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Sample records for diagnostic mammography differs

  1. Performance of diagnostic mammography differs in the United States and Denmark

    DEFF Research Database (Denmark)

    Jensen, Allan; Geller, Berta M; Gard, Charlotte C

    2010-01-01

    in the United States and Denmark. The performance of 93,585 diagnostic mammograms from 180 facilities contributing data to the US Breast Cancer Surveillance Consortium (BCSC) from 1999 to 2001 was compared to that of all 51,313 diagnostic mammograms performed at Danish clinics in 2000. We used the imaging...... workup's final assessment to determine sensitivity, specificity and an estimate of accuracy: area under the receiver-operating characteristics (ROCs) curve (AUC). Diagnostic mammography had slightly higher sensitivity in the United States (85%) than in Denmark (82%). In contrast, it had higher...... specificity in Denmark (99%) than in the United States (93%). The AUC was high in both countries: 0.91 in United States and 0.95 in Denmark. Denmark's higher accuracy may result from supplementary ultrasound examinations, which are provided to 74% of Danish women but only 37% to 52% of US women. In addition...

  2. Mammography: Technique and diagnostic accuracy

    International Nuclear Information System (INIS)

    Kim, Chung Ja; Bahk, Yong Whee; Lee, Don Young

    1974-01-01

    Mammography is now in world wide use, But this has received rather scanty attention in Korea. The purposes of the present communication are twofold: (1) Detailing of technical and photographic aspects of mam in ography and (2) an assessment of its diagnostic accuracy as experienced by us. The clinical materials consisted of 88 cases of mammography performed at the Department of Radiology, St. Mary's Hospital, Catholic Medical College during the 2 years-period from April 1972. We used nonscreen type mammographic or industrial fine- grain films, and a special mammographic device that can be attached to any of the ordinary radiographic machine. Technical factors are shown in Table II. Of 88 cases 19 were operated on or biopsied. There were 7 cases of carcinoma. 8 cases of inflammatory diseases, and 4 cases of benign tumor. Mammographic diagnosis was correct in 85.7% of carcinoma and 87.5% of inflammatory diseases. One misdiagnosis of 7 cases of carcinoma was turned out to be cystosarcoma phylloides. Of 4 cases of benign tumors 2 were correctly diagnosed, and the other 2 mistaken for either inflammatory disease or simple lactating breast. However, none of the benign conditions were diagnosed as malignant process. We found that nonscreen type mammographic or industrial fine-grain films, and hand-processing were necessary in obtaining the mammograms of desirable quality

  3. Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain

    International Nuclear Information System (INIS)

    Domingo, Laia; Sala, Maria; Romero, Anabel; Belvis, Francesc; Macia, Francesc; Castells, Xavier; Sanchez, Mar; Ferrer, Joana; Salas, Dolores; Ibanez, Josefa; Vega, Alfonso; Ferrer, Francesc; Laso, M.S.

    2011-01-01

    To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women. 242,838 screening mammograms (171,191 SFM and 71,647 DM) from 103,613 women aged 45-69 years, performed in four population-based breast cancer screening programmes in Spain, were included. The tumour characteristics and PPVs of each group were compared. Radiological patterns (masses, calcifications, distortions and asymmetries) among recalled women were described and PPVs were evaluated. The percentages of ductal carcinoma in situ (DCIS) were higher in DM than in SFM both in the first [18.5% vs. 15.8%(p = 0.580)] and in successive screenings [23.2% vs. 15.7%(p = 0.115)]. PPVs for masses, asymmetries and calcifications were higher in DM, being statistically significant in masses (5.3% vs. 3.9%; proportion ratio: 1.37 95%CI: 1.08-1.72). Among cancers detected by calcifications, the percentage of DCIS was higher in DM (60.3% vs. 46.4%, p = 0.060). PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics. The greatest improvements in PPVs were found for masses. (orig.)

  4. Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Domingo, Laia; Sala, Maria [IMIM-Hospital del Mar, Department of Epidemiology and Evaluation, Barcelona (Spain); CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona (Spain); Universitat Autonoma de Barcelona (UAB), EHEA Doctoral Program in Public Health. Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Barcelona (Spain); Romero, Anabel; Belvis, Francesc; Macia, Francesc; Castells, Xavier [IMIM-Hospital del Mar, Department of Epidemiology and Evaluation, Barcelona (Spain); CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona (Spain); Sanchez, Mar [Government of Cantabria, General Directorate of Public Health, Department of Health, Santander (Spain); Ferrer, Joana [Radiology Unit. Hospital Santa Caterina, Girona (Spain); Salas, Dolores; Ibanez, Josefa [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia (Spain); Vega, Alfonso [Hospital Universitario Marques de Valdecilla, Radiology Unit, Santander (Spain); Ferrer, Francesc [Hospital del Mar, Radiology and Nuclear Medicine Service, Barcelona (Spain); Laso, M.S. [Breast Cancer Screening Unit Burjassot, Valencia (Spain)

    2011-09-15

    To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women. 242,838 screening mammograms (171,191 SFM and 71,647 DM) from 103,613 women aged 45-69 years, performed in four population-based breast cancer screening programmes in Spain, were included. The tumour characteristics and PPVs of each group were compared. Radiological patterns (masses, calcifications, distortions and asymmetries) among recalled women were described and PPVs were evaluated. The percentages of ductal carcinoma in situ (DCIS) were higher in DM than in SFM both in the first [18.5% vs. 15.8%(p = 0.580)] and in successive screenings [23.2% vs. 15.7%(p = 0.115)]. PPVs for masses, asymmetries and calcifications were higher in DM, being statistically significant in masses (5.3% vs. 3.9%; proportion ratio: 1.37 95%CI: 1.08-1.72). Among cancers detected by calcifications, the percentage of DCIS was higher in DM (60.3% vs. 46.4%, p = 0.060). PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics. The greatest improvements in PPVs were found for masses. (orig.)

  5. Development of diagnostic mammography unit

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, M.; Muraki, T.; Kitade, K. (Toshiba Corp., Kawasaki, Kanagawa (Japan))

    1981-07-01

    The mortality from breast cancer is gradually increasing year after year. Accordingly, it is eagerly desired that X-ray diagnosis information be obtainable with higher accuracy and ease for early detection of the disease. Meeting this demand, development has been made of a 2 x magnification mammography unit (Model MGU-01) capabel of minutely depicting microcalcifications with a size of 150 ..mu..m or thereabout and the peripheral condition of a mammary abscess. The background of the development, the substance of the unit and the examination made of the unit are described here.

  6. Development of diagnostic mammography unit

    International Nuclear Information System (INIS)

    Matsubara, Mitsuyoshi; Muraki, Takeshi; Kitade, Kooichi

    1981-01-01

    The mortality from breast cancer is gradually increasing year after year. Accordingly, it is eagerly desired that X-ray diagnosis information be obtainable with higher accuracy and ease for early detection of the disease. Meeting this demand, development has been made of a 2 x magnification mammography unit (Model MGU-01) capabel of minutely depicting microcalcifications with a size of 150 μm or thereabout and the peripheral condition of a mammary abscess. The background of the development, the substance of the unit and the examination made of the unit are described here. (author)

  7. Organization and standards of screening and diagnostic mammography

    International Nuclear Information System (INIS)

    Linderbraten, L.D.; Chikirdin, Eh.G.; Rozhkova, N.I.

    1999-01-01

    Problem of organizing and standards of the reference and diagnostic mammography in our country is discussed. Attention is paid to the terminology, accreditation of mammographic establishments and specialists, specifications of equipment, image quality, mammography results processing, radiation doses [ru

  8. Diagnostic reference levels in digital mammography: a systematic review

    International Nuclear Information System (INIS)

    Suleiman, Moayyad E.; Brennan, Patrick C.; McEntee, Mark F.

    2015-01-01

    This study aims to review the literature on existing diagnostic reference levels (DRLs) in digital mammography and methodologies for establishing them. To this end, a systematic search through Medline, Cinahl, Web of Science, Scopus and Google scholar was conducted using search terms extracted from three terms: DRLs, digital mammography and breast screen. The search resulted in 1539 articles of which 22 were included after a screening process. Relevant data from the included studies were summarised and analysed. Differences were found in the methods utilised to establish DRLs including test subjects types, protocols followed, conversion factors employed, breast compressed thicknesses and percentile values adopted. These differences complicate comparison of DRLs among countries; hence, an internationally accepted protocol would be valuable so that international comparisons can be made. (authors)

  9. Personalized estimates of radiation dose from dedicated breast CT in a diagnostic population and comparison with diagnostic mammography

    International Nuclear Information System (INIS)

    Vedantham, Srinivasan; Shi, Linxi; Karellas, Andrew; O'Connell, Avice M; Conover, David L

    2013-01-01

    This study retrospectively analyzed the mean glandular dose (MGD) to 133 breasts from 132 subjects, all women, who participated in a clinical trial evaluating dedicated breast CT in a diagnostic population. The clinical trial was conducted in adherence to a protocol approved by institutional review boards and the study participants provided written informed consent. Individual estimates of MGD to each breast from dedicated breast CT was obtained by combining x-ray beam characteristics with estimates of breast dimensions and fibroglandular fraction from volumetric breast CT images, and using normalized glandular dose coefficients. For each study participant and for the breast corresponding to that imaged with breast CT, an estimate of the MGD from diagnostic mammography (including supplemental views) was obtained from the DICOM image headers for comparison. This estimate uses normalized glandular dose coefficients corresponding to a breast with 50% fibroglandular weight fraction. The median fibroglandular weight fraction for the study cohort determined from volumetric breast CT images was 15%. Hence, the MGD from diagnostic mammography was corrected to be representative of the study cohort. Individualized estimates of MGD from breast CT ranged from 5.7 to 27.8 mGy. Corresponding to the breasts imaged with breast CT, the MGD from diagnostic mammography ranged from 2.6 to 31.6 mGy. The mean (± inter-breast SD) and the median MGD (mGy) from dedicated breast CT exam were 13.9 ± 4.6 and 12.6, respectively. For the corresponding breasts, the mean (± inter-breast SD) and the median MGD (mGy) from diagnostic mammography were 12.4 ± 6.3 and 11.1, respectively. Statistical analysis indicated that at the 0.05 level, the distributions of MGD from dedicated breast CT and diagnostic mammography were significantly different (Wilcoxon signed ranks test, p = 0.007). While the interquartile range and the range (maximum–minimum) of MGD from dedicated breast CT was lower than

  10. Artificial Neural Networks in Mammography Interpretation and Diagnostic Decision Making

    Directory of Open Access Journals (Sweden)

    Turgay Ayer

    2013-01-01

    Full Text Available Screening mammography is the most effective means for early detection of breast cancer. Although general rules for discriminating malignant and benign lesions exist, radiologists are unable to perfectly detect and classify all lesions as malignant and benign, for many reasons which include, but are not limited to, overlap of features that distinguish malignancy, difficulty in estimating disease risk, and variability in recommended management. When predictive variables are numerous and interact, ad hoc decision making strategies based on experience and memory may lead to systematic errors and variability in practice. The integration of computer models to help radiologists increase the accuracy of mammography examinations in diagnostic decision making has gained increasing attention in the last two decades. In this study, we provide an overview of one of the most commonly used models, artificial neural networks (ANNs, in mammography interpretation and diagnostic decision making and discuss important features in mammography interpretation. We conclude by discussing several common limitations of existing research on ANN-based detection and diagnostic models and provide possible future research directions.

  11. Performances of different digital mammography imaging systems: Evaluation and comparison

    Energy Technology Data Exchange (ETDEWEB)

    Bisogni, M.G. [Dipartimento di Fisica ' E. Fermi' , Universita di Pisa, e Sezione INFN di Pisa, Pisa (Italy)]. E-mail: giuseppina.bisogni@pi.infn.it; Bulajic, D. [Dipartimento di Fisica ' E. Fermi' , Universita di Pisa, e Sezione INFN di Pisa, Pisa (Italy); International Centre for Theoretical Physics, Trieste (Italy); Delogu, P. [Dipartimento di Fisica ' E. Fermi' , Universita di Pisa, e Sezione INFN di Pisa, Pisa (Italy); Fantacci, M.E. [Dipartimento di Fisica ' E. Fermi' , Universita di Pisa, e Sezione INFN di Pisa, Pisa (Italy); Novelli, M. [Dipartimento di Fisica ' E. Fermi' , Universita di Pisa, e Sezione INFN di Pisa, Pisa (Italy); Quattrocchi, M. [Dipartimento di Fisica ' E. Fermi' , Universita di Pisa, e Sezione INFN di Pisa, Pisa (Italy); Rosso, V. [Dipartimento di Fisica ' E. Fermi' , Universita di Pisa, e Sezione INFN di Pisa, Pisa (Italy); Stefanini, A. [Dipartimento di Fisica ' E. Fermi' , Universita di Pisa, e Sezione INFN di Pisa, Pisa (Italy)

    2005-07-01

    Digital mammography is entering routine clinical use and many commercial systems are now in use in the radiological units for screening and diagnostic mammography. At the same time, the research in the digital mammography field is very active in the development of more and more performing devices. In this paper we present the performance of single photon counting pixel detectors (MedipixI) tailored for digital mammographic applications. These devices are based on semiconductor (Si and GaAs) pixel detectors of different thickness, read-out by custom designed integrated circuits. To assess the imaging capability of such systems, the images of a mammographic phantom have been acquired in standard conditions for a clinical examination. The signal-to-noise ratio (SNR) of details simulating tumor masses has been evaluated. The same phantom has been also radiographed by three different commercial digital mammographic systems in the same reference conditions and a comparison in terms of SNR has been carried out. The spatial resolution of the single photon counting systems has also been evaluated by measuring the line spread function with the edge technique and then calculating the Modulation Transfer Function (MTF). The MTFs of the single photon counting systems have been compared with the MTFs of the commercial systems.

  12. Performances of different digital mammography imaging systems: Evaluation and comparison

    International Nuclear Information System (INIS)

    Bisogni, M.G.; Bulajic, D.; Delogu, P.; Fantacci, M.E.; Novelli, M.; Quattrocchi, M.; Rosso, V.; Stefanini, A.

    2005-01-01

    Digital mammography is entering routine clinical use and many commercial systems are now in use in the radiological units for screening and diagnostic mammography. At the same time, the research in the digital mammography field is very active in the development of more and more performing devices. In this paper we present the performance of single photon counting pixel detectors (MedipixI) tailored for digital mammographic applications. These devices are based on semiconductor (Si and GaAs) pixel detectors of different thickness, read-out by custom designed integrated circuits. To assess the imaging capability of such systems, the images of a mammographic phantom have been acquired in standard conditions for a clinical examination. The signal-to-noise ratio (SNR) of details simulating tumor masses has been evaluated. The same phantom has been also radiographed by three different commercial digital mammographic systems in the same reference conditions and a comparison in terms of SNR has been carried out. The spatial resolution of the single photon counting systems has also been evaluated by measuring the line spread function with the edge technique and then calculating the Modulation Transfer Function (MTF). The MTFs of the single photon counting systems have been compared with the MTFs of the commercial systems

  13. Diagnostic efficacy of mammography in various age groups

    International Nuclear Information System (INIS)

    Tekkel, M.Yu.

    1991-01-01

    The diagnostic efficacy of 935 mammographies from the mammology service for self-referred symptomatic women was assessed for the period of 1975-1988. Breast cancer was detected in 200 women. The paper is concerned with the distribution of true- or false-positive and true- or false-negative mammagraphic diagnoses in the age groups of women under 40, 40 to 49 and over 49. The sensitivity of mammomgraphy in these age groups was 87.5, 72.4 and 89 %, the specificity was 83.5, 76.4 and 83 %, and the positive predictive values were 42, 38,2 and 69.5 %, respectively

  14. Compliance with European Guidelines for Diagnostic Mammography in a Decentralized Health-Care Setting

    International Nuclear Information System (INIS)

    Jensen, A.; Mikkelsen, G.J.; Vestergaard, M.; Lynge, E.; Vejborg, I.

    2005-01-01

    Purpose: To evaluate the compliance of Danish mammography clinics with requirements concerning organization, activity volume, and assessment procedures from two European guidelines for quality assurance in diagnostic mammography (EUSOMA and EUREF). Material and Methods: We used individual records on all diagnostic mammographies performed in Denmark in 2000, and questionnaires given to Danish mammography clinics in 2000, 2002, and 2004. Results: The study showed a marked centralization of the diagnostic activity from 2000 to 2004 to a smaller number of public breast assessment centers with full multidisciplinary breast assessment. However, a relatively large number of these centers did not comply with the activity volume requirement of 2000 mammograms per clinic per year. The number of private diagnostic mammography clinics performing basic diagnostic mammography has remained fairly stable in the period 2000 to 2004. Compared with public breast assessment centers, the private diagnostic mammography clinics had a lower compliance with activity volume requirements. Conclusion: A marked proportion of Danish public breast assessment centers operate with less than optimal activity volume, suggesting that further centralization would be appropriate. The situation in private diagnostic mammography clinics may cause concern, as our study showed that the majority of these clinics did not meet the activity volume requirements

  15. A special ionisation chamber for quality control of diagnostic and mammography X ray equipment

    International Nuclear Information System (INIS)

    Costa, A.M.; Caldas, L.V.E.

    2003-01-01

    A quality control program for X ray equipment used for conventional radiography and mammography requires the constancy check of the beam qualities in terms of the half-value layers. In this work, a special double-faced parallel-plate ionisation chamber was developed with inner electrodes of different materials, in a tandem system. Its application will be in quality control programs of diagnostic and mammography X ray equipment for confirmation of half-value layers previously determined by the conventional method. Moreover, the chamber also may be utilised for measurements of air kerma values (and air kerma rates) in X radiation fields used for conventional radiography and mammography. The chamber was studied in relation to the characteristics of saturation, ion collection efficiency, polarity effects, leakage current, and short-term stability. The energy dependence in response of each of the two faces of the chamber was determined over the conventional radiography and mammography X ray ranges (unattenuated beams). The different energy responses of the two faces of the chamber allowed the formation of a tandem system useful for the constancy check of beam qualities. (author)

  16. A special ionisation chamber for quality control of diagnostic and mammography X ray equipment.

    Science.gov (United States)

    Costa, A M; Caldas, L V E

    2003-01-01

    A quality control program for X ray equipment used for conventional radiography and mammography requires the constancy check of the beam qualities in terms of the half-value layers. In this work, a special double-faced parallel-plate ionisation chamber was developed with inner electrodes of different materials, in a tandem system. Its application will be in quality control programs of diagnostic and mammography X ray equipment for confirmation of half-value layers previously determined by the conventional method. Moreover, the chamber also may be utilised for measurements of air kerma values (and air kerma rates) in X radiation fields used for conventional radiography and mammography. The chamber was studied in relation to the characteristics of saturation, ion collection efficiency, polarity effects, leakage current, and short-term stability. The energy dependence in response of each of the two faces of the chamber was determined over the conventional radiography and mammography X ray ranges (unattenuated beams). The different energy response of the two faces of the chamber allowed the formation of a tandem system useful for the constancy check of beam qualities.

  17. Does gender discrimination impact regular mammography screening? Findings from the race differences in screening mammography study.

    Science.gov (United States)

    Dailey, Amy B; Kasl, Stanislav V; Jones, Beth A

    2008-03-01

    ABSTRACT Objective: To determine if gender discrimination, conceptualized as a negative life stressor, is a deterrent to adherence to mammography screening guidelines. African American and white women (1451) aged 40-79 years who obtained an index screening mammogram at one of five urban hospitals in Connecticut between October 1996 and January 1998 were enrolled in this study. This logistic regression analysis includes the 1229 women who completed telephone interviews at baseline and follow-up (average 29.4 months later) and for whom the study outcome, nonadherence to age-specific mammography screening guidelines, was determined. Gender discrimination was measured as lifetime experience in seven possible situations. Gender discrimination, reported by nearly 38% of the study population, was significantly associated with nonadherence to mammography guidelines in women with annual family incomes of > or =$50,000 (OR 1.99, 95% CI 1.33, 2.98) and did not differ across racial/ethnic group. Our findings suggest that gender discrimination can adversely influence regular mammography screening in some women. With nearly half of women nonadherent to screening mammography guidelines in this study and with decreasing mammography rates nationwide, it is important to address the complexity of nonadherence across subgroups of women. Life stressors, such as experiences of gender discrimination, may have considerable consequences, potentially influencing health prevention prioritization in women.

  18. Mammography

    Science.gov (United States)

    ... breast cancer Whether there is any harm from breast cancer screening, such as side effects from testing or overtreatment of cancer when it's discovered Mammography is performed to screen women to detect early breast cancer when it is ...

  19. ACR BI-RADS Assessment Category 4 Subdivisions in Diagnostic Mammography: Utilization and Outcomes in the National Mammography Database.

    Science.gov (United States)

    Elezaby, Mai; Li, Geng; Bhargavan-Chatfield, Mythreyi; Burnside, Elizabeth S; DeMartini, Wendy B

    2018-05-01

    Purpose To determine the utilization and positive predictive value (PPV) of the American College of Radiology (ACR) Breast Imaging Data and Reporting System (BI-RADS) category 4 subdivisions in diagnostic mammography in the National Mammography Database (NMD). Materials and Methods This study involved retrospective review of diagnostic mammography data submitted to the NMD from January 1, 2008 to December 30, 2014. Utilization rates of BI-RADS category 4 subdivisions were compared by year, facility (type, location, census region), and examination (indication, finding type) characteristics. PPV3 (positive predictive value for biopsies performed) was calculated overall and according to category 4 subdivision. The χ 2 test was used to test for significant associations. Results Of 1 309 950 diagnostic mammograms, 125 447 (9.6%) were category 4, of which 33.3% (41 841 of 125 447) were subdivided. Subdivision utilization rates were higher (P use, subdivisions were utilized in the minority (33.3% [41 841 of 125 447]) of category 4 diagnostic mammograms, with variability based on facility and examination characteristics. When subdivisions were used, PPV3s were in BI-RADS-specified malignancy ranges. This analysis supports the use of subdivisions in broad practice and, given benefits for patient care, should motivate increased utilization. © RSNA, 2018 Online supplemental material is available for this article.

  20. TU-D-209-01: Dosimetry of Diagnostic Work Up Mammography

    Energy Technology Data Exchange (ETDEWEB)

    Jallow, N [Emory University, Atlanta, GA (United States); Sechopoulos, I [Radboud University Medical Centre, Nijmegen (Netherlands)

    2016-06-15

    Purpose: To investigate patient average glandular dose (AGD) characteristics of diagnostic mammography. Methods: The techniques used to image 14420 patients who received diagnostic work up mammography from October 2008 to December 2014 at one academic hospital were retrospectively collected. The most common diagnostic views and the techniques used for each according to compressed breast thickness were determined. For all techniques, 1st half value layer and air kerma output per tube current-exposure time product were measured; then the incident air kerma for each acquisition was calculated. The values for normalized glandular dose (DgN) were obtained with a validated Monte Carlo simulation of mammographic acquisition. The mono-energetic DgN results were combined according to relative fluence using the TASMICS model to obtain DgN coefficients for each spectrum. The spectral DgN and calculated incident air kerma were used to estimate AGD of patients with breast thickness ranging from 2 to 8 cm. Results: The most common views utilized during diagnostic mammography were magnification craniocaudal (24%), magnification mediolateral (19%), spot craniocaudal (28%), and spot mediolateral oblique (24%). The AGD increased with increasing breast thickness for both the magnification and spot views. The AGD for a 5.5 cm thick breast was approximately 6.8 mGy and 2.2 mGy for the magnification and spot views, respectively. The AGD ranged from 3.6 mGy to 6.8 mGy for the magnification views and from 1.0 mGy to 3.1 mGy for spot views. The difference in AGD between the two magnification views or the two spot views was not significant. Conclusion: These results provide information on breast dose to which screening recalled women are exposed to. In addition to understanding the dose used for common clinical imaging tests, this data could be used when comparing use of mammography for diagnostic workup to other potential modalities, such as breast tomosynthesis and breast CT.

  1. TU-D-209-01: Dosimetry of Diagnostic Work Up Mammography

    International Nuclear Information System (INIS)

    Jallow, N; Sechopoulos, I

    2016-01-01

    Purpose: To investigate patient average glandular dose (AGD) characteristics of diagnostic mammography. Methods: The techniques used to image 14420 patients who received diagnostic work up mammography from October 2008 to December 2014 at one academic hospital were retrospectively collected. The most common diagnostic views and the techniques used for each according to compressed breast thickness were determined. For all techniques, 1st half value layer and air kerma output per tube current-exposure time product were measured; then the incident air kerma for each acquisition was calculated. The values for normalized glandular dose (DgN) were obtained with a validated Monte Carlo simulation of mammographic acquisition. The mono-energetic DgN results were combined according to relative fluence using the TASMICS model to obtain DgN coefficients for each spectrum. The spectral DgN and calculated incident air kerma were used to estimate AGD of patients with breast thickness ranging from 2 to 8 cm. Results: The most common views utilized during diagnostic mammography were magnification craniocaudal (24%), magnification mediolateral (19%), spot craniocaudal (28%), and spot mediolateral oblique (24%). The AGD increased with increasing breast thickness for both the magnification and spot views. The AGD for a 5.5 cm thick breast was approximately 6.8 mGy and 2.2 mGy for the magnification and spot views, respectively. The AGD ranged from 3.6 mGy to 6.8 mGy for the magnification views and from 1.0 mGy to 3.1 mGy for spot views. The difference in AGD between the two magnification views or the two spot views was not significant. Conclusion: These results provide information on breast dose to which screening recalled women are exposed to. In addition to understanding the dose used for common clinical imaging tests, this data could be used when comparing use of mammography for diagnostic workup to other potential modalities, such as breast tomosynthesis and breast CT.

  2. Ultrasonography as a diagnostic method in addition to mammography

    Energy Technology Data Exchange (ETDEWEB)

    Otto, H.; Roer, E.

    1988-05-01

    By using ultrasonography in addition to mammography, experienced diagnosticians essentially enhance the safety of their diagnosis of mammary gland diseases. The same applies to gynecomastia, the condition after plastic surgery, and mastitis.

  3. Mammography

    International Nuclear Information System (INIS)

    1975-01-01

    This patent reveals a method and instrument for the detection and registration of breast cancer with the aid of X-radiation, i.e. mammography. The breast is irradiated with soft X-rays whereby the radiation beam is scanned with a moving 'stripform' screen and whereby the picture from the 'stripform' screen is recorded by a television camera that moves simultaneously with the strip. The image is then projected on a monitor

  4. Dose and diagnostic performance comparison between phase-contrast mammography with synchrotron radiation and digital mammography: a clinical study report.

    Science.gov (United States)

    Fedon, Christian; Rigon, Luigi; Arfelli, Fulvia; Dreossi, Diego; Quai, Elisa; Tonutti, Maura; Tromba, Giuliana; Cova, Maria Assunta; Longo, Renata

    2018-01-01

    Two dosimetric quantities [mean glandular dose (MGD) and entrance surface air kerma (ESAK)] and the diagnostic performance of phase-contrast mammography with synchrotron radiation (MSR) are compared to conventional digital mammography (DM). Seventy-one patients (age range, 41 to 82 years) underwent MSR after a DM examination if questionable or suspicious breast abnormalities were not clarified by ultrasonography. The MGD and the ESAK delivered in both examinations were evaluated and compared. Two on-site radiologists rated the images in consensus according to the Breast Imaging Reporting and Data System assessment categories, which were then correlated with the final diagnoses by means of statistical generalized linear models (GLMs). Receiver operating characteristic curves were also used to assess the diagnostic performance by comparing the area under the curve (AUC). An important MGD and ESAK reduction was observed in MSR due to the monoenergetic beam. In particular, an average 43% reduction was observed for the MGD and a reduction of more than 50% for the ESAK. GLM showed higher diagnostic accuracy, especially in terms of specificity, for MSR, confirmed by AUC analysis ([Formula: see text]). The study design implied that the population was characterized by a high prevalence of disease and that the radiologists, who read the DM images before referring the patient to MSR, could have been influenced in their assessments. Within these limitations, the use of synchrotron radiation with the phase-contrast technique applied to mammography showed an important dose reduction and a higher diagnostic accuracy compared with DM. These results could further encourage research on the translation of x-ray phase-contrast imaging into the clinics.

  5. Computer-aided diagnostics of screening mammography using content-based image retrieval

    Science.gov (United States)

    Deserno, Thomas M.; Soiron, Michael; de Oliveira, Júlia E. E.; de A. Araújo, Arnaldo

    2012-03-01

    Breast cancer is one of the main causes of death among women in occidental countries. In the last years, screening mammography has been established worldwide for early detection of breast cancer, and computer-aided diagnostics (CAD) is being developed to assist physicians reading mammograms. A promising method for CAD is content-based image retrieval (CBIR). Recently, we have developed a classification scheme of suspicious tissue pattern based on the support vector machine (SVM). In this paper, we continue moving towards automatic CAD of screening mammography. The experiments are based on in total 10,509 radiographs that have been collected from different sources. From this, 3,375 images are provided with one and 430 radiographs with more than one chain code annotation of cancerous regions. In different experiments, this data is divided into 12 and 20 classes, distinguishing between four categories of tissue density, three categories of pathology and in the 20 class problem two categories of different types of lesions. Balancing the number of images in each class yields 233 and 45 images remaining in each of the 12 and 20 classes, respectively. Using a two-dimensional principal component analysis, features are extracted from small patches of 128 x 128 pixels and classified by means of a SVM. Overall, the accuracy of the raw classification was 61.6 % and 52.1 % for the 12 and the 20 class problem, respectively. The confusion matrices are assessed for detailed analysis. Furthermore, an implementation of a SVM-based CBIR system for CADx in screening mammography is presented. In conclusion, with a smarter patch extraction, the CBIR approach might reach precision rates that are helpful for the physicians. This, however, needs more comprehensive evaluation on clinical data.

  6. Diagnostic accuracy and recall rates for digital mammography and digital mammography combined with one-view and two-view tomosynthesis: results of an enriched reader study.

    Science.gov (United States)

    Rafferty, Elizabeth A; Park, Jeong Mi; Philpotts, Liane E; Poplack, Steven P; Sumkin, Jules H; Halpern, Elkan F; Niklason, Loren T

    2014-02-01

    The purpose of this study was to compare two methods of combining tomosynthesis with digital mammography by assessing diagnostic accuracy and recall rates for digital mammography alone and digital mammography combined with one-view tomosynthesis and two-view tomosynthesis. Three hundred ten cases including biopsy-proven malignancies (51), biopsy-proven benign findings (47), recalled screening cases (138), and negative screening cases (74) were reviewed by 15 radiologists sequentially using digital mammography, adding one-view tomosynthesis, and then two-view tomosynthesis. Cases were assessed for recall and assigned a BI-RADS score and probability of malignancy for each imaging method. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis. Screening recall rates were compared using pooled logistical regression analysis. A p value of tomosynthesis, and DM plus two-view tomosynthesis was 0.828, 0.864, and 0.895, respectively. Both one-view and two-view tomosynthesis plus DM were significantly better than DM alone (Δ AUCs 0.036 [p = 0.009] and 0.068 [p tomosynthesis, and DM plus two-view tomosynthesis were 44.2%, 27.2%, and 24.0%, respectively. Combined with DM, one-view and two-view tomosynthesis both showed significantly lower noncancer recall rates than digital mammography alone (p tomosynthesis showed a significantly lower recall rate than digital mammography with one-view tomosynthesis (p tomosynthesis compared with digital mammography alone. Compared with digital mammography, diagnostic sensitivity for invasive cancers increased with the addition of both one-view (Δ12.0%, p tomosynthesis. The addition of one-view tomosynthesis to conventional digital mammography improved diagnostic accuracy and reduced the recall rate; however, the addition of two-view tomosynthesis provided twice the performance gain in diagnostic accuracy while further reducing the recall rate.

  7. Timeliness of abnormal screening and diagnostic mammography follow-up at facilities serving vulnerable women.

    Science.gov (United States)

    Goldman, L Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla

    2013-04-01

    Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations, such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. We examined receipt of diagnostic evaluation after abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4%-5% difference, Pfacilities serving more rural and low-income populations had lower rates of biopsy (4%-5% difference, Pfacilities serving vulnerable populations had longer times until biopsy than those at facilities serving nonvulnerable populations (21.6 vs. 15.6 d; 95% confidence interval for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range, 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities serving vulnerable populations.

  8. Diagnostic Invasiveness and Psychosocial Consequences of False-Positive Mammography

    DEFF Research Database (Denmark)

    Heleno, Bruno M.; Siersma, Volkert Dirk; Brodersen, John

    2015-01-01

    PURPOSE: We undertook a study to assess whether women with false-positivemammography have worse psychosocial consequences if managed with aworkup that involves a biopsy (invasive group) than if managed with only additional imaging (noninvasive group). METHODS: We performed subgroup analysis...... of a cohort study of 454 womenwith abnormal screening mammography and 908 matched control women withnormal results. Using a condition-specific questionnaire (Consequences of Screening in Breast Cancer), we assessed 12 psychosocial consequences at 5 time points (0, 1, 6, 18, and 36 months after final diagnosis......) and compared the 2 groups of women with false-positives (invasive and noninvasive management groups). RESULTS: Among the 252 women with false-positive mammography eligible forthis study, psychosocial consequences were similar for those managed invasivelyand those managed noninvasively during the 36 months...

  9. Clinical and diagnostic value of preoperative MR mammography and FDG-PET in suspicious breast lesions

    International Nuclear Information System (INIS)

    Walter, C.; Scheidhauer, K.; Theissen, P.; Scharl, A.; Goering, U.J.; Kugel, H.; Krahe, T.; Pietrzyk, U.

    2003-01-01

    Dynamic enhanced magnetic resonance (MR) mammography and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) of the breast were directly compared preoperatively in suspicious breast lesions. Forty-two breast lesions in 40 patients were examined with a three-dimensional dynamic MR imaging series and FDG-PET. The MR and PET examinations were evaluated separately and the results were compared with the histological findings. The sensitivity and specificity of each method were calculated. The diagnostic value of both modalities as single diagnostic tool and in combination was investigated. Nineteen malignant and 23 benign breast lesions were proven histologically. Magnetic resonance mammography and FDG-PET showed a sensitivity of 89 and 63%, respectively. The specificity was 74 and 91%, respectively. The combination of both imaging methods decreased the not-required biopsies from 55 to 17%. Only one false-negative finding - a patient pre-treated with chemotherapy - was observed in both methods. The combination of MR mammography and FDG-PET can help to decrease biopsies of benign breast lesions. Because of their high cost, these modalities should only be used in problematic cases to either rule out or to demonstrate malignancy. The best diagnostic strategy is achieved using MR mammography first. If the diagnosis is still questionable, FDG-PET can be performed. (orig.)

  10. Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Hwa; Chang, Jung Min; Moon, Woo Kyung [Seoul National University Hospital, Department of Radiology, 101 Daehangno, Jongno-gu, Seoul (Korea, Republic of); Moon, Hyeong-Gon [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of); Yi, Ann [Seoul National University Hospital, Department of Radiology, Gangnan Healthcare Center, Seoul (Korea, Republic of); Koo, Hye Ryoung [Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Gweon, Hye Mi [Yonsei University College of Medicine, Department of Radiology, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2016-06-15

    To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers. Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests. The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P = 0.0006) but higher than mammography alone (0.900, P = 0.0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P < 0.0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P = 0.0282). DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI. (orig.)

  11. Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers

    International Nuclear Information System (INIS)

    Kim, Won Hwa; Chang, Jung Min; Moon, Woo Kyung; Moon, Hyeong-Gon; Yi, Ann; Koo, Hye Ryoung; Gweon, Hye Mi

    2016-01-01

    To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers. Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests. The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P = 0.0006) but higher than mammography alone (0.900, P = 0.0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P < 0.0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P = 0.0282). DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI. (orig.)

  12. Tumour forms and microcalcifications as radiological diagnostic criteria of mammography

    International Nuclear Information System (INIS)

    Cullmann, H.

    1979-01-01

    289 cases of breast carcinoma which had occurred over a period of 7 years were examined at mammograms and histological preparations. Especially in view were the frequency of radiologically visible criteria of malignancy with special stress laid on microcalcifications, typical radiological forms of imaging the various sorts of carcinoma, and a statement on the definiteness of diagnoses made with mammography. The exactness of diagnoses of breast cancer established by means of mammography can be states as 96.9% in 289 cases of carcinoma. 81.7% were assessed as definitely malignant and 15.2% were suspected to be malignant. In these cases, surgery confirmed the teutative diagnosis. 3.1% of the cases must be seen as mammographic false diagnoses in the sense of ''false negative''. These percentages are in correspondence with those obtained by other examiners. The radiologically visible growth form of breast cancer often typically reflect the histomorphological sort of the cancer. In 174 (67.1%) of 259 cases, the histological type of carcinoma could be recognized from the radiologically visible growth form. (orig./MG) [de

  13. Comparison of Diagnostic Accuracy of Breast Masses Using Digitized Images Versus Screen-Film Mammography

    International Nuclear Information System (INIS)

    Zhigang Liang; Xiangying Du; Jiabin Liu; Xinyu Yao; Yanhui Yang; Kuncheng Li

    2008-01-01

    Background: Medical film digitizers play an important transitory role as digital-analogue bridges in radiology. Digitized mammograms require evaluation of performance to assure medical image quality. Purpose: To compare the diagnostic accuracy in the interpretation of breast masses using original screen-film mammograms versus digitized images. Material and Methods: A total of 72 female patients between 55 and 81 years of age suspected of having breast cancer were selected by two non-observing radiologists. Of these, 31 cases were benign lesions and 41 cases were cancer. The mammography films were digitized using a laser film digitizer. Three radiologists, each with more than 10 years of experience in mammography, interpreted the screen-film mammograms and digitized images respectively. The time interval was 4 weeks. A four-point malignancy scale was used, with 1 defined as definitely not malignant, 2 as probably not malignant, 3 as probably malignant, and 4 as definitely malignant. Receiver operating characteristic (Roc) curves, sensitivity, and specificity were compared. Results: The average area-under-the-curve (Az) value of the original screen-film mammograms was 0.921, and the average Az value of the digitized images was 0.859. This difference was not statistically significant (P=0.131). The detection specificity of extremely dense breasts was lower than that for other breast compositions for both digitized images and screen-film mammograms. No statistical significance in sensitivity and specificity was observed between digitized images and mammograms for each breast composition. Original screen-film mammograms were observed to perform better than digitized images. Conclusion: Digitized images with a spatial resolution of 175 μm can be used instead of screen-film mammograms in the diagnosis of breast cancer

  14. Diagnostic efficacy and safety of gadoteric acid MR mammography in 1537 patients

    Energy Technology Data Exchange (ETDEWEB)

    Seithe, Tim; Braun, Joachim [Department of Radiology, Charité – University Medicine, Berlin (Germany); Wolf, Michael [Michael Wolf Information Systems, Viktoriastr. 26, 66346 Püttlingen (Germany); Vahldiek, Janis; Wolny, Dajana; Auer, Jonas; Pociej, Joanna [Department of Radiology, Charité – University Medicine, Berlin (Germany); Heine, Oliver [Guerbet GmbH, Otto-Vogler-Str. 11, 65843 Sulzbach (Germany); Hamm, Bernd [Department of Radiology, Charité – University Medicine, Berlin (Germany); Bucourt, Maximilian de, E-mail: mdb@charite.de [Department of Radiology, Charité – University Medicine, Berlin (Germany)

    2016-12-15

    Objectives: To perform a large-scale multicenter post-marketing surveillance study for analyzing diagnostic effectiveness and safety of intravenous (IV) gadoteric acid (Dotarem{sup ®}) in magnetic resonance (MR) mammography under daily practice conditions. Materials and methods: Patients underwent high-resolution MR mammography with gadoteric acid in 15 German centers. Radiologists used a standardized questionnaire to report data including patient demographics and medical history, characteristics of MR examination and results in terms of diagnosis and safety for the patient. Results: A total of 1537 patients were examined. In 99.2% of all patients, a diagnosis was established. In 91.6% of all patients, image quality was excellent or good. Histopathological examinations were performed for 232 of 1537 patients (15.1%) with invasive ductal carcinoma being the most frequent diagnosis (109 patients, 47.0%). Based on histopathology as the standard of reference, IV gadoteric acid-enhanced MR mammography confirmed diagnoses of invasive ductal carcinoma in 93.5% of the patients. Adverse drug reactions occurred in 5 of 1537 patients (0.3%) and were classified as serious in one case (tachycardia, dysphagia, urticaria, rash). All patients with adverse drug reactions fully recovered after the examination. Conclusion: This noninterventional surveillance study shows IV gadoteric acid to be a safe and effective contrast agent for use in MR mammography.

  15. Study about diagnostic quality in a public-center of mammography of Santa Fe, Argentina

    International Nuclear Information System (INIS)

    Lescano, R.; Kiguen, J.; Gaitan, L.; Caspani, C.

    2001-01-01

    The objective is to apply a method that allows us to evaluate the diagnostic quality of a public-center of mammography and to validate it. The representative centers of a social class were grouped; this one is evaluated measuring the mechanics, electrics, dosimetrics and personal parameters of the process to get the mammography diagnostic. The original study and the respective report was submitted to the valuation of a panel of experts, who evaluated image, techniques and diagnostics. The equipment and techniques used are described in this case. The judgment of the ACR and the Argentine legislation are applied. The dosimetric results of the mammography practice serve to determine the local reference levels. The people who intervened in the diagnosis are evaluated, as well as the services that can influence it. Seeking the parametric sensibility in relationship with the succeeded and precocious diagnosis, the success of it is confirmed by the panel of experts. We conclude by indicating that the success percentage in the diagnosis is about 98,36%, that there is 100% of coincidence among the perception and the value of the study quality. The valuation of the image reaches 69,2% of the maximum score, and the placement technique, 73,9%. The parametric sensibilities of the principal variables are discussed. (author)

  16. Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: interobserver blind-reading analysis.

    Science.gov (United States)

    Cheung, Yun-Chung; Lin, Yu-Ching; Wan, Yung-Liang; Yeow, Kee-Min; Huang, Pei-Chin; Lo, Yung-Feng; Tsai, Hsiu-Pei; Ueng, Shir-Hwa; Chang, Chee-Jen

    2014-10-01

    To analyse the accuracy of dual-energy contrast-enhanced spectral mammography in dense breasts in comparison with contrast-enhanced subtracted mammography (CESM) and conventional mammography (Mx). CESM cases of dense breasts with histological proof were evaluated in the present study. Four radiologists with varying experience in mammography interpretation blindly read Mx first, followed by CESM. The diagnostic profiles, consistency and learning curve were analysed statistically. One hundred lesions (28 benign and 72 breast malignancies) in 89 females were analysed. Use of CESM improved the cancer diagnosis by 21.2 % in sensitivity (71.5 % to 92.7 %), by 16.1 % in specificity (51.8 % to 67.9 %) and by 19.8 % in accuracy (65.9 % to 85.8 %) compared with Mx. The interobserver diagnostic consistency was markedly higher using CESM than using Mx alone (0.6235 vs. 0.3869 using the kappa ratio). The probability of a correct prediction was elevated from 80 % to 90 % after 75 consecutive case readings. CESM provided additional information with consistent improvement of the cancer diagnosis in dense breasts compared to Mx alone. The prediction of the diagnosis could be improved by the interpretation of a significant number of cases in the presence of 6 % benign contrast enhancement in this study. • DE-CESM improves the cancer diagnosis in dense breasts compared with mammography. • DE-CESM shows greater consistency than mammography alone by interobserver blind reading. • Diagnostic improvement of DE-CESM is independent of the mammographic reading experience.

  17. Comparative study of diagnostic efficiency of mammography and ultrasonography for breast cancer

    International Nuclear Information System (INIS)

    Koike, Yasuo; Terai, Naoki; Wakabayashi, Toru; Tsuchiya, Shin-ichi

    1995-01-01

    We performed a study of 448 women with breast cancer who visited the breast clinic of Nagano Cancer Center, and underwent mammography (MMG) and ultrasonography (US) at the last examination, between October 1983 and December 1993. These women subsequently underwent surgery at several hospitals after referral from our center. Definitive diagnoses of breast cancer were made histopathologically. Both MMG and US findings were graded using five-step criteria (indicating the level of malignancy) from I (normal) to V (definite malignancy). The diagnostic efficiencies of the two examinations were then compared clinicopathologically. Furthermore, on the basis of the results obtained, we considered supplemental diagnostic methods that could be introduced for mass screening of breast cancer. There was a significant difference between the incidence of cases diagnosed as V IV III b (malignancy) by US (71.9%) and those diagnosed by MMG (60.9%). Among cases suspected to be breast cancer by palpation, the proportion diagnosed as V IV III b (malignancy) by US (83.3%) was significantly higher than that diagnosed by MMG (73.7%). Among cases suspected to be mastopathy by palpation, the proportion diagnosed as malignant by US was higher than that diagnosed by MMG. The false negativity rate for palpation combined with MMG was higher than that for palpation with US. Among cases without palpable masses, the proportion diagnosed as malignant by MMG was higher than that diagnosed by US. However, for palpable tumors less than 5.0 cm in diameter, the proportion of cases diagnosed as malignant by US was higher than that diagnosed by MMG. In terms of the gross appearance of the cut surface, grade of cancer invasion, histological type and grade of chubbiness, the diagnostic efficiency of US was shown to be slightly better than that of MMG. The above results suggest that US should be considered as a supplemental method for introduction to mass screening of breast cancer. (author)

  18. Contrast-enhanced spectral mammography improves diagnostic accuracy in the symptomatic setting.

    Science.gov (United States)

    Tennant, S L; James, J J; Cornford, E J; Chen, Y; Burrell, H C; Hamilton, L J; Girio-Fragkoulakis, C

    2016-11-01

    To assess the diagnostic accuracy of contrast-enhanced spectral mammography (CESM), and gauge its "added value" in the symptomatic setting. A retrospective multi-reader review of 100 consecutive CESM examinations was performed. Anonymised low-energy (LE) images were reviewed and given a score for malignancy. At least 3 weeks later, the entire examination (LE and recombined images) was reviewed. Histopathology data were obtained for all cases. Differences in performance were assessed using receiver operator characteristic (ROC) analysis. Sensitivity, specificity, and lesion size (versus MRI or histopathology) differences were calculated. Seventy-three percent of cases were malignant at final histology, 27% were benign following standard triple assessment. ROC analysis showed improved overall performance of CESM over LE alone, with area under the curve of 0.93 versus 0.83 (p<0.025). CESM showed increased sensitivity (95% versus 84%, p<0.025) and specificity (81% versus 63%, p<0.025) compared to LE alone, with all five readers showing improved accuracy. Tumour size estimation at CESM was significantly more accurate than LE alone, the latter tending to undersize lesions. In 75% of cases, CESM was deemed a useful or significant aid to diagnosis. CESM provides immediately available, clinically useful information in the symptomatic clinic in patients with suspicious palpable abnormalities. Radiologist sensitivity, specificity, and size accuracy for breast cancer detection and staging are all improved using CESM as the primary mammographic investigation. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  19. Clinical MR mammography. Impact of hormonal status on background enhancement and diagnostic accuracy

    International Nuclear Information System (INIS)

    Baltzer, Pascal Andreas Thomas; Dietzel, M.; Burmeister, H.; Pfleiderer, S.O.; Kaiser, W.A.; Vag, T.; Gajda, M.; Camara, O.

