Comparison of dry laser printer versus paper printer in full-field digital mammography

Abstract

Background: Paper printers have been used to document radiological findings in some hospitals. It is critical to establish whether paper printers can achieve the same efficacy and quality as dry laser printers for full-field digital mammography (FFDM). Purpose: To compare the image quality and detection rate of dry laser printers and paper printers for FFDM. Material and Methods: Fifty-five cases (25 with single clustered microcalcifications and 30 controls) were selected by a radiologist not participating in the image review. All images were printed on film and paper by one experienced mammography technologist using the processing algorithm routinely used for our mammograms. Two radiologists evaluated hard copies from dry laser printers and paper printers for image quality and detectability of clustered microcalcifications. For the image quality comparisons, agreement between the reviewers was evaluated by means of kappa statistics. The significance of differences between both of the printers was determined using Wilcoxon's signed-rank test. The detection rate of two printing systems was evaluated using receiver operating characteristic (ROC) analysis. Results: From 110 scores (55 patients, two readers) per printer system, the following quality results were achieved for dry laser printer images: 70 (63.6%) were rated as good and 40 (36.4%) as moderate. By contrast, for the paper printer images, 25 scores (22.7%) were rated as good and 85 (77.3%) as moderate. Therefore, the image quality of the dry laser printer was superior to that achieved by the paper printer ( P=0.00). The average area-under-the-curve (Az) values for the dry laser printer and the paper printer were 0.991 and 0.805, respectively. The difference was 0.186. Results of ROC analysis showed significant difference in observer performance between the dry laser printer and paper printer ( P=0.0015). Conclusion: The performance of dry laser printers is superior to that of paper printers. Paper printers should not be used in FFDM.