Model observers and detectability index in x-ray imaging: historical review, applications and future trends

The detectability index, originally developed in psychophysics, has been applied in medical imaging to integrate objective metrics with subjective assessments. This index accounts for both image processing properties and the limitations of the human visual system, thus enhancing the clinical efficacy of imaging technologies. By providing a single metric that captures multiple aspects of image quality, the detectability index offers a comprehensive evaluation of clinical images. Numerous applications of this index across various areas of medical imaging are documented in the literature, along with recommendations for its use in periodic performance evaluations of imaging devices. However, since different modalities of images may require different detectability indices, it is crucial to assess the adequacy of the properties of the image being analyzed and those from the adopted index. A thorough understanding of this metric, including its statistical nature and complex relationship with model observers, is essential to ensure its proper application and interpretation, and to prevent misuse. Medical physicists face the challenge of a lack of organized guidance on the detectability index, necessitating a comprehensive review of its merits and drawbacks. This paper aims to trace the origins, concepts, and clinical applications of the detectability index, offering insight into its strengths, limitations, and future potential. To achieve this, an extensive literature review was conducted, covering the evolution of the index from its early use in radar interpretation to its current applications in modern imaging techniques and future trends. The paper includes supplementary materials such as a compendium of fundamental concepts, ancillary information, and mathematical deductions to help readers less experienced in the subject.