Introduction: Image blurring due to motion unsharpness in Full Field Digital Mammography (FFDM) is a growing problem. For instance, a study by Seddon et al. reported that over 90% of their screening mammogram technical recalls were due to blurred images [1]. Blurring increases false negative and false positive results as it can mask fine microcalcifications, small cancers and larger lesions. Repeat imaging due to blurring increases client radiation dose and it can add to client anxiety. Technical recalls add further to client anxiety (and that...

Method: We created simulation software to induce image blur [2]; this software allowed for FFDM images to have simulated blur imposed at 0.1mm increments. Twenty normal artefact free FFDM images were selected; blur was then imposed from 0.1 to 1.0mm. In total 120 images were used, comprising 20 with no blur and 100 with varying levels of blur. Figures 1 and 2 show example FFDM images with and without simulated blur imposed. The 120 images were de-identified, randomized and displayed on the 2.3 and 5MP...

Results: The blurring detection rate on the 2.3MP monitor for 0.2, 0.4, 0.6, 0.8 and 1 mm blur was 46, 59, 66, 77and 78% respectively; blurring detection rate on the 5MP monitor was 44, 70, 83 , 96 and 98%. All the non-motion images were identified correctly by the radiographers. There is a statistical difference (X2 (2, N = 6570) =30.59, p<0.001) in the blurring detection rate between 2.3 and 5 MP monitors. As can be seen in Figure 3, the blurring detection rate increased...

Discussion: The results from this study confirms our suspicion that a monitor of lower resolution than a reporting grade monitor would likely have a poorer visual detection rate for FFDM image blurring. In clinical practice some monitors have resolutions as low as 1 MP, and we assume that such monitors would have even poorer visual detection rates than a 2.3 MP monitor, thereby leading to even more technical recalls. One of the limitations of this study is the use of motion simulated images as they...

1. Seddon D, Schofield K A, Waite C A. Investigation into possible caused of blurring in mammograms. Breast Cancer Res. 2000; 2(suppl2): A64. DOI: 10.1186/bcr253 2. Ma WK, Aspin R, Kelly J, S. Millington, Hogg P. What is the minimum amount of simulated breast movement required for visual detection of blurring? An exploratory investigation. Br J Radiol 2015; 88: 20150126. DOI: 10.1259/bjr.20150126 3.National Electrical Manufacturers Association (NEMA) Digital Imaging and Communications in Medicine (DICOM) Part 14: Grayscale Standard Display Function; 2011. 4. Perry N, Broeders...