Effects of magnification and zooming on depth perception in digital stereomammography: an observer performance study

We are evaluating the application of stereoscopic imaging to digital mammography. In the current study, we investigated the effects of magnification and zooming on depth perception. A modular phantom was designed which contained six layers of 1-mm-thick Lexan plates, each spaced 1 mm apart. Eight to nine small, thin nylon fibrils were pasted on each plate in horizontal or vertical orientations such that they formed 25 crossing fibril pairs in a projected image. The depth separation between each fibril pair ranged from 2 to 10 mm. A change in the order of the Lexan plates changed the depth separation of the two fibrils in a pair. Stereoscopic image pairs of the phantom were acquired with a GE full-field digital mammography system. Three different phantom configurations were imaged. All images were obtained using a Rh target/Rh filter spectrum at 30 kVp tube potential and a +/- 3 stereo shift angle. Images were acquired in both contact and 1.8X magnification geometry and an exposure range of 4 to 63 mAs was employed. The images were displayed on a Barco monitor driven by a Metheus stereo graphics board and viewed with LCD stereo glasses. Five observers participated in the study. Each observer visually judged whether the vertical fibril was in front of or behind the horizontal fibril in each fibril pair. It was found that the accuracy of depth discrimination increased with increasing fibril depth separation and x-ray exposure. The accuracy was not improved by electronic display zooming of the contact stereo images by 2X. Under conditions of high noise (low mAs) and small depth separation between the fibrils, the observers' depth discrimination ability was significantly better in stereo images acquired with geometric magnification than in images acquired with a contact technique and displayed with or without zooming. Under our experimental conditions, a 2 mm depth discrimination was achieved with over 60% accuracy on contact images with and without zooming, and with over 90% accuracy on magnification images. This study indicates that stereoscopic imaging, especially with magnification, may be useful for visualizing the spatial distribution of microcalcifications in a cluster and for differentiating overlapping tissues from masses on mammograms.