comparisons. A P value of 0.05 or less was considered to indicate statistical significance.
RESULTS-Statistical analysis indicated significantly better CD characteristics with 39 and 78μm pixel sizes compared to the 100 μm pixel for all disk diameters and phantom thickness conditions (p<0.001). Increase in phantom thickness degraded CD characteristics irrespective of pixel size (p<0.001).CONCLUSION-Based on the conditions of this study, reducing pixel size below 100 μm with low imaging system noise enhances the visual perception of small objects that correspond to typical microcalcification size.Corresponding author: Andrew Karellas Ph.D., Professor of Radiology, Hematology, and Oncology, Director of Medical Physics, Department of Radiology, Emory University School of Medicine, Winship Cancer Institute, 1701 Uppergate Drive, Building C, Suite 5018, Atlanta, GA 30322., Email: akarell@emory.edu, Phone: (404) 712 2411, FAX: (404) 712 5813. Advances in Knowledge: The results of this study indicate superior performance of 39 and 78 μm pixel sizes (high-resolution prototype digital imager) compared with 100 μm pixel size (clinical FFDM system).
Implications for Patient Care:Based on the conditions investigated in this study, it appears that high-resolution (below 100 μm pixel size) and low-noise digital x-ray mammography systems could potentially improve the detection and visualization of microcalcifications leading to early and more accurate diagnosis.Publisher's Disclaimer: This author manuscript accepted for publication in Radiology has not been copyedited and proofread and is not the official, definitive version that will be published in Radiology online and in print, copyright 2007 The Radiological Society of North America. The RSNA disclaims any responsibility or liability for errors or omissions in this...