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12 April 2002 Detecting abnormalities in noncued areas of digitized mammograms: an observer experience
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To assess the performance levels of a radiologist in detecting non-cued masses and microcalcification clusters depicted on digitized mammograms, 120 mammograms depicting 57 verified masses and 38 microcalcification clusters were selected. During an observer performance study, the images were displayed on a computer monitor. Except for the first mode where no regions were cued, the images were cued in the other four modes using a combination of two cueing sensitivities (90% and 50%) and two false-positive rates (0.5 and 2 per image). One reader ignored all cued regions and identified suspicious regions only in non-cued areas. We examined how the performance of this observer was affected using the different cueing modes. Detection sensitivities of non-cued mammographic abnormalities ranged from 43% to 60%, which were lower (P<EQ0.05) than the 76% sensitivity achieved in the non-cued mode. Increasing the false-positive cueing rate from 0.5 to 2 per image reduced (<0.05) the detection sensitivity in the non-cued areas. When using a low performing cueing system, the performance reduction in non-cued areas might offset performance gains in cued areas, resulting in a negative impact on overall performance of the radiologists.
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William R. Poller, Bin Zheng, Jules H. Sumkin M.D., and David Gur "Detecting abnormalities in noncued areas of digitized mammograms: an observer experience", Proc. SPIE 4686, Medical Imaging 2002: Image Perception, Observer Performance, and Technology Assessment, (12 April 2002);

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