digital breast tomosynthesis: future of visualization miit – 2013 toronto ketan thanki...

MIIT 2013

Digital Breast Tomosynthesis: Future of visualizationMIIT – 2013 TorontoKetan Thanki

5/24/2013

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FFDM Vs DBT

Fu

ll F

ield

Dig

ital M

am

mog

rap

hy • Single Frame

images

• Conventional Data sets

• Established workflow

Dig

ital B

reast

Tom

osysn

thesis • Multi-Frame

image stacks

• Larger Data sets

• Intensive workflow: dynamic browsing through image stacks

3

Visualization challenges of DBT study

Limitation of LCD response & cine through multiple images1

Detection probability while scrolling through slices2

Workflow & Time to interpret3

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Limitation of LCD response & cine through multiple images1

LCD Response time deceiving

Large Variations in transition times

2-3 Frames to refresh

Result: Blurring

20ms of Frame time 50+ ms of

transition time

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Blurring on traditional FFDM display during cine

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Detection probability while scrolling through slices2

[Lia06] Temporal Response Measurements of Medical Liquid Crystal Displays, Hongye Liang and Aldo Badano, SPIE medical Imaging 2006

Slow average transition times

Blurring when browsing through

image stack

Result: Masking of subtle image

features Eg. On a typical 5 MegaPixel medical display, the fastest transition is +/- 15ms while the slowest transition requires 150ms (more than 10 display frames) to complete (source: [Lia06])

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Subtle details during cine

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Workflow & Time to interpret3

• Flicker…Pan/Zoom

• Freeze & focus…Magnify

(Continuous zoom)

• Slow fading…Toggle comparison

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Some Technologies

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Rapidframe

Blurring during cine Smooth cine

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Rapidframe Clinical pilot results:

Browsing speed: 25 slices/second

10% higher AUC compared to FFDM

display

Statistically significant

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Ultra high luminance

x2

x1

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Ultra-high Luminance:

PACS display= 500 cd/m2

Tomo display = 1000cd/m2

“Hot light”= 2000 cd/m2

Hot Light toolTemporary boostfor subtle details

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JNDs: Visible shades of gray

Hot Light toolTemporary boostfor subtle details

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Quantification of Detection Probabilityof Microcalcifications at Increased Display

Luminance Levels

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Tomosynthesis Displays:

Three factors for efficient reading time and accuracy

Cine without blur technology

Ultra-high luminance with “Hot light” for subtle details

Display controller with enough memory to hold large stacks of images10-bit imaging:Synchronized to display refresh rate & frame rate

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References

Medical Display optimized for Digital Breast Tomosynthesis

▫ T Kimpe, MS, Kortrijk, _ BEL; A Xthona; C Marchessoux

Quantification of Detection Probability of Micro-calcifications at Increased Display Luminance Levels

▫ Tom R.L. Kimpe and Albert Xthona

Multimodality breast imaging using RapidFrame™

▫ Albert Xthona