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Thirty images with added simulated pathological lesions at two different dose levels (100% and 10% dose) were evaluated with the free-response forced error experiment by nine experienced radiologists. The simulated pathological lesions present in the images were classified according to four different parameters: the position within the lumbar spine, possibility to perform a symmetrical (left-right) comparison, the lesion contrast, and the complexity of the surrounding background where the lesion was situated. The detectability of each lesion was calculated as the fraction of radiologists who successfully detected the lesion before a false positive error was made. The influence of each of the four parameters on lesion detectability was investigated. The results of the study show that the influence of lesion contrast is the most important factor for detectability. Since the dose level had a limited effect on detectability, large dose savings can be made without reducing the detectability of pathological lesions in lumbar spine radiography.
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Anders Tingberg, Magnus Bath, Mark Ruschin, Anna Grahn, Jack Besjakov, Sara Borjesson, Markus Hakansson, Soren Mattsson, Lars Gunnar Mansson, "Detectability of pathological lesions in lumbar spine radiography," Proc. SPIE 5749, Medical Imaging 2005: Image Perception, Observer Performance, and Technology Assessment, (6 April 2005); https://doi.org/10.1117/12.595683