    2011-01-01

    Purpose: Hormonal stimulation can induce background enhancement (BE) in MR mammography (MRM). This fact has been assumed to decrease the accuracy of MRM. Consequently, this report investigates: 1. The prevalence of BE in postmenopausal vs. premenopausal women in correlation to hormonal cycle phase (CP). 2. The impact of hormonal status (HS) and BE on diagnostic accuracy. Materials and Methods: Consecutive patients over 22 months with complete HS information (week of CP or postmenopausal) were included in this prospective investigation. Exclusion criteria were any hormonal therapy, hysterectomy as well as cancer proven by biopsy. The standard of reference was histopathology. All MRM scans were acquired using the same protocol (1.5 T, dynamic T 1w GRE after 0.1 mmol/kg bw Gd-DTPA i. v.). Two radiologists rated all examinations in consensus according to BI-RADS. BE was defined as: 0 = missing, 1 = moderate, 2 = distinct. Results: 224 patients (150 postmenopausal, 74 premenopausal, 45 in the second week of CP) were included in this study (83 benign and 141 malignant findings). BE was more frequent in premenopausal women (p = 0.006), but did not differ between CP (p = 0.460). Neither HS nor BE had a significant impact on the diagnostic parameters of MRM (p ≥ 0.375). However, regarding BE, the relative number of false positive (FP) findings was highest (5 / 10; 50 %) in the distinct BE group. Regarding HS, 17 % more FP findings were observed in premenopausal women examined outside the second week of CP. Conclusion: In premenopausal women, HS leads to increased BE of breast tissue, independent of CP. Distinct BE and less pronounced, non-optimal CP may lead to an increased number of false positive findings. (orig.)

  20. Clinical MR mammography. Impact of hormonal status on background enhancement and diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Baltzer, Pascal Andreas Thomas; Dietzel, M.; Burmeister, H.; Pfleiderer, S.O.; Kaiser, W.A. [Jena Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Vag, T. [Klinikum Rechts der Isar (Germany). Dept. of Radiology; Gajda, M. [Jena Univ. (Germany). Inst. of Pathology; Camara, O. [Jena Univ. (Germany). Clinic of Gynaecology

    2011-05-15

    Purpose: Hormonal stimulation can induce background enhancement (BE) in MR mammography (MRM). This fact has been assumed to decrease the accuracy of MRM. Consequently, this report investigates: 1. The prevalence of BE in postmenopausal vs. premenopausal women in correlation to hormonal cycle phase (CP). 2. The impact of hormonal status (HS) and BE on diagnostic accuracy. Materials and Methods: Consecutive patients over 22 months with complete HS information (week of CP or postmenopausal) were included in this prospective investigation. Exclusion criteria were any hormonal therapy, hysterectomy as well as cancer proven by biopsy. The standard of reference was histopathology. All MRM scans were acquired using the same protocol (1.5 T, dynamic T 1w GRE after 0.1 mmol/kg bw Gd-DTPA i. v.). Two radiologists rated all examinations in consensus according to BI-RADS. BE was defined as: 0 = missing, 1 = moderate, 2 = distinct. Results: 224 patients (150 postmenopausal, 74 premenopausal, 45 in the second week of CP) were included in this study (83 benign and 141 malignant findings). BE was more frequent in premenopausal women (p = 0.006), but did not differ between CP (p = 0.460). Neither HS nor BE had a significant impact on the diagnostic parameters of MRM (p {>=} 0.375). However, regarding BE, the relative number of false positive (FP) findings was highest (5 / 10; 50 %) in the distinct BE group. Regarding HS, 17 % more FP findings were observed in premenopausal women examined outside the second week of CP. Conclusion: In premenopausal women, HS leads to increased BE of breast tissue, independent of CP. Distinct BE and less pronounced, non-optimal CP may lead to an increased number of false positive findings. (orig.)

  1. Diagnostic value of mammography flowing plastic and reconstructive breast surgery

    International Nuclear Information System (INIS)

    Wardzynska, K.; Wesolowska, E.

    2009-01-01

    Breast cancer is the most frequent malignant neoplasm in women. Due to the growing knowledge and self- consciousness about the disease itself as well as regarding treatment options among breast cancer patients. Main indications for reconstruction after mastectomy include fear of both physical and psychological damage and, in a broader sense, the lack of contraindications for the procedure. Altogether, these factors are in fact directly responsible for the increase in the number of reconstructive procedures, which have become one of the important elements in breast cancer treatment. Year by year, the number of plastic surgery procedures has been growing. Assessment of the breast aimed at discerning the presence diminishing procedures. In women with prostheses implanted for cosmetic reasons, mamsaography provides an opportunity to correctly diagnose and confirm implant damage. Women who have undergonew such procedures should be screened mammographically in the same way as the rest of the female population is. The aim of this paper is to summarize the value of diagnostic mammagraphy after plastic and reconstructive surgery. (authors)

  2. Digital mammography: current state and future aspects

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U.; Baum, F. [Womens Health Care Center Goettingen, Diagnostisches Brustzentrum Goettingen, Goettingen (Germany); Hermann, K.P. [Georg-August-Universitaet Goettingen, Abteilung Diagnostische Radiologie, Goettingen (Germany)

    2006-01-01

    The introduction of digital technique in mammography has been the last step in completing the process of digitalization in diagnostic imaging. Meanwhile, some different digital techniques as well as a couple of different digital mammography systems were developed and have already been available for some years. In this review article, the relevant data of key studies are reported, the current status is defined, and perspectives of digital mammography are described. (orig.)

  3. Monte Carlo simulation of x-ray spectra in diagnostic radiology and mammography using MCNP4C

    Energy Technology Data Exchange (ETDEWEB)

    Ay, M R [Department of Physics and Nuclear Sciences, AmirKabir University of Technology, Tehran (Iran, Islamic Republic of); Shahriari, M [Department of Nuclear Engineering, Shahid Beheshti University, Tehran (Iran, Islamic Republic of); Sarkar, S [Department of Medical Physics, Tehran University of Medical Science, Tehran (Iran, Islamic Republic of); Adib, M [TPP Co., GE Medical Systems, Iran Authorized Distributor, Tehran (Iran, Islamic Republic of); Zaidi, H [Division of Nuclear Medicine, Geneva University Hospital, 1211 Geneva (Switzerland)

    2004-11-07

    The general purpose Monte Carlo N-particle radiation transport computer code (MCNP4C) was used for the simulation of x-ray spectra in diagnostic radiology and mammography. The electrons were transported until they slow down and stop in the target. Both bremsstrahlung and characteristic x-ray production were considered in this work. We focus on the simulation of various target/filter combinations to investigate the effect of tube voltage, target material and filter thickness on x-ray spectra in the diagnostic radiology and mammography energy ranges. The simulated x-ray spectra were compared with experimental measurements and spectra calculated by IPEM report number 78. In addition, the anode heel effect and off-axis x-ray spectra were assessed for different anode angles and target materials and the results were compared with EGS4-based Monte Carlo simulations and measured data. Quantitative evaluation of the differences between our Monte Carlo simulated and comparison spectra was performed using student's t-test statistical analysis. Generally, there is a good agreement between the simulated x-ray and comparison spectra, although there are systematic differences between the simulated and reference spectra especially in the K-characteristic x-rays intensity. Nevertheless, no statistically significant differences have been observed between IPEM spectra and the simulated spectra. It has been shown that the difference between MCNP simulated spectra and IPEM spectra in the low energy range is the result of the overestimation of characteristic photons following the normalization procedure. The transmission curves produced by MCNP4C have good agreement with the IPEM report especially for tube voltages of 50 kV and 80 kV. The systematic discrepancy for higher tube voltages is the result of systematic differences between the corresponding spectra.

  4. Monte Carlo simulation of x-ray spectra in diagnostic radiology and mammography using MCNP4C

    Science.gov (United States)

    Ay, M. R.; Shahriari, M.; Sarkar, S.; Adib, M.; Zaidi, H.

    2004-11-01

    The general purpose Monte Carlo N-particle radiation transport computer code (MCNP4C) was used for the simulation of x-ray spectra in diagnostic radiology and mammography. The electrons were transported until they slow down and stop in the target. Both bremsstrahlung and characteristic x-ray production were considered in this work. We focus on the simulation of various target/filter combinations to investigate the effect of tube voltage, target material and filter thickness on x-ray spectra in the diagnostic radiology and mammography energy ranges. The simulated x-ray spectra were compared with experimental measurements and spectra calculated by IPEM report number 78. In addition, the anode heel effect and off-axis x-ray spectra were assessed for different anode angles and target materials and the results were compared with EGS4-based Monte Carlo simulations and measured data. Quantitative evaluation of the differences between our Monte Carlo simulated and comparison spectra was performed using student's t-test statistical analysis. Generally, there is a good agreement between the simulated x-ray and comparison spectra, although there are systematic differences between the simulated and reference spectra especially in the K-characteristic x-rays intensity. Nevertheless, no statistically significant differences have been observed between IPEM spectra and the simulated spectra. It has been shown that the difference between MCNP simulated spectra and IPEM spectra in the low energy range is the result of the overestimation of characteristic photons following the normalization procedure. The transmission curves produced by MCNP4C have good agreement with the IPEM report especially for tube voltages of 50 kV and 80 kV. The systematic discrepancy for higher tube voltages is the result of systematic differences between the corresponding spectra.

  5. Digital spot mammography using an add-on upright unit: diagnostic application in daily practice

    International Nuclear Information System (INIS)

    Mesurolle, Benoit; Mignon, Francois; Ariche-Cohen, Michele; Kao, Ellen; Gagnon, Jean H.; Goumot, Pierre-Alain

    2004-01-01

    Introduction: To present the use of digital spot mammography (DSM) in a diagnostic practice. Methods and patients: Digital spot images of 779 women requiring a spot compression or a spot magnification view were collected. The digital images were acquired on a digital spot upright unit using a 61 mmx61 mm field of view. Lesions reported included masses, calcifications, and areas of distortions. Results: 1065 lesions required additional views with DSM. Lesions reported included masses (n=113), masses and microcalcifications (n=53), spiculated masses (n=34), architectural distortions (n=16), and microcalcifications (n=849). DSMs were considered to be adequate in 97.7% of patients. Unsatisfactory exams resulted from difficulties encountered in targeting the area of interest at the beginning of our experience. Conclusion: DSM, most commonly used to perform interventional procedures, can also be used in a diagnostic practice taking advantage of post-processing of images not available with conventional spot compression and magnification

  6. Predicting diagnostic error in Radiology via eye-tracking and image analytics: Application in mammography

    Energy Technology Data Exchange (ETDEWEB)

    Voisin, Sophie [ORNL; Pinto, Frank M [ORNL; Morin-Ducote, Garnetta [University of Tennessee, Knoxville (UTK); Hudson, Kathy [University of Tennessee, Knoxville (UTK); Tourassi, Georgia [ORNL

    2013-01-01

    Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels. Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from 4 Radiology residents and 2 breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADs images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated. Results: Diagnostic error can be predicted reliably by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model (AUC=0.79). Personalized user modeling was far more accurate for the more experienced readers (average AUC of 0.837 0.029) than for the less experienced ones (average AUC of 0.667 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features. Conclusions: Diagnostic errors in mammography can be predicted reliably by leveraging the radiologists gaze behavior and image content.

  7. Predicting diagnostic error in radiology via eye-tracking and image analytics: Preliminary investigation in mammography

    Energy Technology Data Exchange (ETDEWEB)

    Voisin, Sophie; Tourassi, Georgia D. [Biomedical Science and Engineering Center, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 (United States); Pinto, Frank [School of Engineering, Science, and Technology, Virginia State University, Petersburg, Virginia 23806 (United States); Morin-Ducote, Garnetta; Hudson, Kathleen B. [Department of Radiology, University of Tennessee Medical Center at Knoxville, Knoxville, Tennessee 37920 (United States)

    2013-10-15

    Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists’ gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels.Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from four Radiology residents and two breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADS images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated.Results: Machine learning can be used to predict diagnostic error by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model [area under the ROC curve (AUC) = 0.792 ± 0.030]. Personalized user modeling was far more accurate for the more experienced readers (AUC = 0.837 ± 0.029) than for the less experienced ones (AUC = 0.667 ± 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features.Conclusions: Diagnostic errors in mammography can be predicted to a good extent by leveraging the radiologists’ gaze behavior and image content.

  8. Predicting diagnostic error in radiology via eye-tracking and image analytics: Preliminary investigation in mammography

    International Nuclear Information System (INIS)

    Voisin, Sophie; Tourassi, Georgia D.; Pinto, Frank; Morin-Ducote, Garnetta; Hudson, Kathleen B.

    2013-01-01

    Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists’ gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels.Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from four Radiology residents and two breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADS images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated.Results: Machine learning can be used to predict diagnostic error by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model [area under the ROC curve (AUC) = 0.792 ± 0.030]. Personalized user modeling was far more accurate for the more experienced readers (AUC = 0.837 ± 0.029) than for the less experienced ones (AUC = 0.667 ± 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features.Conclusions: Diagnostic errors in mammography can be predicted to a good extent by leveraging the radiologists’ gaze behavior and image content

  9. Mammography parameters: compression, dose, and discomfort

    International Nuclear Information System (INIS)

    Blanco, S.; Di Risio, C.; Andisco, D.; Rojas, R.R.; Rojas, R.M.

    2017-01-01

    Objective: To confirm the importance of compression in mammography and relate it to the discomfort expressed by the patients. Materials and methods: Two samples of 402 and 268 mammographies were obtained from two diagnostic centres that use the same mammographic equipment, but different compression techniques. The patient age range was from 21 to 50 years old. (authors) [es

  10. Digital mammography

    International Nuclear Information System (INIS)

    Bick, Ulrich; Diekmann, Felix

    2010-01-01

    This state-of-the-art reference book provides in-depth coverage of all aspects of digital mammography, including detector technology, image processing, computer-aided diagnosis, soft-copy reading, digital workflow, and PACS. Specific advantages and disadvantages of digital mammography in comparison to screen-film mammography are thoroughly discussed. By including authors from both North America and Europe, the book is able to outline variations in the use, acceptance, and quality assurance of digital mammography between the different countries and screening programs. Advanced imaging techniques and future developments such as contrast mammography and digital breast tomosynthesis are also covered in detail. All of the chapters are written by internationally recognized experts and contain numerous high-quality illustrations. This book will be of great interest both to clinicians who already use or are transitioning to digital mammography and to basic scientists working in the field. (orig.)

  11. Analysis of utilization patterns and associated costs of the breast imaging and diagnostic procedures after screening mammography

    Directory of Open Access Journals (Sweden)

    Vlahiotis A

    2018-03-01

    Full Text Available Anna Vlahiotis,1 Brian Griffin,2 A Thomas Stavros,3 Jay Margolis1 1Value Based Care, Outcomes Research, Truven Health Analytics, an IBM Company, Bethesda, MD USA; 2Value Based Care, Outcomes Research, Truven Health Analytics, an IBM Company, Newark, NJ, USA; 3Seno Medical Instruments, Inc., San Antonio, TX, USA Background: Little data exist on real-world patterns and associated costs of downstream breast diagnostic procedures following an abnormal screening mammography or clinical exam.Objectives: To analyze the utilization patterns in real-world clinical settings for breast imaging and diagnostic procedures, including the frequency and volume of patients and procedures, procedure sequencing, and associated health care expenditures.Materials and methods: Using medical claims from 2011 to 2015 MarketScan Commercial and Medicare Databases, adult females with breast imaging/diagnostic procedures (diagnostic mammography, ultrasound, molecular breast imaging, tomosynthesis, magnetic resonance imaging, or biopsy other than screening mammography were selected. Continuous health plan coverage without breast diagnostic procedures was required for ≥13 months before the first found breast diagnostic procedure (index event, with a 13-month post-index follow-up period. Key outcomes included diagnostic procedure volumes, sequences, and payments. Results reported descriptively were projected to provide US national patient and procedure volumes.Results: The final sample of 875,526 patients was nationally projected to 12,394,432 patients annually receiving 8,732,909 diagnostic mammograms (53.3% of patients, 6,987,399 breast ultrasounds (42.4% of patients, and 1,585,856 biopsies (10.3% of patients. Following initial diagnostic procedures, 49.4% had second procedures, 20.1% followed with third procedures, and 10.0% had a fourth procedure. Mean (SD costs for diagnostic mammograms of US$349 ($493, ultrasounds US$132 ($134, and biopsies US$1,938 ($2,343 contributed

  12. Mammography: an update of the EUSOBI recommendations on information for women

    OpenAIRE

    Sardanelli, Francesco; Fallenberg, Eva M.; Clauser, Paola; Trimboli, Rubina M.; Camps-Herrero, Julia; Helbich, Thomas H.; Forrai, Gabor

    2016-01-01

    Abstract This article summarises the information to be offered to women about mammography. After a delineation of the aim of early diagnosis of breast cancer, the difference between screening mammography and diagnostic mammography is explained. The need to bring images and reports from the previous mammogram (and from other recent breast imaging examinations) is highlighted. Mammography technique and procedure are described with particular attention to discomfort and pain experienced by a sma...

  13. Replacing single-view mediolateral oblique (MLO) digital mammography (DM) with synthesized mammography (SM) with digital breast tomosynthesis (DBT) images: Comparison of the diagnostic performance and radiation dose with two-view DM with or without MLO-DBT

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hyo-Jin [Department of Radiology, Seoul National University Hospital, 03080 (Korea, Republic of); Chang, Jung Min, E-mail: imchangjm@gmail.com [Department of Radiology, Seoul National University Hospital, 03080 (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine, 03080 (Korea, Republic of); Lee, Joongyub [Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, 03080 (Korea, Republic of); Song, Sung Eun; Shin, Sung Ui [Department of Radiology, Seoul National University Hospital, 03080 (Korea, Republic of); Kim, Won Hwa [Department of Radiology, Kyungpook National University Hospital, 41944 (Korea, Republic of); Bae, Min Sun [Department of Radiology, Seoul National University Hospital, 03080 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University Hospital, 03080 (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine, 03080 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University College Medical Research Center, 03080 (Korea, Republic of)

    2016-11-15

    Objectives: To evaluate the diagnostic performance and radiation dose of single view cranio-caudal (CC) digital mammography (DM) plus mediolateral oblique (MLO) digital breast tomosynthesis (DBT) combined with synthesized mammography (SM) in comparison with two-view DM with or without DBT. Material and methods: This study was approved by our institutional review board, and informed consent was obtained from 130 women. Paired two-view DM and single MLO-DBT with SM images were acquired, and four independent retrospective reading sessions of different combinations of DM, SM and DBT were performed for the presence of malignant tumors using jackknife alternative free-response receiver operator curve (JAFROC) methods. The diagnostic performances and average glandular dose (AGD) were compared between different combinations of DM, SM and DBT. Results: Of 159 lesions in 130 patients, 27 were malignant. When using MLO-DBT with SM instead of MLO-DM, a significantly higher sensitivity (P = 0.016) and specificity (P = 0.012) were noted than with two-view DM, and comparable figure of merit (FOM), sensitivity, and specificity to two-view DM with DBT were noted. The mean AGD of CC-DM plus MLO-DBT with SM was 5.78mGy ± 1.06 per patient, which was significantly lower than that with two-view DM with MLO-DBT (8.45mGy ± 1.32; P <0.001) and slightly higher than that with two-view DM (5.30mGy ± 0.63). Conclusions: The combined use of CC-DM plus MLO-DBT with SM showed higher sensitivity and specificity to two-view DM with a smaller AGD increment and comparable diagnostic performance to that of two-view DM with MLO-DBT with a significantly lower mean AGD.

  14. Socioeconomic status as determinant for participation in mammography screening: assessing the difference between using women's own versus their partner's

    DEFF Research Database (Denmark)

    Kjellén, Malin; von Euler-Chelpin, My

    2010-01-01

    Earlier research has shown that participation in mammography screening tends to vary across socioeconomic levels. We assessed the difference between using the woman's own socioeconomic status (SES) and using that of her household or partner as determinant of participation in mammography screening....

  15. Indications for and comparative diagnostic value of combined ultrasound and X-ray mammography

    International Nuclear Information System (INIS)

    Novak, D.

    1983-01-01

    A standardised method of ultrasound mammography is described. In order to achieve the same position, form, and shape of the breast as during roentgen mammography a Lucite plate in horizontal, and vertical position us used. Ultrasound contact scanning of the whole breast is carried out in cranio-caudal as well as in medio-lateral direction of the ultrasound beam. Ultrasound scanning is performed with the compression of the breast corresponding to the compression during roentgen mammography. It was found that the ultrasound breast examination combined with X-ray mammography optimizes the differentiation between benign and malignant masses and therefore may reduce the incidence of breast biopsy. A combined use of both examination modalities in the evaluation of the breast is advocated. (orig.)

  16. Eighteen cases of small breast cancer: a comparative study of mammography, CT scan and pathology

    International Nuclear Information System (INIS)

    Wu Yaopan; Lin Haogao; Cai Peiqiang; Ouyang Yi; Zhang Weizhang; Lu Bingui

    2003-01-01

    Objective: To improve the early diagnosis of breast cancer through a study of the mammography and CT findings of small breast cancer. Methods: The mammography and CT findings of 18 cases of small breast cancer (φ≤2.0 cm in diameter) were studied and compared with pathological results. Results: The diagnostic accuracy of CT and mammography was 83% and 61%, respectively. There was a statistical difference between both modalities (P<0.05), CT scan was superior to mammography. However, there was no difference between them when assessing the lesion arising in F-type breast. In detecting breast fine cluster of calcification, the sensitivity of mammography was better than CT scan. Conclusion: The patient suspected of small breast cancer should take mammography as the first evaluation. CT scan is reserved for the further investigation. The mammography combined with CT scan can improve the early diagnostic rate of breast cancer

  17. Characterization of microcalcification: can digital monitor zooming replace magnification mammography in full-field digital mammography?

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun-Kyung; Kwak, Jin Young; Son, Eun Ju; Youk, Ji Hyun; Choi, Seon Hyeong; Oh, Ki Keun; Han, Mooyoung

    2009-01-01

    The aim of this study was to compare the diagnostic accuracy and image quality of microcalcifications in zoomed digital contact mammography with digital magnification mammography. Three radiologists with different levels of experience in mammography reviewed 120 microcalcification clusters in 111 patients with a full-field digital mammography system relying on digital magnification mammogram (MAG) images and zoomed images from contact mammography (ZOOM) using commercially available zooming systems on monitors. Each radiologist estimated the probability of malignancy and rated the image quality and confidence rate. Performance was evaluated by sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic (ROC) analysis. All three radiologists rated MAG images higher than ZOOM images for sensitivity with statistical significance (average value, 92% vs. 87%, P<0.05) and performance by ROC analysis improved with MAG imaging. The confidence rate for diagnosis decision and the assessment of lesion characteristics were also better in MAG images than in ZOOM images with statistical significance (P<0.0001). Digital magnification mammography can enhance diagnostic performance when characterizing microcalcifications. Images zoomed from digital contact mammography cannot serve as an alternative to direct magnification digital mammography. (orig.)

  18. Quality control in diagnostic mammography: myths, realities and their importance in the final image quality

    International Nuclear Information System (INIS)

    Mora Rodriguez, Patricia

    2011-01-01

    Mammography is the most used tool for early detection of breast cancer and reduce mortality from this cause. Studies with ionizing radiation it is important that be justified and provide a quality image to make the diagnosis, to get more benefits and fewer risks. The problem is the difficult to obtain an image of the breast. Therefore, the commitment to quality mammography is to maximize the contrast, definition, resolution and reliability, thus minimizing noise and dose. A mammogram performed without quality don't detect early breast cancer and the study doesn't have sense. Quality mammography requires trained and experienced staff, modern equipment and in good conditions, correct positioning, right technical factors and appropriate viewing conditions. In addition, quality programs are required to reach to ensure quality, control in testing techniques and image quality. (author) [es

  19. Heavy-ion mammography and breast cancer

    International Nuclear Information System (INIS)

    Fabrikant, J.I.; Tobias, C.A.; Capp, M.P.; Holley, W.R.; Woodruff, K.H.; Sickles, E.A.

    1980-01-01

    Heavy-ion radiography is a new diagnostic imaging technique developed in our laboratory that produces superior density resolution at low radiation doses. Heavy-ion mammography has now emerged as a low-dose, safe, reliable, noninvasive diagnostic radiological procedure that can quantitate and image very small differences in soft tissue densities in the breast tissues of patients with clinical breast disease. The improved density resolution of heavy-ion mammography over conventional X-ray mammography and breast xerography provides the potential of detecting small breast cancers of less than 1 cm diameter. The radiation dose to the breast from carbon-ion mammorgraphy is about 50 mrad or less, and can potentially be only a fraction of this level. The results of the present clinical trial in progress of heavy-ion mammography in 37 patients, thus far studied, are extremely encouraging, and warrant continued study for application to the early diagnosis of breast cancer in women

  20. Correlation between diagnostic capability of MR-mammography and histology of tissue adjacent to tumor

    Energy Technology Data Exchange (ETDEWEB)

    Takahara, Taro [St. Marianna Univ., Kawasaki, Kanagawa (Japan)

    1996-12-01

    The purpose of this paper is to evaluate correlation between the capability in the diagnosis of tumor extent and histology of adjacent tissue. MR-mammography (MRM) was obtained in twenty-one patients with surgically resected breast cancer by 0.5 T superconducting magnet (PHILIPS GY-ROSCAN T5-II, release 3.1). Pre and postcontrast 3D-spoiled gradient echo sequence were employed for MRM with spectral presaturation with inversion recovery (SPIR) and on-resonance MTC. The contrast determination time, the passing time of the center of k-space, was 1 min 50 s in 14 cases with key-hole imaging, and 2 min 46 s in 7 cases without key-hole imaging. Early enhancing area was considered as a tumor and an accuracy of tumor extent was evaluated by two radiologists. Accurate interpretation was obtained in 9 of 9 cases with atrophic mammary gland with fatty replacement and 3 of 3 cases with severe fibrosis in mammary gland. Seven cases were unclear in tumor margin due to intense enhancement of the adjacent tissue. One of 3 cases with normal mammary gland showed unclear margin of the tumor, which corresponded to the area of rich population of lobules in a young patient. Two of 2 cases of fibrocystic change with nonproliferative lesions in one case and proliferative lesions without atypia in another, showed unclear margin of tumor. Two cases of 2 intraductal spreading and 2 of 2 cases of massive interstitial invasion also showed unclear margin. The accuracy of tumor extent was found to have no correlation with either histology or enhancing ratio of the tumor. In conclusion, it is warranted to say that histology of adjacent tissue is an important factor to determine diagnostic capability of tumor extent by MRM. Fat replacement and fibrosis of the surrounding tissue are main causes of clear visualization of tumor, while normal mammary gland in young patients, fibrocystic change, intraductal spreading and invasion lead to the unclearness of tumor margin. (author)

  1. Correlation between diagnostic capability of MR-mammography and histology of tissue adjacent to tumor

    International Nuclear Information System (INIS)

    Takahara, Taro

    1996-01-01

    The purpose of this paper is to evaluate correlation between the capability in the diagnosis of tumor extent and histology of adjacent tissue. MR-mammography (MRM) was obtained in twenty-one patients with surgically resected breast cancer by 0.5 T superconducting magnet (PHILIPS GY-ROSCAN T5-II, release 3.1). Pre and postcontrast 3D-spoiled gradient echo sequence were employed for MRM with spectral presaturation with inversion recovery (SPIR) and on-resonance MTC. The contrast determination time, the passing time of the center of k-space, was 1 min 50 s in 14 cases with key-hole imaging, and 2 min 46 s in 7 cases without key-hole imaging. Early enhancing area was considered as a tumor and an accuracy of tumor extent was evaluated by two radiologists. Accurate interpretation was obtained in 9 of 9 cases with atrophic mammary gland with fatty replacement and 3 of 3 cases with severe fibrosis in mammary gland. Seven cases were unclear in tumor margin due to intense enhancement of the adjacent tissue. One of 3 cases with normal mammary gland showed unclear margin of the tumor, which corresponded to the area of rich population of lobules in a young patient. Two of 2 cases of fibrocystic change with nonproliferative lesions in one case and proliferative lesions without atypia in another, showed unclear margin of tumor. Two cases of 2 intraductal spreading and 2 of 2 cases of massive interstitial invasion also showed unclear margin. The accuracy of tumor extent was found to have no correlation with either histology or enhancing ratio of the tumor. In conclusion, it is warranted to say that histology of adjacent tissue is an important factor to determine diagnostic capability of tumor extent by MRM. Fat replacement and fibrosis of the surrounding tissue are main causes of clear visualization of tumor, while normal mammary gland in young patients, fibrocystic change, intraductal spreading and invasion lead to the unclearness of tumor margin. (author)

  2. Breast density in screening mammography in Indian population - Is it different from western population?

    Science.gov (United States)

    Singh, Tulika; Khandelwal, Niranjan; Singla, Veenu; Kumar, Dileep; Gupta, Madhu; Singh, Gurpreet; Bal, Amanjit

    2018-05-01

    Mammography is the only method presently considered appropriate for mass screening of breast cancer. However, higher breast density was strongly associated with lower mammographic sensitivity. Breast density is also identified as independent and strongest risk factors for breast cancer. Studies have shown women with high breast density have four to six times increased risk of breast cancer as compare to women with fatty breast. It varies between different age group it generally decreases with increasing age in postmenopausal women and it can be different in different ethnic groups and people from different geographical areas. This study evaluates the breast density in Indian population and its relationship with the age. We reviewed of all screening mammography examinations performed from May 2012 to January 2015 at our institute PGIMER, Chandigarh, INDIA. Descriptive analyses were used to examine the association between age and breast density. A total of 6132 screening mammograms were performed. Each subgroup categorized by decade of age. There was a significant inverse relationship between age and breast density (P density in Indian and Western population with more Indians having ACR Grade 1 and 2 and Western population having 2 and 3. We found an inverse relationship between patient age and mammographic breast density. However, there were a large proportion of young women who had lower grades of mammographic density which could potentially benefit from the use of routine screening mammography in this subgroup of patients. Moreover, the breast density of Indian population is less when compared to the Western population. This might suggest that mammography is a good modality of choice for screening Indian population. © 2017 Wiley Periodicals, Inc.

  3. Experience with digital mammography

    Directory of Open Access Journals (Sweden)

    G. P. Korzhenkova

    2011-01-01

    Full Text Available The use of digital techniques in mammography has become a last step for completing the process of digitization in diagnostic imaging. It is assumed that such a spatial decision will be required for digital mammography, as well as for high-resolution intensifying screen-film systems used in conventional mammography and that the digital techniques will be limited by the digitizer pixel size on detecting minor structures, such as microcalcifications. The introduction of digital technologies in mammography involves a tight control over an image and assures its high quality.

  4. Comparing the diagnostic efficacy of full field digital mammography with digital breast tomosynthesis using BIRADS score in a tertiary cancer care hospital.

    Science.gov (United States)

    Singla, Divya; Chaturvedi, Arvind K; Aggarwal, Abhinav; Rao, S A; Hazarika, Dibyamohan; Mahawar, Vivek

    2018-01-01

    Breast cancer is one of the leading cancers in females worldwide, and its incidence has been rising at an exponential pace in the last 10 years even in India. Mammography has been the mainstay for detection of breast cancer over decades and has gradually advanced from screen film to full-field digital mammography. Recently, tomosynthesis has evolved as an advanced imaging investigation for early diagnosis of breast lesions in both diagnostic and screening settings. To compare and evaluate the impact of digital breast tomosynthesis (DBT) compared to full-field digital mammography (FFDM) in the interpretation of BIRADS score in both diagnostic and screening settings. A 1-year prospective longitudinal study was conducted in the Department of Radio-diagnosis in our institute using Hologic Selenia Dimensions for mammography as well as tomosynthesis. One hundred women known or suspected (opportunistic screening) for breast cancer were evaluated either with FFDM alone or both FFDM and DBT. Sensitivity, specificity, positive predictive value, negative predictive value, and P value were used to assess the various diagnostic criteria in our study. Addition of DBT to FFDM results in a statistically significant increase in the sensitivity, specificity, and positive predictive value, and a statistically significant decrease in the false positive rates. Similar results were noted in both diagnostic and screening cases. It was observed that, in most cases, i.e. a total of 47, DBT did not change the BIRADS scoring; however, its addition increased the diagnostic confidence. BIRADS was upgraded and downgraded in 14 and 31 cases, respectively, with the addition of DBT to FFDM. New lesions were seen with addition of DBT to FFDM in 8 cases. Addition of DBT to FFDM results in increase in sensitivity, specificity, positive predictive value, and a statistically significant decrease in false positive rates in both diagnostic and screening cases. As addition of tomosynthesis results in a

  5. Comparison of Diagnostic Performance of Three-Dimensional Positron Emission Mammography versus Whole Body Positron Emission Tomography in Breast Cancer

    Directory of Open Access Journals (Sweden)

    Dong Dai

    2017-01-01

    Full Text Available Objective. To compare the diagnostic performance of three-dimensional (3D positron emission mammography (PEM versus whole body positron emission tomography (WBPET for breast cancer. Methods. A total of 410 women with normal breast or benign or highly suspicious malignant tumors were randomized at 1 : 1 ratio to undergo 3D-PEM followed by WBPET or WBPET followed by 3D-PEM. Lumpectomy or mastectomy was performed on eligible participants after the scanning. Results. The sensitivity and specificity of 3D-PEM were 92.8% and 54.5%, respectively. WBPET showed a sensitivity of 95.7% and specificity of 56.8%. After exclusion of the patients with lesions beyond the detecting range of the 3D-PEM instrument, 3D-PEM showed higher sensitivity than WBPET (97.0% versus 95.5%, P = 0.913, particularly for small lesions (<1 cm (72.0% versus 60.0%, P = 0.685. Conclusions. The 3D-PEM appears more sensitive to small lesions than WBPET but may fail to detect lesions that are beyond the detecting range. This study was approved by the Ethics Committee (E2012052 at the Tianjin Medical University Cancer Institute and Hospital (Tianjin, China. The instrument positron emission mammography (PEMi was approved by China State Food and Drug Administration under the registration number 20153331166.

  6. A comparison of digital mammography detectors and emerging technology

    International Nuclear Information System (INIS)

    Diffey, J.L.

    2015-01-01

    The overall diagnostic accuracy of digital mammography in the context of screening has been shown to be similar or slightly better than screen-film mammography. However, digital mammography encompasses both Computed Radiography (CR) and integrated Digital Radiography (DR) and there is increasing evidence to suggest that differences in detector technology are associated with variations in cancer detection rate, dose and image quality. These differences are examined in detail. Although digital mammography offers many advantages compared to screen-film, there are still some limitations with its use as a screening tool and reduced cancer detection in dense breasts remains an issue. Digital mammography detectors have paved the way for emerging technologies which may offer improvements. Taking the definition of mammography to only include X-ray imaging of the breast, this article focuses on tomosynthesis, contrast-enhanced digital mammography, stereoscopic mammography and dedicated breast computed tomography. Advanced software applications such as Computed Aided Detection (CAD) and quantitative breast density assessment are also presented. The benefits and limitations of each technique are discussed. - Highlights: • Digital detector technology affects cancer detection rate, dose and image quality. • Digital detectors have facilitated new technologies such as tomosynthesis. • 3-D techniques reduce superimposition and increase cancer detection in dense breasts. • Contrast-enhanced mammography demonstrates improved sensitivity and specificity.

  7. Quality assurance in mammography

    International Nuclear Information System (INIS)

    Fosmark, H.; Olerud, H.M.

    1992-01-01

    Guidelines in mammography are given, including competence of staff, performance of equipment and quality control procedures. The purpose of the guidelines is to ensure optimum diagnostic quality. 5 refs

  8. Diagnostic accuracy of mammography readers and their memory performance have no correlation with each other

    International Nuclear Information System (INIS)

    Kok, P.; Cawson, J.N.; Mercuri, V.; Pitman, A.G.; Gledhill, S.; Shnier, D.; Taft, R.; Zentner, L.

    2010-01-01

    Full text: The study aims to determine if any association exists between visual memory performance and diagnostic accuracy performance in a group of radiologist mammogram readers. Materials and Methods: One hundred proven mammograms (23 with cancers) were grouped into 5 sets of 20 cases, with sets being of equal difficulty. Pairs of sets were presented in 5 reads (40 cases per read, order random) to a panel of 8 radiologist readers (either present or past screening readers, with experience range from 20 years). The readers were asked to either 'clear' or 'call back' cases depending on need for further workup, and at post-baseline reads to indicate whether each case was 'new' or 'old' (i .e. remembered from prior read). Two sets were presented only at baseline (40 cases per reader), and were used to calculate the reader's false recollection rate. Three sets were repeated post-baseline once or twice (100 cases per reader). Reading conditions were standardised. Results: Memory performance differed markedly between readers. The number of correctly remembered cases (of 100 'old' cases) had a median of 10.5 and range of 0-58. The observed number of false recollections (of 40 'totally new' cases) had a median of 2 and range of 0-17. Diagnostic performance measures were mean (range): sensitivity 0.68 (0.54-0.81); specificity 0.82 (0.74-0.91); positive predictive value (PPV) 0.55 (0.500.65); negative predictive value (NPV) 0.89 (0.86-0.93) and accuracy 0.78 (0.76-0.83). Confidence intervals (CIs; 95%) for each reader overlapped for all the diagnostic parameters, indicating a lack of statistically significant difference between the readers at the 5% level. The most sensitive and the most specific reader showed a trend away from each other on sensitivity, specificity, NPV and PPV; their accuracies were 0.76 and 0.82, respectively, and their accuracy 95% CIs overlapped considerably. Correlation analysis by reader showed no association between observed memory performance and

  9. The diagnostic accuracy of dual-view digital mammography, single-view breast tomo-synthesis and a dual-view combination of breast tomo-synthesis and digital mammography in a free-response observer performance study

    International Nuclear Information System (INIS)

    Svahn, T.; Andersson, I.; Chakraborty, D.; Svensson, S.; Ikeda, D.; Foernvik, D.; Mattsson, S.; Tingberg, A.; Zackrisson, S.

    2010-01-01

    The purpose of the present study was to compare the diagnostic accuracy of dual-view digital mammography (DM), single view breast tomo-synthesis (BT) and BT combined with the opposite DM view. Patients with subtle lesions were selected to undergo BT examinations. Two radiologists who are non-participants in the study and have experience in using DM and BT determined the locations and extents of lesions in the images. Five expert mammographers interpreted the cases using the free-response paradigm. The task was to mark and rate clinically reportable findings suspicious for malignancy and clinically relevant benign findings. The marks were scored with reference to the outlined regions into lesion localization or non-lesion localization, and analysed by the jackknife alternative free-response receiver operating characteristic method. The analysis yielded statistically significant differences between the combined modality and dual-view DM (p < 0.05). No differences were found between single-view BT and dual-view DM or between single-view BT and the combined modality. (authors)

  10. Correlation between the physical performances measured from detectors and the diagnostic image quality in digital mammography

    International Nuclear Information System (INIS)

    Perez-Ponce, H.

    2009-05-01

    In digital mammography two approaches exist to estimate image quality. In the first approach, human observer assesses the lesion detection in mammograms. Unfortunately, such quality assessment is subject to interobserver variability, and requires a large amount of time and human resources. In the second approach, objective and human-independent parameters relating to image spatial resolution and noise (MTF and NPS) are used to evaluate digital detector performance; even if these parameters are objective, they are not directly related to lesion detection. A method leading to image quality assessment which is both human independent, and directly related to lesion detection is very important for the optimal use of mammographic units. This Ph.D thesis presents the steps towards such a method: the computation of realistic virtual images using an 'X ray source/digital detector' model taking into account the physical parameters of the detector (spatial resolution and noise measurements) measured under clinical conditions. From results obtained in this work, we have contributed to establish the link between the physical characteristics of detectors and the clinical quality of the image for usual exposition conditions. Furthermore, we suggest the use of our model for the creation of virtual images, in order to rapidly determine the optimal conditions in mammography, which usually is a long and tedious experimental process. This is an essential aspect to be taken into account for radioprotection of patients, especially in the context of organized mass screening of breast cancer. (author)

  11. Comparison of dignity determination of mammographic microcalcification with two systems for digital full-field mammography with different detector resolution. A retrospective clinical study

    International Nuclear Information System (INIS)

    Schulz-Wendtland, R.; Adamietz, B.; Meier-Meitinger, M.; Wenkel, E.; Lell, M.; Anders, K.; Uder, M.; Hermann, K.P.

    2011-01-01

    The aim of this retrospective clinical study was to compare the diagnostic accuracy of the novel 50 μm FFDM (full-field digital mammography) system (DR) with an established 70 μm system (DR) in the differential diagnosis between benign and malignant clusters of microcalcification (n=50) (BI-RADS trademark classification 4/5) and to assess the possible incremental value of the 50 μm pixel-pitch on specificity. From March 2009 to September 2009, 50 patients underwent full-field digital mammography (FFDM) (detector resolution 70 μm) (Novation, Siemens, Erlangen, Germany). As there were suspicious signs of microcalcification classified with BI-RADS trademark 4/5 after diagnosis and preoperative wire localization, control images were made with the new FFDM system (detector: resolution 50 μm) (Amulet, Fujifilm, Tokyo, Japan) with the same exposure parameters. The diagnosis was determined after the operation by five radiologists with different experience in digital mammography from randomly distributed mediolateral views (monitor reading) whose results were correlated with the final histology of all lesions. Histopathology revealed 19 benign and 31 malignant lesions in 50 patients after open biopsy. The results of the five readers showed a higher sensitivity of the new FFDM system (80.0%) in the ability to recognize malignant microcalcification in comparison to the established system (74.8%). The specificity (75.8 versus 71.6%) was slightly higher for the new system but hese results were not statistically significant (p [de

  12. Digital imaging system in mammography with X-ray of two different energies

    International Nuclear Information System (INIS)

    Swientek, K.; Dabrowski, W.; Grybos, P.; Wiacek, P.; Cabal Rodrigez, A. E.; Sanchez, C.C.; Gambaccini, M.; Gaitan, J.L.; Prino, F.; Ramello, L.

    2005-01-01

    The progress in nuclear medicine stimulates the higher quality of image processing at diminished radiation dose. In the presented apparatus system Si-microstrip detector with two-thresholds multichannel amplitude analyzer have been applied. Data acquisition system evaluates simultaneously images for two X-ray beams of different energies following the Bragg reflection of the primary beam from the mosaic crystal. The contrast cancellation technique has been tested using the simple mammography phantom. An efficacy of this method suitable for medical imaging could be significantly increased using an intensive X-ray source and sensitive detectors

  13. A new test phantom with different breast tissue compositions for image quality assessment in conventional and digital mammography

    International Nuclear Information System (INIS)

    Pachoud, Marc; Lepori, D; Valley, Jean-Francois; Verdun, Francis R

    2004-01-01

    Our objective is to describe a new test phantom that permits the objective assessment of image quality in conventional and digital mammography for different types of breast tissue. A test phantom, designed to represent a compressed breast, was made from tissue equivalent materials. Three separate regions, with different breast tissue compositions, are used to evaluate low and high contrast resolution, spatial resolution and image noise. The phantom was imaged over a range of kV using a Contour 2000 (Bennett) mammography unit with a Kodak MinR 2190-MinR L screen-film combination and a Senograph 2000D (General Electric) digital mammography unit. Objective image quality assessments for different breast tissue compositions were performed using the phantom for conventional and digital mammography. For a similar mean glandular dose (MGD), the digital system gives a significantly higher contrast-to-noise ratio (CNR) than the screen-film system for 100% glandular tissue. In conclusion, in mammography, a range of exposure conditions is used for imaging because of the different breast tissue compositions encountered clinically. Ideally, the patient dose-image quality relationship should be optimized over the range of exposure conditions. The test phantom presented in this work permits image quality parameters to be evaluated objectively for three different types of breast tissue. Thus, it is a useful tool for optimizing the patient dose-image quality relationship

  14. A comparison of two different processing chemicals for mammography: Repercussion on dose to patients

    International Nuclear Information System (INIS)

    Sendra-Portero, F.; Ristori-Bogajo, E.; Buch-Tome, P.; Martinez-Morillo, M.; Nava-Baro, E.

    2001-01-01

    The main technical objective of screen-film mammography is to reach the best image quality with the lowest dose to the breast. Sensitometric gradient and speed are factors related to both subjects respectively. For a given choice of film, these factors are affected by processing variables. For this reason, manufacturers have developed different types of films that are recommended for particular processing conditions. The purpose of this work is to compare the variations of both sensitometric characteristics of mammographic screen and film systems induced by two different manufactured chemicals: RPX-Omat EX/LO (Kodak) and G139/G334 (Agfa). A comparison of thirteen mammographic films by means of light sensitometry was performed at different processing conditions: 90s/Kodak, 120s/Kodak, 180s/Kodak, 90s/Agfa, 120s/Agfa and 180s/Agfa. Secondly, 99 combinations of screens and films were evaluated by X-ray sensitometry at 120s/Kodak and 120s/Agfa processing. At light sensitometry, variations in processing time led to different modifications in film speed, depending on the chemicals used. At X-Ray sensitometry, Agfa chemicals induced higher values of sensitivity for almost all combinations, while Kodak chemicals gave higher gradient/speed quotient. The results show that dose to patients in mammography and image contrast are highly dependent on the chemicals selected at medium cycle (120s) processing. (author)

  15. CAD in breast imaging. Application in mammography and MR mammography

    International Nuclear Information System (INIS)

    Obenauer, S.; Hermann, K.P.

    2012-01-01

    Computer aided diagnosis systems (CAD-systems) are evaluated in different parts of diagnostic imaging. In breast imaging double reading which is time- and cost spending is necessary. Therefore a lot of studies evaluated the use of CAD-systems in mammography. However the rate of false-positives is too high to implement CAD-systems as double reader in routine work. In the future, improvements in this technique could perhaps change the performance of CAD-systems. (orig.)

  16. Mammographic findings of women recalled for diagnostic work-up in digital versus screen-film mammography in a population-based screening program

    International Nuclear Information System (INIS)

    Lipasti, Seppo; Pamilo, Martti; Anttila, Ahti

    2010-01-01

    Background: Limited information is available concerning differences in the radiological findings of women recalled for diagnostic work-up in digital mammography (DM) versus screen-film mammography (SFM) screening. Purpose: To compare the radiological findings, their positive predictive values (PPVs) for cancer and other process indicators of DM screening performed by computed radiography (CR) technology and SFM screening in a population-based program. Material and Methods: The material consisted of women, 50-59 years of age, who were invited for screening: 30 153 women with DM in 2007-2008 and 32 939 women with SFM in 1999-2000. The attendance rate was 77.7% (23 440) in the DM arm and 83.8% (27 593) in the SFM arm. In the DM arm, 1.71% of those screened (401) and in the SFM arm 1.59% (438) were recalled for further work-up. The images resulting in the recall were classified as: 1) tumor-like mass, 2) parenchymal distortion/asymmetry, 3) calcifications, and 4) combination of mass and calcifications. The distributions of the various radiological findings and their PPVs for cancer were compared in both study groups. The recall rates, cancer detection rates, test specificities, and PPVs of the DM and SFM groups were also compared. Results: Women were recalled for diagnostic work-up most often due to tumor-like mass. It was more common in SFM (1.08% per woman screened) than in DM (0.93%). The second most common finding was parenchymal distortion and asymmetry, more often in DM (0.58%) than in SFM (0.37%). Calcifications were the third most common finding. DM exposed calcifications more often (0.49%) than SFM (0.26%). The PPVs for cancer of the recalls were higher in DM than in SFM in all subgroups of radiological findings. The test specificities were similar (DM 98.9%, SFM 98.8%). Significantly more cancers were detected by DM (cancer detection rate 0.623% per woman screened, n=146) than by SFM (cancer detection rate 0.406% per woman screened, n=112). The PPVs for

  17. [Comparison of dignity determination of mammographic microcalcification with two systems for digital full-field mammography with different detector resolution: a retrospective clinical study].

    Science.gov (United States)

    Schulz-Wendtland, R; Hermann, K-P; Adamietz, B; Meier-Meitinger, M; Wenkel, E; Lell, M; Anders, K; Uder, M

    2011-02-01

    The aim of this retrospective clinical study was to compare the diagnostic accuracy of the novel 50 µm FFDM (full-field digital mammography) system (DR) with an established 70 µm system (DR) in the differential diagnosis between benign and malignant clusters of microcalcification (n=50) (BI-RADS™ classification 4/5) and to assess the possible incremental value of the 50 µm pixel-pitch on specificity. From March 2009 to September 2009, 50 patients underwent full-field digital mammography (FFDM) (detector resolution 70 µm) (Novation, Siemens, Erlangen, Germany). As there were suspicious signs of microcalcification classified with BI-RADS™ 4/5 after diagnosis and preoperative wire localization, control images were made with the new FFDM system (detector: resolution 50 µm) (Amulet, Fujifilm, Tokyo, Japan) with the same exposure parameters. The diagnosis was determined after the operation by five radiologists with different experience in digital mammography from randomly distributed mediolateral views (monitor reading) whose results were correlated with the final histology of all lesions. Histopathology revealed 19 benign and 31 malignant lesions in 50 patients after open biopsy. The results of the five readers showed a higher sensitivity of the new FFDM system (80.0%) in the ability to recognize malignant microcalcification in comparison to the established system (74.8%). The specificity (75.8 versus 71.6%) was slightly higher for the new system but these results were not statistically significant (pdetector: resolution 50 µm) was also slightly superior to the well-known system (detector: resolution 70 µm) (80.1% versus 76.4%). Our study has shown that the new full-field digital mammography system using the novel detector compared with the already established FFDM system with respect to the assessment of microcalcification is at least equivalent.

