Effects of grayscale window/level parameters on breast lesion detectability

Jeffrey P. Johnson, John Nafziger, Elizabeth A. Krupinski, Jeffrey Lubin, Hans Roehrig

Research output: Contribution to journalConference articlepeer-review

19 Scopus citations


The detectability of low-contrast lesions in medical images can be affected significantly by the choice of grayscale window width and level (W/L) for electronic display. Our objective was to measure the effects of various W/L conditions on lesion detectability in simulated and real mammographic images, and then correlate observer performance with predictions of detection thresholds derived from a visual discrimination model (VDM). In the first experiment, detection thresholds were measured in 2AFC trials for five W/L conditions applied to simulated mammographic backgrounds and lesions (i.e., Gaussian "masses" and blurred-disk "microcalcification clusters") using nonmedical observers. In the second experiment, the detectability of real microcalcification clusters in digitized mammograms was evaluated for three W/L conditions in an ROC observer study with mammographers. For the simulated images, there was generally good agreement between model and experimental thresholds and their variations across W/L conditions. Both experimental and model results showed significant reductions in thresholds when W/L processing was applied locally near the lesion. ROC results with digitized mammograms read by radiologists, however, failed to show enhanced detection of microcalcifications using a localized W/L frame, probably due to the nonuniform appearance of parenchymal tissue across the image.

Original languageEnglish (US)
Pages (from-to)462-473
Number of pages12
JournalProceedings of SPIE - The International Society for Optical Engineering
StatePublished - 2003
EventMedical Imaging 2003: Image Perception, Observer Performance, and Technology Assessment - San Diego, CA, United States
Duration: Feb 18 2003Feb 20 2003


  • Grayscale window/level
  • Lesion detection
  • Mammography
  • Observer performance
  • Visual discrimination model

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Condensed Matter Physics
  • Computer Science Applications
  • Applied Mathematics
  • Electrical and Electronic Engineering


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