Observer performance with computer-generated images of 201Tl-Cl myocardial perfusion

The effect of simple image processing on the interpretation of 201Tl-Cl myocardial perfusion images were evaluated by ROC analysis. Polaroid images of the cathode ray tube of an Anger camera and computer-processed transparent images recorded in color and shades of gray were examined by multiple observers. A total of 198 observer responses was accumulated for each of five image formats. The observer responses were compared with results established by coronary angiography. Better observer performance was obtained for all computer-generated images except in the region of low false positive values. The responses for color-scale formats were, in general, superior to those from the gray-scale formats. No significant improvement in observer performance resulted from the use of background subtraction with a rescaling of the 16-level gray scale to the residual information. When nine-point smoothing was applied to the color-scale display format, there was a poorer observer response.