  18. Racial differences in breast cancer stage at diagnosis in the mammography era.

    Science.gov (United States)

    Chatterjee, Neal A; He, Yulei; Keating, Nancy L

    2013-01-01

    We assessed racial differences in breast cancer mortality by stage at diagnosis, since mammography became available. We calculated adjusted odds of distant (versus local or regional) tumors for 143,249 White and 13,571 Black women aged 50 to 69 years, diagnosed with breast cancer between 1982 and 2007 and living in a Surveillance, Epidemiology, and End Results region. We compared linear trends in stage at diagnosis before and after 1998. Distant-stage cancer was diagnosed in 5.8% of White and 10.2% of Black participants. The Black-White disparity in distant tumors narrowed until 1998 (1998 adjusted difference = 0.65%), before increasing. Between 1982 and 1997, the proportion of distant tumors decreased for Blacks (adjusted odds ratio [AOR]/y = 0.973; 95% confidence interval [CI] = 0.960, 0.987) and Whites (AOR/y = 0.978; 95% CI = 0.973, 0.983), with no racial differences (P = .47). From 1998 to 2007, the odds of distant versus local or regional tumors increased for Blacks (AOR/y = 1.036; 95% CI = 1.013, 1.060) and Whites (AOR/y = 1.011; 95% CI = 1.002, 1.021); the rate of increase was greater for Blacks than Whites (P = .04). In the mammography era, racial disparities remain in stage at diagnosis.

  19. Descriptive study of the quality control in mammography

    International Nuclear Information System (INIS)

    Gaona, E.; Perdigon C, G.M.; Casian C, G.A.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M.

    2005-01-01

    The goal of mammography is to provide contrast between a lesion that is possible residing within the breast and normal surrounding tissue. Quality control is essential for maintaining the contrast imaging performance of a mammography system and incorporate tests that are relevant in that they are predictive of future degradation of contrast imaging performance. These tests will also be done at frequency that is high enough to intercept most drifts in quality imaging or performance before they become diagnostically significant. The quality control study has as objective to describe the results of the assessment of quality imaging elements (film optical density, contrast (density difference), uniformity, resolution and noise) of 62 mammography departments without quality control program and comparison these results with a mammography reference department with a quality control program. When comparing the results they allow seeing the clinical utility of to have a quality control program to reduce the errors of mammography interpretation. (Author)

  20. Measurement of glanduler tissue dose and image quality on mammography investigation at different exposure parameters and systems

    International Nuclear Information System (INIS)

    Akyol, O.

    2004-01-01

    There are many protocols suggested different international organization regarding to routine quality control and acceptance test methods of mammography systems. Users may select the most appropriate method for their routine practices according to infrastructure they have. However if there is a need for national authority to establish protocol for licesing of invidual users or in case of a screening studies for a large populations. Use of standard protocol became is important. Currently, there are more than 550 mamography system use in Turkey. However users implementing neither quality controlnor acceptance on the other hand even the national authorities. The purpose this thesis is to establishment a standard protocol than can be used for quality control and routine tests on mammography systems. This procedures were implented for 18 different mammography systems instoled at different places in Ankara

  1. Breast cancer detection rates using four different types of mammography detectors

    Energy Technology Data Exchange (ETDEWEB)

    Mackenzie, Alistair; Warren, Lucy M.; Dance, David R.; Young, Kenneth C. [Royal Surrey County Hospital, National Coordinating Centre for the Physics in Mammography (NCCPM), Guildford (United Kingdom); University of Surrey, Department of Physics, Guildford (United Kingdom); Wallis, Matthew G. [Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); NIHR Cambridge Biomedical Research Centre, Cambridge Breast Unit, Cambridge (United Kingdom); Cooke, Julie [Jarvis Breast Screening and Diagnostic Centre, Guildford (United Kingdom); Given-Wilson, Rosalind M. [St George' s Healthcare NHS Trust, Department of Radiology, London (United Kingdom); Chakraborty, Dev P. [University of Pittsburgh, Department of Radiology, Pittsburgh, PA (United States); Halling-Brown, Mark D. [Royal Surrey County Hospital, Scientific Computing, Department of Medical Physics, Guildford (United Kingdom); Looney, Padraig T. [Royal Surrey County Hospital, National Coordinating Centre for the Physics in Mammography (NCCPM), Guildford (United Kingdom)

    2016-03-15

    To compare the performance of different types of detectors in breast cancer detection. A mammography image set containing subtle malignant non-calcification lesions, biopsy-proven benign lesions, simulated malignant calcification clusters and normals was acquired using amorphous-selenium (a-Se) detectors. The images were adapted to simulate four types of detectors at the same radiation dose: digital radiography (DR) detectors with a-Se and caesium iodide (CsI) convertors, and computed radiography (CR) detectors with a powder phosphor (PIP) and a needle phosphor (NIP). Seven observers marked suspicious and benign lesions. Analysis was undertaken using jackknife alternative free-response receiver operating characteristics weighted figure of merit (FoM). The cancer detection fraction (CDF) was estimated for a representative image set from screening. No significant differences in the FoMs between the DR detectors were measured. For calcification clusters and non-calcification lesions, both CR detectors' FoMs were significantly lower than for DR detectors. The calcification cluster's FoM for CR NIP was significantly better than for CR PIP. The estimated CDFs with CR PIP and CR NIP detectors were up to 15 % and 22 % lower, respectively, than for DR detectors. Cancer detection is affected by detector type, and the use of CR in mammography should be reconsidered. (orig.)

  2. Breast cancer imaging: Mammography among women of up to 45 years

    International Nuclear Information System (INIS)

    Schnejder-Wilk, A.

    2010-01-01

    Background: Among women under the age of 40, screening mammography examinations are not performed routinely. An ultrasonography scan is considered to be a basic breast imaging examination among younger women. The purpose of this study was to analyze mammography images, as well as to evaluate the usefulness and role of mammography in breast cancer diagnostic processes in women of up to 45 years, based on own experience. Material/Methods: A retrospective analysis of mammography images, including 144 cases of breast cancer diagnosed in the group of 140 women of 45 years of age. All the patients underwent pre-treatment mammography and surgery procedure. The images were evaluated in accordance to BIRADS criteria. Lesions detectable in mammography were grouped as follows: spiculated mass; nonmicrocalcified oval/round mass; microcalcified mass (regardless of shape); microcalcifications; architectural distortion; breast tissue asymmetry. Results: The most common mammographic symptom was solid tumor (41%), followed by microcalcified tumors (20.8%). Clusters of microcalcifications constituted 17.4% of mammography findings. In 4.9% of mammography scans, examination did not reveal any pathological lesions. Conclusions: Breast cancer mammograms of women aged up to 45 years do not differ from diagnostic pictures of breast cancer in older women. The diagnostic appearance of breast cancer in 1/3 of the patients involved microcalcifications detectable only on mammograms. All the women with suspicion of breast cancer should have their mammography examinations performed, irrespective of ultrasonography scans. (author)

  3. Diagnostic performance of digital breast tomosynthesis with a wide scan angle compared to full-field digital mammography for the detection and characterization of microcalcifications

    International Nuclear Information System (INIS)

    Clauser, Paola; Nagl, Georg; Helbich, Thomas H.; Pinker-Domenig, Katja; Weber, Michael; Kapetas, Panagiotis; Bernathova, Maria; Baltzer, Pascal A.T.

    2016-01-01

    Highlights: • Wide scan-angle DBT alone shows a high detection rate for microcalcifications. • DBT and FFDM can characterize microcalcifications at a comparable level. • Characterization is influenced by reader and by lesion type (benign vs malignant). • DBT might be used as a stand-alone technique for the assessment of microcalcifications. - Abstract: Objectives: To assess the diagnostic performance of digital breast tomosynthesis (DBT), with a wide scan-angle, compared to full-field digital mammography (FFDM), for the detection and characterization of microcalcifications. Methods: IRB approval was obtained for this retrospective study. We selected 150 FFDM and DBT (50 benign and 50 malignant histologically verified microcalcifications, 50 cases classified as BI-RADS 1). Four radiologists evaluated, in separate sessions and blinded to patients’ history and histology, the presence of microcalcifications. Cases with microcalcifications were assessed for visibility, characteristics, and grade of suspicion using BI-RADS categories. Detection rate and diagnostic performance were calculated. Visibility, lesions’ characteristics and reading time were analysed. Results: Detection rate and visibility were good for both FFDM and DBT, without intra-reader differences (P = 0.510). Inter-reader differences were detected (P < 0.018). Only two lesions were not detected by any reader on either FFDM or DBT. Diagnostic performance with DBT was as good as that of FFDM, but a significant inter-reader difference was found (P = 0.041). High inter-reader variability in the use of the descriptors was found. Reading time for DBT was almost twice that for FFDM (44 and 25 s, respectively). Conclusion: Wide scan-angle DBT enabled the detection and characterization of microcalcifications with no significant differences from FFDM. Inter-reader variability was seen.

  4. Diagnostic performance of digital breast tomosynthesis with a wide scan angle compared to full-field digital mammography for the detection and characterization of microcalcifications

    Energy Technology Data Exchange (ETDEWEB)

    Clauser, Paola, E-mail: paola.clauser@meduniwien.ac.at [Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Nagl, Georg [Department for Radiology and Interventional Radiology, Landesklinikum Horn, Spitalgasse 10, 3580 Horn (Austria); Helbich, Thomas H., E-mail: thomas.helbich@meduniwien.ac.at [Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Pinker-Domenig, Katja [Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Weber, Michael [Department of Biomedical Imaging and Image-Guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Kapetas, Panagiotis; Bernathova, Maria; Baltzer, Pascal A.T. [Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)

    2016-12-15

    Highlights: • Wide scan-angle DBT alone shows a high detection rate for microcalcifications. • DBT and FFDM can characterize microcalcifications at a comparable level. • Characterization is influenced by reader and by lesion type (benign vs malignant). • DBT might be used as a stand-alone technique for the assessment of microcalcifications. - Abstract: Objectives: To assess the diagnostic performance of digital breast tomosynthesis (DBT), with a wide scan-angle, compared to full-field digital mammography (FFDM), for the detection and characterization of microcalcifications. Methods: IRB approval was obtained for this retrospective study. We selected 150 FFDM and DBT (50 benign and 50 malignant histologically verified microcalcifications, 50 cases classified as BI-RADS 1). Four radiologists evaluated, in separate sessions and blinded to patients’ history and histology, the presence of microcalcifications. Cases with microcalcifications were assessed for visibility, characteristics, and grade of suspicion using BI-RADS categories. Detection rate and diagnostic performance were calculated. Visibility, lesions’ characteristics and reading time were analysed. Results: Detection rate and visibility were good for both FFDM and DBT, without intra-reader differences (P = 0.510). Inter-reader differences were detected (P < 0.018). Only two lesions were not detected by any reader on either FFDM or DBT. Diagnostic performance with DBT was as good as that of FFDM, but a significant inter-reader difference was found (P = 0.041). High inter-reader variability in the use of the descriptors was found. Reading time for DBT was almost twice that for FFDM (44 and 25 s, respectively). Conclusion: Wide scan-angle DBT enabled the detection and characterization of microcalcifications with no significant differences from FFDM. Inter-reader variability was seen.

  5. Diagnostic accuracy of contrast-enhanced spectral mammography in comparison to conventional full-field digital mammography in a population of women with dense breasts.

    Science.gov (United States)

    Mori, Miki; Akashi-Tanaka, Sadako; Suzuki, Satoko; Daniels, Murasaki Ikeda; Watanabe, Chie; Hirose, Masanori; Nakamura, Seigo

    2017-01-01

    Contrast-enhanced spectral mammography to compare clinical efficacy of contrast-enhanced spectral mammography (CESM) and conventional digital mammography (MMG) with histopathology as gold standard in dense breasts. A total of 143 breasts of 72 women who underwent CESM and MMG between 2011 and 2014 at Showa University Hospital were analyzed. 129 (90.2 %) of 143 breasts revealed dense breasts on MMG. 58 (40.6 %) of 143 breasts were diagnosed with breast cancer at histopathology. The remaining 85 breasts were diagnosed with benign findings after image assessments and/or core needle biopsy. CESM revealed 8 false-negative cases among 58 breast cancer cases (sensitivity 86.2 %) and 5 false-positive cases (specificity 94.1 %). Accuracy was 90.9 %. Conventional MMG was assessed true positive in 31 of 58 breast cancer cases (sensitivity 53.4 %) and false positive in 12 cases (specificity 85.9 %). Accuracy was 72.7 %. Sensitivity (p < 0.001), specificity (p = 0.016) and accuracy (p < 0.001) were significantly higher on CESM compared to MMG. MMG missed malignancy in 27 breasts. Of these, 25 were dense breasts. Of these 25, 20 (80.0 %) breasts were positive on CESM. These findings suggest that CESM offers superior clinical performance compared to MMG. Use of CESM may decrease false negatives especially for women with dense breasts.

  6. An analysis of diagnostic practices in a mammography unit in a tertiary hospital in South Africa

    Directory of Open Access Journals (Sweden)

    Clare A. Surridge

    2017-03-01

    Objectives: To perform an audit of the UGCNB biopsies performed at the Grey’s Hospital Mammography Department and assess the accuracy of the radiologists’ use of the BI-RADS scoring system. Methods: Records of all patients who underwent UGCNB biopsy between 01 January 2014 and 31 October 2015 were reviewed. A retrospective study was performed. Results: A total of 304 UGCNB biopsies were performed on 291 patients. The mean age was 49.2 (s.d. = 15.9 years. Tissue samples from 303 lesions were adequate for histological assessment, and of these, 51% of the lesions were malignant whilst 49% were benign. The most common malignant and benign diagnoses were invasive ductal carcinoma and fibroadenoma respectively. The BI-RADS scoring of the radiologists demonstrated a positive predictive value of 61.6% for the identification of possible malignant lesions. Conclusion: This study describes the patient and lesion profile and unit practices in a tertiary hospital setting in South Africa. The radiologists’ application of the BI-RADS scoring largely conforms to the BI-RADS guidelines. The study highlights several challenges encountered by a breast imaging programme in an under-resourced setting as well as making recommendations in overcoming these challenges.

  7. Influence of different anode/filter combination on radiation dose and image quality in digital mammography

    International Nuclear Information System (INIS)

    Liu Jie; Liu Peifang; Zhang Lianlian; Ma Wenjuan

    2013-01-01

    Objective: To explore the effect of different anode/filter combination on radiation dose and image quality in digital mammography, so as to choose optimal anode/filter combination to reduce radiation injury without scarifying image quality. Methods: Mammography accredition phantoms with the thickness from 1.6 cm to 8.6 cm were used to simulate human breast tissue. The same exposure conditions, pressure, compression thickness. and different anode/filter combination were employed under the automatic and manual exposure modes. The image kV, mAs, pressure, filter, average glandular dose (ACD), contrast to noise ratio (CNR) were recorded and the figure of merit (FOM) was calculated. SPSS 17.0 and one-way analysis of variance were used in the statistical analysis. Results: As the phantom thickness increase, the ACD values which were acquired with Mo/Mo, Mo/Rh, and W/Ag three different anode/filter combinations were increased, but CNR and FOM values were decreased, ACD, CNR, and FOM values which were acquired in the phantom with different thickness, and three different anode/filter combinations were statistically different (P=0.000, respectively). The ACD values of Mo/Mo were lowest. For 1.6 cm-2.6 cm phantom thicknesses, the FOMs of Mo/Rh were lowest, and for 3.6 cm-8.6 cm phantom thicknesses, the FOMs of W/Ag were lowest. Conclusion: Phantom thickness in 1.6 cm-2.6 cm and 3.6 cm-8.6 cm. Mo/Rh combination and W/Ag combination respectively can achieve the highest FOM, and can provide the best imaging quality with low radiation dose. (authors)

  8. Comparing the diagnostic efficacy of full field digital mammography with digital breast tomosynthesis using BIRADS score in a tertiary cancer care hospital

    Directory of Open Access Journals (Sweden)

    Divya Singla

    2018-01-01

    Full Text Available Introduction: Breast cancer is one of the leading cancers in females worldwide, and its incidence has been rising at an exponential pace in the last 10 years even in India. Mammography has been the mainstay for detection of breast cancer over decades and has gradually advanced from screen film to full-field digital mammography. Recently, tomosynthesis has evolved as an advanced imaging investigation for early diagnosis of breast lesions in both diagnostic and screening settings. Aim of Study: To compare and evaluate the impact of digital breast tomosynthesis (DBT compared to full-field digital mammography (FFDM in the interpretation of BIRADS score in both diagnostic and screening settings. Settings and Design: A 1-year prospective longitudinal study was conducted in the Department of Radio-diagnosis in our institute using Hologic Selenia Dimensions for mammography as well as tomosynthesis. Materials and Methods: One hundred women known or suspected (opportunistic screening for breast cancer were evaluated either with FFDM alone or both FFDM and DBT. Sensitivity, specificity, positive predictive value, negative predictive value, and P value were used to assess the various diagnostic criteria in our study. Results: Addition of DBT to FFDM results in a statistically significant increase in the sensitivity, specificity, and positive predictive value, and a statistically significant decrease in the false positive rates. Similar results were noted in both diagnostic and screening cases. It was observed that, in most cases, i.e. a total of 47, DBT did not change the BIRADS scoring; however, its addition increased the diagnostic confidence. BIRADS was upgraded and downgraded in 14 and 31 cases, respectively, with the addition of DBT to FFDM. New lesions were seen with addition of DBT to FFDM in 8 cases. Conclusion: Addition of DBT to FFDM results in increase in sensitivity, specificity, positive predictive value, and a statistically significant

  9. Mammography and ultrasound in the evaluation of male breast disease

    Energy Technology Data Exchange (ETDEWEB)

    Munoz Carrasco, Rafaela; Alvarez Benito, Marina; Raya Povedano, Jose Luis [Hospital Universitario ' Reina Sofia' , Radiology Department, Cordoba (Spain); Munoz Gomariz, Elisa [Hospital Universitario ' Reina Sofia' , Support Unit for Research, Cordoba (Spain); Martinez Paredes, Maria [University of Cordoba, Radiology and Physical Medicine Area, Cordoba (Spain)

    2010-12-15

    To assess clinical variables that may be useful in differentiating gynaecomastia from carcinoma and to analyse the contribution of mammography and ultrasound to the evaluation of male breast disease. All men who underwent mammography and/or ultrasound between 1993 and 2006 in our hospital were retrospectively evaluated. Clinical characteristics in patients with gynaecomastia and those with carcinoma were compared. Radiological findings were classified according to the BI-RADS (Breast Imaging Reporting and Data System) criteria. The diagnostic performance of physical examination, mammography and ultrasound was determined and compared. A total of 628 patients with 518 mammograms and 423 ultrasounds were reviewed. The final diagnoses were: 19 carcinomas, 526 gynaecomastias, 84 other benign conditions and 25 normal. There were statistically significant differences in age, bilateral involvement, clinical presentation and physical examination between patients with carcinoma and those with gynaecomastia. The diagnostic performance of physical examination was lower than that of mammography and ultrasound (p < 0.05 for specificity). Mammography was the most sensitive (94.7%) and ultrasound the most specific (95.3%) for detection of malignancy (p > 0.05). We propose an algorithm for the use of mammography and ultrasound in men. Mammography and ultrasound, with a negative predictive value close to 100%, make it possible to avoid very many unnecessary surgical procedures in men. (orig.)

  10. Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme.

    Science.gov (United States)

    Lobbes, Marc B I; Lalji, Ulrich; Houwers, Janneke; Nijssen, Estelle C; Nelemans, Patty J; van Roozendaal, Lori; Smidt, Marjolein L; Heuts, Esther; Wildberger, Joachim E

    2014-07-01

    Feasibility studies have shown that contrast-enhanced spectral mammography (CESM) increases diagnostic accuracy of mammography. We studied diagnostic accuracy of CESM in patients referred from the breast cancer screening programme, who have a lower disease prevalence than previously published papers on CESM. During 6 months, all women referred to our hospital were eligible for CESM. Two radiologists blinded to the final diagnosis provided BI-RADS classifications for conventional mammography and CESM. Statistical significance of differences between mammography and CESM was calculated using McNemar's test. Receiver operating characteristic (ROC) curves were constructed for both imaging modalities. Of the 116 eligible women, 113 underwent CESM. CESM increased sensitivity to 100.0% (+3.1%), specificity to 87.7% (+45.7%), PPV to 76.2% (+36.5%) and NPV to 100.0% (+2.9%) as compared to mammography. Differences between conventional mammography and CESM were statistically significant (p mammography, AUC was 0.779. With CESM, AUC increased to 0.976 (p mammography, even in lower prevalence patient populations such as referrals from breast cancer screening. • CESM is feasible in the workflow of referrals from routine breast screening. • CESM is superior to mammography, even in low disease prevalence populations. • CESM has an extremely high negative predictive value for breast cancer. • CESM is comparable to MRI in assessment of breast cancer extent. • CESM is comparable to histopathology in assessment of breast cancer extent.

  11. Mammography - recent technical developments and their clinical potential

    Energy Technology Data Exchange (ETDEWEB)

    Hemdal, Bengt; Mattsson, Soeren [Malmoe Univ. Hospital (Sweden). Dept. of Radiation Physics; Andersson, Ingvar [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Thilander Klang, Anne [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Medical Physics and Biomedical Engineering; Bengtsson, Gert; Jarlman, O. [Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Leitz, Wolfram [Swedish Radiation Protection Authority, Stockholm (Sweden); Bjurstam, Nils [Univ. of North Norway, Troms (Norway). Dept. of Radiology

    2002-05-01

    The recent technical developments in digital as well as screen-film X-ray mammography have been reviewed in order to evaluate their clinical potential and to analyse possible lines for future development. Material and methods: The scientific literature has been reviewed, conferences covered and contacts with colleagues developed. Companies in the field have been inquired and invited for presentations. Own experience has been gathered from different screen-film and digital mammography systems. Results and conclusions: Although there are important complementary techniques such as ultrasound and magnetic resonance imaging (MRI), X-ray mammography is still the golden standard for breast imaging. It is relatively simple and cost-effective, and it is presently the only realistic technique for screening in a large scale. It is still largely the only technique that can detect breast cancer in a pre invasive stage. Equipment for digital mammography is commercially available both with small area and full field technique (FFDM). The development of FFDM systems is now intense, as well as the development of dedicated workstations and computer-aided detection (CAD). In spite of this, the introduction of digital mammography has been very slow compared to most other X-ray examinations due to high costs and technical challenges to meet the high demands on image quality and dose in mammography as well as the demands on specialised workflow support for screening mammography and suitable display techniques. Film reading of digital mammograms has been the most common display mode so far, but to take full advantage of the digital concept, diagnostic as well as logistic, monitor reading must be applied. There is a potential of FFDM systems for significantly higher image quality or significantly lower dose than screen-film mammography (SFM), or both. Further research is necessary to fully use this potential. The investment costs are much higher for digital than screen-film mammography

  12. Mammography - recent technical developments and their clinical potential

    International Nuclear Information System (INIS)

    Hemdal, Bengt; Mattsson, Soeren; Bjurstam, Nils

    2002-05-01

    The recent technical developments in digital as well as screen-film X-ray mammography have been reviewed in order to evaluate their clinical potential and to analyse possible lines for future development. Material and methods: The scientific literature has been reviewed, conferences covered and contacts with colleagues developed. Companies in the field have been inquired and invited for presentations. Own experience has been gathered from different screen-film and digital mammography systems. Results and conclusions: Although there are important complementary techniques such as ultrasound and magnetic resonance imaging (MRI), X-ray mammography is still the golden standard for breast imaging. It is relatively simple and cost-effective, and it is presently the only realistic technique for screening in a large scale. It is still largely the only technique that can detect breast cancer in a pre invasive stage. Equipment for digital mammography is commercially available both with small area and full field technique (FFDM). The development of FFDM systems is now intense, as well as the development of dedicated workstations and computer-aided detection (CAD). In spite of this, the introduction of digital mammography has been very slow compared to most other X-ray examinations due to high costs and technical challenges to meet the high demands on image quality and dose in mammography as well as the demands on specialised workflow support for screening mammography and suitable display techniques. Film reading of digital mammograms has been the most common display mode so far, but to take full advantage of the digital concept, diagnostic as well as logistic, monitor reading must be applied. There is a potential of FFDM systems for significantly higher image quality or significantly lower dose than screen-film mammography (SFM), or both. Further research is necessary to fully use this potential. The investment costs are much higher for digital than screen-film mammography

  13. Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme

    Energy Technology Data Exchange (ETDEWEB)

    Lobbes, Marc B.I.; Wildberger, Joachim E. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Lalji, Ulrich; Houwers, Janneke; Nijssen, Estelle C. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); Nelemans, Patty J. [Maastricht University, Department of Epidemiology, Maastricht (Netherlands); Roozendaal, Lori van; Heuts, Esther [Maastricht University Medical Center, Department of Surgical Oncology, Maastricht (Netherlands); Smidt, Marjolein L. [Maastricht University Medical Center, Department of Surgical Oncology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2014-07-15

    Feasibility studies have shown that contrast-enhanced spectral mammography (CESM) increases diagnostic accuracy of mammography. We studied diagnostic accuracy of CESM in patients referred from the breast cancer screening programme, who have a lower disease prevalence than previously published papers on CESM. During 6 months, all women referred to our hospital were eligible for CESM. Two radiologists blinded to the final diagnosis provided BI-RADS classifications for conventional mammography and CESM. Statistical significance of differences between mammography and CESM was calculated using McNemar's test. Receiver operating characteristic (ROC) curves were constructed for both imaging modalities. Of the 116 eligible women, 113 underwent CESM. CESM increased sensitivity to 100.0 % (+3.1 %), specificity to 87.7 % (+45.7 %), PPV to 76.2 % (+36.5 %) and NPV to 100.0 % (+2.9 %) as compared to mammography. Differences between conventional mammography and CESM were statistically significant (p < 0.0001). A similar trend was observed in the ROC curve. For conventional mammography, AUC was 0.779. With CESM, AUC increased to 0.976 (p < 0.0001). In addition, good agreement between tumour diameters measured using CESM, breast MRI and histopathology was observed. CESM increases diagnostic performance of conventional mammography, even in lower prevalence patient populations such as referrals from breast cancer screening. (orig.)

  14. Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme

    International Nuclear Information System (INIS)

    Lobbes, Marc B.I.; Wildberger, Joachim E.; Lalji, Ulrich; Houwers, Janneke; Nijssen, Estelle C.; Nelemans, Patty J.; Roozendaal, Lori van; Heuts, Esther; Smidt, Marjolein L.

    2014-01-01

    Feasibility studies have shown that contrast-enhanced spectral mammography (CESM) increases diagnostic accuracy of mammography. We studied diagnostic accuracy of CESM in patients referred from the breast cancer screening programme, who have a lower disease prevalence than previously published papers on CESM. During 6 months, all women referred to our hospital were eligible for CESM. Two radiologists blinded to the final diagnosis provided BI-RADS classifications for conventional mammography and CESM. Statistical significance of differences between mammography and CESM was calculated using McNemar's test. Receiver operating characteristic (ROC) curves were constructed for both imaging modalities. Of the 116 eligible women, 113 underwent CESM. CESM increased sensitivity to 100.0 % (+3.1 %), specificity to 87.7 % (+45.7 %), PPV to 76.2 % (+36.5 %) and NPV to 100.0 % (+2.9 %) as compared to mammography. Differences between conventional mammography and CESM were statistically significant (p < 0.0001). A similar trend was observed in the ROC curve. For conventional mammography, AUC was 0.779. With CESM, AUC increased to 0.976 (p < 0.0001). In addition, good agreement between tumour diameters measured using CESM, breast MRI and histopathology was observed. CESM increases diagnostic performance of conventional mammography, even in lower prevalence patient populations such as referrals from breast cancer screening. (orig.)

  15. Diagnostic Value of Nineteen Different Imaging Methods for Patients with Breast Cancer: a Network Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Xiao-Hong Zhang

    2018-04-01

    Full Text Available Background/Aims: We performed a network meta-analysis (NMA to investigate and compare the diagnostic value of 19 different imaging methods used for breast cancer (BC. Methods: Cochrane Library, PubMed and EMBASE were searched to collect the relevant literature from the inception of the study until November 2016. A combination of direct and indirect comparisons was performed using an NMA to evaluate the combined odd ratios (OR and draw the surface under the cumulative ranking curves (SUCRA of the diagnostic value of different imaging methods for BC. Results: A total of 39 eligible diagnostic tests regarding 19 imaging methods (mammography [MG], breast-specific gamma imaging [BSGI], color Doppler sonography [CD], contrast-enhanced magnetic resonance imaging [CE-MRI], digital breast tomosynthesis [DBT], fluorodeoxyglucose positron-emission tomography/computed tomography [FDG PET/CT], fluorodeoxyglucose positron-emission tomography [FDG-PET], full field digital mammography [FFDM], handheld breast ultrasound [HHUS], magnetic resonance imaging [MRI], automated breast volume scanner [ABUS], magnetic resonance mammography [MRM], scintimammography [SMM], single photon emission computed tomography scintimammography [SPECT SMM], ultrasound elastography [UE], ultrasonography [US], mammography + ultrasonography [MG + US], mammography + scintimammography [MG + SMM], and ultrasound elastography + ultrasonography [UE + US] were included in the study. According to this network meta-analysis, in comparison to the MG method, the CE-MRI, MRI, MRM, MG + SMM and UE + US methods exhibited relatively higher sensitivity, and the specificity of the FDG PET/CT method was higher, while the BSGI and MRI methods exhibited higher accuracy. Conclusion: The results from this NMA indicate that the diagnostic value of the BSGI, MG + SMM, MRI and CE-MRI methods for BC were relatively higher in terms of sensitivity, specificity and accuracy.

  16. A comparison of two digital mammography systems: are there any differences?

    International Nuclear Information System (INIS)

    Evans, T.; Burlton, B.; Devenish, G.; Stevens, G.; Lewis, M.; Gower Thomas, K.

    2016-01-01

    Aim: To compare the performance of two newly introduced digital mammography technologies (Sectra and Hologic) to the Welsh breast-screening service; specifically, whether there are differences in the number, type, size, and grade of tumour identified. Materials and methods: This was a retrospective study of a prospectively collected database of 50,000 consecutive screening episodes from 2012; clients were aged 49–88 years (mean 61.9 years). All studies were double-blind read by two readers. All tumours identified in the two arms of the study were detailed and compared specifically with regards to type (ductal or lobular) size, grade, and whether invasive or non-invasive. Performance was analysed for any statistically significant differences. Results: Twenty-five thousand consecutive women were screened with Hologic (recall rate 5.9% of which 18% were cancer) and 25,000 were screened with Sectra digital mammography (recall rate 4.3% and 22% were cancer). Five hundred tumours were found with no significant difference in invasive cancer detection or between ductal or lobular subtypes. The Hologic system detected 267 tumours; of which 81 (30.33%) were non-invasive (3.24 per 1000), compared to the Sectra system with 233 cancers overall including 36 non-invasive (15.45%, 1.44 per 1000). The difference in non-invasive lesions (mainly ductal carcinoma in situ [DCIS]) detection was significant (p<0.001); 38% of which were high nuclear grade (HNG) using Hologic and 50% HNG lesions using Sectra. There was no significant difference in non-invasive size between the two technologies. The mean glandular dose received using the Sectra system was significantly less (0.7 mGy) compared to the Hologic system (1.6 mGy) for a 50–60 mm breast thickness. Conclusions: Population breast screening is frequently criticised for identifying lesions irrelevant to long-term outcomes or life expectancy and although the two systems seem comparable in terms of invasive cancer detection, a

  17. Comparative study between breast tomosynthesis and classic digital mammography in the evaluation of different breast lesions

    Directory of Open Access Journals (Sweden)

    Sahar Mansour

    2014-09-01

    Conclusion: Three-dimensional tomosynthesis significantly enhanced the detection and characterization of breast lesions on digital mammography especially in the context of dense breast parenchyma (ACR 3&4.

  18. Film-Screen Mammography versus digital storage plate mammography: Hard copy and monitor display of microcalcifications and focal findings - A retrospective clinical and histologic analysis

    International Nuclear Information System (INIS)

    Schulz-Wendtland, R.; Wenkel, E.; Aichinger, U.; Tartsch, M.; Kuchar, I.; Bautz, W.

    2003-01-01

    Purpose: A retrospective clinical-histological study to determine the diagnostic accuracy of mammography using conventional screen-film cassettes (hard copy), high-resolution digital phosphor storage plates (hard copy) and monitor display (soft copy) for microcalcifications and focal lesions (BI-RADS TM category 4 or 5). Materials and methods: From April to November 2001, 76 patients underwent conventional film-screen mammography and, after diagnosis and preoperative wire localization, digital mammography with the same exposure parameters. Five investigators retrospectively determined the diagnosis after the operation from randomly distributed mediolateral views (hard-copy reading) and from the monitor display (soft-copy reading). These results were correlated with the final histology. Results: The accuracy of conventional screen-film mammography, digital mammography and monitor-displayed mammography was 67%, 65% and 68% for all findings, (n = 76), 59%, 59% and 68% for microcalcifications (n = 44) and 75%, 72% and 63% for focal lesions (n = 32). The overall results showed no difference. Conclusions: Our findings indicate equivalence of conventional screen-film mammography, high-resolution digital phosphor storage plate mammography and monitor-displayed mammography. (orig.) [de

  19. Phase-contrast enhanced mammography: A new diagnostic tool for breast imaging

    International Nuclear Information System (INIS)

    Wang Zhentian; Thuering, Thomas; David, Christian; Roessl, Ewald; Trippel, Mafalda; Kubik-Huch, Rahel A.; Singer, Gad; Hohl, Michael K.; Hauser, Nik; Stampanoni, Marco

    2012-01-01

    Phase contrast and scattering-based X-ray imaging can potentially revolutionize the radiological approach to breast imaging by providing additional and complementary information to conventional, absorption-based methods. We investigated native, non-fixed whole breast samples using a grating interferometer with an X-ray tube-based configuration. Our approach simultaneously recorded absorption, differential phase contrast and small-angle scattering signals. The results show that this novel technique - combined with a dedicated image fusion algorithm - has the potential to deliver enhanced breast imaging with complementary information for an improved diagnostic process.

  20. Phase-contrast enhanced mammography: A new diagnostic tool for breast imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wang Zhentian; Thuering, Thomas; David, Christian; Roessl, Ewald; Trippel, Mafalda; Kubik-Huch, Rahel A.; Singer, Gad; Hohl, Michael K.; Hauser, Nik; Stampanoni, Marco [Swiss Light Source, Paul Scherrer Institut, 5232 Villigen (Switzerland); Laboratory for Micro and Nanotechnology, Paul Scherrer Institut, 5232 Villigen (Switzerland); Philips Technologie GmbH, Roentgenstrasse 24, 22335 Hamburg (Germany); Institute of Pathology, Kantonsspital Baden, 5404 Baden (Switzerland); Department of Radiology, Kantonsspital Baden, 5404 Baden (Switzerland); Institute of Pathology, Kantonsspital Baden, 5404 Baden (Switzerland); Department of Gynecology and Obstetrics, Interdisciplinary Breast Center Baden, Kantonsspital Baden, 5404 Baden (Switzerland); Swiss Light Source, Paul Scherrer Institut, 5232 Villigen, Switzerland and Institute for Biomedical Engineering, University and ETH Zuerich, 8092 Zuerich (Switzerland)

    2012-07-31

    Phase contrast and scattering-based X-ray imaging can potentially revolutionize the radiological approach to breast imaging by providing additional and complementary information to conventional, absorption-based methods. We investigated native, non-fixed whole breast samples using a grating interferometer with an X-ray tube-based configuration. Our approach simultaneously recorded absorption, differential phase contrast and small-angle scattering signals. The results show that this novel technique - combined with a dedicated image fusion algorithm - has the potential to deliver enhanced breast imaging with complementary information for an improved diagnostic process.

  1. Mammography: an update of the EUSOBI recommendations on information for women.

    Science.gov (United States)

    Sardanelli, Francesco; Fallenberg, Eva M; Clauser, Paola; Trimboli, Rubina M; Camps-Herrero, Julia; Helbich, Thomas H; Forrai, Gabor

    2017-02-01

    This article summarises the information to be offered to women about mammography. After a delineation of the aim of early diagnosis of breast cancer, the difference between screening mammography and diagnostic mammography is explained. The need to bring images and reports from the previous mammogram (and from other recent breast imaging examinations) is highlighted. Mammography technique and procedure are described with particular attention to discomfort and pain experienced by a small number of women who undergo the test. Information is given on the recall during a screening programme and on the request for further work-up after a diagnostic mammography. The logic of the mammography report and of classification systems such as R1-R5 and BI-RADS is illustrated, and brief but clear information is given about the diagnostic performance of the test, with particular reference to interval cancers, i.e., those cancers that are missed at screening mammography. Moreover, the breast cancer risk due to radiation exposure from mammography is compared to the reduction in mortality obtained with the test, and the concept of overdiagnosis is presented with a reliable estimation of its extent. Information about new mammographic technologies (tomosynthesis and contrast-enhanced spectral mammography) is also given. Finally, frequently asked questions are answered. • Direct digital mammography should be preferred to film-screen or phosphor plates. • Screening (in asymptomatic women) should be distinguished from diagnosis (in symptomatic women). • A breast symptom has to be considered even after a negative mammogram. • Digital breast tomosynthesis increases cancer detection and decreases the recall rate. • Contrast-enhanced spectral mammography can help in cancer detection and lesion characterisation.

  2. Diagnostic value of palpation, mammography, and ultrasonography in the diagnosis of fibroadenoma: impact of breast density, patient age, ultrasonographic size, and palpability.

    Science.gov (United States)

    Zimmermann, N; Ohlinger, R

    2012-12-01

    This retrospective study aimed to assess the diagnostic value of mammography, breast ultrasonography, and palpation in diagnosing fibroadenomas, making consistent use of the BI-RADS classification. The impact of breast density, patient age, and the size and palpability of the mass will be evaluated. Between January 2000 and December 2009, a total of 339 fibroadenomas suitable for inclusion in this study were diagnosed and histologically verified at our institution. Based on their BI-RADS or BI-RADS analog classification, all lesions were categorized as benign or malignant. These results were compared to the corresponding histopathological findings. Specificities were calculated for each of the abovementioned parameters. Chi-square test results with p-values  1.9 cm (κ = 0.464, κ = 0.444). For diagnosing fibroadenomas, ultrasonography is more specific than mammography when all examined variables are taken into account. Ultrasonography should therefore be favored, especially in younger patients. One needs to be aware of the effects of palpability and patient age on the ultrasonographic differentiation "malignant" vs. "benign". In some cases, mammography should be considered as an adjunct. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Evaluation of the quality of the mammography study in the radio-diagnostic service of the National Cancer Institute

    International Nuclear Information System (INIS)

    Rubio Laverde, Alba Lucia; Pineros Petersen, Marion; Betancourt Gil, Claudia

    2003-01-01

    The development of mammography quality control programs at radiology services has had an important progress in the last decades, mainly in developed countries. Although breast cancer is one of the leading causes of cancer mortality and incidence in Colombia, quality control programs for mammography screening are just beginning to be considered. This article describes the results of a baseline evaluation aimed at establishing a quality control program at the Radiology Unit of the National Cancer Institute, in Colombia. The mammography equipment, the film processing, and all main physical parameters were checked and compared to international standards. Quality of the image in 301 mammographic X-ray plates was evaluated. In order to implement a good quality control program, the need for acquiring essential instruments, improving physical facilities and starting a continuous training program is imperative

  4. Digital mammography; Mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Chevalier, M.; Torres, R.

    2010-07-01

    Mammography represents one of the most demanding radiographic applications, simultaneously requiring excellent contrast sensitivity, high spatial resolution, and wide dynamic range. Film/screen is the most widely extended image receptor in mammography due to both its high spatial resolution and contrast. The film/screen limitations are related with its narrow latitude, structural noise and that is at the same time the medium for the image acquisition, storage and presentation. Several digital detector made with different technologies can overcome these difficulties. Here, these technologies as well as their main advantages and disadvantages are analyzed. Also it is discussed its impact on the mammography examinations, mainly on the breast screening programs. (Author).

  5. Magnification mammography

    International Nuclear Information System (INIS)

    Sickles, E.A.

    1987-01-01

    Lack of detail, a situation commonly encountered, renders unreliable the diagnostic criteria described above, leading to equivocal radiographic interpretations. Standard practice calls for biopsy of such equivocal lesions in order to rule out malignancy; indeed, this is necessary to detect as many small cancers as possible. An unfortunate consequence of this approach, however, is that several benign lesions have to be removed for each cancer discovered. In some circumstances, especially when malignancy is thought to be unlikely, biopsy is deferred in favor of a series of follow-up mammographic examinations. It is even more unfortunate, if this latter course of action is chosen, when the underlying lesion proves to be cancerous and appropriate treatment is thereby delayed. One potential solution to this double-edged problem of equivocal interpretations is to substantially improve the sharpness and detail of the radiographic image, thus permitting one to utilize more fully the standard mammographic interpretive criteria that otherwise might be ignored. If this approach proves successful, some equivocal interpretations will be converted into more definitive diagnoses, either benign or malignant. The technique of direct radiographic magnification has been shown to be very helpful in this regard. Not only are magnification images known to display improved sharpness and detail, but magnification techniques have already been applied successfully to mammography, angiography, and skeletal radiography, resulting in increased diagnostic accuracy for these examinations

  6. Evaluation of the influence of parameters that determine the mean glandular dose in mammography using different detectors

    International Nuclear Information System (INIS)

    Costa, K.; Nogueira, M. S.

    2015-10-01

    Full text: Mammography is a test used for early detection of breast cancer. The mean glandular dose (MGD) is dosimetric greatness accepted as indicative of carcinogenic risk induced by ionizing radiation in the breasts of women undergoing mammography exams. MGD value is estimated from the incident air kerma (k i), associated with conversion factors which depend on the half-value layer (HVL), the breast composition and thickness compressed breast. This study aims to evaluate the influence of the parameters used to determine the MGD using different measurement detectors. Measurements were performed on a Siemens Mammomat Model 300 Nova mammography equipment; this has the combinations Anode/Filter of Mo/Mo, Mo/Rh and W/Rh. Detectors used were the ionization chamber Model 10X6-6M manufactured by Radcal Co., two solid-state detectors, one Model AGMS-M manufactured by Radcal Co. and other Model Xi Mammo manufactured by UNFORS. The detectors measures were compared and the MGD value was estimated; differences between measurements and the reference values were higher in HVL and k i parameters. The results are displayed according to other published works. (Author)

  7. Digital mammography with high-resolution storage plates (CR) versus full-field digital mammography (CCD) (DR) for microcalcifications and focal lesions - a retrospective clinical histologic analysis (n = 102)

    International Nuclear Information System (INIS)

    Schulz-Wendtland, R.; Lell, M.; Wenkel, E.; Boehner, C.; Dassel, M.S.; Bautz, W.

    2005-01-01

    Purpose: to determine the diagnostic accuracy of microcalcifications and focal lesions in a retrospective clinical-histological study using high-resolution digital phosphor storage plates (hard copy) and full-field digital mammography (hard copy). Materials and methods: from May 2003 to September 2003, 102 patients underwent digital storage plate mammography (CR), using a mammography unit (Mammomat 3000 N, Siemens) in combination with a high resolution (9 lp/mm) digital storage phosphor plate system (pixel size 50 μm) (Fuji/Siemens). After diagnosis and preoperative wire localization, full-field digital mammography (CCD) (DR) was performed with the same exposure parameters. The full-field digital mammography used a CCD-detector (SenoScan) (fisher imaging) with a resolution of 10 Ip/mm and a pixel size of 50 μm. Five investigators determined the diagnosis (BI-RADS trademark I-V) retrospectively after the operation from randomly distributed mediolateral views (hard copy reading). These results were correlated with the final histology. Results: the diagnostic accuracy of digital storage plate mammography (CR) and full-field digital mammography (CCD) (DR) was 73% and 71% for all findings (n = 102), 73% and 71% for microcalcifications (n = 51), and 72% and 70% for focal lesions (n = 51). The overall results showed no difference. Conclusion: our findings indicate the equivalence of high-resolution digital phosphor storage plate mammography (CR) and full-field digital mammography (CCD) (DR). (orig.)

  8. Impact of a program of diagnostic imaging quality control in mammography centers of the Federal District, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Rosangela da Silveira; Ferreira, Rubemar de Souza [Centro Regional de Ciencias Nucleares do Centro-Oeste (CRCN/CNEN-CO), Abadia de Goias, GO (Brazil)]. E-mail: rcorrea@cnen.gov.br; Peixoto, Joao Emilio [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Silver, Lynn Dee [New York Health Department, New York, NY (United States); Dias, Cintia Melazo [Comissao Nacional de Energia Nuclear (Diplan/CNEN), Braslia, DF (Brazil). Distrito do Planalto Central; Nogueira, Maria do Socorro [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Hwang, Suy Ferreira [Centro Regional de Ciencias Nucleares do Nordeste (CRCN/CNEN-NE), Recife, PE (Brazil)

    2008-03-15

    Objective: The present study was aimed at evaluating the quality and the impact of an intervention involving inspection and education in mammography centers of the Federal District, Brazil. Materials and methods: Forty one mammography centers in the Federal District were studied in the period between 2000 and 2002. The intervention involved an initial inspection followed by a training activity and notification of mammography centers by the Federal District Sanitary Vigilance authority. The imaging quality was compared before and after the intervention. Results: None of the 36 centers which completed the study reached more than 90% compliance with the standard imaging quality prior to the interventions, whereas ten were above 90% afterwards. Major improvements were observed in chassis maintenance, breast compression and visualization of microcalcifications. Conclusion: Despite the availability of a great number of mammography centers in the Federal District, most of them did not meet the required quality standards. The intervention has shown to be effective for improving the imaging quality, however a continued action is required to solve the remaining problems and increase the impact of the program. (author)

  9. Influence of different exposure modes on image quality and radiation dose in digital mammography

    International Nuclear Information System (INIS)

    Liu Jie; Wang Xia; Li Xiaokang; Liu Peifang

    2013-01-01

    Objective: To evaluate the effect of different exposure modes on radiation dose and image quality in digital mammography, and to explore how to reduce patient's radiation injury by choosing proper exposure mode and exposure conditions without sacrifice image quality. Methods: A breast phantom was exposed by using automatic exposure mode (60 mAs, 28 k/V) and manual exposure modes (37.5 to 70 mAs range, 24 to 32 kV range) respectively. Same oppression thickness and pressure were set for all modes. The average glandular dose (AGD), entrance surface dose (ESD), and image quality score according to American College of Radiology (ACR) criteria were recorded for each image. Kruskal Wallis test was used to compare the image quality scores between automatic and manual modes. All statistic analyses were performed by using SPSS17.0. Results: Compared to automatic exposure mode (60 mAs, 28 k/V), the overall score of image quality of manual modes (45 to 70 mAs range, 26 to 32 kV range) had no significant difference. Both ESD and ACD decreased 26.1% and increased 15.4% when the tube loading was changed from 60 mAs to 45 mAs and 70 mAs respectively. The ESD and ACD decreased 22.6%, 28.2% and increased 47.0%, 62.7% when the tube voltage was changed from 28 kV to 26 kV and 32 kV respectively. Conclusion: When the image quality reaches to a certain level, it will not be raised by a higher photographic condition. Without sacrifice image quality, the tube loading and tube voltage can be manually decreased to reduce radiation dose. (authors)

  10. Comparison between mammography and ultrasonography for palpable breast mass: focusing fibroadenoma and breast cancer

    International Nuclear Information System (INIS)

    Kim, Do Kyun; Koh, Mi Kyung; Choi, Chul Soon; Chung, Soo Young; Yi, Jeong Geun; Yoon, Dae Young; Kim, Ho Chul; Bae, Sang Hoon

    1997-01-01

    The purpose of our study was to compare the diagnostic accuracy of mammography and breast ultrasonography between fibroadenoma and palpable breast cancer and to evaluate the feasibility of ultrasonography as a primary diagnostic modality to differentiate between these two tumor types. In 36 cases of fibroadenoma and 35 of breast cancer, all palpable and pathologically-proven, the diagnostic accuracy of mammography and ultrasonography was retros-pectively analysed. In fibroadenoma cases, the diagnostic accuracy of mammography and ultrasonography was 53% and 80%, respectively, and the difference was statistically significant(p=3D0.0162). In cases of breast cancer, the corresponding figures were 74% and 82%, respectively;the difference was not statistically signigicant(p-0.55). Overall, the diagnostic accuracy of mammography and ultrasonog-raphy was 63% and 82%, respectively, and this difference was statistically significant(p=3D0.0164). The total diagnostic accuracy of both studies was 90%, and this was signigicantly different(p=3D0.044) from that of ultrasonography(82%). In patients who have clinically palpable breast masses, ultrasonography can be recommended as the primary diagnostic modality, though for other breast lesions, mammography is the recommended primary modality.=20

  11. Comparison between mammography and ultrasonography for palpable breast mass: focusing fibroadenoma and breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Do Kyun; Koh, Mi Kyung; Choi, Chul Soon; Chung, Soo Young; Yi, Jeong Geun; Yoon, Dae Young; Kim, Ho Chul; Bae, Sang Hoon [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    The purpose of our study was to compare the diagnostic accuracy of mammography and breast ultrasonography between fibroadenoma and palpable breast cancer and to evaluate the feasibility of ultrasonography as a primary diagnostic modality to differentiate between these two tumor types. In 36 cases of fibroadenoma and 35 of breast cancer, all palpable and pathologically-proven, the diagnostic accuracy of mammography and ultrasonography was retros-pectively analysed. In fibroadenoma cases, the diagnostic accuracy of mammography and ultrasonography was 53% and 80%, respectively, and the difference was statistically significant(p=3D0.0162). In cases of breast cancer, the corresponding figures were 74% and 82%, respectively;the difference was not statistically signigicant(p-0.55). Overall, the diagnostic accuracy of mammography and ultrasonog-raphy was 63% and 82%, respectively, and this difference was statistically significant(p=3D0.0164). The total diagnostic accuracy of both studies was 90%, and this was signigicantly different(p=3D0.044) from that of ultrasonography(82%). In patients who have clinically palpable breast masses, ultrasonography can be recommended as the primary diagnostic modality, though for other breast lesions, mammography is the recommended primary modality.=20.

