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Digital Breast Tomosynthesis: Future of visualization

Digital Breast Tomosynthesis: Future of visualization. MIIT – 2013 Toronto Ketan Thanki. FFDM Vs DBT. Single Frame images Conventional Data sets Established workflow. Multi-Frame image stacks Larger Data sets Intensive workflow: dynamic browsing through image stacks.

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Digital Breast Tomosynthesis: Future of visualization

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  1. Digital Breast Tomosynthesis: Future of visualization MIIT – 2013 Toronto Ketan Thanki MIIT 2013

  2. FFDM Vs DBT • Single Frame images • Conventional Data sets • Established workflow • Multi-Frame image stacks • Larger Data sets • Intensive workflow: dynamic browsing through image stacks • Full Field Digital Mammography • Digital Breast Tomosysnthesis

  3. Visualization challenges of DBT study 1 • Limitation of LCD response & cine through multiple images 2 • Detection probability while scrolling through slices 3 • Workflow & Time to interpret

  4. Limitation of LCD response & cine through multiple images 1 • LCD Response time deceiving • 20ms of Frame time • 50+ ms of transition time • Large Variations in transition times • 2-3 Frames to refresh • Result: Blurring

  5. Blurring on traditional FFDM display during cine

  6. 2 • Detection probability while scrolling through slices [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])

  7. Subtle details during cine

  8. 3 • Workflow & Time to interpret • Pan/Zoom • Flicker… • Magnify • (Continuous zoom) • Freeze & focus… • Toggle comparison • Slow fading…

  9. Some Technologies

  10. Rapidframe • Blurring during cine • Smooth cine

  11. Rapidframe Clinical pilot results: • Browsing speed: 25 slices/second • 10% higher AUC compared to FFDM display • Statistically significant

  12. Ultra high luminance x2 x1

  13. Ultra-high Luminance: • PACS display • = 500 cd/m2 • Tomo display = 1000cd/m2 • “Hot light”= 2000 cd/m2 Hot Light tool Temporary boost for subtle details

  14. JNDs: Visible shades of gray Hot Light tool Temporary boost for subtle details

  15. Quantification of Detection Probabilityof Microcalcifications at Increased DisplayLuminance Levels

  16. 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 images • 10-bit imaging:Synchronized to display refresh rate & frame rate

  17. 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

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