Optimised Mammogram Displays for Improved Breast Cancer Detection

Abstract

In current mammography practice, radiologists typically view mammograms in a symmetric, side-by-side, configuration in the belief that abnormalities will be made salient because they break the perceived symmetry. The literature on the use of symmetry as an aid to signal detection is limited and this thesis has taken a psychophysical approach to investigate the radiologist’s task of detecting a small mass (a blob) in paired mammogram backgrounds. Initial experiments used Gaussian white noise and synthetic mammogram backgrounds to test observer performance for the radiologist’s task using symmetric (side-by-side) displays and animated (the two images of a pair alternated sequentially in the same location) displays. The use of animated displays was then tested using real mammogram backgrounds in the subsequent experiments. The results showed that side-by-side presentation of paired images does not provide any benefit for the detection of a blob, whereas, alternated presentation enabled the observer to use the correlation present between the paired images to improve detection performance. The effect of alternation was not evident when applied to the task of detecting a small mass in real mammogram pairs and subsequent investigation suggested that the loss of effect resulted from the lack of scale invariance of real images. This meant that, regardless of the level of global correlation between two images, the localised correlation, at a region size reflecting the visual angle subtended by the fovea, was much lower. Thus, decorrelation by the visual system was ineffective and performance for the detection of a blob in the paired images was also ineffective. This thesis suggests that, whilst animated displays can be a powerful tool for the identification of differences between paired images, the underpinning mechanism of decorrelation makes them unsuited for mammograms where scale invariance means that correlation at local levels is a fraction of the global correlation level.