  12. Assessment of Mean Glandular Dose in Mammography System with Different Anode-Filter Combinations Using MCNP Code.

    Science.gov (United States)

    Gholamkar, Lida; Mowlavi, Ali Asghar; Sadeghi, Mahdi; Athari, Mitra

    2016-10-01

    X-ray mammography is one of the general methods for early detection of breast cancer. Since glandular tissue in the breast is sensitive to radiation and it increases the risk of cancer, the given dose to the patient is very important in mammography. The aim of this study was to determine the average absorbed dose of X-ray radiation in the glandular tissue of the breast during mammography examinations as well as investigating factors that influence the mean glandular dose (MGD). One of the precise methods for determination of MGD absorbed by the breast is Monte Carlo simulation method which is widely used to assess the dose. We studied some different X-ray sources and exposure factors that affect the MGD. "Midi-future" digital mammography system with amorphous-selenium detector was simulated using the Monte Carlo N-particle extended (MCNPX) code. Different anode/filter combinations such as tungsten/silver (W/Ag), tungsten/rhodium (W/Rh), and rhodium/aluminium (Rh/Al) were simulated in this study. The voltage of X-ray tube ranged from 24 kV to 32 kV with 2 kV intervals and the breast phantom thickness ranged from 3 to 8 cm, and glandular fraction g varied from 10% to 100%. MGD was measured for different anode/filter combinations and the effects of changing tube voltage, phantom thickness, combination and glandular breast tissue on MGD were studied. As glandular g and X-ray tube voltage increased, the breast dose increased too, and the increase of breast phantom thickness led to the decrease of MGD. The obtained results for MGD were consistent with the result of Boone et al. that was previously reported. By comparing the results, we saw that W/Rh anode/filter combination is the best choice in breast mammography imaging because of the lowest delivered dose in comparison with W/Ag and Rh/Al. Moreover, breast thickness and g value have significant effects on MGD.

  13. Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

    Directory of Open Access Journals (Sweden)

    Dobrosavljević Aleksandar

    2016-01-01

    Full Text Available Background/Aim. Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant. The aim of this study was to assess the role of sonography in the diagnosis of palpable breast masses according to the American College of Radiology Ultrasonographic Breast Imaging Reporting and Data System (BI-RADS and to correlate the BI-RADS 4 and BI-RADS 5 category with pathohistological findings. Methods. A retrospective study was conducted with the breast sonograms of 30 women presented with palpable breast masses found to be mammography category BI-RADS 0 and ultrasonographic BI-RADS categories 4 and 5. The sonographic categories were correlated with pathohistological findings. Results. Surgical biopsy in 30 masses revealed: malignancy (56.7%, fibroadenoma (26.7%, fibrocystic dysplasia with/without atypia (10%, lipoma (3.3% and intramammary lymph node (3.3%. Correlation between BI-RADS categories and pathohistological findings was found (p < 0.05. All BI-RADS 5 masses were malignant, while in BI-RADS 4A category fibroadenomas dominated. A total of 53.8% of all benign lesions were found in women 49 years of age or younger as compared with 35.3% of all malignancies in this group (p < 0.05. Conclusion. Ultrasonography BI-RADS improved classification of breast masses. The ultrasound BI-RADS 4 (A, B, C and BI-RADS 5 lesions should be worked-up with biopsy.

  14. Descriptive study of the quality control in mammography; Estudio descriptivo del control de calidad en mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Gaona, E.; Perdigon C, G.M.; Casian C, G.A.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M. [UAM, Xochimilco 14000 Mexico D.F. (Mexico)

    2005-07-01

    The goal of mammography is to provide contrast between a lesion that is possible residing within the breast and normal surrounding tissue. Quality control is essential for maintaining the contrast imaging performance of a mammography system and incorporate tests that are relevant in that they are predictive of future degradation of contrast imaging performance. These tests will also be done at frequency that is high enough to intercept most drifts in quality imaging or performance before they become diagnostically significant. The quality control study has as objective to describe the results of the assessment of quality imaging elements (film optical density, contrast (density difference), uniformity, resolution and noise) of 62 mammography departments without quality control program and comparison these results with a mammography reference department with a quality control program. When comparing the results they allow seeing the clinical utility of to have a quality control program to reduce the errors of mammography interpretation. (Author)

  15. Image quality in mammography

    International Nuclear Information System (INIS)

    Haus, A.G.; Doi, K.; Metz, C.E.; Bernstein, J.

    1976-01-01

    In mammography, image quality is a function of the shape, size, and x-ray absorption properties of the anatomic part to be radiographed and of the lesion to be detected; it also depends on geometric unsharpness, and the resolution, characteristic curve and noise properties of the recording system. X-ray energy spectra, modulation transfer functions, Wiener spectra, characteristic and gradient curves, and radiographs of a breast phantom and of a resected breast specimen containing microcalcifications are used in a review of some current considerations of the factors, and the complex relationship among factors, that affect image quality in mammography. Image quality and patient radiation exposure in mammography are interrelated. An approach to the problem of evaluating the trade-off between diagnostic certainty and the cost or risk of performing a breast imaging procedure is discussed

  16. Preclinical study of diagnostic performances of contrast-enhanced spectral mammography versus MRI for breast diseases in China.

    Science.gov (United States)

    Wang, Qingguo; Li, Kangan; Wang, Lihui; Zhang, Jianbing; Zhou, Zhiguo; Feng, Yan

    2016-01-01

    To evaluate diagnostic performances of CESM for breast diseases with comparison to breast MRI in China. Sixty-eight patients with 77 breast lesions underwent MR and CESM. Two radiologists interpreted either MRI or CESM images, separately and independently. BI-RADS 1-3 and BI-RADS 4-5 were classified into the suspicious benign and suspicious malignant groups. Diagnostic accuracy parameters were calculated. Receiver operating characteristic (ROC) curves were constructed for the two modalities. The agreement and correlation between maximum lesion diameter based on CESM and MRI, or CESM and pathology were analyzed. Diagnostic accuracy parameters for CESM were sensitivity 95.8 %, specificity 65.5 %, PPV 82.1 %, NPV 90.5 % and accuracy 84.4 %. The diagnostic accuracy parameters for breast MRI were sensitivity 93.8 %, specificity 82.8 %, PPV 88.2 %, NPV 92.3 %and accuracy 89.6 %. Area under the curve (AUC) of ROC was 0.96 for breast MRI and 0.88 for CESM. The Bland-Altman plots showed a mean difference of 0.7 mm with 95 % limits of agreement of 11.4 mm in tumor diameter measured using CESM and breast MRI. The differences of size measurement between CESM and breast MRI were significant, whereas no difference was observed between CESM and pathology as well as between breast MRI and pathology. The better correlation with pathological results was found in CESM than breast MRI. Our study demonstrates that CESM possesses better diagnostic performances than breast MRI in terms of diagnostic sensitivity and lesion size assessment. And CESM is a good alternative method of screening breast cancer in high-risk people.

  17. Estimation of percentage breast tissue density: comparison between digital mammography (2D full field digital mammography) and digital breast tomosynthesis according to different BI-RADS categories.

    Science.gov (United States)

    Tagliafico, A S; Tagliafico, G; Cavagnetto, F; Calabrese, M; Houssami, N

    2013-11-01

    To compare breast density estimated from two-dimensional full-field digital mammography (2D FFDM) and from digital breast tomosynthesis (DBT) according to different Breast Imaging-Reporting and Data System (BI-RADS) categories, using automated software. Institutional review board approval and written informed patient consent were obtained. DBT and 2D FFDM were performed in the same patients to allow within-patient comparison. A total of 160 consecutive patients (mean age: 50±14 years; mean body mass index: 22±3) were included to create paired data sets of 40 patients for each BI-RADS category. Automatic software (MedDensity(©), developed by Giulio Tagliafico) was used to compare the percentage breast density between DBT and 2D FFDM. The estimated breast percentage density obtained using DBT and 2D FFDM was examined for correlation with the radiologists' visual BI-RADS density classification. The 2D FFDM differed from DBT by 16.0% in BI-RADS Category 1, by 11.9% in Category 2, by 3.5% in Category 3 and by 18.1% in Category 4. These differences were highly significant (pBI-RADS categories and the density evaluated using 2D FFDM and DBT (r=0.56, pBI-RADS categories. These data are relevant for clinical practice and research studies using density in determining the risk. On DBT, breast density values were lower than with 2D FFDM, with a non-linear relationship across the classical BI-RADS categories.

  18. Mammography and radiation risk; Mammographie und Strahlenrisiko

    Energy Technology Data Exchange (ETDEWEB)

    Jung, H. [Hamburg Univ. (Germany). Inst. fuer Biophysik und Strahlenbiologie

    1998-10-01

    Breast cancer is the most frequent malignant neoplasia among women in Germany. The use of mammography as the most relevant diagnostic procedure has increased rapidly over the last decade. Radiation risks associated with mammography may be estimated from the results of numerous epidemiological studies providing risk coefficients for breast cancer in relation to age at exposure. Various calculations can be performed using the risk coefficients. For instance, a single mammography examination (bilateral, two views of each breast) of a women aged 45 may enhance the risk of developing breast cancer during her lifetime numerically from about 12% of 12.0036%. This increase in risk is lower by a factor of 3,300 as compared to the risk of developing breast cancer in the absence of radiation exposure. At the age of 40 or more, the benefit of mammography exceeds the radiation risk by a factor of about 100. At higher ages this factor increases further. Finally, the dualism of individual risk and collective risk is considered. It is shown that the individual risk of a patient, even after multiple mammography examinations, is vanishingly small. Nevertheless, the basic principle of minimising radiation exposure must be followed to keep the collective risk in the total population as low as reasonably achievable. (orig.) [Deutsch] Das Mammakarzinom ist in Deutschland die haeufigste Krebserkrankung der Frau, und entsprechend oft wird die Mammographie als das derzeit wichtigste Diagnoseverfahren eingesetzt. Zur Beurteilung des mit einer mammographischen Untersuchung verbundenen Strahlenrisikos liegen die Resultate einer groesseren Anzahl strahlenepidemiologischer Studien vor. Diese liefern den Risikokoeffizienten fuer Brustkrebs in Abhaengigkeit vom Lebensalter bei Strahlenexposition und ermoeglichen somit die Berechnung des altersabhaengigen Strahlenrisikos. Beispielsweise wird durch eine einmalige Mammographie-Untersuchung (bilateral, je zwei Aufnahmen in zwei Ebenen) bei einer 45

  19. Determining the spatial heterogeneity underlying racial and ethnic differences in timely mammography screening

    Directory of Open Access Journals (Sweden)

    Joseph Gibbons

    2016-11-01

    Full Text Available Abstract Background The leading cause of cancer death for women worldwide continues to be breast cancer. Early detection through timely mammography has been recognized to increase the probability of survival. While mammography rates have risen for many women in recent years, disparities in screening along racial/ethnic lines persist across nations. In this paper, we argue that the role of local context, as identified through spatial heterogeneity, is an unexplored dynamic which explains some of the gaps in mammography utilization by race/ethnicity. Methods We apply geographically weighted regression methods to responses from the 2008 Public Health Corporations’ Southeastern Household Health Survey, to examine the spatial heterogeneity in mammograms in the Philadelphia metropolitan area. Results We find first aspatially that minority identity, in fact, increases the odds of a timely mammogram: 74% for non-Hispanic Blacks and 80% for Hispanic/Latinas. However, the geographically weighted regression confirms the relation of race/ethnicity to mammograms varies by space. Notably, the coefficients for Hispanic/Latinas are only significant in portions of the region. In other words, the increased odds of a timely mammography we found are not constant spatially. Other key variables that are known to influence timely screening, such as the source of healthcare and social capital, measured as community connection, also vary by space. Conclusions These results have ramifications globally, demonstrating that the influence of individual characteristics which motivate, or inhibit, cancer screening may not be constant across space. This inconsistency calls for healthcare practitioners and outreach services to be mindful of the local context in their planning and resource allocation efforts.

  20. Ultrasonic mammography

    International Nuclear Information System (INIS)

    Hueneke, B.

    1982-01-01

    608 women are examined by means of ultrasonic mammography during the period of 1 year. 432 patients were examined with the compound method with the U.I. Octoson, a water tank scanner, and 176 patients with the real time method with a directly connected linear-array-scanner. The following results were obtained at the end of the examination period: In the ultrasonic and also in the X-ray mammogram tumour diameters can be determined with an error rate of +- 30%. In the diagnosing of carcinomas, a significant dependence of the exactness on the sice of the tumour is found for the combination of the five methods tested (clinical examination, X-ray mammography, ultrasonic mammography, thermography, cytology). Classifying the individual methods with regard to their exactness, X-ray mammography ranks in front of ultrasonic mammography. Mastopathic changes in the breast can be screened by means of ultrasonic mammography. The structure of the changes can be determined more exactly than with an X-ray picture which is due to the possibility of differentiating solid and cystic structures. In diagnosing fibro-adenomas and establishing diagnoses on young women with dense gland bodies, ultrasonic mammography is superior to radiology both in the ability of screening a finding of a fibro-adenoma (US=88%, X-ray=75%) and in the possibility of classifying it as ''more benign than malignant''. (orig./MG) [de

  1. Digital mammography and their developments

    International Nuclear Information System (INIS)

    Wienbeck, Susanne

    2015-01-01

    At the present time digital mammography is a satisfactory breast diagnostic imaging in clinical as well as screening mammography in defined age groups. Nevertheless it shows beside the application of ionizing radiation in women with dense breasts limitations in the detection of non calcification breast cancers. Tomosynthesis, digital contrast-enhanced mammography and breast-CT with or without contrast media lead to better results. Especially the application of contrast media for the visualisation of the tumor angiogenesis is invariably superior to all other non-contrast imaging modalities. However, the excellent results of breast MRI will be probably accessible with none of the new procedures.

  2. Quality Imaging - Comparison of CR Mammography with Screen-Film Mammography

    International Nuclear Information System (INIS)

    Gaona, E.; Azorin Nieto, J.; Iran Diaz Gongora, J. A.; Arreola, M.; Casian Castellanos, G.; Perdigon Castaneda, G. M.; Franco Enriquez, J. G.

    2006-01-01

    The aim of this work is a quality imaging comparison of CR mammography images printed to film by a laser printer with screen-film mammography. A Giotto and Elscintec dedicated mammography units with fully automatic exposure and a nominal large focal spot size of 0.3 mm were used for the image acquisition of phantoms in screen-film mammography. Four CR mammography units from two different manufacturers and three dedicated x-ray mammography units with fully automatic exposure and a nominal large focal spot size of 0.3 mm were used for the image acquisition of phantoms in CR mammography. The tests quality image included an assessment of system resolution, scoring phantom images, Artifacts, mean optical density and density difference (contrast). In this study, screen-film mammography with a quality control program offers a significantly greater level of quality image relative to CR mammography images printed on film

  3. Mammography Facilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mammography Facility Database is updated periodically based on information received from the four FDA-approved accreditation bodies: the American College of...

  4. Digital mammography: what do we and what don't we know?

    International Nuclear Information System (INIS)

    Bick, Ulrich; Diekmann, Felix

    2007-01-01

    High-quality full-field digital mammography has been available now for several years and is increasingly used for both diagnostic and screening mammography. A number of different detector technologies exist, which all have their specific advantages and disadvantages. Diagnostic accuracy of digital mammography has been shown to be at least equivalent to film-screen mammography in a general screening population. Digital mammography is superior to screen-film mammography in younger women with dense breasts due to its ability to selectively optimize contrast in areas of dense parenchyma. This advantage is especially important in women with a genetic predisposition for breast cancer, where intensified early detection programs may have to start from 25 to 30 years of age. Tailored image processing and computer-aided diagnosis hold the potential to further improve the early detection of breast cancer. However, at present no consensus exists among radiologists on which processing is optimal for digital mammograms. Image processing may also vary significantly among vendors with so far limited interoperability. This review aims to summarize the available information regarding the impact of digital mammography on workflow and breast cancer diagnosis. (orig.)

  5. Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer.

    Science.gov (United States)

    Candelaria, Rosalind P; Huang, Monica L; Adrada, Beatriz E; Bassett, Roland; Hunt, Kelly K; Kuerer, Henry M; Smith, Benjamin D; Chavez-MacGregor, Mariana; Yang, Wei Tse

    2017-02-01

    This study aims to determine if locoregional restaging with diagnostic mammography and ultrasound (US) of the whole breast and regional nodes performed for quality assurance in women with newly diagnosed breast cancer who were referred to a tertiary care center yields incremental cancer detection. An institutional review board-approved retrospective, single-institution database review was performed on the first 1000 women referred to our center in 2010 with a provisional breast cancer diagnosis. Locoregional restaging consisted of diagnostic full-field digital mammography combined with US of the whole breast and regional nodal basins. Bilateral whole-breast US was performed in women with contralateral mammographic abnormality or had heterogeneously or extremely dense parenchyma. Demographic, clinical, and pathologic factors were analyzed. Final analyses included 401 women. Of the 401 women, 138 (34%) did not have their outside images available for review upon referral. The median age was 54 years (range 21-92); the median tumor size was 2.9 cm (range 0.6-18.0) for women whose disease was upstaged and 2.2 cm (range 0.4-15.0) for women whose disease was not upstaged. Incremental cancer detection rates were 15.5% (62 of 401) in the ipsilateral breast and 3.9% (6 of 154) in the contralateral breast (P breast and regional nodal US that is performed for standardization of the imaging workup for newly diagnosed breast cancer patients can reduce underestimation of disease burden and impact therapeutic planning. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  6. The accuracy of digital breast tomosynthesis compared with coned compression magnification mammography in the assessment of abnormalities found on mammography

    International Nuclear Information System (INIS)

    Morel, J.C.; Iqbal, A.; Wasan, R.K.; Peacock, C.; Evans, D.R.; Rahim, R.; Goligher, J.; Michell, M.J.

    2014-01-01

    Aim: To compare the diagnostic accuracy of the digital breast tomosynthesis (DBT) with coned compression magnification mammography (CCMM). Materials and methods: The study design included two reading sessions completed by seven experienced radiologists. In the first session, all readers read bilateral standard two-view mammograms and a CCMM view of the lesion before giving a combined score for assessment. In the second session, readers read bilateral standard two-view mammograms plus one-view DBT. The two reading sessions of the experiment were separated by at least 2 weeks to reduce the chance of reader memory of the images read in the previous session from influencing the performance in the subsequent session. Results: Three hundred and fifty-four lesions were assessed and receiver-operative characteristic (ROC) analysis was used to evaluate the difference between the two modes. For standard two-view mammography plus CCMM, the area under the curve (AUC) was 0.87 [95% confidence interval (CI): 0.83–0.91] and for standard two-view mammography plus DBT the AUC was 0.93 (95% CI: 0.91–0.95). The difference between the AUCs was 0.06 with p-value of 0.0014. Conclusion: Two-view mammography with one-view DBT showed significantly improved accuracy compared to two-view mammography and CCMM in the assessment of mammographic abnormalities. These results show that DBT can be used effectively in the further evaluation of mammographic abnormalities found at screening and in symptomatic diagnostic practice. - Highlights: • Diagnostic accuracy of magnification mammography and digital breast tomosynthesis. • There is statistical difference between CCMM and DBT. • DBT has a role in evaluating mammographic abnormalities

  7. Digital breast tomosynthesis versus digital mammography: a clinical performance study

    International Nuclear Information System (INIS)

    Gennaro, Gisella; Baldan, Enrica; Bezzon, Elisabetta; Polico, Ilaria; Proietti, Alessandro; Toffoli, Aida; Toledano, Alicia; Di Maggio, Cosimo; La Grassa, Manuela; Pescarini, Luigi; Muzzio, Pier Carlo

    2010-01-01

    To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population. The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores. Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was -4.9%. Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views. (orig.)

  8. Screening mammography. A risk versus risk decision

    International Nuclear Information System (INIS)

    Ritenour, E.R.; Hendee, W.R.

    1989-01-01

    The potential risk of a radiologic procedure often is compared with the potential benefit of the procedure. While risk vs. benefit analysis has been useful as a step toward increased communication and understanding among radiologists, referring physicians, and the general public, it has the disadvantage that risk and benefit are fundamentally different quantities. Hence, their juxtaposition for purposes of comparison presents contextual difficulties. In this article, the concept is presented of comparing the risk of doing a procedure with the risk of choosing not to do the procedure. An example of risk vs. risk analysis of screening mammography for women over the age of 50 is given, with the conclusion that the risk of having yearly mammograms is less than 1/10 the risk of early death caused by failure to diagnose breast cancer by x-ray mammography. This approach to risk analysis would yield interesting data for examinations that are part of more complicated diagnostic pathways.19 references

  9. Application of phase contrast imaging to mammography

    International Nuclear Information System (INIS)

    Tohyama, Keiko; Yamada, Katsuhiko; Katafuchi, Tetsuro; Matsuo, Satoru; Morishita, Junji

    2005-01-01

    Phase contrast images were obtained experimentally by using a customized mammography unit with a nominal focal spot size of 100 μm and variable source-to-image distances of up to 1.5 m. The purpose of this study was to examine the applicability and potential usefulness of phase contrast imaging for mammography. A mammography phantom (ACR156 RMI phantom) was imaged, and its visibility was examined. The optical density of the phantom images was adjusted to approximately 1.3 for both the contact and phase contrast images. Forty-one observers (18 medical doctors and 23 radiological technologists) participated in visual evaluation of the images. Results showed that, in comparison with the images of contact mammography, the phantom images of phase contrast imaging demonstrated statistically significantly superior visibility for fibers, clustered micro-calcifications, and masses. Therefore, phase contrast imaging obtained by using the customized mammography unit would be useful for improving diagnostic accuracy in mammography. (author)

  10. Analysis of participant factors that affect the diagnostic performance of screening mammography: A report of the alliance for breast cancer screening in Korea

    International Nuclear Information System (INIS)

    Kim, Young Joong; Lee, Eu Hye

    2017-01-01

    To analyze participant factors that affect the diagnostic performance of screening mammography. We enrolled 128756 cases from 10 hospitals between 2005 and 2010. We analyzed recall rate, cancer detection rate (CDR) per 1000 examinations, positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and interval cancer rate (ICR) per 1000 negative examinations according to participant factors including age, breast density, and number of visit to the same institution, and adjusted for confounding variables. Increasing age improved recall rates (27.4% in 40's, 17.5% in 50's, 11.1% in 60's, and 8.6% in 70's), CDR (2.7, 3.2, 2.0, and 2.4), PPV (1.0, 1.8, 1.8, and 2.8%), sensitivity (81.3, 88.8, 90.3, and 94.7%), specificity (72.7, 82.7, 89.0, and 91.7%), and FPR (27.3, 17.3, 11.0, and 8.4%) (p < 0.05). Higher breast density impaired recall rates (4.0% in P1, 9.0% in P2, 28.9% in P3, and 27.8% in P4), PPV (3.3, 2.3, 1.2, and 1.3%), specificity (96.1, 91.2, 71.4, and 72.5%), and FPR (3.9, 8.9, 28.6, and 27.6%) (p < 0.001). It also increased CDR (1.3, 2.1, 3.3, and 3.6) and ICR (0.2, 0.3, 0.6, and 1.6) (p < 0.05). Successive visits to the same institution improved recall rates (20.9% for one visit, 10.7% for two visits, 7.7% for more than three visits), PPV (1.6, 2.8, and 2.7%), specificity (79.4, 89.6, and 92.5%), and FPR (20.6, 10.4, and 7.5%) (p < 0.001). Young age and dense breasts negatively affected diagnostic performance in mammography screening, whereas successive visits to the same institution had a positive effect. Examinee education for successive visits to the same institution would improve the diagnostic performance

  11. Analysis of participant factors that affect the diagnostic performance of screening mammography: A report of the alliance for breast cancer screening in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Joong [Dept. of Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of); Lee, Eu Hye [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); and others

    2017-08-01

    To analyze participant factors that affect the diagnostic performance of screening mammography. We enrolled 128756 cases from 10 hospitals between 2005 and 2010. We analyzed recall rate, cancer detection rate (CDR) per 1000 examinations, positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and interval cancer rate (ICR) per 1000 negative examinations according to participant factors including age, breast density, and number of visit to the same institution, and adjusted for confounding variables. Increasing age improved recall rates (27.4% in 40's, 17.5% in 50's, 11.1% in 60's, and 8.6% in 70's), CDR (2.7, 3.2, 2.0, and 2.4), PPV (1.0, 1.8, 1.8, and 2.8%), sensitivity (81.3, 88.8, 90.3, and 94.7%), specificity (72.7, 82.7, 89.0, and 91.7%), and FPR (27.3, 17.3, 11.0, and 8.4%) (p < 0.05). Higher breast density impaired recall rates (4.0% in P1, 9.0% in P2, 28.9% in P3, and 27.8% in P4), PPV (3.3, 2.3, 1.2, and 1.3%), specificity (96.1, 91.2, 71.4, and 72.5%), and FPR (3.9, 8.9, 28.6, and 27.6%) (p < 0.001). It also increased CDR (1.3, 2.1, 3.3, and 3.6) and ICR (0.2, 0.3, 0.6, and 1.6) (p < 0.05). Successive visits to the same institution improved recall rates (20.9% for one visit, 10.7% for two visits, 7.7% for more than three visits), PPV (1.6, 2.8, and 2.7%), specificity (79.4, 89.6, and 92.5%), and FPR (20.6, 10.4, and 7.5%) (p < 0.001). Young age and dense breasts negatively affected diagnostic performance in mammography screening, whereas successive visits to the same institution had a positive effect. Examinee education for successive visits to the same institution would improve the diagnostic performance.

  12. Diagnostic accuracy of sonoelastography in different diseases

    Directory of Open Access Journals (Sweden)

    Iqra Manzoor

    2018-03-01

    Full Text Available The objective of this study was to evaluate the diagnostic accuracy of sonoelastography in patients of primary and secondary health care settings. Google scholar, PubMed, Medline, Medscape, Wikipedia and NCBI were searched in October 2017 for all original studies and review articles to identify the relevant material. Two reviewers independently selected articles for evaluation of the diagnostic accuracy of sonoelastography in different diseases based on titles and abstracts retrieved by the literature search. The accuracy of sonoelastography in different diseases was used as the index text, while B-mode sonography, micro pure imaging, surgery and histological findings were used as reference texts. Superficial lymph nodes, neck nodules, malignancy in thyroid nodules, benign and malignant cervical lymph nodes, thyroid nodules, prostate carcinoma, benign and malignant breast abnormalities, liver diseases, parotid and salivary gland masses, pancreatic masses, musculoskeletal diseases and renal disorders were target conditions. The data extracted by the two reviewers concerning selected study characteristics and results were presented in tables and figures. In total, 46 studies were found for breast masses, lymph nodes, prostate carcinoma, liver diseases, salivary and parotid gland diseases, pancreatic masses, musculoskeletal diseases and renal diseases, and the overall sensitivity of sonoelastography in diagnosing all these diseases was 83.14% while specificity was 81.41%. This literature review demonstrates that sonoelastography is characterized by high sensitivity and specificity in diagnosing different disorders of the body.

  13. Hardware for mammography

    International Nuclear Information System (INIS)

    Rozhkova, N.I.; Chikirdin, Eh.G.; Ryudiger, Yu.G.; Kochetova, G.P.; Lisachenko, I.V.; Yakobs, O.Eh.

    2000-01-01

    The comparative studies on various visualization means, in particular, the intensifying screens and films with application of quantitative methods for determining small details on photographs, including measurements of corresponding exposures, absorbed doses and verification of conclusions through the analysis of clinical observations are carried out. It is shown, that technical equipment of the modern mammography room should include the X-ray mammographic apparatus, providing for the image high-quality by low dose loads with special film holders, meeting the mammography requirements, the corresponding X-ray film and the automatic photolaboratory process, provided by one and the same company. The quality of photographs under such conditions is guarantied, the defects and errors by the image interpretation are excluded. The modern computerized information technologies for work with medical images on the basic of creating new generations of diagnostic instrumentation with digital video channels and computerized working places dispose of many medical, technological, organizational and financial problems [ru

  14. Estimation of mean glandular dose for patients who undergo mammography and studying the factors affecting it

    Science.gov (United States)

    Barzanje, Sana L. N. H.; Harki, Edrees M. Tahir Nury

    2017-09-01

    The objective of this study was to determine mean glandular dose (MGD) during diagnostic mammography. This study was done in two hospitals in Hawler city in Kurdistan -region /Iraq, the exposure parameters kVp and mAs was recorded for 40 patients under go mammography. The MGD estimated by multiplied ESD with normalized glandular dose (Dn). The ESD measured indirectly by measuring output radiation mGy/mAs by using PalmRAD 907 as a suitable detector (Gigger detector).the results; shown that the mean and its standard deviation of MGD for Screen Film Mammography and Digital Mammography are (0.95±0.18)mGy and (0.99±0.26)mGy, respectively. And there is a significant difference between MGD for Screen Film Mammography and Digital Mammography views (p≤0. 05). Also the mean value and its standard deviation of MGD for screen film mammography is (0.96±0.21) for CC projection and (1.03±0.3) mGy for MLO projection, but mean value and its standard deviation evaluated of MGD for digital mammography is (0.92±0.17) mGy for CC projection and (0.98±0.2) mGy for MLO projection. As well as, the effect of kVp and mAs in MGD were studied, shows that in general as kVp and mAs increased the MGD increased accordingly in both of mammography systems.

  15. Diagnostic criteria for CRPS I: differences between patient profiles using three different diagnostic sets.

    Science.gov (United States)

    Perez, Roberto S G M; Collins, Susan; Marinus, Johan; Zuurmond, Wouter W A; de Lange, Jaap J

    2007-11-01

    Complex Regional Pain Syndrome type I (CRPS I) is an illness which usually occurs due to major or minor tissue injury to the extremities. Because a unique pathophysiological mechanism for CRPS I has not yet been established, the diagnosis is based on observation and measurement of clinical symptoms and signs. In this study, a comparison was made between three sets of diagnostic criteria (the IASP, Bruehl et al. and Veldman et al.) based on patient reports and physicians' assessments of signs and symptoms associated with CRPS I, in 372 outpatients suspected of having CRPS I. Agreement between CRPS I diagnosis among the three sets was poor (kappa-range: 0.29-0.42), leading to positive CRPS I diagnoses according to Veldman et al.'s criteria in 218 cases (59%), according to the IASP in 268 cases (72%), and according to Bruehl et al. in 129 cases (35%). Significant differences in patient profiles were found between the diagnostic sets for the number of patients reporting continuing disproportionate pain, larger area affected than the initial trauma (both pCRPS I were found for reported hyperesthesia (SE+SP:165%), allodynia (160%), observed color asymmetry (162%), hyperesthesia (157%), temperature asymmetry (154%) and edema (152%). The lack of agreement between the different diagnostic sets for CRPS I and the different clinical profiles that result from it may lead to different therapeutic and study populations, hampering adequate treatment and scientific development for this illness. We propose explicit reference to diagnostic criteria used in studies, and registration in trials of a broad variety of CRPS I features, as used in this study, to make subgroup phenotyping and post hoc analyses based on different diagnostic criteria possible.

  16. Mammography accreditation program

    Energy Technology Data Exchange (ETDEWEB)

    Wilcox, P.

    1993-12-31

    In the mid-1980`s, the movement toward the use of dedicated mammography equipment provided significant improvement in breast cancer detection. However, several studies demonstrated that this change was not sufficient to ensure optimal image quality at a low radiation dose. In particular, the 1985 Nationwide Evaluation of X-ray Trends identified the wide variations in image quality and radiation dose, even from dedicated units. During this time period, the American Cancer Society (ACS) launched its Breast Cancer Awareness Screening Campaign. However, there were concerns about the ability of radiology to respond to the increased demand for optimal screening examinations that would result from the ACS program. To respond to these concerns, the ACS and the American College of Radiology (ACR) established a joint committee on mammography screening in 1986. After much discussion, it was decided to use the ACR Diagnostic Practice Accreditation Program as a model for the development of a mammography accreditation program. However, some constraints were required in order to make the program meet the needs of the ACS. This voluntary, peer review program had to be timely and cost effective. It was determined that the best way to address these needs would be to conduct the program by mail. Finally, by placing emphasis on the educational nature of the program, it would provide an even greater opportunity for improving mammographic quality. The result of this effort was that, almost six years ago, in May 1987, the pilot study for the ACR Mammography Accreditation Program (MAP) began, and in August of that year, the first applications were received. In November 1987, the first 3-year accreditation certificates were awarded.

  17. Mammography accreditation program

    International Nuclear Information System (INIS)

    Wilcox, P.

    1993-01-01

    In the mid-1980's, the movement toward the use of dedicated mammography equipment provided significant improvement in breast cancer detection. However, several studies demonstrated that this change was not sufficient to ensure optimal image quality at a low radiation dose. In particular, the 1985 Nationwide Evaluation of X-ray Trends identified the wide variations in image quality and radiation dose, even from dedicated units. During this time period, the American Cancer Society (ACS) launched its Breast Cancer Awareness Screening Campaign. However, there were concerns about the ability of radiology to respond to the increased demand for optimal screening examinations that would result from the ACS program. To respond to these concerns, the ACS and the American College of Radiology (ACR) established a joint committee on mammography screening in 1986. After much discussion, it was decided to use the ACR Diagnostic Practice Accreditation Program as a model for the development of a mammography accreditation program. However, some constraints were required in order to make the program meet the needs of the ACS. This voluntary, peer review program had to be timely and cost effective. It was determined that the best way to address these needs would be to conduct the program by mail. Finally, by placing emphasis on the educational nature of the program, it would provide an even greater opportunity for improving mammographic quality. The result of this effort was that, almost six years ago, in May 1987, the pilot study for the ACR Mammography Accreditation Program (MAP) began, and in August of that year, the first applications were received. In November 1987, the first 3-year accreditation certificates were awarded

  18. Mammography-oncogenecity at low doses

    International Nuclear Information System (INIS)

    Heyes, G J; Mill, A J; Charles, M W

    2009-01-01

    Controversy exists regarding the biological effectiveness of low energy x-rays used for mammography breast screening. Recent radiobiology studies have provided compelling evidence that these low energy x-rays may be 4.42 ± 2.02 times more effective in causing mutational damage than higher energy x-rays. These data include a study involving in vitro irradiation of a human cell line using a mammography x-ray source and a high energy source which matches the spectrum of radiation observed in survivors from the Hiroshima atomic bomb. Current radiation risk estimates rely heavily on data from the atomic bomb survivors, and a direct comparison between the diagnostic energies used in the UK breast screening programme and those used for risk estimates can now be made. Evidence highlighting the increase in relative biological effectiveness (RBE) of mammography x-rays to a range of x-ray energies implies that the risks of radiation-induced breast cancers for mammography x-rays are potentially underestimated by a factor of four. A pooled analysis of three measurements gives a maximal RBE (for malignant transformation of human cells in vitro) of 4.02 ± 0.72 for 29 kVp (peak accelerating voltage) x-rays compared to high energy electrons and higher energy x-rays. For the majority of women in the UK NHS breast screening programme, it is shown that the benefit safely exceeds the risk of possible cancer induction even when this higher biological effectiveness factor is applied. The risk/benefit analysis, however, implies the need for caution for women screened under the age of 50, and particularly for those with a family history (and therefore a likely genetic susceptibility) of breast cancer. In vitro radiobiological data are generally acquired at high doses, and there are different extrapolation mechanisms to the low doses seen clinically. Recent low dose in vitro data have indicated a potential suppressive effect at very low dose rates and doses. Whilst mammography is a low

  19. MR mammography (MRM)

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, W.A.

    1993-01-01

    The book deals with MRI for the diagnostic evaluation of malignant breast lesions. A survey of methods available for breast examination, magnetic resonance mammography (MRM) is briefly explained in terms of development and technical problems encountered in the various examinations. The clinical aspects from a central part of the book, giving information relating to the various neoplasms and a comprehensive review of cases. The book concludes with a chapter discussing the interpretation of data and images, presenting examples of normal findings and of manifestations of carcinoma, fibroadenoma, cysts, mastopathies, scars due to plastic surgery, and the lactating breast. (UWA). 648 figs., 25 tabs.

  20. Mammography screening in Denmark

    DEFF Research Database (Denmark)

    Vejborg, Ilse; Mikkelsen, Ellen Margrethe; Garne, Jens Peter

    2011-01-01

    Mammography screening is offered healthy women, and a high standard on professional and organizational level is mandatory not only in the screening programme but even in the diagnostic work-up and treatment. The main goal is to achieve a substantial reduction in disease specific mortality......, but it is not possible to evaluate the effect on mortality until several years later, and continuously monitoring of the quality of all aspects of a screening programme is necessary. Based on other European guidelines, 11 quality indicators have been defined, and guidelines concerning organizational requirements...... for a Danish screening programme as well as recommendations for the radiographic and radiological work have been drawn up....

  1. Knowledge about mammography and associated factors: population surveys with female adults and elderly

    Directory of Open Access Journals (Sweden)

    Ione Jayce Ceola Schneider

    2013-12-01

    Full Text Available The purpose of this paper is to describe the knowledge about mammography and to identify associated factors in female adults and elderly. Data were obtained from two population surveys, one with female adults and another with elderly women from Florianópolis (SC in 2009 - 2010. A descriptive analysis of the variables was carried out, the appropriate mean of responses about mammography was estimated and crude and adjusted Poisson regression was conducted to identify associated factors. Among adults, 23.1% answered all of the questions appropriately and the appropriate average responses was 7.2 (95%CI 7.1 - 7.3 in a total of 9. In the adjusted model, older age, higher education and income were associated with knowledge about mammography. For the elderly, 15.3% answered all questions appropriately and the average of appropriate responses was 6.4 (95%CI 5.2 - 6.5 and the factors associated with knowledge about mammography in the adjusted model were younger age groups, increased education and income, and identification of mammography as the main diagnostic method for breast cancer. Information about mammography can neither be transmitted in a clear way nor be easily understood; there are also demographic and socioeconomic differences concerning the knowledge about the exam.

  2. Calculation of the X-Ray Spectrum of a Mammography System with Various Voltages and Different Anode-Filter Combinations Using MCNP Code

    Directory of Open Access Journals (Sweden)

    Lida Gholamkar

    2016-09-01

    Full Text Available Introduction One of the best methods in the diagnosis and control of breast cancer is mammography. The importance of mammography is directly related to its value in the detection of breast cancer in the early stages, which leads to a more effective treatment. The purpose of this article was to calculate the X-ray spectrum in a mammography system with Monte Carlo codes, including MCNPX and MCNP5. Materials and Methods The device, simulated using the MCNP code, was Planmed Nuance digital mammography device (Planmed Oy, Finland, equipped with an amorphous selenium detector. Different anode/filter materials, such as molybdenum-rhodium (Mo-Rh, molybdenum-molybdenum (Mo-Mo, tungsten-tin (W-Sn, tungsten-silver (W-Ag, tungsten-palladium (W-Pd, tungsten-aluminum (W-Al, tungsten-molybdenum (W-Mo, molybdenum-aluminum (Mo-Al, tungsten-rhodium (W-Rh, rhodium-aluminum (Rh-Al, and rhodium-rhodium (Rh-Rh, were simulated in this study. The voltage range of the X-ray tube was between 24 and 34 kV with a 2 kV interval. Results The charts of changing photon flux versus energy were plotted for different types of anode-filter combinations. The comparison with the findings reported by others indicated acceptable consistency. Also, the X-ray spectra, obtained from MCNP5 and MCNPX codes for W-Ag and W-Rh combinations, were compared. We compared the present results with the reported data of MCNP4C and IPEM report No. 78 for Mo-Mo, Mo-Rh, and W-Al combinations. Conclusion The MCNPX calculation outcomes showed acceptable results in a low-energy X-ray beam range (10-35 keV. The obtained simulated spectra for different anode/filter combinations were in good conformity with the finding of previous research.

  3. Diagnostics using different configurations of sensing networks

    Energy Technology Data Exchange (ETDEWEB)

    Wandowski, T; Malinowski, P; Ostachowicz, W, E-mail: tomaszw@imp.gda.pl [Institute of Fluid-Flow Machinery of Polish Academy of Sciences, Fiszera 14, 80-952 Gdansk (Poland)] [Gdynia Maritime University, Faculty of Navigation, Al. Jana Pawla II 3, 81-345, Gdynia (Poland)

    2011-07-19

    The aim of this work was the investigation and improvement of a Structural Health Monitoring method. This method was based on guided elastic waves propagation. These waves propagate in thin-walled structures guided by their walls. This particular technique has been considered in the literature as very promising. This research concentrated on diagnostics using attached piezoelectric transducers that excite guided elastic waves. Non-contact method of measurement was used. The laser vibrometer was utilized to measure the velocities of out of plane vibrations related to propagating elastic waves. Excited waves propagate and reflect from the discontinuities encountered on their way, therefore registering them one can obtain information about the structural health of the structure. Several sensor arrangements (networks) were investigated. The focus of the research was on possible area of application and limitations of the investigated networks. Presented research was based on laboratory experiments on prepared specimens. Signals gathered in the discrete network nodes were processed in order to obtain diagnostics information for the whole surface monitored. The voltage signals in the time domain were transferred into spatial domain to indicate the damage position. The signal processing oriented on structural diagnostics was realized in the MATLAB environment.

  4. Dual-frequency electrical impedance mammography for the diagnosis of non-malignant breast disease

    International Nuclear Information System (INIS)

    Trokhanova, O V; Okhapkin, M B; Korjenevsky, A V

    2008-01-01

    Electrical impedance tomography (EIT) enables one to determine and visualize non-invasively the spatial distribution of the electrical properties of the tissues inside the body, thus providing valuable diagnostic information. The electrical impedance mammography (EIM) system is a specialized EIT system for diagnostics and imaging of the breast. While breast cancer is the main target for any investigation conducted in this area, the diagnosis of non-cancerous diseases is also very important because it opens the way to improve the quality of life for many women and it may also reduce the incidence of breast cancer through effective treatment of mastopathy. This paper presents the main results of a comprehensive examination of 166 women using four methods: multifrequency electrical impedance mammography, ultrasonic investigation, x-ray mammography and puncture biopsy. The objective of the investigation is to estimate the usefulness of multifrequency electrical impedance mammography for diagnosing dyshormonal mammary gland diseases. The results demonstrate the advantages of the multifrequency EIM method. In particular, dual-frequency electrical impedance mammography in contrast with the single-frequency variant enables one not only to diagnose mastopathy, but also allows accurate detection of its cystless form based on observation of the absence of any difference between average conductivity in both phases of the menstrual cycle. Because the cystless form of mastopathy is associated with a higher risk of cancer development, this method allows identification of a higher risk group of patients for more frequent investigations

  5. Mammography fixture

    International Nuclear Information System (INIS)

    Henkes, J.L. Jr.

    1979-01-01

    A device is described for compressing a pendant breast during tomographic mammography using X-rays. The device utilises a thin, elastic membrane pressurised by a fluid whose X-ray absorption properties are similar to those of soft human tissue. The membrane changes the normal conical shape of a pendant breast into a substantially cylindrical shape. The breast is surrounded by a second fluid medium whose X-ray absorption properties are also similar to that of soft human tissue and tomography transmission is carried out through the second fluid medium and the breast. This patent claims the advantages of eliminating high gradients in X-ray absorption density and the effective detection of breast tumours with minimum radiation dosage and processing time. (UK)

  6. Quality control of mammography departments in Slovakia

    International Nuclear Information System (INIS)

    Horvathova, M.; Nikodemova, D.

    2007-01-01

    Complete test of publication follows. Considering the fact that mammary gland is the most sensitive organ to ionizing radiation, the Commission of the Ministry of Health of SR for QA in radiology organized a pilot two-run country wide audit conducted in 42 mammography departments that have met the beforehand criteria. During the audit the methods for establishing the individual parameters in technical and clinical part of quality assurance in mammography were elaborated and implemented. Technical and clinical parameters of the imaging process that mostly affect the quality of diagnostic information were followed up. These parameters included: the object thickness compensation, optical density deviation, evaluation of the film quality by means of special phantom, etc. Important measurement of ESDs at participating departments enabled to compare the radiation load of mammography patients in Slovakia with reference values in European guidelines. The uniform standard method for QA at mammography departments was elaborated and published as the regulation of the Ministry of Health for performance of preventive mammography examinations in SR. The presented results show the improved quality of mammography examinations due to regular check-ups of technical and clinical parameters and fulfilment of the required values in all parameters. The audit results are the basis for continuous quality assessment of mammography departments as a main prerequisite for conducting preventive examinations and for health insurance purposes.

