A clinical evaluation of contrast-detail analysis for ultrasound images

We report on the reproducibility of human observers' vanishing detection thresholds for visual targets in contrast-detail (C/D) analysis of ultrasound B-mode images. The images used in this study contain visual targets which are circular cross sections of constant-contrast conical structures in the C/D phantom. The vanishing threshold diameters for these targets vary as a function of the perceived size of the imaged target, target-to-background contrast, image noise content, and reproducibility of the decision levels of human observers for repeated observations. Our study indicates that the determination of absolute vanishing threshold diameter values for several targets of different contrast by human observers yields a high degree of error that is not predicted by existing theoretical assumptions based on a static threshold detector. We find that systematic error is introduced by the observers during the course of the experiment and that the levels of sensitivity of the observers differ widely at all times, and increase the amount of total observer error. These results suggest that, due to the large total observer error, C/D analysis may be impractical in a clinical environment, unless there is access to a team of observers specifically and extensively trained in this task. We suggest that a computer-based observer may be more reliable for the objective performance of contrast-detail analysis as a method for evaluating ultrasound image quality and comparison of imaging systems.