In digital breast imaging, a medical display is the eyes of the radiologist. It affects every decision he or she makes. To help you understand the benefits of certain specs and tools, I’ll tackle the most critical display factors in a series of blog posts. Today’s topic: display luminance and screen resolution.
1. Acquisition versus display
Before we dive into the world of mammography displays, it is important to understand the ins and outs of medical imaging. To get a digital breast image, you need a machine that actually takes the images. We call these machines acquisition or imaging systems. They come in all shapes and forms and create breast images with a specific resolution. For example, the resolution of a mammogram captured by a GE digital mammography system is 2400 x 3070 pixels. The resolution of a mammogram taken by a Hologic machine, on the other hand, is 3328 x 4096 pixels.
Why is this important to know? The resolution of both the display and the acquisition system should match as closely as possible. This is also recommended by the American College of Radiology (ACR)1. It’s the only way for radiologists to detect every image detail on the screen.
The table below lists a selection of commonly used imaging systems and mammography displays. The table also shows the native resolution of these systems. Display systems with a resolution of 5 megapixels or higher are in line with the ACR guidelines. These displays are able to match the resolution matrix of the imaging systems and be approved by the manufacturer.
The total resolution of a mammography display should be high enough to fit various acquisition resolutions.
2. More screen, fewer clicks
It’s clear that the resolution of mammography displays is vital in the correct representation and interpretation of mammograms. A high display resolution brings nothing but benefits. First of all, radiologists can see details much clearer. Secondly, more resolution helps radiologists with their workflow.
How? In mammography imaging, radiologists should view breast images in full size. If you have more vertical resolution, it is easier to fit the whole breast image on the screen. Take a look at the image below. On a regular mammography display (5 megapixels), you need 4 steps to view every part of the breast image at 1:1. On a mammography display with a slightly higher resolution (e.g. 5.8 megapixels), you only need 2 steps to read the same image.
High-resolution mammography displays, with a resolution of 5.8 or 12 MP, optimize mammography workflow by reducing the number of steps needed for viewing breast images full-size. A standard 5 MP display requires 4 steps (clicks) to read the image, a 5.8 MP display requires only 2 steps.
3. Fusion increases productivity
Besides screen size and resolution, screen format is another important factor. A so-called Fusion format combines two stand-alone displays into one. This can be helpful for breast radiologists, in terms of reading productivity and ergonomics. With a Fusion display, radiologists can place breast images where they want on the screen. This makes it easier for them to compare multiple images side by side, be it mammograms, breast ultrasounds or breast MRI.
In fact, Barco has a Fusion display that increases a radiologist’s reading productivity by up to 19%2
. What’s more, it helps to minimize head and eye strain because there’s no hindering bezel between displays. All images are neatly displayed in the radiologist’s optimal field of view. For a radiologist, this results in more comfortable reading sessions.
Barco has a special mammography display, Coronis Uniti®, that supports flexible color multimodality imaging. It means 2D, breast tomosynthesis, ultrasound and breast MR images can be laid out anywhere on the screen.
4. Higher brightness, better detection
Resolution is not the only spec that defines the quality of a mammography display. Luminance is equally important. Multiple studies indicate that luminance impacts detection of small details during breast cancer screening. In fact, the higher the luminance,the bigger the chance to catch breast cancer.
Most mammography displays offer a high calibrated luminance of at least 500 candela. In some cases, this is not the maximum brightness the display can achieve. Special tools can help increase display luminance to 1000 candela or higher. Barco’s higher-end mammography displays have an internal luminance booster to increase the brightness of the display. This way, we are able to increase the detection of small details like microcalcifications by up to 30%3.
5. Higher brightness, faster workflow
Luminance boosters can also improve a radiologist’s reading speed and accuracy. Barco displays come with a special clinical tool, called SpotView™. It increases luminance in a region of interest and dims the surrounding area. A recent study indicates that SpotView increases reading accuracy by up to 6.2%4. What’s more, it reduces reading time by up to 16%4.
Because Spotview boosts display luminance to unseen levels, it speeds up a radiologist’s reading workflow.
6. Higher brightness, lower radiation
For all of the reasons explained above, choosing the right mammography display can make a real difference for radiologists. It can help them to spot the early signs of breast cancer with greater accuracy. It enables them to read cases more quickly. And it can make their reading routine more comfortable. In the end, this will also benefit the patient.
In fact, with the right mammography display, there are even more benefits for patients. We all understand that screening mammograms are vital in breast cancer detection. Still, many women (and men) worry about radiation dose and related risks when exposed to mammography.
Not many women (and men) know that radiation exposure during screening mammography is actually lower than when you take a transatlantic flight. Still, if we can try to lower radiation dose without negatively impacting clinical results, we should. A recent clinical study, conducted by Dr. Elizabeth A. Krupinski, found that radiologists using SpotView were able to reduce radiation dose when taking breast X-ray images. Even though radiation was lower, they could make equally accurate diagnoses4.
So what to look for when you buy a new mammography display? First of all, look further than a medical-grade design and resolution or luminance specs. Consider additional tools that can help to further boost display brightness. It has proven to have a positive impact on breast cancer detection. Also consider the impact of the mammography display on reading ergonomics and workflow. If your reading routine is comfortable and productive, it will benefit both doctor and patient.
Interested in more?
Download our ebook: What to consider when choosing a mammography display
1. ACR–AAPM–SIIM PRACTICE PARAMETER FOR DETERMINANTS OF IMAGE QUALITY IN DIGITAL MAMMOGRAPHY, revised 2017
2. Weschler, M. (2012). 6MP Displays Offer Speed, Comfort Benefits. Auntminnie, 2012
3. Kimpe, T. R. & Xthona, A. (2012). Quantification of Detection Probability of Microcalcifications at Increased Display Luminance Levels. Breast Imaging, Springer 7361, 490-497. 2012
4. Krupinski, E. (2018). Reducing Radiation Dose in Digital Mammography by Increasing Display Luminance. Proceedings of SIIM, 2018