  7. Future of mammography-based imaging; Zukunft mammographiebasierter Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Schulz-Wendtland, R.; Brehm, B.; Meier-Meitinger, M.; Uder, M. [Klinikum der Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Gynaekologische Radiologie, Radiologisches Institut, Erlangen (Germany); Wittenberg, T. [Fraunhofer-Institut fuer Integrierte Schaltkreise IIS, Erlangen (Germany); Michel, T.; Anton, G. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Erlangen Centre for Astroparticle Physics, Erlangen (Germany); Hartmann, A. [Klinikum der Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Institut fuer Pathologie, Erlangen (Germany); Beckmann, M.W.; Rauh, C.; Jud, S.M.; Fasching, P.A. [Klinikum der Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN, Erlangen (Germany)

    2014-03-15

    Mammography is the central diagnostic method for clinical diagnostics of breast cancer and the breast cancer screening program. In the clinical routine complementary methods, such as ultrasound, tomosynthesis and optional magnetic resonance imaging (MRI) are already combined for the diagnostic procedure. Future developments will utilize investigative procedures either as a hybrid (combination of several different imaging modalities in one instrument) or as a fusion method (the technical fusion of two or more of these methods) to implement fusion imaging into diagnostic algorithms. For screening there are reasonable hypotheses to aim for studies that individualize the diagnostic process within the screening procedure. Individual breast cancer risk prediction and individualized knowledge about sensitivity and specificity for certain diagnostic methods could be tested. The clinical implementation of these algorithms is not yet in sight. (orig.) [German] Die Mammographie ist die zentrale diagnostische Methode der klinischen symptombezogenen Abklaerung von Brusterkrankungen und des Brustkrebsscreenings. In der klinischen Diagnostik wird sie heute schon oft durch zusaetzliche Untersuchungsmethoden wie dem Ultraschall, der Tomosynthese und ggf. auch der MRT-Bildgebung unterstuetzt. Zukuenftige Entwicklungen gehen in die Richtung, dass diese Kombination aus 2 oder mehr Untersuchungsverfahren entweder in Hybrid- (Aufnahme mehrerer unterschiedlicher Bildmodalitaeten in einem einzigen Geraet) oder in Fusionsmethoden (Zusammenfuehrung und Registrierung von Bilddaten aus verschiedenen Modalitaeten) technisch professionalisiert werden. Des Weiteren koennten an subgruppenbezogene Erkrankungsrisiken und individuelle Sensitivitaeten und Spezifitaeten angepasste Diagnostikkombinationen fuer eine Screeningdiagnostik Gegenstand kuenftiger Studien sein. Wir stellen die aktuellen Entwicklungen auf diesen Gebieten und deren momentane Relevanz fuer die klinische Praxis und

  8. Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer

    Directory of Open Access Journals (Sweden)

    Dragana Roganovic

    2015-11-01

    Full Text Available Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI, digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities.  We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p < 0.001, while the difference between breast tomosynthesis and breast MRI was not significant (p = 0.20. 

  9. BMI and breast cancer prognosis benefit: mammography screening reveals differences between normal weight and overweight women.

    Science.gov (United States)

    Crispo, Anna; Grimaldi, Maria; D'Aiuto, Massimiliano; Rinaldo, Massimo; Capasso, Immacolata; Amore, Alfonso; D'Aiuto, Giuseppe; Giudice, Aldo; Ciliberto, Gennaro; Montella, Maurizio

    2015-02-01

    Few studies are available on the potential impact of body weight on breast cancer prognosis in screen-detected patients. Moreover, it is not known whether body mass index (BMI) could have a different prognostic impact in screen-detected versus symptomatic breast cancer patients. To investigate these unsolved issues, we carried out a retrospective study evaluating the effect of BMI on breast cancer prognosis in screen-detected vs symptomatic breast cancer patients. We conducted a follow-up study on 448 women diagnosed with incident, histologically-confirmed breast cancer. Patients were categorized according to their BMI as normal weight, overweight and obese. Disease free survival (DFS), overall survival (OS), and BMI curves were compared according to mode of cancer detection. Among screen-detected patients, higher BMI was associated with a significant lower DFS, whereas no significant difference was observed among symptomatic patients. OS showed similar results. In the multivariate analysis adjusting for age, education, tumor size, nodal status, estrogen receptor (ER), progesterone receptor (PR) and menopausal status, the risk for high level of BMI among screen-detected patients did not reach the statistical significance for either recurrence or survival. Our study highlights the potential impact of high bodyweight in breast cancer prognosis, the findings confirm that obesity plays a role in women breast cancer prognosis independently from diagnosis mode. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. CONTRAST ENHANCED SPECTRAL MAMMOGRAPHY (CESM (REVIEW

    Directory of Open Access Journals (Sweden)

    N. I. Rozhkova

    2015-01-01

    Full Text Available The problem of early diagnosis of a breast cancer is extremely actual. Growth of incidence at women from 19 to 39 years increased for 34% over the last 10 years. It defines need of acceleration of development and deployment of the latest technologies of identification of the earliest symptoms of diseases. The x-ray mammography is the conducting method among of all radiological methods of diagnostics. Nevertheless a number of restrictions of method reduces its efficiency. The technologies increasing informational content of x-ray mammography – the leading method of screening – due to use of artificial contrasting and advantages of digital technologies are constantly developed. In this review it is described works, in which the authors having clinical experience of application of CESM – contrastenhanced spectral mammography on representative group of women. Positive sides and restrictions of new technology in comparison with mammography, ultrasonography and MRT are shown in this article.

  11. Radiographic techniques for digital mammography

    International Nuclear Information System (INIS)

    Horita, Katsuhei

    2007-01-01

    Since the differences in X-ray absorption between various breast tissues are small, a dedicated X-ray system for examination of the breast and a high-contrast, high-resolution screen/film system (SFM) (light-receiving system) are employed for X-ray diagnosis. Currently, however, there is a strong trend toward digital imaging in the field of general radiography, and this trend is also reflected in the field of mammographic examination. In fact, approximately 70% of facilities purchasing new mammography systems are now selecting a digital mammography system (DRM). Given this situation, this report reviews the differences between SFM and DRM and discusses the radiographic techniques and quality assurance procedures for digital mammography. (author)

  12. A comparison of the accuracy of film-screen mammography, full-field digital mammography, and digital breast tomosynthesis

    International Nuclear Information System (INIS)

    Michell, M.J.; Iqbal, A.; Wasan, R.K.; Evans, D.R.; Peacock, C.; Lawinski, C.P.; Douiri, A.; Wilson, R.; Whelehan, P.

    2012-01-01

    Aim: To measure the change in diagnostic accuracy of conventional film-screen mammography and full-field digital mammography (FFDM) with the addition of digital breast tomosynthesis (DBT) in women recalled for assessment following routine screening. Materials and methods: Ethics approval for the study was granted. Women recalled for assessment following routine screening with screen-film mammography were invited to participate. Participants underwent bilateral, two-view FFDM and two-view DBT. Readers scored each lesion separately for probability of malignancy on screen-film mammography, FFDM, and then DBT. The scores were compared with the presence or absence of malignancy based on the final histopathology outcome. Results: Seven hundred and thirty-eight women participated (93.2% recruitment rate). Following assessment 204 (26.8%) were diagnosed as malignant (147 invasive and 57 in-situ tumours), 286 (37.68%) as benign, and 269 (35.4%) as normal. The diagnostic accuracy was evaluated by using receiving operating characteristic (ROC) and measurement of area under the curve (AUC). The AUC values demonstrated a significant (p = 0.0001) improvement in the diagnostic accuracy with the addition of DBT combined with FFDM and film-screen mammography (AUC = 0.9671) when compared to FFDM plus film-screen mammography (AUC = 0.8949) and film-screen mammography alone (AUC = 0.7882). The effect was significantly greater for soft-tissue lesions [AUC was 0.9905 with the addition of DBT and AUC was 0.9201 for FFDM with film-screen mammography combined (p = 0.0001)] compared to microcalcification [with the addition of DBT (AUC = 0.7920) and for FFDM with film-screen mammography combined (AUC = 0.7843; p = 0.3182)]. Conclusion: The addition of DBT increases the accuracy of mammography compared to FFDM and film-screen mammography combined and film-screen mammography alone in the assessment of screen-detected soft-tissue mammographic abnormalities.

  13. Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer.

    Science.gov (United States)

    Roganovic, Dragana; Djilas, Dragana; Vujnovic, Sasa; Pavic, Dag; Stojanov, Dragan

    2015-11-16

    Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities. We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS) was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC) curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p tomosynthesis and breast MRI was not significant (p=0.20).

  14. Digital Mammography Tomosynthesis

    International Nuclear Information System (INIS)

    Gergov, I.; Alexov, G.; Rusonov, K.

    2017-01-01

    Siemens MAMMOMAT Inspiration with Tomosynthesis enhances the diagnostic precision in mammographic screening. The apparatus has a wide-angle tomosynthesis up to 50 degrees. The Siemens breast augmentation algorithm reconstructs multiple two-dimensional breast images into three-dimensional images at the lowest doses to help detect tumors hidden from the overlapping chest tissue, allowing for a more accurate diagnosis than standard 2-dimensional digital mammography, and reducing the number of false positive results. 3D digital tomosynthesis improves the precision of detecting and diagnosing a larger number of expansive lesions, ensures better morphological mass analysis and architectural distortion, and detecting calcifications by adding digital breast tomosynthesis to the traditional two-dimensional digital mammogram of the patient. In this way, it solves the problem of overlapping parenchyma, reduces the number of unnecessary biopsies from questionable sonomammographic findings, and the need for stressful repeating procedures, which usually contributes to both better patient outcomes and cost saving. [bg

  15. Contrast-enhanced spectral mammography vs. mammography and MRI - clinical performance in a multi-reader evaluation

    NARCIS (Netherlands)

    Fallenberg, E.M.; Schmitzberger, F.F.; Amer, H.; Ingold-Heppner, B.; Balleyguier, C.; Diekmann, F.; Engelken, F.; Mann, R.M.; Renz, D.M.; Bick, U.; Hamm, B.; Dromain, C.

    2017-01-01

    OBJECTIVES: To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) to digital mammography (MG) and magnetic resonance imaging (MRI) in a prospective two-centre, multi-reader study. METHODS: One hundred seventy-eight women (mean age 53 years) with invasive breast

  16. Advanced Breast Cancer as Indicator of Quality Mammography

    International Nuclear Information System (INIS)

    Gaona, Enrique

    2003-01-01

    Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the Mexican Republic. Mammography is the more important screening tool for detecting early breast cancer. Screening mammography involves taking x-rays from two views from each breast, typically from above (cranial-caudal view, CC) and from an oblique or angled view (mediolateral-oblique, MLO). The purpose of this study was to carry out an exploratory survey of the issue of patients with advanced breast cancer who have had a screening mammography. A general result of the survey is that 22.5% of all patients (102) with advanced breast cancer that participated in the study had previous screening mammography. But we should consider that 10% of breast cancers are not detected by mammography. Only 70% of the family doctors prescribed a diagnostic mammography when the first symptoms were diagnosed

  17. Use of different simulators to quality evaluation of image quality in digital mammography; Utilizacao de diferentes simuladores na avaliacao da qualidade da imagem em mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Leslie S.; Coutinho, Celia M.C., E-mail: leslie@ird.gov.br, E-mail: celia@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Magalhaes, Luis A.G.; Almeida, Carlos Eduardo de, E-mail: luisalexandregm@hotmail.com, E-mail: cea71@yahoo.com.br [Universidade do Estado do Rio de Janeiro (LCR/UERJ), Rio de Janeiro, RJ (Brazil). Laboratorio de Ciencias Radiologicas

    2013-11-01

    In this study, the digital images were acquired with different exposure simulators to evaluate the quality of the image, noting the tumor mass detection, microcalcification fiber and representing regions of interest during mammography. The technical parameters of exposure depends on the thickness and composition of the breast, thus affecting the dose and image quality. The simulators were used: ACR, SBP 1054, BREAST PHANTOM CIRS and for evaluation of image quality, as well as measures kerma incident on the entrance surface (Ki) and calculating the mean glandular dose (MGD)

  18. Diagnostic criteria for sarcopenia relate differently to insulin resistance

    NARCIS (Netherlands)

    Bijlsma, A.Y.; Meskers, C.G.M.; van Heemst, D.; Westendorp, R.G.J.; Craen, A.J.M.; Maier, A.B.

    2013-01-01

    Skeletal muscle is important in insulinstimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in

  19. Mamma diagnostics for MTRA (medical-radiological personnel)/RT (radiologists); Mammadiagnostik fuer MTRA/RT

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Uwe; Baum, Friedemann

    2014-07-01

    The text book on mamma diagnostics for MTRA (medical-radiological personnel)/RT (radiologists) covers the following issues: Anatomy, development and physiology of mammary glands; tumor development an breast cancer risk; pathology, non-imaging diagnostics; mammography: physical-technical fundamentals; mammography: analogue technique; mammography: digital technique; mammography: quality assurance; mammography: legal questions and radiation protection; mammography: new developments; mammography: setting technique; mammography: use and appraisal; mamma-sonography: technique and methodology; mamma-sonography: assignment and appraisal, mamma-NMR: technique and methodology; mamma-NMR: assignment and appraisal lymph node diagnostics; mamma interventions; biopsy; mamma interventions: marking examination concepts; therapeutic concepts; hygienic concepts; communication and interaction.

  20. Influence of diagnostic quality scanning technique with CR mammography; Influencia de la tecnica de exploracion en la calidad diagnostica de la mamografia ocn CR

    Energy Technology Data Exchange (ETDEWEB)

    Rivas Ballarin, M. A.; Ruiz Manzano, P.; Ortega Pardina, P.; Laliena Bielsa, V.; Calvo Carrillo, S.; Garcia Romero, A.; Millan Cebrian, E.

    2013-07-01

    Image quality criteria laid down in the Spanish Protocol of Control of quality in Radiology (PECCR) to a team of mammography with CR imaging system are applied in this work and evaluated the dosimetry impact implied by the modification of the technique of exposure required for the fulfilment of those criteria. Is also analyzes the impact on the image quality of the new radiographic technique, evaluated by three radiologists. (Author)

  1. Computer assisted visualization of digital mammography images

    International Nuclear Information System (INIS)

    Funke, M.; Breiter, N.; Grabbe, E.; Netsch, T.; Biehl, M.; Peitgen, H.O.

    1999-01-01

    Purpose: In a clinical study, the feasibility of using a mammography workstation for the display and interpretation of digital mammography images was evaluated and the results were compared with the corresponding laser film hard copies. Materials and Methods: Digital phosphorous plate radiographs of the entire breast were obtained in 30 patients using a direct magnification mammography system. The images were displayed for interpretation on the computer monitor of a dedicated mammography workstation and also presented as laser film hard copies on a film view box for comparison. The images were evaluted with respect to the image handling, the image quality and the visualization of relevant structures by 3 readers. Results: Handling and contrast of the monitor displayed images were found to be superior compared with the film hard copies. Image noise was found in some cases but did not compromise the interpretation of the monitor images. The visualization of relevant structures was equal with both modalities. Altogether, image interpretation with the mammography workstation was considered to be easy, quick and confident. Conclusions: Computer-assisted visualization and interpretation of digital mammography images using a dedicated workstation can be performed with sufficiently high diagnostic accuracy. (orig.) [de

  2. Mammography performance in Oman: Review of factors influencing cancer yield and positive predictive value.

    Science.gov (United States)

    Taif, Sawsan; Tufail, Fatma; Alnuaimi, Ahmed Sameer

    2016-06-01

    The aim of this study is to assess mammography performance in Oman by estimating the breast cancer rate and the positive predictive value (PPV) with the influence of some variables. This cross-sectional study was conducted on mammograms done in one of the three main breast imaging centers in Oman between January 2008 and July 2012. Diagnostic and screening groups were identified and assessed separately. Rate of abnormal mammograms, rate of breast cancer and the PPV were estimated according to Breast Imaging Reporting and Data System (BIRADS) score, presence of breast lump and patient's age. Total of 653 mammograms were included, 254 diagnostic and 399 screening. Abnormal mammograms (BIRADS 4 and 5) form 31.9% of the diagnostic examinations compared with 6.8% of screening examinations. Breast cancer was present in 17.9% of the diagnostic compared with 1.0% of the screening group. The PPV of BIRADS 5 was 94.1%, and for BIRADS 4 was 37.1 and 26.7% for diagnostic and screening studies. Overall PPV for abnormal mammograms was 65.2% in the diagnostic and 26.7% in the screening group. Mammography PPV shows positive association with age (P = 0.039) while presence of breast lump has no significant effect on the PPV (P = 0.38). BIRADS 5 score was found to have a high cancer yield making it a strong predictor of cancer. Different results were obtained in the diagnostic compared with screening mammography with higher rates of abnormal mammograms and breast cancer. Mammography performance should be better in the older women. © 2014 Wiley Publishing Asia Pty Ltd.

  3. Potential Cost Savings of Contrast-Enhanced Digital Mammography.

    Science.gov (United States)

    Patel, Bhavika K; Gray, Richard J; Pockaj, Barbara A

    2017-06-01

    The purpose of this article is to discuss whether the sensitivity and specificity of contrast-enhanced digital mammography (CEDM) render it a viable diagnostic alternative to breast MRI. That CEDM couples low-energy images (comparable to the diagnostic quality of standard mammography) and subtracted contrast-enhanced mammograms make it a cost-effective modality and a realistic substitute for the more costly breast MRI.

  4. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

    O'Connor, Maja; Lasgaard, Mathias; Spindler, Helle

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinations...... of criteria on PTSD prevalence. A sample of 242 Danish social work students (M =29.2 years) completed a list of potentially traumatizing events, major life events and the Harvard Trauma Questionnaire. A considerable difference in PTSD prevalence as a result of different diagnostic criteria of PTSD was found....... Future meta-analyses and reviews of PTSD prevalence must take into account the impact of changing criteria on prevalence. Clinicians also need to address this issue when assessing PTSD...

  5. Tomosynthesis and contrast-enhanced digital mammography: recent advances in digital mammography

    International Nuclear Information System (INIS)

    Diekmann, Felix; Bick, Ulrich

    2007-01-01

    Digital mammography is more and more replacing conventional mammography. Initial concerns about an inferior image quality of digital mammography have been largely overcome and recent studies even show digital mammography to be superior in women with dense breasts, while at the same time reducing radiation exposure. Nevertheless, an important limitation of digital mammography remains: namely, the fact that summation may obscure lesions in dense breast tissue. However, digital mammography offers the option of so-called advanced applications, and two of these, contrast-enhanced mammography and tomosynthesis, are promising candidates for improving the detection of breast lesions otherwise obscured by the summation of dense tissue. Two techniques of contrast-enhanced mammography are available: temporal subtraction of images acquired before and after contrast administration and the so-called dual-energy technique, which means that pairs of low/high-energy images acquired after contrast administration are subtracted. Tomosynthesis on the other hand provides three-dimensional information on the breast. The images are acquired with different angulations of the X-ray tube while the object or detector is static. Various reconstruction algorithms can then be applied to the set of typically nine to 28 source images to reconstruct 1-mm slices with a reduced risk of obscuring pathology. Combinations of both advanced applications have only been investigated in individual experimental studies; more advanced software algorithms and CAD systems are still in their infancy and have only undergone preliminary clinical evaluation. (orig.)

  6. A Standard Mammography Unit - Standard 3D Ultrasound Probe Fusion Prototype: First Results.

    Science.gov (United States)

    Schulz-Wendtland, Rüdiger; Jud, Sebastian M; Fasching, Peter A; Hartmann, Arndt; Radicke, Marcus; Rauh, Claudia; Uder, Michael; Wunderle, Marius; Gass, Paul; Langemann, Hanna; Beckmann, Matthias W; Emons, Julius

    2017-06-01

    The combination of different imaging modalities through the use of fusion devices promises significant diagnostic improvement for breast pathology. The aim of this study was to evaluate image quality and clinical feasibility of a prototype fusion device (fusion prototype) constructed from a standard tomosynthesis mammography unit and a standard 3D ultrasound probe using a new method of breast compression. Imaging was performed on 5 mastectomy specimens from patients with confirmed DCIS or invasive carcinoma (BI-RADS ™ 6). For the preclinical fusion prototype an ABVS system ultrasound probe from an Acuson S2000 was integrated into a MAMMOMAT Inspiration (both Siemens Healthcare Ltd) and, with the aid of a newly developed compression plate, digital mammogram and automated 3D ultrasound images were obtained. The quality of digital mammogram images produced by the fusion prototype was comparable to those produced using conventional compression. The newly developed compression plate did not influence the applied x-ray dose. The method was not more labour intensive or time-consuming than conventional mammography. From the technical perspective, fusion of the two modalities was achievable. In this study, using only a few mastectomy specimens, the fusion of an automated 3D ultrasound machine with a standard mammography unit delivered images of comparable quality to conventional mammography. The device allows simultaneous ultrasound - the second important imaging modality in complementary breast diagnostics - without increasing examination time or requiring additional staff.

  7. Radiographer involvement in mammography image interpretation: A survey of United Kingdom practice

    International Nuclear Information System (INIS)

    Culpan, A.M.

    2016-01-01

    Breast cancer is most often diagnosed using x-ray mammography. Traditionally mammography images have been interpreted and reported by medically qualified practitioners – radiologists. Due to radiologist workforce shortages in recent years some non-medical practitioners, radiographers, now interpret and report mammography images. The aims of this survey were to describe the characteristics and practices of radiographers who interpret and report mammography images in NHS hospitals in the UK, and in particular to establish the extent of their practice beyond low-risk asymptomatic screening cases. This service evaluation demonstrated that UK radiographers are interpreting and reporting images across the full spectrum of clinical indications for mammography including: low-risk population screening, symptomatic, annual surveillance, family history and biopsy/surgical cases. The survey revealed that radiographers are involved in a diverse range of single and double reading practices where responsibility for diagnostic decision making is shared or transferred between radiologists and/or other radiographers. Comparative analysis of sub-group data suggested that there might be differences in the characteristics and practices of radiographers who interpret only low-risk screening mammograms and those who interpret and report a wider range of cases. The findings of this survey provide a platform for further research to investigate how and why the roles and responsibilities of radiographers who interpret and report mammograms vary between organisations, between practitioners and across different examinations. Further research is also needed to explore the implications of variation in practice for patients, practitioners and service providers. - Highlights: • UK radiographers interpret mammograms across the full spectrum of clinical indications. • UK radiographers are involved in a wide range of single/double mammography reading practices. • Characteristics required for

  8. Thermoluminescence dosimetry in quality imaging in CR mammography systems

    Energy Technology Data Exchange (ETDEWEB)

    Gaona, E.; Franco E, J.G. [UAM-Xochimilco, 04960 Mexico D.F. (Mexico); Azorin N, J. [UAM-Iztapalapa, 09340 Mexico D.F. (Mexico); Diaz G, J.A.I. [CICATA, Unidad Legaria, Av. Legaria 694, 11599 mexico D.F. (Mexico); Arreola, M. [Department of Radiology, Shands Hospital at UF, PO Box 100374, Gainesville, FL 32610-0374 (United States)

    2006-07-01

    The aim of this work is to estimate the average glandular dose with Thermoluminescence Dosimetry (TLD) and comparison with quality imaging in CR mammography. For measuring dose, FDA and ACR use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, Full Field Digital Mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one CR mammography system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium fluoro halide. We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated x-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose that overcomes 3.0 mGy and it doesn't improve the image quality and dose to the breast will be excessive. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement. (Author)

  9. Thermoluminescence dosimetry in quality imaging in CR mammography systems

    International Nuclear Information System (INIS)

    Gaona, E.; Franco E, J.G.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M.

    2006-01-01

    The aim of this work is to estimate the average glandular dose with Thermoluminescence Dosimetry (TLD) and comparison with quality imaging in CR mammography. For measuring dose, FDA and ACR use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, Full Field Digital Mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one CR mammography system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium fluoro halide. We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated x-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose that overcomes 3.0 mGy and it doesn't improve the image quality and dose to the breast will be excessive. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement. (Author)

  10. Clinical experience of photon counting breast tomosynthesis: comparison with traditional mammography

    International Nuclear Information System (INIS)

    Svane, Gunilla; Azavedo, Edward; Lindman, Karin; Urech, Mattias; Nilsson, Jonas; Weber, Niclas; Lindqvist, Lars; Ullberg, Christer

    2011-01-01

    Background: In two-dimensional mammography, a well-known problem is over- and underlying tissue which can either obstruct a lesion or create a false-positive result. Tomosynthesis, with an ability to layer the tissue in the image, has the potential to resolve these issues. Purpose: To compare the diagnostic quality, sensitivity and specificity of a single tomosynthesis mammography image and a traditional two-view set of two-dimensional mammograms and to assess the comfort of the two techniques. Material and Methods: One hundred and forty-four women, mainly chosen because of suspicious features on standard mammograms (76 malignant), had a single tomosynthesis image taken of one breast using a novel photon counting system. On average, the dose of the tomosynthesis images was 0.63 times that of the two-view images and the compression force during the procedure was halved. The resulting images were viewed by two radiologists and assessed both individually and comparing the two techniques. Results: In 56% of the cases the radiologists rated the diagnostic quality of the lesion details higher in the tomosynthesis images than in the conventional images (and in 91% equal or higher), which means there is a statistically significant preference for the tomosynthesis technique. This included the calcifications which were rated as having better quality in 41% of the cases. While sensitivity was slightly higher for traditional mammography the specificity was higher for tomosynthesis. However, neither of these two differences was large enough to be statistically significant. Conclusion: The overall accuracy of the two techniques was virtually equal despite the radiologist's very limited experience with tomosynthesis images and vast experience with two-dimensional mammography. As the diagnostic quality of the lesion details in the tomosynthesis images was valued considerably higher this factor should improve with experience. The patients also favored the tomosynthesis examination

  11. Mammography - importance, possibilities, current screening situation of the breast cancer and further expansion possibilities

    International Nuclear Information System (INIS)

    Bella, V.

    2006-01-01

    Breast cancer still remains the most frequent cancer in women population. Incidence of breast cancer is increasing, but mortality is decreasing. The most important for decreasing of breast cancer mortality is early diagnostic, especially screening. Screening is a form of secondary prevention. Although many screening studies have shown that mammography decreases of the breast cancer death, there are still many controversies. The published recommendations for the breast screening are sometimes very different. (author)

  12. Dual-energy contrast-enhanced mammography.

    Science.gov (United States)

    Travieso Aja, M M; Rodríguez Rodríguez, M; Alayón Hernández, S; Vega Benítez, V; Luzardo, O P

    2014-01-01

    The degree of vascularization in breast lesions is related to their malignancy. For this reason, functional diagnostic imaging techniques have become important in recent years. Dual-energy contrast-enhanced mammography is a new, apparently promising technique in breast cancer that provides information about the degree of vascularization of the lesion in addition to the morphological information provided by conventional mammography. This article describes the state of the art for dual-energy contrast-enhanced mammography. Based on 15 months' clinical experience, we illustrate this review with clinical cases that allow us to discuss the advantages and limitations of this technique. Copyright © 2014 SERAM. Published by Elsevier Espana. All rights reserved.

  13. Quality control tests for conventional mammography

    International Nuclear Information System (INIS)

    Dawod, Alnazer Ahmed Ibrahim

    2014-12-01

    Mammography is this the test that allows the radiologist to look at images of the inside of the breasts. Mammograms help detect breast cancer early successful treatment of breast cancer depends on that early diagnosis. Breast cancer is a very common condition. About one in every nine women develops breast cancer by the age of eighty. In addition to the clinical examination and self-examination, mammography plays important role in the detection of breast cancer before they become clinically visible tumors. The mammography is the most common test for early detection of breast cancer. Quality control techniques that done ensured importance of this programme to produce images with good diagnostic values and help radiologist to diagnose breast discase easily and avoid exposing patient to radiation hazards.(Author)

  14. Racial Differences by Ischemic Stroke Subtype: A Comprehensive Diagnostic Approach

    Directory of Open Access Journals (Sweden)

    Sarah Song

    2012-01-01

    Full Text Available Background. Previous studies have suggested that black populations have more small-vessel and fewer cardioembolic strokes. We sought to analyze racial differences in ischemic stroke subtype employing a comprehensive diagnostic workup with magnetic resonance-imaging-(MRI- based evaluation including diffusion-weighted imaging (DWI. Methods. 350 acute ischemic stroke patients admitted to an urban hospital with standardized comprehensive diagnostic evaluations were retrospectively analyzed. Ischemic stroke subtype was determined by three Trial of Org 10172 in Acute Stroke Treatment (TOAST classification systems. Results. We found similar proportions of cardioembolic and lacunar strokes in the black and white cohort. The only subtype category with a significant difference by race was “stroke of other etiology,” more common in whites. Black stroke patients were more likely to have an incomplete evaluation, but this did not reach significance. Conclusions. We found similar proportions by race of cardioembolic and lacunar strokes when employing a full diagnostic evaluation including DWI MRI. The relatively high rate of cardioembolism may have been underappreciated in black stroke patients when employing a CT approach to stroke subtype diagnosis. Further research is required to better understand the racial differences in frequency of “stroke of other etiology” and explore disparities in the extent of diagnostic evaluations.

  15. Screen-film mammography

    International Nuclear Information System (INIS)

    Logan, W.W.; Janus, J.A.

    1987-01-01

    The development of screen-film mammography has resulted in the re-emergence of confidence, rather than fear, in mammography. When screen-film mammography is performed with state-of-the-art dedicated equipment utilizing vigorous breast compression and a ''soft'' x-ray beam for improved contrast, screen-film images are equivalent or superior to those of reduced-dose xeromammography and superior to those of nonscreen film mammography. Technological aids for conversion from xeromammographic or nonscreen film mammographic techniques to screen-film techniques have been described. Screen-film mammography should not be attempted until dedicated equipment has been obtained and the importance of vigorous compression has been understood

  16. Mammography and breast sonography in transsexual women

    Energy Technology Data Exchange (ETDEWEB)

    Weyers, S., E-mail: steven.weyers@ugent.b [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Villeirs, G.; Vanherreweghe, E. [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Verstraelen, H. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Monstrey, S. [Department of Plastic Surgery, Ghent University Hospital, Ghent (Belgium); Van den Broecke, R.; Gerris, J. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)

    2010-06-15

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  17. Mammography and breast sonography in transsexual women

    International Nuclear Information System (INIS)

    Weyers, S.; Villeirs, G.; Vanherreweghe, E.; Verstraelen, H.; Monstrey, S.; Van den Broecke, R.; Gerris, J.

    2010-01-01

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  18. Evaluation of breast symptoms with mammography and ultrasonography

    Directory of Open Access Journals (Sweden)

    Emine Devolli Disha

    2011-12-01

    Full Text Available Introduction: Aim of the study was to discern which are more frequent symptoms presented in malign and benign masses diagnosed by mammography and ultrasonography.Methods: Our study group consisted of 546 female patients, with breast symptoms such as palpable lumps (40.8%, pain in the breast (26%, localized lumpiness or nodularity (13.7%, nipple retraction (11.2%, nipplebloody discharge (5.1% and redness and swelling of the breast (3.1%. All 546 patients were examined by ultrasonography and mammography. Biopsy was performed according to the findings of mammography and ultrasonography.Results: In breast cancer detection ultrasonography showed an efficiency of 79.4% compared to 55.0% for mammography in detecting breast lump, in the case of nipple retraction mammography showed an efficiency of 89.1% compared to 80.4% for ultrasound, while the lowest efficiency for mammography was in the cases with localized lumpiness or nodularity 17.1% compared to 45.7% for ultrasound. In detecting fibrocystic changes where the most common symptoms was pain, ultrasonography showed an efficiency of 99.3 % compared to 84.2 % for mammography.Conclusions: Our study confirmed that breast lumps are detectable in the majority of patients with breast cancer. The most frequent symptoms in patient with benign lesions were pain or localized discomfort. The diagnostic accuracy for carcinomas of the breast and for benign lesions according to symptoms was higher for ultrasound than for mammography.

  19. Effects of Different Compression Techniques on Diagnostic Accuracies of Breast Masses on Digitized Mammograms

    International Nuclear Information System (INIS)

    Zhigang Liang; Xiangying Du; Jiabin Liu; Yanhui Yang; Dongdong Rong; Xinyu Y ao; Kuncheng Li

    2008-01-01

    Background: The JPEG 2000 compression technique has recently been introduced into the medical imaging field. It is critical to understand the effects of this technique on the detection of breast masses on digitized images by human observers. Purpose: To evaluate whether lossless and lossy techniques affect the diagnostic results of malignant and benign breast masses on digitized mammograms. Material and Methods: A total of 90 screen-film mammograms including craniocaudal and lateral views obtained from 45 patients were selected by two non-observing radiologists. Of these, 22 cases were benign lesions and 23 cases were malignant. The mammographic films were digitized by a laser film digitizer, and compressed to three levels (lossless and lossy 20:1 and 40:1) using the JPEG 2000 wavelet-based image compression algorithm. Four radiologists with 10-12 years' experience in mammography interpreted the original and compressed images. The time interval was 3 weeks for each reading session. A five-point malignancy scale was used, with a score of 1 corresponding to definitely not a malignant mass, a score of 2 referring to not a malignant mass, a score of 3 meaning possibly a malignant mass, a score of 4 being probably a malignant mass, and a score of 5 interpreted as definitely a malignant mass. The radiologists' performance was evaluated using receiver operating characteristic analysis. Results: The average Az values for all radiologists decreased from 0.8933 for the original uncompressed images to 0.8299 for the images compressed at 40:1. This difference was not statistically significant. The detection accuracy of the original images was better than that of the compressed images, and the Az values decreased with increasing compression ratio. Conclusion: Digitized mammograms compressed at 40:1 could be used to substitute original images in the diagnosis of breast cancer

  20. Digital mammography and their developments; Digitale Mammografie und ihre Weiterentwicklung

    Energy Technology Data Exchange (ETDEWEB)

    Wienbeck, Susanne [Universitaetsmedizin Goettingen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Fischer, Uwe [Diagnostisches Brustzentrum Goettingen (Germany)

    2015-09-15

    At the present time digital mammography is a satisfactory breast diagnostic imaging in clinical as well as screening mammography in defined age groups. Nevertheless it shows beside the application of ionizing radiation in women with dense breasts limitations in the detection of non calcification breast cancers. Tomosynthesis, digital contrast-enhanced mammography and breast-CT with or without contrast media lead to better results. Especially the application of contrast media for the visualisation of the tumor angiogenesis is invariably superior to all other non-contrast imaging modalities. However, the excellent results of breast MRI will be probably accessible with none of the new procedures.

  1. Diagnostic value of different tumor markers, our experience

    International Nuclear Information System (INIS)

    Pervez, T.; Anwar, S.

    2000-01-01

    Variety of tumor markers with varying sensitivity and specificity are used for diagnosis of different malignancies. This study was done to determine the diagnostic value of different tumor markers in our patients with various malignancies. Out of 235 patients studied, 162 were suffering from malignant and 73 from benign diseases. Among these 84 were positive for tumor markers. Out of these positive tumor markers, 75 were suffering from malignancy. Tumor marker analyzed were ca-15-3, ca-125, BETA-HCG, CEA, PSA and alpha-FP depending upon the type of the disease these cases presented. Analysis of the results revealed that different tumor markers had sensitivity varying from 76.9-95.8% and specificity varying form 75-90.9%. CA-125 was observed to be the most specific and sensitive tumor marker for ovarian tumors followed by alpha-FP for hepatocellular tumors and CEA for gastrointestinal tumors. Similarly, PSA for prostate cancers, beta-HCG for choriocarcinoma and CA-15-3 for breast cancer. It is concluded that all the tumor markers have a variable diagnostic value, which cannot be relied upon independently, without other tests added to increase diagnostic value. (author)

  2. Comparison of tomosynthesis plus digital mammography and digital mammography alone for breast cancer screening.

    Science.gov (United States)

    Haas, Brian M; Kalra, Vivek; Geisel, Jaime; Raghu, Madhavi; Durand, Melissa; Philpotts, Liane E

    2013-12-01

    To compare screening recall rates and cancer detection rates of tomosynthesis plus conventional digital mammography to those of conventional digital mammography alone. All patients presenting for screening mammography between October 1, 2011, and September 30, 2012, at four clinical sites were reviewed in this HIPAA-compliant retrospective study, for which the institutional review board granted approval and waived the requirement for informed consent. Patients at sites with digital tomosynthesis were offered screening with digital mammography plus tomosynthesis. Patients at sites without tomosynthesis underwent conventional digital mammography. Recall rates were calculated and stratified according to breast density and patient age. Cancer detection rates were calculated and stratified according to the presence of a risk factor for breast cancer. The Fisher exact test was used to compare the two groups. Multivariate logistic regression was used to assess the effect of screening method, breast density, patient age, and cancer risk on the odds of recall from screening. A total of 13 158 patients presented for screening mammography; 6100 received tomosynthesis. The overall recall rate was 8.4% for patients in the tomosynthesis group and 12.0% for those in the conventional mammography group (P tomosynthesis reduced recall rates for all breast density and patient age groups, with significant differences (P tomosynthesis versus 5.2 per 1000 in patients receiving conventional mammography alone (P = .70). Patients undergoing tomosynthesis plus digital mammography had significantly lower screening recall rates. The greatest reductions were for those younger than 50 years and those with dense breasts. A nonsignificant 9.5% increase in cancer detection was observed in the tomosynthesis group. © RSNA, 2013.

  3. Investigation of actual conditions of mammography in Kagoshima prefecture

    International Nuclear Information System (INIS)

    Baba, Natsuki; Tanimoto, Eriko; Kobayashi, Yasuhiro; Kuma, Kouji

    2009-01-01

    We surveyed the actual conditions of mammography with regard to image quality and radiation dose at 44 facilities in Kagoshima prefecture in 1999. In April 2004, guidelines for mammography newly included the standard of digital mammography. From September to October 2005, the survey was conducted at 48 facilities, and the results of the survey were compared with that in 1999. We visited 44 of the 48 facilities, and visually evaluated the image quality of mammograms for RMI156 and clinical mammograms. In addition, we measured average mammary gland dose at each facility. The number of the mammography device that satisfied the specified guideline criterion was larger than that in 1999. Image quality for the RMI156 mammograms improved. However, the results of the present survey revealed several problems. First, the number of facilities that had quality control instruments for mammography are few. Second, radiological technologists, medical doctors, and nurses did not share knowledge or information regarding mammography. Finally, there were differences in devices and image quality for mammography among the facilities. We achieved an understanding of the actual conditions of mammography in Kagoshima prefecture by visiting many facilities, evaluating image quality, and communicating with many staff members. Our results may be useful for the development of mammography examinations. (author)

  4. A study of some technical essentials of X-ray mammography

    International Nuclear Information System (INIS)

    Cao Houde; Jiang Qin

    2000-01-01

    Objective: To improve the quality of mammography and diagnostic accuracy by analyzing and studying some of the technical essentials of X-ray mammography. Methods: The mammography quality of 21 hospitals were investigated. The image quality of normal intensifying screen-film combination was tested and compared with computerized mammography. The filming positions and operating skills were studied. Results: The important mammography details that were displayed have low conformity with the diagnostic requirements, mainly due to non-conformity of these equipment to the requirements. The optimal pressure suitable for mammography of the Chinese women was around 12 kg. Conclusion: Necessary attention must be paid to the improvement of imaging features of these equipment. The improved operating skills will greatly raise the detecting percentage of pathological changes of breasts

  5. Rayleigh imaging in spectral mammography

    Science.gov (United States)

    Berggren, Karl; Danielsson, Mats; Fredenberg, Erik

    2016-03-01

    Spectral imaging is the acquisition of multiple images of an object at different energy spectra. In mammography, dual-energy imaging (spectral imaging with two energy levels) has been investigated for several applications, in particular material decomposition, which allows for quantitative analysis of breast composition and quantitative contrast-enhanced imaging. Material decomposition with dual-energy imaging is based on the assumption that there are two dominant photon interaction effects that determine linear attenuation: the photoelectric effect and Compton scattering. This assumption limits the number of basis materials, i.e. the number of materials that are possible to differentiate between, to two. However, Rayleigh scattering may account for more than 10% of the linear attenuation in the mammography energy range. In this work, we show that a modified version of a scanning multi-slit spectral photon-counting mammography system is able to acquire three images at different spectra and can be used for triple-energy imaging. We further show that triple-energy imaging in combination with the efficient scatter rejection of the system enables measurement of Rayleigh scattering, which adds an additional energy dependency to the linear attenuation and enables material decomposition with three basis materials. Three available basis materials have the potential to improve virtually all applications of spectral imaging.

  6. Bi-directional x-ray phase-contrast mammography.

    Directory of Open Access Journals (Sweden)

    Kai Scherer

    Full Text Available Phase-contrast x-ray imaging is a promising improvement of conventional absorption-based mammography for early tumor detection. This potential has been demonstrated recently, utilizing structured gratings to obtain differential phase and dark-field scattering images. However, the inherently anisotropic imaging sensitivity of the proposed mono-directional approach yields only insufficient diagnostic information, and has low diagnostic sensitivity to highly oriented structures. To overcome these limitations, we present a two-directional x-ray phase-contrast mammography approach and demonstrate its advantages by applying it to a freshly dissected, cancerous mastectomy breast specimen. We illustrate that the two-directional scanning procedure overcomes the insufficient diagnostic value of a single scan, and reliably detects tumor structures, independently from their orientation within the breast. Our results indicate the indispensable diagnostic necessity and benefit of a multi-directional approach for x-ray phase-contrast mammography.

  7. Comparative analysis of diagnostic accuracy of different brain biopsy procedures.

    Science.gov (United States)

    Jain, Deepali; Sharma, Mehar Chand; Sarkar, Chitra; Gupta, Deepak; Singh, Manmohan; Mahapatra, A K

    2006-12-01

    Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different stereotactic and ultrasound-guided brain biopsy procedures. A retrospective analysis was conducted of all brain biopsies (frame-based and frameless stereotactic and ultrasound-guided) performed in a single tertiary care neurosciences center between 1995 and 2005. The overall diagnostic accuracy achieved on histopathology and correlation with type of biopsy technique was evaluated. A total of 130 cases were included, which consisted of 82 males and 48 females. Age ranged from 4 to 75 years (mean age 39.5 years). Twenty per cent (27 patients) were in the pediatric age group, while 12% (16 patients) were >or= 60-years of age. A definitive histological diagnosis was established in 109 cases (diagnostic yield 80.2%), which encompassed 101 neoplastic and eight nonneoplastic lesions. Frame-based, frameless stereotactic and ultrasound-guided biopsies were done in 95, 15 and 20 patients respectively. Although the numbers of cases were small there was trend for better yield with frameless image-guided stereotactic biopsy and maximum diagnostic yield was obtained i.e, 87% (13/15) in comparison to conventional frame-based CT-guided stereotactic biopsy and ultrasound-guided biopsy. Overall, a trend of higher diagnostic yield was seen in cases with frameless image-guided stereotactic biopsy. Thus, this small series confirms that frameless neuronavigator-guided stereotactic procedures represent the lesion sufficiently in order to make histopathologic diagnosis.

  8. Comparative performance of modern digital mammography systems in a large breast screening program

    Energy Technology Data Exchange (ETDEWEB)

    Yaffe, Martin J., E-mail: martin.yaffe@sri.utoronto.ca; Bloomquist, Aili K.; Hunter, David M.; Mawdsley, Gordon E. [Physical Sciences Division, Sunnybrook Research Institute, Departments of Medical Biophysics and Medical Imaging, University of Toronto, Ontario M4N 3M5 (Canada); Chiarelli, Anna M. [Prevention and Cancer Control, Cancer Care Ontario, Dalla Lana School of Public Health, University of Toronto, Ontario M4N 3M5, Canada and Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Muradali, Derek [Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Mainprize, James G. [Physical Sciences Division, Sunnybrook Research Institute, Toronto, Ontario M4N 3M5 (Canada)

    2013-12-15

    Purpose: To compare physical measures pertaining to image quality among digital mammography systems utilized in a large breast screening program. To examine qualitatively differences in these measures and differences in clinical cancer detection rates between CR and DR among sites within that program. Methods: As part of the routine quality assurance program for screening, field measurements are made of several variables considered to correlate with the diagnostic quality of medical images including: modulation transfer function, noise equivalent quanta, d′ (an index of lesion detectability) and air kerma to allow estimation of mean glandular dose. In addition, images of the mammography accreditation phantom are evaluated. Results: It was found that overall there were marked differences between the performance measures of DR and CR mammography systems. In particular, the modulation transfer functions obtained with the DR systems were found to be higher, even for larger detector element sizes. Similarly, the noise equivalent quanta, d′, and the phantom scores were higher, while the failure rates associated with low signal-to-noise ratio and high dose were lower with DR. These results were consistent with previous findings in the authors’ program that the breast cancer detection rates at sites employing CR technology were, on average, 30.6% lower than those that used DR mammography. Conclusions: While the clinical study was not large enough to allow a statistically powered system-by-system assessment of cancer detection accuracy, the physical measures expressing spatial resolution, and signal-to-noise ratio are consistent with the published finding that sites employing CR systems had lower cancer detection rates than those using DR systems for screening mammography.

  9. Phosphor plate mammography: contrast studies and clinical experience

    International Nuclear Information System (INIS)

    Chang, C.H.J.; Martin, N.L.; Templeton, A.W.; Cook, L.T.; Harrison, L.A.; McFadden, M.A.; Dwyer, S.J. III; Spicer, J.; Crystal, J.M.

    1992-01-01

    Mammography and accurate microcalcification detection require very good spatial resolution. We have compared the diagnostic capabilities of reduced-exposure, third-generation, 5 cycles/mm computed radiography (CR) phosphor plates with conventional screen-film in 67 patients. No difference in diagnostic accuracy was detected. The digital characteristics of storage phosphor plates erabled us to study the relationship between contrast and spatial resolution. We developed a computer program to identify a single 100 μm pixel in a digital image and assign various gray levels to that pixel. Using this model, we determined that, for our 5 cycles/mm CR system, the imaged contrast of a 100 μm object was 62% of the original contrast. Current 5 cycles/mm phosphor plate systems cannot adequately detect microcalcifications that approximate 100 μm or smaller unless a magnification technique is used. (orig.)

  10. Computer-aided diagnosis in routine mammography

    International Nuclear Information System (INIS)

    Sittek, H.; Perlet, C.; Helmberger, R.; Linsmeier, E.; Kessler, M.; Reiser, M.

    1998-01-01

    Purpose: Computer-aided diagnosis in mammography is a topic many study groups have been concerned with since the first presentation of a system for computer-aided interpretation in 1967. Currently, there is only one system avilable for clinical use in mammography, the CAD-System Image Checker (R2 Technology). The purpose of our prospective study was to evaluate whether the integration of the CAD-system into the routine of a radiological breast diagnosis unit is feasible. Results: After the installation of the CAD-system, 300 patients with 1110 mammograms were included for evaluation in the present study. In 54 of these cases histological examination was indicated due to suspect criteria on conventional mammography. In 39 of 54 cases (72,2%) malignancy could be proven histologically. The CAD-system marked 82,1% of the histologically verified carcinomas correctly 94,3% of all 1797 marks made by the CAD-system indicated normal or benign structures. Routinely performed CAD analysis prolonged patients waiting time by about 15 min because the marks of the CAD system had to be interpreted in addition to the routine diagnostic investigations. Conclusion: Our experience with the use of the CAD-system in daily routine showed that CAD analysis can easily be integrated into a preexisting mammography unit. However, the diagnostic benefit is not yet clearly established. Since the rate of false negative marks by the CAD-system Image Checker is still high, the results of CAD analysis must be checked and corrected by an observer well experienced in mammography reading. (orig.) [de

  11. Quality assurance programme for screen film mammography

    International Nuclear Information System (INIS)

    2009-01-01

    The application of radiation in human health, for both the diagnosis and treatment of disease, is an important component of the work of the IAEA. In the area of diagnostic radiology, this work is focused on quality assurance methods to both the promotion of the effective use of radiation for diagnostic outcome, through achieving and maintaining appropriate image quality, and also on dose determination to allow the monitoring and reduction of dose to the patient. In response to heightened awareness of the importance of patient dose contributed by radiology procedures, the IAEA published Dosimetry in Diagnostic Radiology: An International Code of Practice (Technical Reports Series No. 457) in 2007, to form a basis for patient dose determination for the Member States. Further to this, it is recognized that for complex diagnostic procedures, such as mammography, a detailed guidance document is required to give the professionals in the clinical centre the knowledge necessary to assess the patient dose, as well as to ensure that the procedure gives the maximal patient benefit possible. It is well documented that without the implementation of a quality culture and a systematic quality assurance programme with appropriate education, the detection of breast cancer cannot be made at an early enough stage to allow effective curative treatment to be undertaken. Currently there are a number of established quality assurance protocols in mammography from national and regional institutions, however, many of these protocols are distinctive and so a harmonized approach is required. This will allow the Member States to facilitate quality assurance in mammography in a standardized way which will also facilitate the introduction of national quality assurance programmes that are needed to underpin effective population screening programmes for breast cancer. Development of a quality assurance document for screen film mammography was started in 2005 with the appointment of a drafting

  12. Mammography with rare earth intensifying screens

    International Nuclear Information System (INIS)

    Maurer, H.J.; Goos, F.

