Using a human visual system model to optimize soft-copy mammography display: Influence of veiling glare

Rationale and Objectives. This project evaluated human observer performance and that of a human visual system model (JNDmetrix) to assess whether the veiling glare of a digital display influences observer performance during soft-copy interpretation of mammographic images for the detection of masses. Materials and Methods. A set of 160 mammographic images, half containing a single mass, was processed to simulate four levels of veiling glare: none, comparable to a medical grade monochrome curved-screen cathode ray tube (CRT) display, double that of the CRT and quadruple that of the CRT. The images were shown to six observers in a randomized presentation order on a liquid crystal display (LCD) that had essentially no veiling glare. The images were also analyzed using the JNDmetrix human visual system model. Results. Observer performance as measured using receiver operating characteristic techniques declined with increasing veiling glare (F = 6.884, P = .0035), with quadruple veiling glare yielding significantly lower performance than the lower veiling glare levels. The JNDmetrix model did not show a large reduction in performance as a function of veiling glare, and correlation with the human observer data was modest (0.588). Conclusions. Soft-copy display veiling glare can influence observer performance, but only at extreme levels. The impact of veiling glare on performance may be more pronounced for less experienced readers.