Observer Study for Evaluating Potential Utility of a Super-High-Resolution LCD in the Detection of Clustered Microcalcifications on Digital Mammograms

We evaluated the potential utility of a newly developed liquid-crystal display (LCD), which used an independent sub-pixel drive (ISD) technique for increasing the spatial resolution of a standard LCD three times in one direction, by use of receiver operating characteristic (ROC) analysis and a two-alternative-forced-choice (2AFC) method to determine improvement in radiologists’ accuracy in the detection of clustered microcalcifications (MCLs) on digital mammograms. We used a standard LCD without and with the ISD technique, which can increase the spatial resolution of the LCD three times in one direction from three mega- to nine megapixels without changes in the size of the display. We used 60 single views of digital mammograms (30 with and 30 without clustered MCLs) for ROC studies and 60 regions of interest (ROIs) with clustered MCLs for 2AFC studies. In the ROC study, seven radiologists attempted to detect clustered MCLs without and with the ISD on the same LCD. In the 2AFC study, the same observer group compared the visibility of MCLs by use of the LCD without and with the ISD. Our institutional review board approved the use of this database and the participation of radiologists in this study. The accuracy in detecting clustered MCLs in the ROC study was improved by use of the LCD with the ISD, but the improvement was not statistically significant (p = 0.08). However, the superiority of the LCD with the ISD was demonstrated as significant (p < 0.001) in the 2AFC study. An LCD with ISD can improve the visibility of clustered MCLs when high-resolution digital mammograms are available.