    1987-01-01

    Screens basing on rare earth phosphors with suitable films green or blue sensitive may be used in mammography with grids without diagnostic losses. Highest definition will be obtained with medium densities on film. High-speed screens may reduce dose, but definition is poor. Best compromise between speed and high definition may be reached with relative low thickness of phosphor layers. A system of high definition films (Medichrome) and special rare earth screens give best results. (orig.) [de

  13. Studies Comparing Screen-Film Mammography and Full-Field Digital Mammography in Breast Cancer Screening: Updated Review

    International Nuclear Information System (INIS)

    Skaane, P.

    2009-01-01

    Full-field digital mammography (FFDM) has several potential benefits as compared with screen-film mammography (SFM) in mammography screening. Digital technology also opens for implementation of advanced applications, including computer-aided detection (CAD) and tomosynthesis. Phantom studies and experimental clinical studies have shown that FFDM is equal or slightly superior to SFM for detection and characterization of mammographic abnormalities. Despite obvious advantages, the conversion to digital mammography has been slower than anticipated, and not only due to higher costs. Until very recently, some countries did not even permit the use of digital mammography in breast cancer screening. The reason for this reluctant attitude was concern about lower spatial resolution and about using soft-copy reading. Furthermore, there was a lack of data supporting improved diagnostic accuracy using FFDM in a screening setting, since two pioneer trials both showed nonsignificantly lower cancer detection rate at FFDM. The 10 studies comparing FFDM and SFM in mammography screening published so far have shown divergent and rather conflicting results. Nevertheless, there is a rapid conversion to digital mammography in breast cancer screening in many western countries. The aim of this article is to give an updated review of these studies, discuss the conflicting findings, and draw some conclusions from the results

  14. Addition of tomosynthesis to conventional digital mammography: effect on image interpretation time of screening examinations.

    Science.gov (United States)

    Dang, Pragya A; Freer, Phoebe E; Humphrey, Kathryn L; Halpern, Elkan F; Rafferty, Elizabeth A

    2014-01-01

    To determine the effect of implementing a screening tomosynthesis program on real-world clinical performance by quantifying differences between interpretation times for conventional screening mammography and combined tomosynthesis and mammography for multiple participating radiologists with a wide range of experience in a large academic center. In this HIPAA-compliant, institutional review board-approved study, 10 radiologists prospectively read images from screening digital mammography or screening combined tomosynthesis and mammography examinations for 1-hour-long uninterrupted sessions. Images from 3665 examinations (1502 combined and 2163 digital mammography) from July 2012 to January 2013 were interpreted in at least five sessions per radiologist per modality. The number of cases reported during each session was recorded for each reader. The experience level for each radiologist was also correlated to the average number of cases reported per hour. Analysis of variance was used to assess the number of studies interpreted per hour. A linear regression model was used to evaluate correlation between breast imaging experience and time taken to interpret images from both modalities. The mean number of studies interpreted in hour was 23.8 ± 0.55 (standard deviation) (range, 14.4-40.4) for combined tomosynthesis and mammography and 34.0 ± 0.55 (range, 20.4-54.3) for digital mammography alone. A mean of 10.2 fewer studies were interpreted per hour during combined tomosynthesis and mammography compared with digital mammography sessions (P tomosynthesis and mammography and 1.9 minutes ± 0.6 (range, 1.1-3.0) for digital mammography; interpretation time with combined tomosynthesis and mammography was 0.9 minute longer (47% longer) compared with digital mammography alone (P tomosynthesis and mammography examinations decreased (R(2) = 0.52, P = .03). Addition of tomosynthesis to mammography results in increased time to interpret images from screening examinations compared

  15. Breast cancer screening using tomosynthesis in combination with digital mammography.

    Science.gov (United States)

    Friedewald, Sarah M; Rafferty, Elizabeth A; Rose, Stephen L; Durand, Melissa A; Plecha, Donna M; Greenberg, Julianne S; Hayes, Mary K; Copit, Debra S; Carlson, Kara L; Cink, Thomas M; Barke, Lora D; Greer, Linda N; Miller, Dave P; Conant, Emily F

    2014-06-25

    Mammography plays a key role in early breast cancer detection. Single-institution studies have shown that adding tomosynthesis to mammography increases cancer detection and reduces false-positive results. To determine if mammography combined with tomosynthesis is associated with better performance of breast screening programs in the United States. Retrospective analysis of screening performance metrics from 13 academic and nonacademic breast centers using mixed models adjusting for site as a random effect. Period 1: digital mammography screening examinations 1 year before tomosynthesis implementation (start dates ranged from March 2010 to October 2011 through the date of tomosynthesis implementation); period 2: digital mammography plus tomosynthesis examinations from initiation of tomosynthesis screening (March 2011 to October 2012) through December 31, 2012. Recall rate for additional imaging, cancer detection rate, and positive predictive values for recall and for biopsy. A total of 454,850 examinations (n=281,187 digital mammography; n=173,663 digital mammography + tomosynthesis) were evaluated. With digital mammography, 29,726 patients were recalled and 5056 biopsies resulted in cancer diagnosis in 1207 patients (n=815 invasive; n=392 in situ). With digital mammography + tomosynthesis, 15,541 patients were recalled and 3285 biopsies resulted in cancer diagnosis in 950 patients (n=707 invasive; n=243 in situ). Model-adjusted rates per 1000 screens were as follows: for recall rate, 107 (95% CI, 89-124) with digital mammography vs 91 (95% CI, 73-108) with digital mammography + tomosynthesis; difference, -16 (95% CI, -18 to -14; P tomosynthesis; difference, 1.3 (95% CI, 0.4-2.1; P = .004); for cancer detection, 4.2 (95% CI, 3.8-4.7) with digital mammography vs 5.4 (95% CI, 4.9-6.0) with digital mammography + tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P tomosynthesis was associated with an increase

  16. Contrast-enhanced spectral mammography vs. mammography and MRI - clinical performance in a multi-reader evaluation.

    Science.gov (United States)

    Fallenberg, Eva M; Schmitzberger, Florian F; Amer, Heba; Ingold-Heppner, Barbara; Balleyguier, Corinne; Diekmann, Felix; Engelken, Florian; Mann, Ritse M; Renz, Diane M; Bick, Ulrich; Hamm, Bernd; Dromain, Clarisse

    2017-07-01

    To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) to digital mammography (MG) and magnetic resonance imaging (MRI) in a prospective two-centre, multi-reader study. One hundred seventy-eight women (mean age 53 years) with invasive breast cancer and/or DCIS were included after ethics board approval. MG, CESM and CESM + MG were evaluated by three blinded radiologists based on amended ACR BI-RADS criteria. MRI was assessed by another group of three readers. Receiver-operating characteristic (ROC) curves were compared. Size measurements for the 70 lesions detected by all readers in each modality were correlated with pathology. Reading results for 604 lesions were available (273 malignant, 4 high-risk, 327 benign). The area under the ROC curve was significantly larger for CESM alone (0.84) and CESM + MG (0.83) compared to MG (0.76) (largest advantage in dense breasts) while it was not significantly different from MRI (0.85). Pearson correlation coefficients for size comparison were 0.61 for MG, 0.69 for CESM, 0.70 for CESM + MG and 0.79 for MRI. This study showed that CESM, alone and in combination with MG, is as accurate as MRI but is superior to MG for lesion detection. Patients with dense breasts benefitted most from CESM with the smallest additional dose compared to MG. • CESM has comparable diagnostic performance (ROC-AUC) to MRI for breast cancer diagnostics. • CESM in combination with MG does not improve diagnostic performance. • CESM has lower sensitivity but higher specificity than MRI. • Sensitivity differences are more pronounced in dense and not significant in non-dense breasts. • CESM and MRI are significantly superior to MG, particularly in dense breasts.

  17. Artificial Neural Networks for differential diagnosis of breast lesions in MR-Mammography: A systematic approach addressing the influence of network architecture on diagnostic performance using a large clinical database

    International Nuclear Information System (INIS)

    Dietzel, Matthias; Baltzer, Pascal A.T.; Dietzel, Andreas; Zoubi, Ramy; Gröschel, Tobias; Burmeister, Hartmut P.; Bogdan, Martin; Kaiser, Werner A.

    2012-01-01

    Rationale and objectives: Differential diagnosis of lesions in MR-Mammography (MRM) remains a complex task. The aim of this MRM study was to design and to test robustness of Artificial Neural Network architectures to predict malignancy using a large clinical database. Materials and methods: For this IRB-approved investigation standardized protocols and study design were applied (T1w-FLASH; 0.1 mmol/kgBW Gd-DTPA; T2w-TSE; histological verification after MRM). All lesions were evaluated by two experienced (>500 MRM) radiologists in consensus. In every lesion, 18 previously published descriptors were assessed and documented in the database. An Artificial Neural Network (ANN) was developed to process this database (The-MathWorks/Inc., feed-forward-architecture/resilient back-propagation-algorithm). All 18 descriptors were set as input variables, whereas histological results (malignant vs. benign) was defined as classification variable. Initially, the ANN was optimized in terms of “Training Epochs” (TE), “Hidden Layers” (HL), “Learning Rate” (LR) and “Neurons” (N). Robustness of the ANN was addressed by repeated evaluation cycles (n: 9) with receiver operating characteristics (ROC) analysis of the results applying 4-fold Cross Validation. The best network architecture was identified comparing the corresponding Area under the ROC curve (AUC). Results: Histopathology revealed 436 benign and 648 malignant lesions. Enhancing the level of complexity could not increase diagnostic accuracy of the network (P: n.s.). The optimized ANN architecture (TE: 20, HL: 1, N: 5, LR: 1.2) was accurate (mean-AUC 0.888; P: <0.001) and robust (CI: 0.885–0.892; range: 0.880–0.898). Conclusion: The optimized neural network showed robust performance and high diagnostic accuracy for prediction of malignancy on unknown data.

  18. Artificial Neural Networks for differential diagnosis of breast lesions in MR-Mammography: a systematic approach addressing the influence of network architecture on diagnostic performance using a large clinical database.

    Science.gov (United States)

    Dietzel, Matthias; Baltzer, Pascal A T; Dietzel, Andreas; Zoubi, Ramy; Gröschel, Tobias; Burmeister, Hartmut P; Bogdan, Martin; Kaiser, Werner A

    2012-07-01

    Differential diagnosis of lesions in MR-Mammography (MRM) remains a complex task. The aim of this MRM study was to design and to test robustness of Artificial Neural Network architectures to predict malignancy using a large clinical database. For this IRB-approved investigation standardized protocols and study design were applied (T1w-FLASH; 0.1 mmol/kgBW Gd-DTPA; T2w-TSE; histological verification after MRM). All lesions were evaluated by two experienced (>500 MRM) radiologists in consensus. In every lesion, 18 previously published descriptors were assessed and documented in the database. An Artificial Neural Network (ANN) was developed to process this database (The-MathWorks/Inc., feed-forward-architecture/resilient back-propagation-algorithm). All 18 descriptors were set as input variables, whereas histological results (malignant vs. benign) was defined as classification variable. Initially, the ANN was optimized in terms of "Training Epochs" (TE), "Hidden Layers" (HL), "Learning Rate" (LR) and "Neurons" (N). Robustness of the ANN was addressed by repeated evaluation cycles (n: 9) with receiver operating characteristics (ROC) analysis of the results applying 4-fold Cross Validation. The best network architecture was identified comparing the corresponding Area under the ROC curve (AUC). Histopathology revealed 436 benign and 648 malignant lesions. Enhancing the level of complexity could not increase diagnostic accuracy of the network (P: n.s.). The optimized ANN architecture (TE: 20, HL: 1, N: 5, LR: 1.2) was accurate (mean-AUC 0.888; P: <0.001) and robust (CI: 0.885-0.892; range: 0.880-0.898). The optimized neural network showed robust performance and high diagnostic accuracy for prediction of malignancy on unknown data. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Practical digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Beverly E. [Washington Univ., Seattle, WA (United States)]|[Virginia Mason Medical Center, VA (United States)

    2008-07-01

    This book is meant for the radiologist who is facing the challenge of organizing a digital mammographic imaging center. This text is meant to be a practical book that provides information about digital mammographic physics and equipment which will allow one to intelligently compare technologies and systems. Some of the major challenges include: large expense; rapidly changing technology, and inconsistent connectivity; and finally, need for strong information technology support. The initial conversion cost to digital mammographic imaging is relatively expensive due to the cost of digital mammography hardware, software, and storage. Virtually all other imaging modalities are being converted to purely digital storage and transfer, and the digital trend in mammography is inevitable. Technical advantages of digital mammography are described. However, the improved flexibility in image display and transfer are some of its strongest features. In conclusion, although there are increasing imaging modalities that may be used to evaluate breast disease, mammography will continue to play a key role in detecting breast cancer. To be an effective imager, the radiologist should become familiar with digital mammography and understand its role within the increasing complex structure of breast imaging techniques.

  20. Practical digital mammography

    International Nuclear Information System (INIS)

    Hashimoto, Beverly E.

    2008-01-01

    This book is meant for the radiologist who is facing the challenge of organizing a digital mammographic imaging center. This text is meant to be a practical book that provides information about digital mammographic physics and equipment which will allow one to intelligently compare technologies and systems. Some of the major challenges include: large expense; rapidly changing technology, and inconsistent connectivity; and finally, need for strong information technology support. The initial conversion cost to digital mammographic imaging is relatively expensive due to the cost of digital mammography hardware, software, and storage. Virtually all other imaging modalities are being converted to purely digital storage and transfer, and the digital trend in mammography is inevitable. Technical advantages of digital mammography are described. However, the improved flexibility in image display and transfer are some of its strongest features. In conclusion, although there are increasing imaging modalities that may be used to evaluate breast disease, mammography will continue to play a key role in detecting breast cancer. To be an effective imager, the radiologist should become familiar with digital mammography and understand its role within the increasing complex structure of breast imaging techniques

  1. Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Molen, Aart J. van der [Department of Radiology C-2S, Leiden University Medical Centre, Albinusdreef 2, NL-2333 ZA Leiden (Netherlands)], E-mail: molen@lumc.nl; Bellin, Marie-France [Universite Paris-Sud XI, AP-HP, Service de Radiologie, Hopital Paul Brousse, 12-14 Avenue Paul Vaillant Couturier, F-94804 Villejuif Cedex (France)

    2008-05-15

    Since the introduction of the first gadolinium-based contrast agent (Gd-CA) in 1988 it has become clear that these agents significantly improve the diagnostic efficacy of MRI. Studies on single agents have shown that, in comparison to unenhanced sequences, all agents help to improve the detection and delineation of lesions which can alter diagnosis in up to 40% of patients. Doubling or tripling the standard dose of 0.1 mmol/kg body weight may be beneficial for selected indications (e.g. brain perfusion, equivocal single dose study in MRI for brain metastasis, small vessel MR angiography). A more limited number of studies have compared the various agents. These studies do not show clinically significant differences in diagnostic efficacy between the various extracellular Gd-CA. Agents with higher concentration or protein binding may be relatively better suitable for selected applications (e.g. perfusion MRI). The higher relaxivity agents may be used in somewhat lower doses than the extracellular agents.

  2. Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

    International Nuclear Information System (INIS)

    Molen, Aart J. van der; Bellin, Marie-France

    2008-01-01

    Since the introduction of the first gadolinium-based contrast agent (Gd-CA) in 1988 it has become clear that these agents significantly improve the diagnostic efficacy of MRI. Studies on single agents have shown that, in comparison to unenhanced sequences, all agents help to improve the detection and delineation of lesions which can alter diagnosis in up to 40% of patients. Doubling or tripling the standard dose of 0.1 mmol/kg body weight may be beneficial for selected indications (e.g. brain perfusion, equivocal single dose study in MRI for brain metastasis, small vessel MR angiography). A more limited number of studies have compared the various agents. These studies do not show clinically significant differences in diagnostic efficacy between the various extracellular Gd-CA. Agents with higher concentration or protein binding may be relatively better suitable for selected applications (e.g. perfusion MRI). The higher relaxivity agents may be used in somewhat lower doses than the extracellular agents

  3. Analysis on imaging features of mammography in computer radiography and investigation on gray scale transform and energy subtraction

    International Nuclear Information System (INIS)

    Feng Shuli

    2003-01-01

    In this dissertation, a novel transform method based on human visual response features for gray scale mammographic imaging in computer radiography (CR) is presented. The parameters for imaging quality on CR imaging for mammography were investigated experimentally. In addition, methods for image energy subtraction and a novel method of image registration for mammography of CR imaging are presented. Because the images are viewed and investigated by humans, the method of displaying differences in gray scale images is more convenient if the gray scale differences are displayed in a manner commensurate with human visual response principles. Through transformation of image gray scale with this method, the contrast of the image will be enhanced and the capability for humans to extract the useful information from the image will be increased. Tumors and microcalcifications are displayed in a form for humans to view more simply after transforming the image. The method is theoretically and experimentally investigated. Through measurement of the parameters of a geometrically blurred image, MTF, DQE, and ROC on CR imaging, and also comparison with the imaging quality of screen-film systems, the results indicate that CR imaging qualities in DQE and ROC are better than those of screen-film systems. In geometric blur of the image and MTF, the differences in image quality between CR and the screen-film system are very small. The results suggest that the CR system can replace the screen-film system for mammography imaging. In addition, the results show that the optimal imaging energy for CR mammography is about 24 kV. This condition indicates that the imaging energy of the CR system is lower than that of the screen-film system and, therefore, the x-ray dose to the patient for mammography with the CR system is lower than that with the screen-film system. Based on the difference of penetrability of x ray with different wavelength, and the fact that the part of the x-ray beam will pass

  4. Fluorescent diagnostics of epithelial neoplasms of different colon parts.

    Science.gov (United States)

    Korneva, Yulia S; Dorosevich, Alexander E; Maryakhina, Valeriya S

    2017-10-01

    Changes in the biochemical composition of the tissue during colon cancer progression usually precede morphological changes registered by light microscopy. These changes are very sensitive and may be used for diagnostics in difficult cases, when it is impossible to obtain sufficient amount of material during colonoscopy. The aim of the study is analysis of spectral characteristics of sporadic adenomas and tumors in different parts of colon for improving tumors diagnostics in disputable cases. The spectra of fluorescence excitation of histological sections from 78 patients with colon cancer (adenocarcinoma) and colonic adenomas of different localizations were measured. The spectra of fluorescence excitation of all types of adenomas as well as adenocarcinoma have two maxima at 260/270 nm and at 330/340 nm. The first maximum is primarily defined by tryptophan and phenylalanin containing peptides, one of them is glucagon. The second maximum is mainly defined by collagen in stroma. Progression of precancer lesions to advanced cancer leads to increase of NADH concentration impacting on the second maximum of spectra. However, spectra of all types of the investigated lesions have peculiarities depending on localization. At odds to the previous data about similarities between distal colon and rectum, our results demonstrate similar spectra for proximal colon and rectum due to some similarities in morphological and, as a consequence, biochemical composition. Tumor can be detected by spectral techniques on histological slides even if the specimen contains very few tumorous cells in stroma. Biochemical changes and their similarities for precancer lesions and advanced colon cancer have described. Peculiarities of spectral data for different parts of colon may change the previous opinion about similar mechanisms of cancerogenesis for distal colon and rectum. Moreover, investigation of tissue specimen obtained for histological examination and containing lack of malignant

  5. Reproducibility of Mammography Units, Film Processing and Quality Imaging

    International Nuclear Information System (INIS)

    Gaona, Enrique

    2003-01-01

    The purpose of this study was to carry out an exploratory survey of the problems of quality control in mammography and processors units as a diagnosis of the current situation of mammography facilities. Measurements of reproducibility, optical density, optical difference and gamma index are included. Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the Mexican Republic. Mammography is a radiographic examination specially designed for detecting breast pathology. We found that the problems of reproducibility of AEC are smaller than the problems of processors units because almost all processors fall outside of the acceptable variation limits and they can affect the mammography quality image and the dose to breast. Only four mammography units agree with the minimum score established by ACR and FDA for the phantom image

  6. Evaluation of the influence of parameters that determine the mean glandular dose in mammography using different detectors; Evaluacion de la influencia de los parametros que determinan la dosis glandular media en Mamografia utilizando diferentes detectores

    Energy Technology Data Exchange (ETDEWEB)

    Costa, K.; Nogueira, M. S., E-mail: katicostabh@gmail.com [Centro de Desenvolvimento da Tecnologia Nuclear, Pos-graduacao em Ciencias e Tecnologia das Radiacoes, Minerais e Materiais / CNEN, Av. Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte, Minas Gerais (Brazil)

    2015-10-15

    Full text: Mammography is a test used for early detection of breast cancer. The mean glandular dose (MGD) is dosimetric greatness accepted as indicative of carcinogenic risk induced by ionizing radiation in the breasts of women undergoing mammography exams. MGD value is estimated from the incident air kerma (k i), associated with conversion factors which depend on the half-value layer (HVL), the breast composition and thickness compressed breast. This study aims to evaluate the influence of the parameters used to determine the MGD using different measurement detectors. Measurements were performed on a Siemens Mammomat Model 300 Nova mammography equipment; this has the combinations Anode/Filter of Mo/Mo, Mo/Rh and W/Rh. Detectors used were the ionization chamber Model 10X6-6M manufactured by Radcal Co., two solid-state detectors, one Model AGMS-M manufactured by Radcal Co. and other Model Xi Mammo manufactured by UNFORS. The detectors measures were compared and the MGD value was estimated; differences between measurements and the reference values were higher in HVL and k i parameters. The results are displayed according to other published works. (Author)

  7. Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis--Comparison to contrast-enhanced breast MRI.

    Science.gov (United States)

    Chou, Chen-Pin; Lewin, John M; Chiang, Chia-Ling; Hung, Bao-Hui; Yang, Tsung-Lung; Huang, Jer-Shyung; Liao, Jia-Bin; Pan, Huay-Ben

    2015-12-01

    To compare the diagnostic accuracy of contrast-enhanced digital mammography (CEDM) and contrast-enhanced tomosynthesis (CET) to dynamic contrast enhanced breast MRI (DCE-MRI) using a multireader-multicase study. Institutional review board approval and informed consents were obtained. Total 185 patients (mean age 51.3) with BI-RADS 4 or 5 lesions were evaluated before biopsy with mammography, tomosynthesis, CEDM, CET and DCE-MRI. Mediolateral-oblique and cranio-caudal views of the target breast CEDM and CET were acquired at 2 and 4 min after contrast agent injection. A mediolateral-oblique view of the non-target breast was taken at 6 min. Each lesion was scored with forced BI-RADS categories by three readers. Each reader interpreted lesions in the following order: mammography, tomosynthesis, CEDM, CET, and DCE-MRI during a single reading session. Histology showed 81 cancers and 144 benign lesions in the study. Of the 81 malignant lesions, 44% (36/81) were invasive and 56% (45/81) were non-invasive. Areas under the ROC curve, averaged for the 3 readers, were as follows: 0.897 for DCE-MRI, 0.892 for CET, 0.878 for CEDM, 0.784 for tomosynthesis and 0.740 for mammography. Significant differences in AUC were found between the group of contrast enhanced modalities (CEDM, CET, DCE-MRI) and the unenhanced modalities (all p0.05). CET and CEDM may be considered as an alternative modality to MRI for following up women with abnormal mammography. All three contrast modalities were superior in accuracy to conventional digital mammography with or without tomosynthesis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Estimating the relative utility of screening mammography.

    Science.gov (United States)

    Abbey, Craig K; Eckstein, Miguel P; Boone, John M

    2013-05-01

    The concept of diagnostic utility is a fundamental component of signal detection theory, going back to some of its earliest works. Attaching utility values to the various possible outcomes of a diagnostic test should, in principle, lead to meaningful approaches to evaluating and comparing such systems. However, in many areas of medical imaging, utility is not used because it is presumed to be unknown. In this work, we estimate relative utility (the utility benefit of a detection relative to that of a correct rejection) for screening mammography using its known relation to the slope of a receiver operating characteristic (ROC) curve at the optimal operating point. The approach assumes that the clinical operating point is optimal for the goal of maximizing expected utility and therefore the slope at this point implies a value of relative utility for the diagnostic task, for known disease prevalence. We examine utility estimation in the context of screening mammography using the Digital Mammographic Imaging Screening Trials (DMIST) data. We show how various conditions can influence the estimated relative utility, including characteristics of the rating scale, verification time, probability model, and scope of the ROC curve fit. Relative utility estimates range from 66 to 227. We argue for one particular set of conditions that results in a relative utility estimate of 162 (±14%). This is broadly consistent with values in screening mammography determined previously by other means. At the disease prevalence found in the DMIST study (0.59% at 365-day verification), optimal ROC slopes are near unity, suggesting that utility-based assessments of screening mammography will be similar to those found using Youden's index.

  9. Teaching atlas of mammography

    International Nuclear Information System (INIS)

    Tabar, L.; Dean, P.B.

    1985-01-01

    The illustrated case reports in this teaching atlas cover practically the entire range of possible pathological changes and are based on in-patient case material and 80,000 screening documents. The two basic approaches, - detection and analysis of changes -, are taught comprehensively and in great detail. A systematic procedure for analysing the mammographies, in order to detect even the very least changes, and its practical application is explained using mammographies showing unclear findings at first sight. A system of coordinates is presented which allows precise localisation of the changes. Exercises for practising the technique of identifying the pathological changes round up the methodolical chapters. Additional imaging technical enhancements and detail enlargements are of great help in interpreting the findings. The specific approach adopted for this teaching atlas is a 'reverse procedure', which leaves the beaten track and starts with analysing the mammographies and evaluating the radiographic findings, in order to finally derive the diagnosis. (orig./CB) [de

  10. Patient dose assessment in different diagnostic procedures in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sena, E de; Bejar, M J; Berenguer, R [Servicio de Radiofisica y Proteccion Radiologica, Salamanca (Spain); Ruano, R; Tamayo, P [Servicio de Medicina Nuclear, Hospital Universitario de Salamanca (Spain)

    2001-03-01

    Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

  11. Patient dose assessment in different diagnostic procedures in nuclear medicine

    International Nuclear Information System (INIS)

    Sena, E. de; Bejar, M.J.; Berenguer, R.; Ruano, R.; Tamayo, P.

    2001-01-01

    Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

  12. TL dosimetry for quality control of CR mammography imaging systems

    Science.gov (United States)

    Gaona, E.; Nieto, J. A.; Góngora, J. A. I. D.; Arreola, M.; Enríquez, J. G. F.

    The aim of this work is to estimate the average glandular dose with thermoluminescent (TL) dosimetry and comparison with quality imaging in computed radiography (CR) mammography. For a measuring dose, the Food and Drug Administration (FDA) and the American College of Radiology (ACR) use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, full field digital mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium flourohalideE We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated X-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose greater than 3.0 mGy without demonstrating improved image quality. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement for X-rays with a HVL (0.35-0.38 mmAl) and kVp (24-26) used in quality control procedures with ACR Mammography Accreditation Phantom.

  13. Effectiveness of mammography boot camp for radiology residents

    International Nuclear Information System (INIS)

    Kim, Keum Won; Kim, Young Joong; Seo, Jae Young

    2017-01-01

    To evaluate an educational effect of the mammography boot camp (MBC) for radiology residents and analyze affecting factors. Between December 2014 and February 2015, radiology residents in 16 institutions performed the MBC program. We compared the educational effect (score difference between pre- and post-camp test) using 25 case series and analyzed the affecting factors including institution, grades of residents, training periods, presence of sub-specialized breast staff, breast density, and types of cases. The mean scores of 92 residents were 52.80 ± 18.10 and 72.50 ± 12.91 in the pre- and post-camp test, respectively (p = 0.001). There was no significant difference of educational effect according to institution (19.70 ± 16.31), grade, or training period. Although the educational effect of non-trainees was superior to that of trainees (28.10 ± 17.55 vs. 15.90 ± 14.22; p = 0.001), the scores of trainees were higher than those of non-trainees. The diagnostic accuracy showed more improvement in a fatty breast and cases with microcalcifications than compared with others. The MBC showed an effective educational result for radiology residents when interpretating a mammography. It was helpful even for non-trainees. The institution, grades training period, and presence of sub-specialized breast staff did not affect the educational effect

  14. Effectiveness of mammography boot camp for radiology residents

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keum Won; Kim, Young Joong; Seo, Jae Young [Dept. of Radiology, Konyang University Hospital, Daejeon (Korea, Republic of); and others

    2017-01-15

    To evaluate an educational effect of the mammography boot camp (MBC) for radiology residents and analyze affecting factors. Between December 2014 and February 2015, radiology residents in 16 institutions performed the MBC program. We compared the educational effect (score difference between pre- and post-camp test) using 25 case series and analyzed the affecting factors including institution, grades of residents, training periods, presence of sub-specialized breast staff, breast density, and types of cases. The mean scores of 92 residents were 52.80 ± 18.10 and 72.50 ± 12.91 in the pre- and post-camp test, respectively (p = 0.001). There was no significant difference of educational effect according to institution (19.70 ± 16.31), grade, or training period. Although the educational effect of non-trainees was superior to that of trainees (28.10 ± 17.55 vs. 15.90 ± 14.22; p = 0.001), the scores of trainees were higher than those of non-trainees. The diagnostic accuracy showed more improvement in a fatty breast and cases with microcalcifications than compared with others. The MBC showed an effective educational result for radiology residents when interpretating a mammography. It was helpful even for non-trainees. The institution, grades training period, and presence of sub-specialized breast staff did not affect the educational effect.

  15. Compilation of historical dose to the breast received during mammography

    International Nuclear Information System (INIS)

    Thierry-Chef, Isabelle; Cardis, Elisabeth; Simon, Steven L.; Linet, Martha S.

    2008-01-01

    Full text: The effect of low to moderate diagnostic radiation exposures is a topic of interest currently in radiation protection and medicine. Most epidemiological studies, however, lack accurate information on doses received by individuals from medical diagnostic examinations. The need for a better assessment of doses from different types of radiographic examination, especially in the past is crucial for retrospective studies involving medical irradiation. The objective of the present study was to collect and review historic literature discussing radiation dose to the breast likely received from mammography as a function of year. Relevant publications related to mammography for time periods in the 20th century were collected and reviewed for data pertaining to doses to the breast. In many publications, dose to the breasts was not provided. However, it could be estimated in many cases from the dosimetric quantities reported, such as entrance surface dose, either by using provided technical parameters (kV, mAs, filtration) or by assuming typical values. The average value of dose to the breast was derived for each publication. Quality coefficients were derived to assign a greater weight to the most detailed and informative publications. From the dose data and the quality coefficients, a weighted average, minimum and maximum, by time period, were then estimated. Mammography has a long history, from its first use by Salomon in 1913 on 3000 mastectomy specimens to compare x-ray images with tumor lesions. Since then, mammography techniques have evolved in order to obtain better image quality with the objective of improving the diagnosis of breast cancer and other breast diseases. Major technology improvements were seen in the 1970's and 1980's resulting in modifications of medical protocols and consequential reductions of dose to the breast. Dose to the breast from a single view in mammography is presently about 10 times lower than it was in the 1960's when it was about

  16. The impact of breast cancer biological subtyping on tumor size assessment by ultrasound and mammography - a retrospective multicenter cohort study of 6543 primary breast cancer patients

    International Nuclear Information System (INIS)

    Stein, Roland Gregor; Wollschläger, Daniel; Kreienberg, Rolf; Janni, Wolfgang; Wischnewsky, Manfred; Diessner, Joachim; Stüber, Tanja; Bartmann, Catharina; Krockenberger, Mathias; Wischhusen, Jörg; Wöckel, Achim; Blettner, Maria; Schwentner, Lukas

    2016-01-01

    Mammography and ultrasound are the gold standard imaging techniques for preoperative assessment and for monitoring the efficacy of neoadjuvant chemotherapy in breast cancer. Maximum accuracy in predicting pathological tumor size non-invasively is critical for individualized therapy and surgical planning. We therefore aimed to assess the accuracy of tumor size measurement by ultrasound and mammography in a multicentered health services research study. We retrospectively analyzed data from 6543 patients with unifocal, unilateral primary breast cancer. The maximum tumor diameter was measured by ultrasound and/or mammographic imaging. All measurements were compared to final tumor diameter determined by postoperative histopathological examination. We compared the precision of each imaging method across different patient subgroups as well as the method-specific accuracy in each patient subgroup. Overall, the correlation with histology was 0.61 for mammography and 0.60 for ultrasound. Both correlations were higher in pT2 cancers than in pT1 and pT3. Ultrasound as well as mammography revealed a significantly higher correlation with histology in invasive ductal compared to lobular cancers (p < 0.01). For invasive lobular cancers, the mammography showed better correlation with histology than ultrasound (p = 0.01), whereas there was no such advantage for invasive ductal cancers. Ultrasound was significantly superior for HR negative cancers (p < 0.001). HER2/neu positive cancers were also more precisely assessed by ultrasound (p < 0.001). The size of HER2/neu negative cancers could be more accurately predicted by mammography (p < 0.001). This multicentered health services research approach demonstrates that predicting tumor size by mammography and ultrasound provides accurate results. Biological tumor features do, however, affect the diagnostic precision

  17. Contrast Enhanced Spectral Mammography: A Review.

    Science.gov (United States)

    Patel, Bhavika K; Lobbes, M B I; Lewin, John

    2018-02-01

    Contrast-enhanced spectral mammography (CESM) provides low-energy 2D mammographic images comparable to standard digital mammography and a post-contrast recombined image to assess tumor neovascularity similar to magnetic resonance imaging (MRI). The utilization of CESM in the United States is currently low but could increase rapidly given many potential indications for clinical use. This article discusses historical background and literature review of indications and diagnostic accuracy of CESM to date. CESM is a growing technique for breast cancer detection and diagnosis that has levels of sensitivity and specificity on par with contrast-enhanced breast MRI. Because of its similar performance and ease of implementation, CESM is being adopted for multiple indications previously reserved for MRI, such as problem-solving, disease extent in newly diagnosed patients, and evaluating the treatment response of neoadjuvant chemotherapy. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Population-based mammography screening: comparison of screen-film and full-field digital mammography with soft-copy reading--Oslo I study.

    Science.gov (United States)

    Skaane, Per; Young, Kari; Skjennald, Arnulf

    2003-12-01

    To compare screen-film and full-field digital mammography with soft-copy reading in a population-based screening program. Full-field digital and screen-film mammography were performed in 3,683 women aged 50-69 years. Two standard views of each breast were acquired with each modality. Images underwent independent double reading with use of a five-point rating scale for probability of cancer. Recall rates and positive predictive values were calculated. Cancer detection rates determined with both modalities were compared by using the McNemar test for paired proportions. Retrospective side-by-side analysis for conspicuity of cancers was performed by an external independent radiologist group with experience in both modalities. In 3,683 cases, 31 cancers were detected. Screen-film mammography depicted 28 (0.76%) malignancies, and full-field digital mammography depicted 23 (0.62%) malignancies. The difference between cancer detection rates was not significant (P =.23). The recall rate for full-field digital mammography (4.6%; 168 of 3,683 cases) was slightly higher than that for screen-film mammography (3.5%; 128 of 3,683 cases). The positive predictive value based on needle biopsy results was 46% for screen-film mammography and 39% for full-field digital mammography. Side-by-side image comparison for cancer conspicuity led to classification of 19 cancers as equal for probability of malignancy, six cancers as slightly better demonstrated at screen-film mammography, and six cancers as slightly better demonstrated at full-field digital mammography. There was no statistically significant difference in cancer detection rate between screen-film and full-field digital mammography. Cancer conspicuity was equal with both modalities. Full-field digital mammography with soft-copy reading is comparable to screen-film mammography in population-based screening.

  19. Quality assurance programme at Slovak mammography departments

    International Nuclear Information System (INIS)

    Horvathova, M.; Nikodemova, D.

    2004-01-01

    A co-ordinated research program (CRP) for optimisation of image quality in mammography in some Eastern European countries has been initiated by IAEA between 1999 and 2001 and the Slovak Republic took part in this program. The aim of this program was to implement the European QA/QC protocol in a sample of mammography departments and to achieve improvement of the image quality and patient dose reduction. On the national level 28 mammography units were chosen in accordance with equipment performance for quality control programme at this departments, for the first part of the mammography audit in the years 2002-2004. Realisation of CRP project contains: 1) Collection and evaluation of clinical images in agreement with EC criteria; 2) Evaluation of the image quality using mammography test phantom; 3) Measurements of the ESD at patients using TLD; 4) Intercomparison of TLD system calibration with IAEA laboratory; 5) Film reject analysis; 6) Implementation of QC program to the mammography units. The measurements of ESD on patients were performed with TLD (LiF 700 Harshaw). In the 6 month period were collected the results of measurements of: 1) object thickness compensation (measured weekly); 2) long time reproducibility (measured daily); 3) phantom image quality on the standard RMI 156 phantom (measured weekly); 4) ESD on phantom with TLD (once during the audit). Automatic Exposure Control compensation for the object thickness variation was measured by exposing different PMMA plates of thickness ranging from 20 to 60 mm, using the clinical settings. The long term reproducibility has been assessed from the measurements of the optical density and mAs product resulted from the exposure on the PMMA plates. In order to estimate the quality of the images the RMI 156 mammography accreditation phantom was chosen. The accreditation phantom contains test objects which simulate small structures seen in the breast (microcalcifications, fibrils, and tumor like masses). Results of

  20. Contrast-enhanced spectral mammography vs. mammography and MRI - clinical performance in a multi-reader evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Fallenberg, Eva M.; Schmitzberger, Florian F.; Amer, Heba; Engelken, Florian; Bick, Ulrich; Hamm, Bernd [Charite Universitaetsmedizin Berlin, Clinic of Radiology, Campus Virchow-Klinikum, Berlin (Germany); Ingold-Heppner, Barbara [Charite - Universitaetsmedizin Berlin, Institut of Pathology, Berlin (Germany); Balleyguier, Corinne; Dromain, Clarisse [Gustave Roussy Cancer Campus, Department of Radiology, Villejuif (France); Diekmann, Felix [St. Joseph-Stift Bremen, Department of Medical Imaging, Bremen (Germany); Mann, Ritse M. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Renz, Diane M. [Universitaetsklinikum Jena, Department of Radiology, Jena (Germany)

    2017-07-15

    To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) to digital mammography (MG) and magnetic resonance imaging (MRI) in a prospective two-centre, multi-reader study. One hundred seventy-eight women (mean age 53 years) with invasive breast cancer and/or DCIS were included after ethics board approval. MG, CESM and CESM + MG were evaluated by three blinded radiologists based on amended ACR BI-RADS criteria. MRI was assessed by another group of three readers. Receiver-operating characteristic (ROC) curves were compared. Size measurements for the 70 lesions detected by all readers in each modality were correlated with pathology. Reading results for 604 lesions were available (273 malignant, 4 high-risk, 327 benign). The area under the ROC curve was significantly larger for CESM alone (0.84) and CESM + MG (0.83) compared to MG (0.76) (largest advantage in dense breasts) while it was not significantly different from MRI (0.85). Pearson correlation coefficients for size comparison were 0.61 for MG, 0.69 for CESM, 0.70 for CESM + MG and 0.79 for MRI. This study showed that CESM, alone and in combination with MG, is as accurate as MRI but is superior to MG for lesion detection. Patients with dense breasts benefitted most from CESM with the smallest additional dose compared to MG. (orig.)

  1. Quality control in digital mammography: the noise components

    International Nuclear Information System (INIS)

    Leyton, Fernando; Nogueira, Maria do Socorro; Duran, Maria Paz; Dantas, Marcelino; Ubeda, Carlos

    2011-01-01

    To measure the linearity of the detector and determine the noise components (quantum, electronic and structural noise) that contributed to losing image quality and to determine the signal noise ratio (SNR) and contrast noise ratio (CNR). This paper describes the results of the implementation of a protocol for quality control in digital mammography performed in two direct digital mammography equipment (Hologic, Selenia) in Santiago of Chile. Shows the results of linearity and noise analysis of the images which establishes the main cause of noise in the image of the mammogram to ensure the quality and optimize procedures. The study evaluated two digital mammography's Selenia, Hologic (DR) from Santiago, Chile. We conducted the assessment of linearity of the detector, the signal noise ratio, contrast noise ratio and was determined the contribution of different noise components (quantum, electronics and structural noise). Used different thicknesses used in clinical practice according to the protocol for quality control in digital mammography of Spanish society of medical physics and NHSBSP Equipment Report 0604 Version 3. The Selenia mammography software was used for the analysis of images and Unfors Xi detector for measuring doses. The mammography detector has a linear performance, the CNR and SNR did not comply with the Protocol for the thicknesses of 60 and 70 mm. The main contribution of the noise corresponds to the quantum noise, therefore it is necessary to adjust and optimize the mammography system. (author)

  2. Quality control in digital mammography: the noise components

    Energy Technology Data Exchange (ETDEWEB)

    Leyton, Fernando [Universidade de Tarapaca, Arica (Chile). Centro de Estudios en Ciencias Radiologicas; Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Nogueira, Maria do Socorro, E-mail: mnogue@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Duran, Maria Paz [Clinica Alemana, Santiago (Chile). Dept. de Radiologia; Dantas, Marcelino, E-mail: marcelino@inb.gov.b [Industrias Nucleares do Brasil (INB), Caldas, MG (Brazil). Unidade de Tratamento de Minerios; Ubeda, Carlos, E-mail: cubeda@uta.c [Universidade de Tarapaca, Arica (Chile). Fac. de Ciencias de la Salud

    2011-07-01

    To measure the linearity of the detector and determine the noise components (quantum, electronic and structural noise) that contributed to losing image quality and to determine the signal noise ratio (SNR) and contrast noise ratio (CNR). This paper describes the results of the implementation of a protocol for quality control in digital mammography performed in two direct digital mammography equipment (Hologic, Selenia) in Santiago of Chile. Shows the results of linearity and noise analysis of the images which establishes the main cause of noise in the image of the mammogram to ensure the quality and optimize procedures. The study evaluated two digital mammography's Selenia, Hologic (DR) from Santiago, Chile. We conducted the assessment of linearity of the detector, the signal noise ratio, contrast noise ratio and was determined the contribution of different noise components (quantum, electronics and structural noise). Used different thicknesses used in clinical practice according to the protocol for quality control in digital mammography of Spanish society of medical physics and NHSBSP Equipment Report 0604 Version 3. The Selenia mammography software was used for the analysis of images and Unfors Xi detector for measuring doses. The mammography detector has a linear performance, the CNR and SNR did not comply with the Protocol for the thicknesses of 60 and 70 mm. The main contribution of the noise corresponds to the quantum noise, therefore it is necessary to adjust and optimize the mammography system. (author)

  3. Cost-effectiveness of increasing access to mammography through mobile mammography for older women.

    Science.gov (United States)

    Naeim, Arash; Keeler, Emmett; Bassett, Lawrence W; Parikh, Jay; Bastani, Roshan; Reuben, David B

    2009-02-01

    To compare the costs of mobile and stationary mammography and examine the incremental cost-effectiveness of using mobile mammography to increase screening rates. A cost-effectiveness analysis was performed using effectiveness data from a randomized clinical trial and modeling of costs associated with the mobile mammography intervention. The trial involved 60 community-based meal sites, senior centers, and clubs. Four hundred ninety-nine individuals were enrolled in the study, of whom 463 had outcome data available for analysis. Costs were calculated for stationary and mobile mammography, as well as costs due to differences in technology and film versus digital. Incremental cost-effectiveness (cost per additional screen) was modeled, and sensitivity analysis was performed by altering efficiency (throughput) and effectiveness based on subgroup data from the randomized trial. The estimated annual costs were $435,162 for a stationary unit, $539,052 for a mobile film unit, and $456, 392 for a mobile digital unit. Assuming mobile units are less efficient (50% annual volume), the cost per screen was $41 for a stationary unit, $86 for a mobile film unit, and $102 for a mobile digital unit. The incremental cost per additional screen were $207 for a mobile film unit and $264 for a mobile digital unit over a stationary unit. Although mobile mammography is a more effective way to screen older women, the absolute cost per screen of mobile units is higher, whereas the reimbursement is no different. Financial barriers may impede the widespread use of this approach.

  4. Fetal Implications of Diagnostic Radiation Exposure During Pregnancy: Evidence-based Recommendations.

    Science.gov (United States)

    Rimawi, Bassam H; Green, Victoria; Lindsay, Michael

    2016-06-01

    The purpose of this article is to review the fetal and long-term implications of diagnostic radiation exposure during pregnancy. Evidence-based recommendations for radiologic imaging modalities utilizing exposure of diagnostic radiation during pregnancy, including conventional screen-film mammography, digital mammography, tomosynthesis, and contrast-enhanced mammography are described.

  5. Contrast-Enhanced Spectral Mammography: Comparison with Conventional Mammography and Histopathology in 152 Women

    Energy Technology Data Exchange (ETDEWEB)

    Luczyńska, Elzbieta; Heinze-Paluchowska, Sylwia; Dyczek, Sonia [Department of Radiology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115 (Poland); Blecharz, Pawel [Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115 (Poland); Rys, Janusz [Department of Tumour Pathology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115 (Poland); Reinfuss, Marian [Department of Radiotherapy, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow 31-115 (Poland)

    2014-07-01

    The goal of the study was to compare conventional mammography (MG) and contrast-enhanced spectral mammography (CESM) in preoperative women. The study was approved by the local Ethics Committee and all participants provided informed consent. The study included 152 consecutive patients with 173 breast lesions diagnosed on MG or CESM. All MG examinations and consults were conducted in one oncology centre. Non-ionic contrast agent, at a total dose of 1.5 mL/kg body weight, was injected intravenous. Subsequently, CESM exams were performed with a mammography device, allowing dual-energy acquisitions. The entire procedure was done within the oncology centre. Images from low and high energy exposures were processed together and the combination provided an 'iodine' image which outlined contrast up-take in the breast. MG detected 157 lesions in 150 patients, including 92 infiltrating cancers, 12 non-infiltrating cancers, and 53 benign lesions. CESM detected 149 lesions in 128 patients, including 101 infiltrating cancers, 13 non-infiltrating cancers, and 35 benign lesions. CESM sensitivity was 100% (vs. 91% for MG), specificity was 41% (vs. 15% for MG), area under the receiver operating characteristic curve was 0.86 (vs. 0.67 for MG), and accuracy was 80% (vs. 65% for MG) for the diagnosis of breast cancer. Both MG and CESM overestimated lesion sizes compared to histopathology (p < 0.001). CESM may provide higher sensitivity for breast cancer detection and greater diagnostic accuracy than conventional mammography.

  6. Average glandular dose in routine mammography screening using a Sectra Microdose Mammography unit

    International Nuclear Information System (INIS)

    Hemdal, B.; Herrnsdorf, L.; Andersson, I.; Bengtsson, G.; Heddson, B.; Olsson, M.

