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

Reducing dose increases noise impacting image quality but can be offset by increasing display luminance. Two contrast detail mammography images were obtained at 26 kV and the same distance between detectors, at 45 and 50 mAs resulting in entrance surface doses of 7.09 and 7.88 mGy, respectively. They were processed to make average gray level of the background independent of the dose level while maintaining original SNR. Eight radiologists viewed the images at 420, 1000 cd / m², and SpotView™ a tool that resulted in an average display luminance of 3138.8 cd / m². Percent correct (PC) for all three luminances was higher for high versus low dose. Performance was always higher with high dose no matter what the luminance. For low dose, PC was highest with SpotView™, and SpotView™ and 1000 cd / m² were significantly higher than 420 cd / m². At high dose, SpotView™ 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 SpotView™ having significantly shorter times. Increasing luminance from 420 to 1000 cd / m² significantly increases target detection by ∼3.0 % and with SpotView™ by ∼6.2 %. Increasing display luminance with SpotView™ significantly decreases reading time by 16.0%.