The purpose of this study was to determine the impact of default image display, presentation protocol, and workstation configuration on the softcopy interpretation of mammograms. Results from ROC studies that compared film to softcopy mammography were analyzed for this purpose. On average, no difference in performance was observed between the two modalities. However, differences were identified in individual observer performance and the qualitative evaluation of the two platforms that were related to the system’s speed, the default grayscale display of the images, and possibly the CRT phosphor. Speed and default display were ranked as the top two impact factors on softcopy reading.

The purpose of this study was to evaluate the frequency and reasons of disagreement between film and full-field digital mammography (FFDM) interpretations observed in a prospective clinical trial performed with the GE Senographe 2000D system. The data from 643 mammography examinations comprising both digital and film mammograms were analyzed for this purpose. Reports indicated that 455 findings were identified on the digital softcopy reading and 457 findings on the standard film mammography with 408 discrepancies. Findings with discrepancies were matched and analyzed. A reason was identified and a relative conspicuity score of 0 to 10 was assigned to each finding at the time of resolution; 0 corresponded to a finding highly conspicuous on digital, 10 to a finding highly conspicuous on film, and 5 denoted equal visibility on both. After review, agreement was established between the two modalities in 73.3% of the findings; 13.5% of findings were seen better on digital and 13.2% of the findings were seen better on film. Approximately 63% of the discrepancies occurred due to variability in the reporting style of the radiologists and/or unavailability of prior films for comparison. Three cancer cases were identified in this study; two were seen on both modalities and one only on film. In conclusion, no statistically significant differences were observed between digital and film mammography, a result that despite the small size of our dataset is in agreement with previous reports. Interobserver variability, display differences, and presentation disagreements are the main reasons for interpretation differences that are primarily identified in the classification and BIRADS assignment.