    2005-01-01

    The Sectra MicroDose Mammography system is based on direct photon counting (with a solid-state detector), and a substantially lower dose to the breast than when using conventional system can be expected. In this work absorbed dose measurements have been performed for the first unit used in routine mammography screening (at the Hospitals of Helsingborg (Sweden)). Two European protocols on dosimetry in mammography have been followed. Measurement of half value layer (HVL) cannot be performed as prescribed, but this study has demonstrated than non-invasive measurements of HVL can be performed accurately with a sensitive and well collimated solid-state detector with simultaneous correction for the energy dependence. The average glandular dose for a 50 mm standard breast with 50% glandularity, simulated by 45 mm polymethylmethacrylate, was found to be 0.21 and 0.28 mGy in March and December 2004, respectively. These values are much lower than for any other mammography system on the market today. It has to be stressed that the measurement were made using the current clinical settings and that no systematic optimisation of the relationship between absorbed dose and diagnostic image quality has been performed within the present study. In order to further increase the accuracy of absorbed dose measurements for this unit, the existing dose protocols should be revised to account also for the tungsten/aluminium anode/filter combination, the multi-slit pre-collimator device and the occurrence of a dose profile in the scanning direction. (authors)

  7. Contrast-Enhanced Spectral Mammography: Comparison with Conventional Mammography and Histopathology in 152 Women

    International Nuclear Information System (INIS)

    Luczyńska, Elzbieta; Heinze-Paluchowska, Sylwia; Dyczek, Sonia; Blecharz, Pawel; Rys, Janusz; Reinfuss, Marian

    2014-01-01

    The goal of the study was to compare conventional mammography (MG) and contrast-enhanced spectral mammography (CESM) in preoperative women. The study was approved by the local Ethics Committee and all participants provided informed consent. The study included 152 consecutive patients with 173 breast lesions diagnosed on MG or CESM. All MG examinations and consults were conducted in one oncology centre. Non-ionic contrast agent, at a total dose of 1.5 mL/kg body weight, was injected intravenous. Subsequently, CESM exams were performed with a mammography device, allowing dual-energy acquisitions. The entire procedure was done within the oncology centre. Images from low and high energy exposures were processed together and the combination provided an 'iodine' image which outlined contrast up-take in the breast. MG detected 157 lesions in 150 patients, including 92 infiltrating cancers, 12 non-infiltrating cancers, and 53 benign lesions. CESM detected 149 lesions in 128 patients, including 101 infiltrating cancers, 13 non-infiltrating cancers, and 35 benign lesions. CESM sensitivity was 100% (vs. 91% for MG), specificity was 41% (vs. 15% for MG), area under the receiver operating characteristic curve was 0.86 (vs. 0.67 for MG), and accuracy was 80% (vs. 65% for MG) for the diagnosis of breast cancer. Both MG and CESM overestimated lesion sizes compared to histopathology (p < 0.001). CESM may provide higher sensitivity for breast cancer detection and greater diagnostic accuracy than conventional mammography

  8. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.

    2007-01-01

    of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems...... on ITER is a substantial challenge. Because of the harsh environment (high levels of neutron and gamma fluxes, neutron heating, particle bombardment) diagnostic system selection and design has to cope with a range of phenomena not previously encountered in diagnostic design. Extensive design and R......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

  9. Results of a 2011 national questionnaire for investigation of mean glandular dose from mammography in Japan.

    Science.gov (United States)

    Asada, Y; Suzuki, S; Minami, K; Shirakawa, S

    2014-03-01

    Diagnostic reference levels (DRLs) for mammography have yet to be created in Japan. A national questionnaire investigation into radiographic conditions in Japan was carried out for the purpose of creating DRLs. Items investigated included the following: tube voltage; tube current; current-time product; source-image distance; craniocaudal view; automatic exposure control (AEC) settings; name of mammography unit; image receptor system (computed radiography (CR), flat panel detector (FPD), or film/screen (F/S)); and supported or unsupported monitor diagnosis (including monitor resolution). Estimation of the mean glandular dose (MGD) for mammography was performed and compared with previous investigations. The MGD was 1.58(0.48) mGy, which did not significantly differ from a 2007 investigation. In relation to image receptors, although no difference in average MGD values was observed between CR and FPD systems, F/S systems had a significantly decreased value compared to both CR and FPDs. Concerning digital systems (FPDs), the MGD value of the direct conversion system was significantly higher than the indirect conversion system. No significant difference in MGD value was evident concerning type of monitor diagnosis for either the CR or the FPD digital systems; however, hard copies were used more often in CR. No significant difference in the MGD value was found in relation to monitor resolution. This report suggests ways to lower the doses patients undergoing mammography receive in Japan, and serves as reference data for 4.2 cm compressed breast tissue of 50% composition DRLs. Furthermore, our findings suggest that further optimisation of FPD settings can promote a reduction in the MGD value.

  10. Laboratory Information Systems in Molecular Diagnostics: Why Molecular Diagnostics Data are Different.

    Science.gov (United States)

    Lee, Roy E; Henricks, Walter H; Sirintrapun, Sahussapont J

    2016-03-01

    Molecular diagnostic testing presents new challenges to information management that are yet to be sufficiently addressed by currently available information systems for the molecular laboratory. These challenges relate to unique aspects of molecular genetic testing: molecular test ordering, informed consent issues, diverse specimen types that encompass the full breadth of specimens handled by traditional anatomic and clinical pathology information systems, data structures and data elements specific to molecular testing, varied testing workflows and protocols, diverse instrument outputs, unique needs and requirements of molecular test reporting, and nuances related to the dissemination of molecular pathology test reports. By satisfactorily addressing these needs in molecular test data management, a laboratory information system designed for the unique needs of molecular diagnostics presents a compelling reason to migrate away from the current paper and spreadsheet information management that many molecular laboratories currently use. This paper reviews the issues and challenges of information management in the molecular diagnostics laboratory.

  11. Satellite teleradiology test bed for digital mammography

    Science.gov (United States)

    Barnett, Bruce G.; Dudding, Kathryn E.; Abdel-Malek, Aiman A.; Mitchell, Robert J.

    1996-05-01

    Teleradiology offers significant improvement in efficiency and patient compliance over current practices in traditional film/screen-based diagnosis. The increasing number of women who need to be screened for breast cancer, including those in remote rural regions, make the advantages of teleradiology especially attractive for digital mammography. At the same time, the size and resolution of digital mammograms are among the most challenging to support in a cost effective teleradiology system. This paper will describe a teleradiology architecture developed for use with digital mammography by GE Corporate Research and Development in collaboration with Massachusetts General Hospital under National Cancer Institute (NCI/NIH) grant number R01 CA60246-01. The testbed architecture is based on the Digital Imaging and Communications in Medicine (DICOM) standard, created by the American College of Radiology and National Electrical Manufacturers Association. The testbed uses several Sun workstations running SunOS, which emulate a rural examination facility connected to a central diagnostic facility, and uses a TCP-based DICOM application to transfer images over a satellite link. Network performance depends on the product of the bandwidth times the round- trip time. A satellite link has a round trip of 513 milliseconds, making the bandwidth-delay a significant problem. This type of high bandwidth, high delay network is called a Long Fat Network, or LFN. The goal of this project was to quantify the performance of the satellite link, and evaluate the effectiveness of TCP over an LFN. Four workstations have Sun's HSI/S (High Speed Interface) option. Two are connected by a cable, and two are connected through a satellite link. Both interfaces have the same T1 bandwidth (1.544 Megabits per second). The only difference was the round trip time. Even with large window buffers, the time to transfer a file over the satellite link was significantly longer, due to the bandwidth-delay. To

  12. Effect of adding screening ultrasonography to screening mammography on patient recall and cancer detection rates: A retrospective study in Japan

    International Nuclear Information System (INIS)

    Tohno, Eriko; Umemoto, Takeshi; Sasaki, Kyoko; Morishima, Isamu; Ueno, Ei

    2013-01-01

    Purpose: To determine whether adding screening ultrasonography to screening mammography can reduce patient recall rates and increase cancer detection rates. Materials and methods: We analyzed the results of mammography and ultrasonography breast screenings performed at the Total Health Evaluation Center Tsukuba, Japan, between April 2011 and March 2012. We also reviewed the modalities and results of diagnostic examinations from women with mammographic abnormalities who visited the Tsukuba Medical Center Hospital for further testing. Results: Of 11,753 women screened, cancer was diagnosed in 10 (0.22%) of the 4529 participants who underwent mammography alone, 23 (0.37%) of the 6250 participants who underwent ultrasonography alone, and 5 (0.51%) of the 974 participants who underwent mammography and ultrasonography. The recall rate due to mammographic abnormalities was 4.9% for women screened only with mammography and 2.6% for those screened with both modalities. The cancer detection rate was 0.22% for women screened only with mammography (positive predictive value, 4.5%) and 0.31% for those screened with both modalities (positive predictive value, 12.0%). Of the 211 lesions presenting as mammographic abnormalities investigated further, diagnostic ultrasonography found no abnormalities in 63 (29.9%) and benign findings in 69 (33.7%). The rest 36.4% needed mammography, cytological or histological examinations or follow-up in addition to diagnostic ultrasonography. Conclusions: It is possible to reduce the recall rate in screening mammography by combining mammography and ultrasonography for breast screening

  13. Dose measurements in mammography

    International Nuclear Information System (INIS)

    Kainberger, F.; Kallinger, W.

    1977-01-01

    Dose measurements at the mamma during mammography were carried out in the form of direct measurement with thermoluminescent dosimetry. Measurement was done for the in- and outcoming doses at the mamma, the dose exposure of the sternal region and the scattered rays above the symphysis, the latter as parameter for the genetic radiation exposure. As expected, the dose of the smooth radiation used for mammography showed a strong decrease at the outcome point in comparison with the income point. Surprisingly high was the scattered radiation in the sternal region. A corresponding protection by lead plates could be taken into consideration. Extremely low is the scattered radiation above the symphysis. Even measurements with the very sensitive calcium fluoride dosimeters did not reveal any practically important dose in the symphysis region. Most measurement values remained below the determinable dose of 0.3mR. Some maximal values varied in the range of 3-1 mR. (orig.) [de

  14. Current status of mammography

    International Nuclear Information System (INIS)

    Crymes, J.E.

    1979-01-01

    Great progress has been made in recent years in the diagnosis and treatment of breast cancer; however, breast cancer continues to be the most common and lethal cancer in women today. Early diagnosis is essential in order for treatmet to be given before the tumor spreads beyond the breast. The radiation risks of mammography have been greatly reduced with the use of newer low-dose techniques, and the benefits of mammography have increased because of a better understanding of the natural history of breast cancer, as well as improved methods of treatment. Radiologists must continue to take an active role in the early diagnosis of breast cancer. Continued research is needed in order to improve screening methods and to develop newer, noninvasive techniques

  15. Soft copy digital mammography

    International Nuclear Information System (INIS)

    Kim, Hak Hee

    2005-01-01

    Screen-film mammography (SFM) has been the standard method used for breast cancer screening and making a clinical diagnosis. It is a valuable modality for the detection and differentiation of breast calcifications. The advantages are the high spatital resolution, the convenient display, and inexpensiveness. However, it has some inherent limitations such as its low detective quantum efficiency and difficulty of post-processing after obtaining after an image. Digital mammography (DM) has the potential to overcome the inherent limitations of SFM. DM systems directly qualify x-ray photons and decouple the process of x-ray photon detection from the image display. The digital images can be processed by a computer and displayed in multiple formats. Thus, DM is better than SFM for the detection of mass lesions due to its high contrast resolution

  16. Analysis of medical exposures in digital mammography

    International Nuclear Information System (INIS)

    Oliveira, Sergio R.; Mantuano, Natalia O.; Albrecht, Afonso S.

    2014-01-01

    Currently, the use of digital mammography in the early diagnosis of breast cancer is increasingly common due to the production of high definition image that allows to detect subtle changes in breast images profiles. However it is necessary to be an improvement of the technique used since some devices offer minimization parameters of entrance dose to the skin. Thus, this study seeks to examine how the qualification of technical professionals in radiology interferes with the use of the techniques applied in mammography. For this, survey was carried out in a hospital in the city of Rio de Janeiro, which evaluated the scans of 1190 patients undergoing routine mammography (It is considered routinely the 4 basic exhibitions: with 2 flow skull and 2 medium oblique side, excluding repeats and supplements) in 2013. The medical exposures analyzed obtained from a single full digital equipment, model Senographe DS were compared with three different procedures performed by professionals in mammography techniques. The images were classified according to exposure techniques available in the equipment: Standard (STD), contrast (CNT) and dose (dose), and to be selected as breast density of the patient. Comparing the variation of the radiographic technique in relation to the professional who made the exhibition, what is observed is that the professional B presented the best conduct in relation to radiological protection, because she considered breast density in the choice of technical equipment parameter. The professional A, which is newly formed, and C, which has more service time, almost did not perform variations in the pattern of exposure, even for different breast densities. Thus, we can conclude that there is a need to update the professionals so that the tools available of dose limitation and mamas variability to digital mammography are efficiently employed in the service routine and thus meet the requirements of current legislation

  17. Radiology Residents' Performance in Screening Mammography Interpretation

    International Nuclear Information System (INIS)

    Lee, Eun Hye; Lyou, Chae Yeon

    2013-01-01

    To evaluate radiology residents' performance in screening mammography interpretation and to analyze the factors affecting performance. We enrolled 203 residents from 21 institutions and performed mammography interpretation tests. Between the trainee and non-trainee groups, we compared the interpretation score, recall rate, sensitivity, positive predictive value (PPV) and false-positive rate (FPR). We estimated the training effect using the score differences between trainee and non-trainee groups. We analyzed the factors affecting performance between training-effective and non-effective groups. Trainees were superior to non-trainees regarding interpretation score (43.1 vs. 37.1), recall rate (11.0 vs. 15.5%), sensitivity (83.6 vs. 72.0%), PPV (53.0 vs. 32.4%) and FPR (13.5 vs. 25.5). The longer the training period, the better were the interpretation score, recall rate, sensitivity, PPV and FPR (rho = 0.486, -0.375, 0.343, 0.504, -0.446, respectively). The training affected an increase by an average of 6 points; however, 31.6% of institutions showed no effect. A difference was noted in the volume of mammography interpretation during a month (594.0 vs. 476.9) and dedication of breast staff (61.5 vs. 0%) between training-effective and non-effective groups. Trainees showed better performance in mammography interpretation compared to non-trainees. Moreover, performance was correlated with the training period. The factors affecting performance were the volume of mammography interpretation and the dedication of the breast staff.

  18. Diagnosing Chronic Pancreatitis Comparison and Evaluation of Different Diagnostic Tools

    NARCIS (Netherlands)

    Issa, Yama; van Santvoort, Hjalmar C.; van Dieren, Susan; Besselink, Marc G.; Boermeester, Marja A.; Ahmed Ali, Usama

    2017-01-01

    Objectives: This study aims to compare theM-ANNHEIM, Buchler, and Luneburg diagnostic tools for chronic pancreatitis (CP). Methods: A cross-sectional analysis of the development of CP was performed in a prospectively collected multicenter cohort including 669 patients after a first episode of acute

  19. The effects of gray scale image processing on digital mammography interpretation performance.

    Science.gov (United States)

    Cole, Elodia B; Pisano, Etta D; Zeng, Donglin; Muller, Keith; Aylward, Stephen R; Park, Sungwook; Kuzmiak, Cherie; Koomen, Marcia; Pavic, Dag; Walsh, Ruth; Baker, Jay; Gimenez, Edgardo I; Freimanis, Rita

    2005-05-01

    To determine the effects of three image-processing algorithms on diagnostic accuracy of digital mammography in comparison with conventional screen-film mammography. A total of 201 cases consisting of nonprocessed soft copy versions of the digital mammograms acquired from GE, Fischer, and Trex digital mammography systems (1997-1999) and conventional screen-film mammograms of the same patients were interpreted by nine radiologists. The raw digital data were processed with each of three different image-processing algorithms creating three presentations-manufacturer's default (applied and laser printed to film by each of the manufacturers), MUSICA, and PLAHE-were presented in soft copy display. There were three radiologists per presentation. Area under the receiver operating characteristic curve for GE digital mass cases was worse than screen-film for all digital presentations. The area under the receiver operating characteristic for Trex digital mass cases was better, but only with images processed with the manufacturer's default algorithm. Sensitivity for GE digital mass cases was worse than screen film for all digital presentations. Specificity for Fischer digital calcifications cases was worse than screen film for images processed in default and PLAHE algorithms. Specificity for Trex digital calcifications cases was worse than screen film for images processed with MUSICA. Specific image-processing algorithms may be necessary for optimal presentation for interpretation based on machine and lesion type.

  20. Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment

    Science.gov (United States)

    Nikitovic-Jokic, Milica; Tu, Hong Anh; Palimaka, Stefan; Higgins, Caroline; Holubowich, Corinne

    2016-01-01

    Background Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Ultrasound has been suggested as a safe adjunct screening tool that can detect breast cancers missed on mammography. We investigated the benefits, harms, cost-effectiveness, and cost burden of ultrasound as an adjunct to mammography compared with mammography alone for screening women at average risk and at high risk for breast cancer. Methods We searched Ovid MEDLINE, Ovid Embase, EBM Reviews, and the NHS Economic Evaluation Database, from January 1998 to June 2015, for evidence of effectiveness, harms, diagnostic accuracy, and cost-effectiveness. Only studies evaluating the use of ultrasound as an adjunct to mammography in the specified populations were included. We also conducted a cost analysis to estimate the costs in Ontario over the next 5 years to fund ultrasound as an adjunct to mammography in breast cancer screening for high-risk women who are contraindicated for MRI, the current standard of care to supplement mammography. Results No studies in average-risk women met the inclusion criteria of the clinical review. We included 5 prospective, paired cohort studies in high-risk women, 4 of which were relevant to the Ontario context. Adjunct ultrasound identified between 2.3 and 5.9 additional breast cancers per 1,000 screens. The average pooled sensitivity of mammography and ultrasound was 53%, a statistically significant increase relative to mammography alone (absolute increase 13%; P screening alone. The GRADE for this body of evidence was low. Additional annual costs of using breast ultrasound as an adjunct to mammography for high-risk women in Ontario contraindicated for MRI would range from $15,500 to $30,250 in the next 5 years. Conclusions We found no evidence that evaluated the comparative effectiveness or diagnostic accuracy of screening breast ultrasound as an adjunct to

  1. Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program.

    Science.gov (United States)

    Skaane, Per; Bandos, Andriy I; Gullien, Randi; Eben, Ellen B; Ekseth, Ulrika; Haakenaasen, Unni; Izadi, Mina; Jebsen, Ingvild N; Jahr, Gunnar; Krager, Mona; Niklason, Loren T; Hofvind, Solveig; Gur, David

    2013-04-01

    To assess cancer detection rates, false-positive rates before arbitration, positive predictive values for women recalled after arbitration, and the type of cancers detected with use of digital mammography alone and combined with tomosynthesis in a large prospective screening trial. A prospective, reader- and modality-balanced screening study of participants undergoing combined mammography plus tomosynthesis, the results of which were read independently by four different radiologists, is under way. The study was approved by a regional ethics committee, and all participants provided written informed consent. The authors performed a preplanned interim analysis of results from 12,631 examinations interpreted by using mammography alone and mammography plus tomosynthesis from November 22, 2010, to December 31, 2011. Analyses were based on marginal log-linear models for binary data, accounting for correlated interpretations and adjusting for reader-specific performance levels by using a two-sided significance level of .0294. Detection rates, including those for invasive and in situ cancers, were 6.1 per 1000 examinations for mammography alone and 8.0 per 1000 examinations for mammography plus tomosynthesis (27% increase, adjusted for reader; P = .001). False-positive rates before arbitration were 61.1 per 1000 examinations with mammography alone and 53.1 per 1000 examinations with mammography plus tomosynthesis (15% decrease, adjusted for reader; P tomosynthesis; P = .72). Twenty-five additional invasive cancers were detected with mammography plus tomosynthesis (40% increase, adjusted for reader; P tomosynthesis (P tomosynthesis in a screening environment resulted in a significantly higher cancer detection rate and enabled the detection of more invasive cancers. Clinical trial registration no. NCT01248546. RSNA, 2013

  2. Comparison of dignity determination of mammographic microcalcification with two systems for digital full-field mammography with different detector resolution. A retrospective clinical study; Vergleich der Dignitaetsbestimmung von mammographischem Mikrokalk mit zwei Systemen zur digitalen Vollfeldmammographie unterschiedlicher Detektoraufloesung. Eine retrospektive klinische Studie

    Energy Technology Data Exchange (ETDEWEB)

    Schulz-Wendtland, R.; Adamietz, B.; Meier-Meitinger, M.; Wenkel, E.; Lell, M.; Anders, K.; Uder, M. [Universitaetsklinikum Erlangen, Abteilung Gynaekologische Radiologie, Radiologisches Institut, Erlangen (Germany); Hermann, K.P. [Universitaetsmedizin Goettingen, Abteilung Diagnostische Radiologie, Goettingen (Germany)

    2011-02-15

    The aim of this retrospective clinical study was to compare the diagnostic accuracy of the novel 50 {mu}m FFDM (full-field digital mammography) system (DR) with an established 70 {mu}m system (DR) in the differential diagnosis between benign and malignant clusters of microcalcification (n=50) (BI-RADS trademark classification 4/5) and to assess the possible incremental value of the 50 {mu}m pixel-pitch on specificity. From March 2009 to September 2009, 50 patients underwent full-field digital mammography (FFDM) (detector resolution 70 {mu}m) (Novation, Siemens, Erlangen, Germany). As there were suspicious signs of microcalcification classified with BI-RADS trademark 4/5 after diagnosis and preoperative wire localization, control images were made with the new FFDM system (detector: resolution 50 {mu}m) (Amulet, Fujifilm, Tokyo, Japan) with the same exposure parameters. The diagnosis was determined after the operation by five radiologists with different experience in digital mammography from randomly distributed mediolateral views (monitor reading) whose results were correlated with the final histology of all lesions. Histopathology revealed 19 benign and 31 malignant lesions in 50 patients after open biopsy. The results of the five readers showed a higher sensitivity of the new FFDM system (80.0%) in the ability to recognize malignant microcalcification in comparison to the established system (74.8%). The specificity (75.8 versus 71.6%) was slightly higher for the new system but hese results were not statistically significant (p<0.001). Considering the diagnostic accuracy, the new system (detector: resolution 50 {mu}m) was also slightly superior to the well-known system (detector: resolution 70 {mu}m) (80.1% versus 76.4%). Our study has shown that the new full-field digital mammography system using the novel detector compared with the already established FFDM system with respect to the assessment of microcalcification is at least equivalent. (orig.) [German] Das

  3. Statistical Texture Model for mass Detection in Mammography

    Directory of Open Access Journals (Sweden)

    Nicolás Gallego-Ortiz

    2013-12-01

    Full Text Available In the context of image processing algorithms for mass detection in mammography, texture is a key feature to be used to distinguish abnormal tissue from normal tissue. Recently, a texture model based on a multivariate Gaussian mixture was proposed, of which the parameters are learned in an unsupervised way from the pixel intensities of images. The model produces images that are probabilistic maps of texture normality and it was proposed as a visualization aid for diagnostic by clinical experts. In this paper, the usability of the model is studied for automatic mass detection. A segmentation strategy is proposed and evaluated using 79 mammography cases.

  4. Contrast-enhanced Spectral Mammography: Technique, Indications, and Clinical Applications.

    Science.gov (United States)

    Bhimani, Chandni; Matta, Danielle; Roth, Robyn G; Liao, Lydia; Tinney, Elizabeth; Brill, Kristin; Germaine, Pauline

    2017-01-01

    Contrast-enhanced spectral mammography (CESM) combines the benefits of full field digital mammography with the concept of tumor angiogenesis. Technique and practical applications of CESM are discussed. An overview of the technique is followed by a demonstration of practical applications of CESM in our practice. We have successfully implemented CESM into our practice as a screening, diagnostic, staging, and treatment response tool. It is important to understand the technique of CESM and how to incorporate it into practice. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  5. Trimodel Mammography with Perfect Coregistration

    Science.gov (United States)

    2017-02-01

    background, the major confounding factor in reading mammography; the imaging characteristics suggest that this contrast mechanism would be preferable...image with enhanced edges and reduced anatomical background, the major confounding factor in reading mammography; the imaging characteristics suggest...subjects, vertebrate animals , biohazards, and/or select agents Describe significant deviations, unexpected outcomes, or changes in approved protocols

  6. Serological diagnosis of syphilis: a comparison of different diagnostic methods.

    Science.gov (United States)

    Simčič, Saša; Potočnik, Marko

    2015-01-01

    Serological tests' limitations in syphilis diagnosis as well as numerous test interpretations mean that patients with discordant serology results can present diagnostic and treatment challenges for clinicians. We analyzed three common diagnostic algorithms for detecting suspected syphilis in high-prevalence populations in Slovenia. The prospective study included a total of 437 clinical serum samples from adults throughout Slovenia tested with Rapid Plasma Reagin (RPR), Treponema pallidum hemagglutination (TPHA), and an automated chemiluminescence immunoassay (CIA) according to the manufacturer's instructions. In addition to percent agreement, kappa coefficients were calculated as a secondary measure of agreement between the three algorithms. Overall, of 183 subjects that had seroreactive results, 180 were seroreactive in both the reverse sequence and the European Centre for Disease Prevention and Control (ECDC) algorithm. The traditional algorithm had a missed serodiagnosis rate of 30.0%, the overall percent agreement between the traditional and the reverse algorithm (or the ECDC algorithm) was 87.6%, and the kappa value was 0.733. However, the reverse and ECDC algorithm failed to detect three subjects with positive serodiagnosis determined by additional confirmative treponemal assays. Our results supported the ECDC algorithm in the serodiagnosis of syphilis in high-prevalence populations and the use of nontreponemal serology to monitor the response to treatment.

  7. Different clinical presentations, diagnostic difficulties, and management of cecal duplication.

    Science.gov (United States)

    Temiz, Abdulkerim; Oğuzkurt, Pelin; Ezer, Semire Serin; İnce, Emine; Gezer, Hasan Özkan; Hiçsönmez, Akgün

    2013-03-01

    Cecal duplications (CDs) are very rare, representing 0.4% of all gastrointestinal duplications. This study evaluates the variable clinical presentations, imaging workup, and surgical management of CDs. The records of 7 patients who underwent surgery between April 2001 and December 2011 for CD were retrospectively reviewed. Sex, age, duration of complaints, diagnostic studies, surgical intervention, and pathologic findings were recorded. The median age was 8 months, and mean age was 1.65 ± 2.88 years. Complaints were abdominal pain, rectal bleeding, vomiting, cough and dyspnea, and a prenatally detected cystic mass. The patients were referred with the diagnosis of appendicular abscess, necrotizing enterocolitis, gastrointestinal lymphoma, and intraabdominal cystic mass. Abdominal distention, signs of peritonitis, substernal retraction, fullness at right lower quadrant, and normal findings were detected on physical examination. Diagnostic imaging included plain abdominal radiography (7), ultrasonography (7), computed tomography (3), and magnetic resonance imaging (2). A cystic mass was reported on radiologic studies in 6 patients and appendicular abscess in 1. Cyst and cecum were resected, ileocolostomy was performed in 6 patients, and cyst excision was performed in 1. The diagnosis of duplication cyst was made by pathologic examination in all patients. Cecal duplications may be detected incidentally; however, they may mimic appendicular abscess, a tumor mass, or necrotizing enterocolitis. Whether cystic lesions are symptomatic, they should be excised when detected because of possible complications. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Determination of mean glandular dose on patients and phantom in X-ray mammography

    International Nuclear Information System (INIS)

    Avramova-Cholakova, S.; Vassileva, J.

    2008-01-01

    The statistics of breast cancer rate in Bulgaria show a tendency towards increase of the morbidity from this disease. Last years campaigns against breast cancer are organized yearly. This leads to an increased number of screening and diagnostic mammograms that are made in the country. The dose associated with the examination is very low but not slightingly small. The glandular tissue in the breast is considered to be the most sensitive in relation to the radiation exposure. Several publications propose different methods, measurement set up or conversion coefficients for the calculation of the mean glandular dose (MGD) delivered to the breast during the X-ray examination. The question about the standardization of the measurement procedures arises since the differences in the results obtained using different methodologies may be quite big. The aim of this work is to develop a standard procedure for the measurement of MGD based on the recommendations mentioned in the European protocol on dosimetry in mammography, the European protocol for the quality control of the physical and technical aspects of mammography screening and the Code of practice: TRS 457 of the IAEA. Five contemporary film-screen mammography units were included in this study. Attention should be paid to the measurement set up. The reference point is chosen 6 cm from the chest wall edge laterally centered. If an ionization chamber is used for dose measurements the compression plate should be placed in close contact with it. If solid state detectors are used the compression plate should be put away from the detector and the output recalculated like if the plate is near the detector. The conversion coefficients for age dependence are not used in this study as not appropriate for the population included in it. PMMA measurements for the determination of diagnostic reference levels could be used but more correct results would be obtained with patient measurements

  9. Time for a re-evaluation of mammography in the young? Results of an audit of mammography in women younger than 40 in a resource restricted environment.

    Science.gov (United States)

    Taylor, Liezel; Basro, Sarinah; Apffelstaedt, Justus P; Baatjes, Karin

    2011-08-01

    Mammography in younger women is considered to be of limited value. In a resource restricted environment without access to magnetic resonance imaging (MRI) and with a high incidence of breast cancer in the young, mammography remains an important diagnostic tool. Recent technical advances and better regulation of mammography make a reassessment of its value in these conditions necessary. Data of all the mammograms performed at a tertiary hospital and private breast clinic between January 2003 and July 2009 in women less than 40 years of age were collected. Indications were the presence of a mass, follow-up after primary cancer therapy, and screening for patients perceived at high risk due to a family history or the presence of atypical hyperplasia. Data acquired were as follows: Demographics, prior breast surgery, indication for mammography, outcome of mammography, diagnostic procedures, and their results. Of 2,167 mammograms, 393 were performed for a palpable mass, diagnostic mammography. In these, the overall cancer detection rate was 40%. If the mammography was reported as breast imaging reporting and data system (BIRADS(®)) 5 versus BIRADS(®) 3 and 4 versus BIRADS(®) 1 and 2, a final diagnosis of malignancy was established in 96, 48, and 5%, respectively. Of 367 mammograms done for the follow-up after primary treatment of breast cancer, seven cancers were diagnosed for a detection rate of 1.9%. Of 1,312 mammograms performed for screening, the recall rate was 4%; the biopsy rate 2%, and the cancer diagnosis rate 3/1,000 examinations. In contrast to past series, this series has shown that recent advances in mammography have made it a useful tool in the management of breast problems in young women, notably in a resource-restricted environment. Women for screening should be selected carefully.

  10. Influence of age and menstrual cycle on mammography and MR imaging of the breast; Einfluss von Alter und Menstruationszyklus auf Mammographie und MR-Mammographie

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Schimpfle, M.; Ohmenhaeuser, K.; Claussen, C.D. [Tuebingen Univ. (Germany). Abt. fuer Radiologische Diagnostik

    1997-09-01

    Age and menstrual cycle have an important influence on the breast. This well-known fact is experienced in the daily routine of gynecologists and radiologists. The number of publications addressing the effect of these influences on imaging, however, is surprisingly low. The aim of this work is to describe the influences of age and menstrual cycle on the breast and to address their clinical relevance for mammography and MR mammography. Therefore, own data are presented concerning the age and menstrual cycle influences on breast parenchyma in dynamic MR mammography. Literature data are used to correlate mammography and MR imaging findings with these influences. The changes of the breast due to age and menstrual cycle have important direct implications on performing and reading conventional mammography and MR mammography. The knowledge of these changes is also helpful in the interpretation of findings when comparing different methods. Finally, the data gained by using imaging methods enable important basic insights into physiology and physiopathology of the breast in vivo. (orig.) [Deutsch] Alter und Menstruationszyklus stellen wichtige Einflussfaktoren auf die Mamma dar. Diese Tatsache ist klinisch lange bekannt und im Alltag des Gynaekologen wie Radiologen staendig praesent. Dagegen ist die Anzahl der Publikationen zu den Auswirkungen dieser Einfluesse auf die Bildgebung erstaunlich niedrig. Ziel dieser Arbeit ist es, die alters- und zyklusabhaengigen Veraenderungen der Mamma und deren klinische Relevanz fuer die Mammographie und MR-Mammographie darzustellen. Zu diesem Zweck werden aus einer eigenen Studie Daten der dynamischen MR-Tomographie zum Alters- und Zykluseinfluss auf das Mammaparenchym praesentiert. Darueber hinaus werden diese Einflussfaktoren mit mammographischen und MR-tomographischen Daten aus der Literatur korreliert. Dabei zeigt sich, dass sich aus den alters- und menstruationszyklusbedingten Veraenderungen der Brust wichtige unmittelbare

  11. Quality control: comparison of images quality with screen film system and digital mammography CR

    International Nuclear Information System (INIS)

    Alvarenga, Frederico L.; Nogueira, Maria do Socorro

    2008-01-01

    The mammography screen film system should be used as part of processing chemicals, revelation process, equipment and this system has have a progressive replacing by the digital technology Full Field Digital Mammography FFDM, Computed Radiography (CR) Mammography and hardcopy. This new acquisition process of medical images has improved radiology section; however it is necessary efficient means for evaluating of the quality parameters. It should be considered taking into account the adaptation of the existent equipment and that procedures adopted for the exam, as well the adaptation of the new mammography films, the radiologist view box constitutes a part of the quality control program. This program aims at obtaining radiography with good quality that allows obtaining more information for the diagnosis and decreases the patient dose. For evaluation the quality image, this article is focused on presenting the differences regarding the acquired images through simulator mammography radiographic PMMA (Poly methyl methacrylate) in CR Mammography system and screen film system. The tests were accomplished at the same equipment of Mammography with the Automatic Exposure Control using a tension of 28 kV for both systems. The quality tests evaluated the spatial resolution, the own structures of the phantom, artifacts, optical density and contrast with conventional and laser films by mammography system. The installation for the accomplishment of the test has a quality control program. The evaluation was based on the pattern developed by the competent organ of the State of Minas Gerais. In this study, it was verified that the suitable Phantom Mama used by the Brazilian School of Radiology for conventional mammography did not obtain satisfactory result for Spatial Resolution in the digital mammography system CR. The final aim of this work is to obtain parameters to characterize the reference phantom quality image in an objective way. These parameters will be used to compare

  12. Slit aperture technique for mammography

    International Nuclear Information System (INIS)

    Friedrich, M.

    1984-01-01

    Following a discussion of various principles used in the elimination of scatter, the prototype of a simple slit aperture mammography apparatus is described (modified Mammomat, Siemens). The main advantage of this technique compared with grid mammography is a halving of the radiation dose for identical image quality, using an identical film system. The technical requirements (heavy duty tube, new generator) are, however, considerable. If the film-screen systems currently in use are to remain the common systems for the future, then the development of a multi-lamellar slit diaphragm technique carries much promise for mammography. (orig.) [de

  13. Comparison between magnetic resonance findings and conventional techniques (ultrasonography and mammography) in breast disease

    International Nuclear Information System (INIS)

    Martin, J.L.; Garofono, J.M.; Berquet, A.; Fernandez, F.J.; Fuentes, P.; Alvarez de Cienfuegos, E.

    1996-01-01

    Although mammography is indisputably the best diagnostic method for detecting breast abnormalities, there are other techniques, such as ultrasonography and magnetic resonance, which are increasingly widely employed as additional indispensable aids. The present work compares mammography, ultrasound and magnetic resonance images of normal breast and of the major pathologies that can be observed in breast, including sclerosing adenosis, giant fibroadenoma, multifocal carcinoma, fibrocystic breast disease, infiltrating duct carcinoma, colloid carcinoma, radical scar, abscess and breast prosthesis. (Author) 10 refs

  14. Synthesized Mammography: Clinical Evidence, Appearance, and Implementation

    Directory of Open Access Journals (Sweden)

    Melissa A. Durand

    2018-04-01

    Full Text Available Digital breast tomosynthesis (DBT has improved conventional mammography by increasing cancer detection while reducing recall rates. However, these benefits come at the cost of increased radiation dose. Synthesized mammography (s2D has been developed to provide the advantages of DBT with nearly half the radiation dose. Since its F.D.A. approval, multiple studies have evaluated the clinical performance of s2D. In clinical practice, s2D images are not identical to conventional 2D images and are designed for interpretation with DBT as a complement. This article reviews the present literature to assess whether s2D is a practical alternative to conventional 2D, addresses the differences in mammographic appearance of findings, and provides suggestions for implementation into clinical practice.

  15. Synthesized Mammography: Clinical Evidence, Appearance, and Implementation.

    Science.gov (United States)

    Durand, Melissa A

    2018-04-04

    Digital breast tomosynthesis (DBT) has improved conventional mammography by increasing cancer detection while reducing recall rates. However, these benefits come at the cost of increased radiation dose. Synthesized mammography (s2D) has been developed to provide the advantages of DBT with nearly half the radiation dose. Since its F.D.A. approval, multiple studies have evaluated the clinical performance of s2D. In clinical practice, s2D images are not identical to conventional 2D images and are designed for interpretation with DBT as a complement. This article reviews the present literature to assess whether s2D is a practical alternative to conventional 2D, addresses the differences in mammographic appearance of findings, and provides suggestions for implementation into clinical practice.

  16. Mindfulness training in a heterogeneous psychiatric sample : Outcome evaluation and comparison of different diagnostic groups

    NARCIS (Netherlands)

    Bos, Elisabeth H.; Merea, Ria; van den Brink, Erik; Sanderman, Robbert; Bartels-Velthuis, Agna A.

    ObjectivesTo examine outcome after mindfulness training in a heterogeneous psychiatric outpatient population and to compare outcome in different diagnostic groups. MethodOne hundred and forty-three patients in 5 diagnostic categories completed questionnaires about psychological symptoms, quality of

  17. Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience

    International Nuclear Information System (INIS)

    Thomassin-Naggara, Isabelle; Perrot, Nicolas; Dechoux, Sophie; Ribeiro, Carine; Chopier, Jocelyne; Bazelaire, Cedric de

    2015-01-01

    Highlights: • Breast tomosynthesis improves diagnostic performance especially for radiologists with lower experience in mammography. • Adding only one-view digital breast tomosynthesis to mammography improves the cancer detection rate. • Breast tomosynthesis is mainly useful for helping radiologists to detect architectural distortion. - Abstract: Purpose: To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. Materials and methods: Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24–92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings. Results: There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4

  18. Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience

    Energy Technology Data Exchange (ETDEWEB)

    Thomassin-Naggara, Isabelle, E-mail: isabelle.thomassin@tnn.aphp.fr [Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris (France); INSERM, UMR970, Equipe 2, Imagerie de l’angiogenèse, 75005 Paris (France); AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Perrot, Nicolas [AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Centre Pyramides, Paris (France); Dechoux, Sophie [Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris (France); AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Ribeiro, Carine [Centre Pyramides, Paris (France); Chopier, Jocelyne [AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Bazelaire, Cedric de [APHP, Department of Radiology, Hôpital Saint Louis, 75010 Paris (France)

    2015-02-15

    Highlights: • Breast tomosynthesis improves diagnostic performance especially for radiologists with lower experience in mammography. • Adding only one-view digital breast tomosynthesis to mammography improves the cancer detection rate. • Breast tomosynthesis is mainly useful for helping radiologists to detect architectural distortion. - Abstract: Purpose: To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. Materials and methods: Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24–92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings. Results: There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4

  19. Effectiveness of a Mobile Mammography Program.

    Science.gov (United States)

    Stanley, Elizabeth; Lewis, Madelene C; Irshad, Abid; Ackerman, Susan; Collins, Heather; Pavic, Dag; Leddy, Rebecca J

    2017-12-01

    Mobile mammography units have increasingly been used to address patient health care disparities; however, there are limited data comparing mobile units to stationary sites. This study aims to evaluate the characteristics of women who underwent mammography screening in a mobile unit versus those who underwent mammography screening at a cancer center. In this retrospective study, we analyzed all screening mammography examinations performed in a mobile unit in 2014 (n = 1433 examinations). For comparison, we randomized and reviewed an equivalent number of screening mammography examinations performed at our cancer center in 2014 (n = 1434 examinations). BI-RADS assessment, adherence to follow-up, biopsies performed, cancer detection rate, and sociodemographic variables were recorded. An independent-samples t test was conducted to identify potential differences in age between cancer center patients and mobile unit patients. Chi-square analyses were used to test for associations between location and factors such as health insurance, race, marital status, geographic area, adherence to screening guidelines, recall rate, adherence to follow-up, and cancer detection rates. Patients visiting our cancer center (mean = 57.74 years; SD = 10.55) were significantly older than those visiting the mobile unit (mean = 52.58 years; SD = 8.19; p mobile van (cancer center = 3.70%, mobile unit = 38.73%). There was a significant association between screening location and patient race (χ 2 = 118.75, p mobile unit = 33.30%), more black patients being screened in the mobile van (cancer center = 49.30%, mobile unit = 54.15%), and more Hispanic patients being screened in the mobile van (cancer center = 1.05%, mobile unit = 6.77%). There was a significant association between location and patient marital status (χ 2 = 135.61, p mobile unit = 38.31%), more single patients screened in the mobile van (cancer center = 25.17%, mobile unit = 34.47%), and more widowed patients being screened at the

  20. Improvements in mammography

    International Nuclear Information System (INIS)

    Redington, R.W.; Henkes, J.L.

    1976-01-01

    Equipment for positioning and supporting patients during tomographic X-ray mammography is described. It is comprised of a table and fabric slings which permit the examination of a downward, pendant breast of a prone patient by allowing the breast to pass through an aperture in the table into a fluid filled container. The fluid has an X-ray absorption coefficient similar to that of soft human tissue allowing high density resolution radiography and permitting accurate detection of breast tumours. The shape of the equipment and the positioning of the patient allow the detector and X-ray source to rotate 360 0 about a vertical axis through the breast. This permits the use of relatively simple image reconstruction algorithms and a divergent X-ray geometry with multiple detectors. Successive planes of the breast are scanned by translating the detectors and source vertically to produce a three-dimensional image of the breast tissue structure. (U.K.)

  1. Assessment of the usefulness of telemammography for the second reading in screening mammography

    International Nuclear Information System (INIS)

    Okuda, Itsuko; Nakajima, Yasuo; Okazaki, Hiroko; Shimamoto, Hiroshi; Okamoto, Kyoko; Kanemaki, Yoshihide; Irimoto, Masahiro

    2010-01-01

    We assessed the usefulness of telemammography by soft-copy diagnosis. A wide area network for teleradiology was set up incorporating seven institutions located in two prefectures. A total of 1053 subjects were enrolled. The first reading was performed using hard-copy images at the institution where mammography was undertaken. The second reading using hard-copy images was then performed. These images were transferred to our institution, where a second reading based on soft-copy images was performed. The result of soft-copy diagnosis were then compared with those of the hard-copy diagnosis. The diagnosis concordance rate, which was higher than category 3, was evaluated. Category 1 or 2 accounted for 956 cases at the stage of the second hard-copy diagnosis, of which category 1 or 2 accounted for 930 cases analyzed in the second soft-copy diagnosis. A category higher than 3 accounted for 97 cases at the second hard-copy diagnosis, of which a category higher than 3 accounted for 75 cases at the stage of the second soft-copy diagnosis. The κ-value for the diagnosis concordance rate was 0.751. The diagnostic concordance between hard-copy diagnosis and soft-copy diagnosis was good. Diagnostic accuracy showed no significant difference between the two. We conclude that soft-copy diagnosis by telemammography is useful, and that its application is desirable for screening mammography. (author)

  2. Comparison of the practical diagnostic value of different tomographic movements

    International Nuclear Information System (INIS)

    Laehde, S.; Vuoria, P.

    1977-01-01

    The practical results of linear and circular tomography with angles of 6, 20, 30 and 45 degrees and spiral tomography were compared. The spiral proved to be suitable as a tomographic movement for different purposes. In zonography, circular movement with 6 degrees of deviation proved suitable. The linear movement presented no advantages when compared with the multidirectional movements. ( orig.) [de

  3. Patients Mammographic Dose Survey in a Sample of Slovak Mammography Departments

    International Nuclear Information System (INIS)

    Nikodemova, D.; Horvathova, M.; Gbelcova, L.

    2008-01-01

    Breast cancer is the most frequent cancer and the most frequent cause of cancer induced deaths in Europe. Demographic trends indicate a continuing increase in this substantial public health problem. Systematic early detection, effective diagnostic pathways and high quality services have the ability for lowering the breast cancer mortality rates and for reducing the burden of this disease in the population The widespread use of mammography for early breast cancer detection is highly accepted all over the world. For achievement of a successful national mammography programme in Slovakia, a national QA/QC mammography system was introduced. Coming from alarming values of increase of malignant neoplasm of breast in Slovakia a national mammography audit has been initiated, performed in three runs and working in three phases: assessment of existing status of practice and equipment performance, as well as education and training of radiologists and radiographers of 42 mammography departments; implementation of technical quality programme and patient dose evaluation; clinical image evaluation. Preventive mammography in spite of being a reasonable examination, which represents health benefit for patient, exceed also the health risk. In 1991-1996 mammographic examination created 1.3% from all medical radiodiagnostic expositions made in Slovakia. In 2005 there were realized 241 208 mammographic examinations, 140 798 of them were noticed like preventive examinations. In 2006 the number of all mammographic examinations in Slovakia increased to 271 755 and of them 156 199 were preventive mammographic examinations. In our presentation we tried to establish the average absorbed glandular doses of patients undergoing mammography examinations in 10 selected departments and to compare the obtained results with European diagnostic reference values. The obtained values were used for the proposal of a new national diagnostic reference value for mammography examinations

  4. A study to determine the differences between the displayed dose values for two full-field digital mammography units and values calculated using a range of Monte-Carlo-based techniques: A phantom study

    International Nuclear Information System (INIS)

    Borg, M.; Badr, I.; Royle, G. J.

    2013-01-01

    Modern full-field digital mammography (FFDM) units display the mean glandular dose (MGD) and the entrance or incident air kerma (K) to the breast following each exposure. Information on how these values are calculated is limited and knowing how displayed MGD values compare and correlate to conventional Monte-Carlo-based methods is useful. From measurements done on polymethyl methacrylate (PMMA) phantoms, it has been shown that displayed and calculated MGD values are similar for thin to medium thicknesses and appear to differ with larger PMMA thicknesses. As a result, a multiple linear regression analysis on the data was performed to generate models by which displayed MGD values on the two FFDM units included in the study may be converted to the Monte-Carlo values calculated by conventional methods. These models should be a useful tool for medical physicists requiring MGD data from FFDM units included in this paper and should reduce the survey time spent on dose calculations. (authors)

  5. Comparative analysis of diagnostic accuracy of different brain biopsy procedures

    OpenAIRE

    Jain Deepali; Sharma Mehar; Sarkar Chitra; Gupta Deepak; Singh Manmohan; Mahapatra A

    2006-01-01

    Background: Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. Aims: The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different s...

  6. Comparison of different phantoms used in digital diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bor, Dogan, E-mail: bor@eng.ankara.edu.tr [Ankara University, Faculty of Engineering, Department of Engineering Physics. Tandogan, 06100 Ankara (Turkey); Unal, Elif, E-mail: elf.unall@gmail.com [Radat Dosimetry Laboratory Services, 06830, Golbasi, Ankara (Turkey); Uslu, Anil, E-mail: m.aniluslu@gmail.com [Radat Dosimetry Laboratory Services, 06830, Golbasi, Ankara (Turkey)

    2015-09-21

    The organs of extremity, chest, skull and lumbar were physically simulated using uniform PMMA slabs with different thicknesses alone and using these slabs together with aluminum plates and air gaps (ANSI Phantoms). The variation of entrance surface air kerma and scatter fraction with X-ray beam qualities was investigated for these phantoms and the results were compared with those measured from anthropomorphic phantoms. A flat panel digital radiographic system was used for all the experiments. Considerable variations of entrance surface air kermas were found for the same organs of different designs, and highest doses were measured for the PMMA slabs. A low contrast test tool and a contrast detail test object (CDRAD) were used together with each organ simulation of PMMA slabs and ANSI phantoms in order to test the clinical image qualities. Digital images of these phantom combinations and anthropomorphic phantoms were acquired in raw and clinically processed formats. Variation of image quality with kVp and post processing was evaluated using the numerical metrics of these test tools and measured contrast values from the anthropomorphic phantoms. Our results indicated that design of some phantoms may not be efficient enough to reveal the expected performance of the post processing algorithms.

  7. Supposed cancer risk from mammography. Reply to previous statements

    Energy Technology Data Exchange (ETDEWEB)

    Oeser, H; Koeppe, P; Rach, K [Freie Univ. Berlin (Germany, F.R.). Klinik fuer Radiologie, Nuklearmedizin und Physikalische Therapie

    1976-12-01

    The view that exposure to diagnostic radiation presents a cancer risk to the female breast should be considered together with the fact that the major factor is ageing of the patient. This risk factor is hidden in experimental and statistical studies on cancer production by exongenous agents; for instance, in studies of radiation effects, it is inherent in the time taken. The assumption that mammography presents a cancer risk is unjustifiable and is denied.

