Increasing display luminance as a means to enhance interpretation accuracy and efficiency when reducing full-field digital mammography dose

FFDM reduces radiation dose, but risks are still a concern. Reducing dose increases noise impacting image quality, but can be dealt with at the display level by increasing luminance. Two CDMAM images were obtained at 26 kV and the same distance between detectors, at 45 and 50 mAs resulting in entrance surface doses of 7.093 and 7.880 mGy. They were processed to make average gray level of the background independent of dose level, while maintaining SNR. Eight radiologists viewed the images at 420 cd/m², 1000 cd/m² and SpotView^TMa tool that resulted in an average display luminance of 3138.8 cd/m². Percent correct (PC) for all 3 luminances was higher in high vs low dose. In low dose, PC was highest with SpotView^TM, and SpotView^TM and 1000 cd/m² were significantly higher than 420 cd/m². In high dose, SpotView^TM PC was significantly higher than both lower luminances. Average time per image was lower in high dose, and at both doses time decreased as luminance increased, with SpotViewTM have significantly shorter times. Increasing luminance from 420 cd/m2 to 1000 cd/m2 significantly increases reading accuracy by approximately 3.0%; SpotView^TM by approximately 6.2%. Increasing display luminance with SpotView^TM significantly decreases reading time by 16.0%.