  8. Mild cognitive impairment. Diagnostic value of different MR techniques

    International Nuclear Information System (INIS)

    Hauser, T.; Stieltjes, B.; Essig, M.; Thomann, P.A.

    2011-01-01

    In view of an increasingly aging population the prevalence of dementia is also expected to increase rapidly. As well as clinical, neuropsychological and laboratory procedures magnetic resonance imaging (MRI) plays an important role in the early diagnosis of dementia which is important in the precursor stage of mild cognitive impairment (MCI). On the one hand this stage is associated with an increased risk of dementia and on the other hand an early treatment in this stage could attenuate development of the disease. In addition to morphological changes different functional MRI techniques can help in the early diagnosis of dementia and the precursor stages. Moreover, it is important to detect those MCI patients who are at particularly risk for developing dementia. In the differentiation of converters to non-converters initial studies suggest that particularly voxel-based morphometry, MR spectroscopy and diffusion tensor imaging can provide important additional information. (orig.) [de

  9. Tests for radiation protection in X-Ray mammography room for professional and non-professional exposure

    International Nuclear Information System (INIS)

    Naidenov, I.; Skocheva, A.

    2006-01-01

    Full text: Control tests for radiation protection of medical diagnostic rooms in our country are based on the guidelines to the use of x-rays in medicine and on the basic safety standards for radiation protection. The mammography room tests are not supported by basic data (such as normal conditions for testing and secondary limits) which to allow the developing of methods as the case is with the conventional x-ray rooms. The material presents and discusses over the situation of the matter with the aim to find solution of the problem. In mammography units the space distribution of the dose field of the object scattering radiation is not symmetrical, the maximum being in a direction opposite to the primary beam. Control tests were made for stray radiation in major (in the plane of beam rotation) test points in five rooms with mammography units of different producers and generation, under angles of scattering from the direction of the beam of 900 (horizontal table - 0 deg projection) and 1630 (tilt table - 730 deg projection). The results on the stray radiation show up to four times higher values in the 730 projection, the remaining conditions being the same. Normalization to the week loading used in the shielding design, like the comparison with secondary limits as published in the available norms do not give unambiguous idea. It is advisable to use this projection in control tests for radiation protection and the values shall be compared with the secondary limits of the corresponding standard loading

  10. Mammography: MedlinePlus Health Topic

    Science.gov (United States)

    ... Questions (National Cancer Institute) Mammography for Women with Breast Implants (American Cancer Society) Also in Spanish Mammography: What You Need to Know (Food and Drug Administration) Nipple Aspirate Test Is ... Specifics Breast Tomosynthesis (American College of Radiology, Radiological Society of ...

  11. Mammography screening: A major issue in medicine.

    Science.gov (United States)

    Autier, Philippe; Boniol, Mathieu

    2018-02-01

    -detected cancers. Overdiagnosis leads to overtreatment and inflicts considerable physical, psychological and economic harm on many women. Overdiagnosis has also exerted considerable disruptive effects on the interpretation of clinical outcomes expressed in percentages (instead of rates) or as overall survival (instead of mortality rates or stage-specific survival). Rates of radical mastectomies have not decreased following the introduction of screening and keep rising in some countries (e.g. the United States of America (USA)). Hence, the epidemiological picture of mammography screening closely resembles that of screening for neuroblastoma. Reappraisals of Swedish mammography trials demonstrate that the design and statistical analysis of these trials were different from those of all trials on screening for cancers other than breast cancer. We found compelling indications that these trials overestimated reductions in breast cancer mortality associated with screening, in part because of the statistical analyses themselves, in part because of improved therapies and underreporting of breast cancer as the underlying cause of death in screening groups. In this regard, Swedish trials should publish the stage-specific breast cancer mortality rates for the screening and control groups separately. Results of the Greater New York Health Insurance Plan trial are biased because of the underreporting of breast cancer cases and deaths that occurred in women who did not participate in screening. After 17 years of follow-up, the United Kingdom (UK) Age Trial showed no benefit from mammography screening starting at age 39-41. Until around 2005, most proponents of breast screening backed the monitoring of changes in advanced cancer incidence and comparative studies on breast cancer mortality for the evaluation of breast screening effectiveness. However, in an attempt to mitigate the contradictions between results of mammography trials and population data, breast-screening proponents have elected to

  12. Dual-energy contrast-enhanced digital mammography: initial clinical results

    International Nuclear Information System (INIS)

    Dromain, Clarisse; Thibault, Fabienne; Tardivon, Anne; Muller, Serge; Rimareix, Francoise; Delaloge, Suzette; Balleyguier, Corinne

    2011-01-01

    To assess the diagnostic accuracy of Dual-Energy Contrast-Enhanced Digital Mammography (CEDM) as an adjunct to mammography (MX) versus MX alone and versus mammography plus ultrasound (US). 120 women with 142 suspect findings on MX and/or US underwent CEDM. A pair of low- and high-energy images was acquired using a modified full-field digital mammography system. Exposures were taken in MLO at 2 min and in CC at 4 min after the injection of 1.5 ml/kg of an iodinated contrast agent. One reader evaluated MX, US and CEDM images during 2 sessions 1 month apart. Sensitivity, specificity, and area under the ROC curve were estimated. The results from pathology and follow-up identified 62 benign and 80 malignant lesions. Areas under the ROC curves were significantly superior for MX+CEDM than it was for MX alone and for MX+US using BI-RADS. Sensitivity was higher for MX+CEDM than it was for MX (93% vs. 78%; p < 0.001) with no loss in specificity. The lesion size was closer to the histological size for CEDM. All 23 multifocal lesions were correctly detected by MX+CEDM vs. 16 and 15 lesions by MX and US respectively. Initial clinical results show that CEDM has better diagnostic accuracy than mammography alone and mammography+ultrasound. (orig.)

  13. Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil.

    Science.gov (United States)

    Chojniak, Rubens; Carneiro, Dominique Piacenti; Moterani, Gustavo Simonetto Peres; Duarte, Ivone da Silva; Bitencourt, Almir Galvão Vieira; Muglia, Valdair Francisco; D'Ippolito, Giuseppe

    2017-01-01

    To map the different methods for diagnostic imaging instruction at medical schools in Brazil. In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

  14. Performance of combined clinical mammography and needle biopsy: a nationwide study from Denmark

    DEFF Research Database (Denmark)

    Jensen, Allan; Rank, Fritz; Dyreborg, Uffe

    2006-01-01

    Clinical mammography and needle biopsy are key tools for non-operative assessment of breast lesions. We evaluated the performance of all combined tests undertaken in Denmark in 2000. Clinical mammography and needle biopsy data were collected and linked to final cancer outcome, to determine sensit...... with a suspicious or malignant result indicated a high risk of cancer, and excisional diagnostic biopsy therefore still has an important role to play.......Clinical mammography and needle biopsy are key tools for non-operative assessment of breast lesions. We evaluated the performance of all combined tests undertaken in Denmark in 2000. Clinical mammography and needle biopsy data were collected and linked to final cancer outcome, to determine...

  15. Absorbed dose measurements in mammography using Monte Carlo method and ZrO2+PTFE dosemeters

    International Nuclear Information System (INIS)

    Duran M, H. A.; Hernandez O, M.; Salas L, M. A.; Hernandez D, V. M.; Vega C, H. R.; Pinedo S, A.; Ventura M, J.; Chacon, F.; Rivera M, T.

    2009-10-01

    Mammography test is a central tool for breast cancer diagnostic. In addition, programs are conducted periodically to detect the asymptomatic women in certain age groups; these programs have shown a reduction on breast cancer mortality. Early detection of breast cancer is achieved through a mammography, which contrasts the glandular and adipose tissue with a probable calcification. The parameters used for mammography are based on the thickness and density of the breast, their values depend on the voltage, current, focal spot and anode-filter combination. To achieve an image clear and a minimum dose must be chosen appropriate irradiation conditions. Risk associated with mammography should not be ignored. This study was performed in the General Hospital No. 1 IMSS in Zacatecas. Was used a glucose phantom and measured air Kerma at the entrance of the breast that was calculated using Monte Carlo methods and ZrO 2 +PTFE thermoluminescent dosemeters, this calculation was completed with calculating the absorbed dose. (author)

  16. [Mammography screening of breast cancer in Tunisia. Results of first experience].

    Science.gov (United States)

    Kribi, Lilia; Sellami, Dorra; el Amri, Aïda; Mnif, Nejla; Ellouze, Thouraya; Chebbi, Ali; Ben Romdhane, Khaled; Hamza, Radhi

    2003-01-01

    This article reports the results of a mammography screening program of breast cancer, realized in the department of Radiology, Charles Nicolle hospital. A free screening mammography with two incidences was offered to women aged from 40 to 70 years old. 2200 mammographies were realized from May 1995 till July 1997. Women having a positive test benefited of a diagnostic explorations in the same unity. The positive test rate was 24%. Predictive positive value was 31%. This program allowed to detect 10 subclinical cancers, corresponding to a rate of detection of 4.5 cancers for 1000 women. This program is a first experience which demonstrated the feasibility of the mammography screening to wide scale and allowed the medical and paramedical team to acquire an experience.

  17. Digital Mammography in Young Women: Is a Single View Sufficient?

    Science.gov (United States)

    Gossner, Johannes

    2016-03-01

    Single view mammography may be a less time consuming, more comfortable and radiation reduced alternative for young women, but there are no studies examining this approach after the implementation of digital mammography into clinical practice. Retrospective analysis of all mammographies performed in women younger than 40 years during a 24 month period. The sample consisted of 109 women with 212 examined breasts. All patients initially received standard two- view mammography. In the study setting the MLO- views were read by a single viewer and compared to a composite reference standard. In this sample 7 malignant findings were present and the review of the MLO-view detected 6 of them (85%). In patients with dense breasts 4 out of 5 malignant findings were found on the single-view (sensitivity 80%) and all 2 malignant findings were detected in patients with low breast density (sensitivity 100%). There were 7 false positive findings (3.3%). i.e. in total 8 out of 212 examined breasts were therefore misinterpreted (3.8%). Single view digital mammography detects the vast majority of malignant findings, especially in low density breast tissue and the rate of false-positive findings is within acceptable limits. Therefore this approach may be used in different scenarios (for example in increasing patient throughout in resource poor settings, reducing radiation burden in the young or in combination with ultrasound to use the strengths of both methods). More research on this topic is needed to establish its potential role in breast imaging.

  18. Comparison of TLD air kerma measurements in mammography

    International Nuclear Information System (INIS)

    Pernicka, F.

    2002-01-01

    The mammography examination is usually targeted at asymptomatic women so the narrow balance between benefit and undesirable effects is important. During the past few decades there have been significant advances in the equipment used for mammography. Even when the latest equipment and imaging systems are used, there is considerable variation from centre-to-centre in the choice of imaging parameters and techniques. There may be quite large differences in image quality and breast dose among the centres. A Co-ordinated Research Programme on 'Image quality and patient dose optimization in mammography in Eastern European Countries' was conducted by the IAEA, aiming at defining a methodology for the implementation of a quality assurance (QA) programme in mammography and at exercising the assessment of image quality and patient doses in a sample of hospitals in East European countries. Selected mammography clinics from Czech Republic, Hungary, Poland, Romania and Slovakia participate in the project. The teams consisted of experienced clinicians and physicists. They were supported by a group of experts (clinicians and medical physicists) from France, Italy and Spain. As an outcome of the project, improvements in these indicators (image quality and patient dose) after the implementation of the QA programme are expected. A comparison of dosimetry systems has been organized to assure that dosimetry measurements done in the frame of the project are comparable and traceable to the international measurement system. All five East European countries plus Spain took part in the exercise. The thermoluminescent (TL) method was selected for the comparison

  19. Can positron emission mammography help to identify clinically significant breast cancer in women with suspicious calcifications on mammography?

    Energy Technology Data Exchange (ETDEWEB)

    Bitencourt, Almir G.V.; Lima, Eduardo N.P.; Macedo, Bruna R.C.; Conrado, Jorge L.F.A.; Marques, Elvira F.; Chojniak, Rubens [A C Camargo Cancer Center-Department of Imaging, Sao Paulo, SP (Brazil)

    2017-05-15

    To evaluate the diagnostic accuracy of positron emission mammography (PEM) for identifying malignant lesions in patients with suspicious microcalcifications detected on mammography. A prospective, single-centre study that evaluated 40 patients with suspicious calcifications at mammography and indication for percutaneous or surgical biopsy, with mean age of 56.4 years (range: 28-81 years). Patients who agreed to participate in the study underwent PEM with 18F-fluorodeoxyglucose before the final histological evaluation. PEM findings were compared with mammography and histological findings. Most calcifications (n = 34; 85.0 %) were classified as BIRADS 4. On histology, there were 25 (62.5 %) benign and 15 (37.5 %) malignant lesions, including 11 (27.5 %) ductal carcinoma in situ (DCIS) and 4 (10 %) invasive carcinomas. On subjective analysis, PEM was positive in 15 cases (37.5 %) and most of these cases (n = 14; 93.3 %) were confirmed as malignant on histology. There was one false-positive result, which corresponded to a fibroadenoma, and one false negative, which corresponded to an intermediate-grade DCIS. PEM had a sensitivity of 93.3 %, specificity of 96.0 % and accuracy of 95 %. PEM was able to identify all invasive carcinomas and high-grade DCIS (nuclear grade 3) in the presented sample, suggesting that this method may be useful for further evaluation of patients with suspected microcalcifications. (orig.)

  20. Mammary carcinoma diagnostics and therapy

    International Nuclear Information System (INIS)

    Fischer, Uwe; Baum, Friedemann

    2014-01-01

    The book on mammary carcinoma diagnostics and therapy covers the following issues: development, anatomy and physiology of the mammary glands, pathology of benign and malign mammary gland changes, non-imaging diagnostics; mammography; ultrasonic mammography; magnetic resonance tomography of the mammary glands; imaging diagnostics findings; mammary interventions; examination concepts; operative therapy of the mammary carcinoma; chemotherapy of the mammary carcinoma; radio-oncological therapy of the mammary carcinoma; logistics in a medical center for mammary gland diseases; logistics in an interdisciplinary center for mammary diseases; dialogue conduction and psycho-social attendance.

  1. Automated daily quality control analysis for mammography in a multi-unit imaging center.

    Science.gov (United States)

    Sundell, Veli-Matti; Mäkelä, Teemu; Meaney, Alexander; Kaasalainen, Touko; Savolainen, Sauli

    2018-01-01

    Background The high requirements for mammography image quality necessitate a systematic quality assurance process. Digital imaging allows automation of the image quality analysis, which can potentially improve repeatability and objectivity compared to a visual evaluation made by the users. Purpose To develop an automatic image quality analysis software for daily mammography quality control in a multi-unit imaging center. Material and Methods An automated image quality analysis software using the discrete wavelet transform and multiresolution analysis was developed for the American College of Radiology accreditation phantom. The software was validated by analyzing 60 randomly selected phantom images from six mammography systems and 20 phantom images with different dose levels from one mammography system. The results were compared to a visual analysis made by four reviewers. Additionally, long-term image quality trends of a full-field digital mammography system and a computed radiography mammography system were investigated. Results The automated software produced feature detection levels comparable to visual analysis. The agreement was good in the case of fibers, while the software detected somewhat more microcalcifications and characteristic masses. Long-term follow-up via a quality assurance web portal demonstrated the feasibility of using the software for monitoring the performance of mammography systems in a multi-unit imaging center. Conclusion Automated image quality analysis enables monitoring the performance of digital mammography systems in an efficient, centralized manner.

  2. Comparing the American and European diagnostic guidelines for cystic fibrosis: same disease, different language?

    Science.gov (United States)

    Ooi, Chee Y; Dupuis, Annie; Ellis, Lynda; Jarvi, Keith; Martin, Sheelagh; Gonska, Tanja; Dorfman, Ruslan; Kortan, Paul; Solomon, Melinda; Tullis, Elizabeth; Durie, Peter R

    2012-07-01

    The American and European cystic fibrosis (CF) guidelines recommend different diagnostic criteria. This study assessed diagnostic concordance between these recommendations. Subjects with single organ manifestations suggestive of CF (chronic sinopulmonary disease (RESP), chronic/recurrent pancreatitis (PANC) or obstructive azoospermia (AZOOSP)) were prospectively evaluated by sweat test, nasal potential difference and genotyping. Concordance in diagnostic outcomes between the two algorithms was measured using observed agreement and κ statistics. A total of 208 subjects were evaluated. Observed agreement was 84.8% and level of agreement was excellent (κ=0.87) between the American and European recommendations. The RESP phenotype was associated with the highest degree of concordance (observed agreement ≥90%, κ=0.92) compared with the PANC (observed agreement 86%, κ=0.65) and AZOOSP (observed agreement 80%, κ=0.87) phenotypes. Incorporation of nasal potential difference into the American algorithm failed to improve the overall degree of concordance (good agreement level; κ=0.75); the level of agreement was unchanged in RESP and PANC subjects, but reduced in AZOOSP subjects (from excellent to good). Extensive genotyping had limited clinical utility in the diagnosis of CF in both algorithms. Despite inconsistencies between the American and European diagnostic recommendations, concordance in diagnostic outcomes among subjects presenting with single organ manifestations of CF was good to excellent. These diagnostic guidelines provide guidance and promote rigorous evaluation for the diagnosis of CF but neither guideline should be regarded as dogma.

  3. [Fine needle aspiration cytology of mammography screening

    DEFF Research Database (Denmark)

    Engvad, B.; Laenkholm, A.V.; Schwartz, Thue W.

    2009-01-01

    INTRODUCTION: In the year 2000 a quality assurance programme for the preoperative breast diagnostics was introduced in Denmark. The programme was based on the "European guidelines for quality assurance in breast cancer screening and diagnosis" where - among other measures - five cytological......-choice treatment. MATERIAL AND METHODS: 767 women had FNAC performed from a total of 783 lesions at the Mammography Clinic, University Hospital Odense. All FNACs were compared with the final histology diagnosis. Nine statistical parameters were calculated according to the European guidelines. RESULTS: A total...... of 66% of the 783 FNACs had a malignant cytology diagnosis, which in 99% of the cases turned out to be the correct diagnosis. Four lesions were false positives all of which represented benign proliferative breast diseases. The surgical procedures in these cases were either excisional biopsy...

  4. Pain and discomfort during mammography

    DEFF Research Database (Denmark)

    Aro, A R; Absetz-Ylöstalo, P; Eerola, T

    1996-01-01

    was the most powerful factor explaining pain and discomfort among women with earlier mammography. However, it had no effect among women without earlier mammography, for whom screening-related nervousness and perceptions of staff were crucial. Suggested interventions include better information before screening......The aim of this prospective study was to investigate associations of mammography pain and discomfort with sociodemographics, personal history and psychological and situational factors. Subjects were women with a negative screening finding (n = 883) from a random sample of 50-year-old Finnish women...... attending their first breast cancer screening. Questionnaires were sent 1 month before the screening invitation and 2 months after screening. Sixty-one per cent reported painful and 59% uncomfortable mammograms (4% severely). Linear regression analyses showed that anticipation of pain and discomfort...

  5. Mammography quality assurance in Morocco

    International Nuclear Information System (INIS)

    Zaoui, F.; Talsmat, K.; Lalaoui, K.

    2001-01-01

    The 'Centre National de l'Energie, des Sciences et des Techniques Nucleaires' (CNESTEN) realised, from February 1999 to March 2000, a quality control of 41 mammography facilities in Morocco. The protocol and standards adopted for achieving the control of elements constituting the mammography chain are those elaborated by GIM and Qualix association. Statistics and conformities results are presented. The program was performed in order to demonstrate to the practitioners in mammography field, the utility and necessity to have a national quality assurance policy. The main objective of CNESTEN is to be accredited by the Moroccan government as a reference laboratory in quality control and dose evaluation in medical imaging and radiotherapy. To achieve this goal the CNESTEN has set up Medical Physic Unit well trained and equipped with the necessary instruments. (author)

  6. Physical image quality of computed radiography in mammography system

    International Nuclear Information System (INIS)

    Norriza Mohd Isa; Muhammad Jamal Isa; Wan Muhamad Saridan Wan Hassan; Fatimah Othman

    2013-01-01

    Full-text: Mammography is a screening procedure that mostly used for early detection of breast cancer. In digital imaging system, Computed Radiography is a cost-effective technology that applied indirect conversion detector. The paper presents physical image quality parameter measurements namely modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE) of Computed Radiography in mammography system. MTF was calculated from two different orientations of slanted images of an edge test device and NNPS was estimated using flat-field image. Both images were acquired using a standard mammography beam quality. DQE was determined by applying the MTF and NNPS values into our developed software program. Both orientations have similar DQE characteristics. (author)

  7. Impact of full field digital mammography on the classification and mammographic characteristics of interval breast cancers

    Energy Technology Data Exchange (ETDEWEB)

    Knox, Mark, E-mail: marktknox@gmail.com; O’Brien, Angela, E-mail: angelaobrien@doctors.org.uk; Szabó, Endre, E-mail: endrebacsi@freemail.hu; Smith, Clare S., E-mail: csmith@mater.ie; Fenlon, Helen M., E-mail: helen.fenlon@cancerscreening.ie; McNicholas, Michelle M., E-mail: michelle.mcnicholas@cancerscreening.ie; Flanagan, Fidelma L., E-mail: fidelma.flanagan@cancerscreening.ie

    2015-06-15

    Highlights: • Digital mammography has changed the presentation of interval breast cancer. • Less interval breast cancers are associated with microcalcifications following FFDM. • Interval breast cancer audit remains a key feature of any breast screening program. - Abstract: Objective: Full field digital mammography (FFDM) is increasingly replacing screen film mammography (SFM) in breast screening programs. Interval breast cancers are an issue in all screening programs and the purpose of our study is to assess the impact of FFDM on the classification of interval breast cancers at independent blind review and to compare the mammographic features of interval cancers at FFDM and SFM. Materials and methods: This study included 138 cases of interval breast cancer, 76 following an FFDM screening examination and 62 following screening with SFM. The prior screening mammogram was assessed by each of five consultant breast radiologists who were blinded to the site of subsequent cancer. Subsequent review of the diagnostic mammogram was performed and cases were classified as missed, minimal signs, occult or true interval. Mammographic features of the interval cancer at diagnosis and any abnormality identified on the prior screening mammogram were recorded. Results: The percentages of cancers classified as missed at FFDM and SFM did not differ significantly, 10.5% (8 of 76) at FFDM and 8.1% (5 of 62) at SFM (p = .77). There were significantly less interval cancers presenting as microcalcifications (alone or in association with another abnormality) following screening with FFDM, 16% (12 of 76) than following a SFM examination, 32% (20 of 62) (p = .02). Conclusion: Interval breast cancers continue to pose a problem at FFDM. The switch to FFDM has changed the mammographic presentation of interval breast cancer, with less interval cancers presenting in association with microcalcifications.

  8. Impact of full field digital mammography on the classification and mammographic characteristics of interval breast cancers

    International Nuclear Information System (INIS)

    Knox, Mark; O’Brien, Angela; Szabó, Endre; Smith, Clare S.; Fenlon, Helen M.; McNicholas, Michelle M.; Flanagan, Fidelma L.

    2015-01-01

    Highlights: • Digital mammography has changed the presentation of interval breast cancer. • Less interval breast cancers are associated with microcalcifications following FFDM. • Interval breast cancer audit remains a key feature of any breast screening program. - Abstract: Objective: Full field digital mammography (FFDM) is increasingly replacing screen film mammography (SFM) in breast screening programs. Interval breast cancers are an issue in all screening programs and the purpose of our study is to assess the impact of FFDM on the classification of interval breast cancers at independent blind review and to compare the mammographic features of interval cancers at FFDM and SFM. Materials and methods: This study included 138 cases of interval breast cancer, 76 following an FFDM screening examination and 62 following screening with SFM. The prior screening mammogram was assessed by each of five consultant breast radiologists who were blinded to the site of subsequent cancer. Subsequent review of the diagnostic mammogram was performed and cases were classified as missed, minimal signs, occult or true interval. Mammographic features of the interval cancer at diagnosis and any abnormality identified on the prior screening mammogram were recorded. Results: The percentages of cancers classified as missed at FFDM and SFM did not differ significantly, 10.5% (8 of 76) at FFDM and 8.1% (5 of 62) at SFM (p = .77). There were significantly less interval cancers presenting as microcalcifications (alone or in association with another abnormality) following screening with FFDM, 16% (12 of 76) than following a SFM examination, 32% (20 of 62) (p = .02). Conclusion: Interval breast cancers continue to pose a problem at FFDM. The switch to FFDM has changed the mammographic presentation of interval breast cancer, with less interval cancers presenting in association with microcalcifications

  9. Clinical evaluation of mammography using a screen-film system. Pt. 3

    International Nuclear Information System (INIS)

    Wurm, J.; Behrends, E.; Hofmann-Preiss, K.; Paterok, E.M.; Saebel, M.; Weishaar, J.

    1983-01-01

    In a clinical image quality test, the parameter image quality is analysed using the ROC method and on the basis of mammograms already classified by means of histological findings into ''benign'' and ''malignant'' cases. The results of this analysis confirmed those of the first two studies: The screen-film system, due to its almost equally good image quality, achieves a diagnostic accuracy as good as the Definix test film without screen. In addition, the following two parameters have been investigated in this clinical test: Different knowledge and experience of the evaluating experts in the field of mammography, and the learning progress in the course of expert training. The difference in knowledge and experience of the various evaluators becomes apparent in ROC analysis only with an evaluator having much more experience than the others in the field of mammography. The parameter learning progress - as shown by repeating the evaluation after three months of intensive training - does not come forth clear enough in the ROC curves. An analysis of the frequency distribution of the five decision thresholds reveals the approach of the individual evaluator. (orig.) [de

  10. Evidence on Synthesized Two-dimensional Mammography Versus Digital Mammography When Using Tomosynthesis (Three-dimensional Mammography) for Population Breast Cancer Screening.

    Science.gov (United States)

    Houssami, Nehmat

    2017-09-28

    One limitation of using digital breast tomosynthesis (3-dimensional [3D] mammography) technology with conventional (2-dimensional [2D]) mammography for breast cancer (BC) screening is the increased radiation dose from dual acquisitions. To resolve this problem, synthesized 2D (s2D) reconstruction images similar to 2D mammography were developed using tomosynthesis acquisitions. The present review summarizes the evidence for s2D versus digital mammography (2D) when using tomosynthesis (3D) for BC screening to address whether using s2D instead of 2D (alongside 3D) will yield similar detection measures. Comparative population screening studies have provided consistent evidence that cancer detection rates do not differ between integrated 2D/3D (range, 5.45-8.5/1000 screens) and s2D/3D (range, 5.03-8.8/1000 screens). Also, although the recall measures were relatively heterogeneous across included studies, little difference was found between the 2 modalities. The mean glandular dose for s2D/3D was 55% to 58% of that for 2D/3D. In the context of BC screening, s2D/3D involves substantially less radiation than 2D/3D and provides similar detection measures. Thus, consideration of transitioning to tomosynthesis screening should aim to use s2D/3D to minimize harm. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Interdisciplinary group of mammography (IGM). Quality assurance in mammography

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    Assurance quality must be a preoccupation of each day in mammography. To be efficient and of low cost it must be discussed between radiologists and physicists; some countries like Federal Republic of Germany, Belgium, United Kingdom, Scandinavia and Netherlands engaged actions to make assurance quality a daily practice

  12. Studies of breast masses in Korean woman using tungsten anode mammography

    International Nuclear Information System (INIS)

    Suh, C. O.; Oh, K. K.; Lee, K. S.

    1979-01-01

    Mammography is the oldest and most popular method in the diagnosis of breast disease and received the special attention as the powerful instrument in early detection of breast cancer. In Korea, the mammography has not been widely used, yet, but nowadays, increasing incidence of breast cancer and good prognosis after early detection and proper treatment need the clinical application of mammography for management of patient with breast disease and for the detection of occult cancer. The technique obtaining the good quality film is essential for improving the diagnostic accuracy of mammography in breast disease and in general, excellent film radiographs of breast can be obtained with proper combination of Kvp, processing, selection of fine grained film, fine focus tube and compression. In present study, radiographic technique was used in which 36-40 Kvp and 200 mAs were derived from a small focus Tungsten Anode tube. Medio-lateral and Cranio-caudad view were taken using Acryl compression device, which was specially designed by authors in order to properly examine the small, dense breasts of Korean women. Non-screen fine grained mammographic films was used and processing was manual.The materials consisted of 150 cases of mammography performed at Yonsei University Medical College, Severance Hospital, since January, 1978. We analyzed the diagnostic accuracy of mammography and mammographic findings in pathologically confirmed 39 cases. The conclusions are as follows: 1. Because women are sensitive to her breast changes, mammography is very useful not only in diagnosis of breast disease and early detection of cancer, but also management of patients with breast symptom and sign. 2. We obtained the relatively good quality film and high diagnostic accuracy with our own method, using conventional Tungsten Anode tube, compression device and hand processing. 3. We also applied specimen radiography in diagnosis of breast disease, which was helpful in verification of the adequacy

  13. Quality-of-Life Differences among Diagnostic Subgroups of Children Receiving Ventilating Tubes for Otitis Media

    DEFF Research Database (Denmark)

    Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse

    2015-01-01

    OBJECTIVE: The pathological picture may differ considerably between diagnostic subgroups of children with otitis media receiving ventilating tubes. The aims of this study are to investigate differences in quality of life among diagnostic subgroups of children treated with ventilating tubes...... media with effusion (OME), and 38% mixed diagnosis of rAOM and OME (rAOM/OME). There were no significant differences between children diagnosed with rAOM and children diagnosed with rAOM/OME. However, these children had a significantly poorer quality of life at baseline compared with children diagnosed...... with only OME. Factors associated with clinical success included a diagnosis of rAOM, number of interrupted nights, physician visits, and canceled social activities due to OM. CONCLUSIONS: Results highlight the importance of distinguishing between diagnostic subgroups of children having ventilating tube...

  14. Stereotaxic cytology of nonpalpable lesions detected at mammography

    International Nuclear Information System (INIS)

    Ciatto, S.; Rosselli del Turco, M.; Bravetti, P.; Catarzi, S.

    1991-01-01

    The authors report on 791 consecutive cases undergoing stereotaxic cytology for non palpable lesions detected at mammography. Histologic diagnosis (malignant = 179, benign = 107) or mammographic folow-up after at least one year (benign = 275) was available in 561 cases. The overall inadequacy rate of stereotaxic cytology was 0.21, and dependent on lesion type (benign = 0.25, malignant = 0.13 p<0.001) and on sampling operator experience (range 0.17-0.31, p<0.001). Sensitivity (dubious+positive, after exclusion of inadequates) was 0.83 and dependent on histologic type (infiltrating = 0.87, intraductal = 0.68). Specificity (negative/benign, after exclusion of inadequates) was 0.96. Stereotaxic cytology helped in reducing the number of unnecessary beningn biopsies and the biopsy ratio was 0.6 benign to 1 malignant biopsy. In cases with moderate suspicion at mammography the radiologist felt reassured by negative cytology and advised mammographic control rather than surgical biopsy. Cytology was determinant in advising surgical biopsy in 9 cancer cases whereas the absence of cytologic positivity contributed to diagnostic delay in 2 cancer cases. Overall, stereotaxic cytology allowed a relevant reduction of unnecessary benign biopsies and should be routinely employed in the diagnostic work-up of nonpalpable lesions detected at mammography

  15. Computed tomographic mammography using a conventional body scanner.

    Science.gov (United States)

    Chang, C H; Nesbit, D E; Fisher, D R; Fritz, S L; Dwyer, S J; Templeton, A W; Lin, F; Jewell, W R

    1982-03-01

    The technique for computed tomographic (CT) examination of the breasts using a conventional body scanner is described, and experience with 67 patients is reported. In the diagnosis of both malignant and benign breast lesions, the results with a body scanner were equal to those of a dedicated CT/M mammographic unit. Although the CT study of the breast cannot replace conventional mammography in screening or in routine diagnostic workup, the unique capability of demonstrating both anatomic changes and increased iodide concentration in a cancer provides many advantages over conventional mammography. CT mammography appears to have the capability to detect breast cancers that are occult to other methods. Indications for a CT study of the breasts are: (1) clinically suspected breast cancer, especially with a mammographically occult lesion; (2) questionable mammographic findings, including microcalcifications, tumor shape, architectural distortion, and uncertain lesion location; and (3) evaluation of postbiopsy or postlumpectomy breast cancers when a primary irradiation therapy is contemplated. Breast CT also appears to be a valuable diagnostic tool in searching for a second primary breast cancer, follow-up study of postirradiation of breast cancer, followup study for postmastectomy patients, and screening procedure for genetically high-risk patients, especially those with dense breasts.

  16. Quantification of breast arterial calcification using full field digital mammography

    International Nuclear Information System (INIS)

    Molloi, Sabee; Xu Tong; Ducote, Justin; Iribarren, Carlos

    2008-01-01

    Breast arterial calcification is commonly detected on some mammograms. Previous studies indicate that breast arterial calcification is evidence of general atherosclerotic vascular disease and it may be a useful marker of coronary artery disease. It can potentially be a useful tool for assessment of coronary artery disease in women since mammography is widely used as a screening tool for early detection of breast cancer. However, there are currently no available techniques for quantification of calcium mass using mammography. The purpose of this study was to determine whether it is possible to quantify breast arterial calcium mass using standard digital mammography. An anthropomorphic breast phantom along with a vessel calcification phantom was imaged using a full field digital mammography system. Densitometry was used to quantify calcium mass. A calcium calibration measurement was performed at each phantom thickness and beam energy. The known (K) and measured (M) calcium mass on 5 and 9 cm thickness phantoms were related by M=0.964K-0.288 mg (r=0.997 and SEE=0.878 mg) and M=1.004K+0.324 mg (r=0.994 and SEE=1.32 mg), respectively. The results indicate that accurate calcium mass measurements can be made without correction for scatter glare as long as careful calcium calibration is made for each breast thickness. The results also indicate that composition variations and differences of approximately 1 cm between calibration phantom and breast thickness introduce only minimal error in calcium measurement. The uncertainty in magnification is expected to cause up to 5% and 15% error in calcium mass for 5 and 9 cm breast thicknesses, respectively. In conclusion, a densitometry technique for quantification of breast arterial calcium mass was validated using standard full field digital mammography. The results demonstrated the feasibility and potential utility of the densitometry technique for accurate quantification of breast arterial calcium mass using standard digital

  17. Mammography in women under 35

    International Nuclear Information System (INIS)

    Panzarola, P.; Bellucci, M.C.

    1991-01-01

    The detection of breast cancer in women under 35 is quite an uncommon event, accounting only for 3.2-3.4% of all breast cancers. To determine the indications for mammography in women under 35, the authors correlated clinical, mammographic, and US findings with fine-needle aspiration/surgical biopsy and follow-up results in 1040 symptomatic women examined at the Center of Senology of the Istitute of Radiology - University of Perugia, Italy, from 1984 to June 1990. Of 1040 women, 482 (41.6%) had normal findings; benign disease was diagnosed in 558 (53.7%) cases, and malignant disease in 49 (4.7%). Mammography was very useful to diagnose malignancy in palpable breast lesions, as well as to suggest the need for biopsy, to detect metachronous cancer and to define lesion sizes. In inflammatory process - e.g., mastitis and abscesses - both mammography and US were capable as its remission after therapy. Galactography had a specific role in the evaluation of the mammary duct and demonstrated intraductal pathologic conditions. In the authors'experiences, mammography never showed occult breast cancers in women with no palpable breast lesions or hematic nipple discharge

  18. Surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, Clare; Boachie, Charles; Fraser, Cynthia; MacLennan, Graeme; Mowatt, Graham; Thomas, Ruth E. [University of Aberdeen, Health Services Research Unit, Aberdeen (United Kingdom); Ragupathy, Senthil Kumar Arcot [NHS Grampian, Radiology Department, Aberdeen Royal Infirmary, Aberdeen (United Kingdom); Heys, Steve D. [University of Aberdeen and Aberdeen Royal Infirmary, NHS Grampian, Division of Applied Medicine, School of Medicine and Dentistry, Aberdeen (United Kingdom); Gilbert, Fiona J. [University of Aberdeen and Aberdeen Royal Infirmary, NHS Grampian, Aberdeen Biomedical Imaging Centre, Aberdeen (United Kingdom)

    2011-12-15

    To determine the diagnostic accuracy of surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. A systematic review of surveillance mammography compared with ultrasound, magnetic resonance imaging (MRI), specialist-led clinical examination or unstructured primary care follow-up, using histopathological assessment for test positives and follow-up for test negatives as the reference standard. Nine studies met our inclusion criteria. Variations in study comparisons precluded meta-analysis. For routine ipsilateral breast tumour detection, surveillance mammography sensitivity ranged from 64-67% and specificity ranged from 85-97%. For MRI, sensitivity ranged from 86-100% and specificity was 93%. For non-routine ipsilateral breast tumour detection, sensitivity and specificity for surveillance mammography ranged from 50-83% and 57-75% and for MRI 93-100% and 88-96%. For routine metachronous contralateral breast cancer detection, one study reported sensitivity of 67% and specificity of 50% for both surveillance mammography and MRI. Although mammography is associated with high sensitivity and specificity, MRI is the most accurate test for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. Results should be interpreted with caution because of the limited evidence base. (orig.)

  19. Value of breast MRI as supplement to mammography and sonography for high risk breast cancer patients

    International Nuclear Information System (INIS)

    Schlossbauer, T.; Hellerhoff, K.; Reiser, M.

    2008-01-01

    The aim of this study is to give an overview on early detection of breast cancer in patients with an increased risk of breast cancer. Sensitivities and diagnostic accuracies of breast MRI, mammography and ultrasound were compared. A systematic literature search of the past 3 years was performed. Studies which compared breast imaging modalities and used image-guided biopsy results as standard of reference were included. Patients included had to have had an increased lifetime risk for breast cancer (>15%). Regarding sensitivity and diagnostic accuracy, breast MRI performed best in comparison to the other modalities within this collective of patients. Sensitivities ranged from 71-100%, 0-78%, and 13-65%, for MRI, mammography, and ultrasound, respectively Breast MRI is a well established tool for screening in patients at high risk for developing breast cancer and is a valuable supplement to mammography and ultrasound within this selected cohort of patients. (orig.) [de

  20. Factors influencing elderly women's mammography screening decisions: implications for counseling

    Directory of Open Access Journals (Sweden)

    Davis Roger B

    2007-11-01

    Full Text Available Abstract Background Although guidelines recommend that clinicians consider life expectancy before screening older women for breast cancer, many older women with limited life expectancies are screened. We aimed to identify factors important to mammography screening decisions among women aged 80 and older compared to women aged 65–79. Methods Telephone surveys of 107 women aged 80+ and 93 women aged 65–79 randomly selected from one academic primary care practice who were able to communicate in English (60% response rate. The survey addressed the following factors in regards to older women's mammography screening decisions: perceived importance of a history of breast disease, family history of breast cancer, doctor's recommendations, habit, reassurance, previous experience, mailed reminder cards, family/friend's recommendations or experience with breast cancer, age, health, and media. The survey also assessed older women's preferred role in decision making around mammography screening. Results Of the 200 women, 65.5% were non-Hispanic white and 82.8% were in good to excellent health. Most (81.3% had undergone mammography in the past 2 years. Regardless of age, older women ranked doctor's recommendations as the most important factor influencing their decision to get screened. Habit and reassurance were the next two highly ranked factors influencing older women to get screened. Among women who did not get screened, women aged 80 and older ranked age and doctor's counseling as the most influential factors and women aged 65–79 ranked a previous negative experience with mammography as the most important factor. There were no significant differences in preferred role in decision-making around mammography screening by age, however, most women in both age groups preferred to make the final decision on their own (46.6% of women aged 80+ and 50.5% of women aged 65–79. Conclusion While a doctor's recommendation is the most important factor influencing

  1. Factors influencing elderly women's mammography screening decisions: implications for counseling.

    Science.gov (United States)

    Schonberg, Mara A; McCarthy, Ellen P; York, Meghan; Davis, Roger B; Marcantonio, Edward R

    2007-11-16

    Although guidelines recommend that clinicians consider life expectancy before screening older women for breast cancer, many older women with limited life expectancies are screened. We aimed to identify factors important to mammography screening decisions among women aged 80 and older compared to women aged 65-79. Telephone surveys of 107 women aged 80+ and 93 women aged 65-79 randomly selected from one academic primary care practice who were able to communicate in English (60% response rate). The survey addressed the following factors in regards to older women's mammography screening decisions: perceived importance of a history of breast disease, family history of breast cancer, doctor's recommendations, habit, reassurance, previous experience, mailed reminder cards, family/friend's recommendations or experience with breast cancer, age, health, and media. The survey also assessed older women's preferred role in decision making around mammography screening. Of the 200 women, 65.5% were non-Hispanic white and 82.8% were in good to excellent health. Most (81.3%) had undergone mammography in the past 2 years. Regardless of age, older women ranked doctor's recommendations as the most important factor influencing their decision to get screened. Habit and reassurance were the next two highly ranked factors influencing older women to get screened. Among women who did not get screened, women aged 80 and older ranked age and doctor's counseling as the most influential factors and women aged 65-79 ranked a previous negative experience with mammography as the most important factor. There were no significant differences in preferred role in decision-making around mammography screening by age, however, most women in both age groups preferred to make the final decision on their own (46.6% of women aged 80+ and 50.5% of women aged 65-79). While a doctor's recommendation is the most important factor influencing elderly women's mammography screening decisions, habit and reassurance

  2. Comparative study on mammographic findings between conventional mammography and digital mammography

    International Nuclear Information System (INIS)

    Gonzalez Calle, Aurelio; Saldarriaga Jaramillo, Ximena; Zapata Walliser, Luz Estela; Mejia Restrepo, Jorge Hernando; Arango Martinez, Adriana; Velez Arango, Jorge Mario

    2007-01-01

    We performed conventional-film mammograms in 180 patients between 35 and 6 years and additionally, we added 2 digital CR technique images to each patient, either craneocaudal (90 patients) or oblique (90 patients). All images were interpreted independently by four radiologists for a total of 720 evaluations, who compared film versus digital images through a 5 mega pixel monitor (soft-copy), using a score scale using the following parameters: mass visualization, detection of micro-calcifications, architectural distortion, visibility of the skin line, and image sharpness and noise. Additionally the tissue density was classified as well as the BIRADS score. The data was processed with the Teleform program and analyzed by de SPSSS program. Results: 52.6% of the micro-calcifications were equally visualized with both systems, in 13.5% of the cases they were better visualized with digital mammography. Similarly, in 50% of the cases, the skin line was better visualized with the digital CR modality. Conclusion: the sharpness of the image was also better seen with the digital CR technique in 48.2%. On the contrary, more noise was seen in digital CR images (63%). digital mammography is a diagnostic alternative that can improve mammographic findings detection and finally become a useful tool in breast cancer diagnosis

  3. Digital mammography in breast cancer screening: Evaluation and innovation

    NARCIS (Netherlands)

    Bluekens, A.M.J.

    2015-01-01

    With all other imaging modalities in radiology being digitised and conventional mammography being ready to phase out the transition to digital mammography was inevitable. This thesis describes the performance of digital screening mammography and the consequences of implementation in a

  4. Classification of breast microcalcifications using spectral mammography

    Science.gov (United States)

    Ghammraoui, B.; Glick, S. J.

    2017-03-01

    Purpose: To investigate the potential of spectral mammography to distinguish between type I calcifications, consisting of calcium oxalate dihydrate or weddellite compounds that are more often associated with benign lesions, and type II calcifications containing hydroxyapatite which are predominantly associated with malignant tumors. Methods: Using a ray tracing algorithm, we simulated the total number of x-ray photons recorded by the detector at one pixel from a single pencil-beam projection through a breast of 50/50 (adipose/glandular) tissues with inserted microcalcifications of different types and sizes. Material decomposition using two energy bins was then applied to characterize the simulated calcifications into hydroxyapatite and weddellite using maximumlikelihood estimation, taking into account the polychromatic source, the detector response function and the energy dependent attenuation. Results: Simulation tests were carried out for different doses and calcification sizes for multiple realizations. The results were summarized using receiver operating characteristic (ROC) analysis with the area under the curve (AUC) taken as an overall indicator of discrimination performance and showing high AUC values up to 0.99. Conclusion: Our simulation results obtained for a uniform breast imaging phantom indicate that spectral mammography using two energy bins has the potential to be used as a non-invasive method for discrimination between type I and type II microcalcifications to improve early breast cancer diagnosis and reduce the number of unnecessary breast biopsies.

  5. Value of mammography and breast ultrasound in male patients with nipple discharge.

    Science.gov (United States)

    Muñoz Carrasco, Rafaela; Álvarez Benito, Marina; Rivin del Campo, Eleonor

    2013-03-01

    To assess the contribution of mammography and ultrasound in men with nipple discharge. All men with nipple discharge who underwent mammography and/or ultrasound between 1993 and 2011 in our hospital were retrospectively evaluated. Radiological findings were classified according to BI-RADS lexicon. The final diagnosis was made based on histopathological results or clinical-radiological follow-up. The diagnostic performance of physical examination, mammography and ultrasound was calculated and compared. 26 men with 21 mammograms and 19 ultrasounds were reviewed. The final diagnoses were: 6 carcinomas (23.1%), 10 gynaecomastias, 2 pseudogynaecomastias and 8 normal breast tissues. Mammograms and ultrasounds performed on all five patients with infiltrating carcinoma showed a mass (categories 4 and 5). In all these patients except one, a breast mass was also noted and the physical examination was positive or suspected malignancy. In the patient with carcinoma in situ, the only conspicuous clinical sign was bloody nipple discharge and the mammography showed calcifications (category 4) that were not visible on ultrasound. Radiological findings of all patients without malignancy were classified as categories 1 and 2. The diagnostic performance of physical examination was lower than mammography and ultrasound (P>0.05). Mammography was more sensitive than ultrasound (100% vs. 83.3%). Both techniques showed the same specificity (100%). Men with nipple discharge have a high incidence of breast carcinoma. Nipple discharge may be the only clinical sign of carcinoma in situ. Mammography and ultrasound are useful in the evaluation of men with nipple discharge, diagnosing carcinoma in initial stages, avoiding unnecessary biopsies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Contrast-enhanced spectral mammography in patients with MRI contraindications.

    Science.gov (United States)

    Richter, Vivien; Hatterman, Valerie; Preibsch, Heike; Bahrs, Sonja D; Hahn, Markus; Nikolaou, Konstantin; Wiesinger, Benjamin

    2017-01-01

    Background Contrast-enhanced spectral mammography (CESM) is a novel breast imaging technique providing comparable diagnostic accuracy to breast magnetic resonance imaging (MRI). Purpose To show that CESM in patients with MRI contraindications is feasible, accurate, and useful as a problem-solving tool, and to highlight its limitations. Material and Methods A total of 118 patients with MRI contraindications were examined by CESM. Histology was obtained in 94 lesions and used as gold standard for diagnostic accuracy calculations. Imaging data were reviewed retrospectively for feasibility, accuracy, and technical problems. The diagnostic yield of CESM as a problem-solving tool and for therapy response evaluation was reviewed separately. Results CESM was more accurate than mammography (MG) for lesion categorization (r = 0.731, P < 0.0001 vs. r = 0.279, P = 0.006) and for lesion size estimation (r = 0.738 vs. r = 0.689, P < 0.0001). Negative predictive value of CESM was significantly higher than of MG (85.71% vs. 30.77%, P < 0.0001). When used for problem-solving, CESM changed patient management in 2/8 (25%) cases. Superposition artifacts and timing problems affected diagnostic utility in 3/118 (2.5%) patients. Conclusion CESM is a feasible and accurate alternative for patients with MRI contraindications, but it is necessary to be aware of the method's technical limitations.

  7. The efficacy of using CAD for detection of breast cancer in mammography screening A systematic review

    DEFF Research Database (Denmark)

    Henriksen, Emilie; Lauridsen, Carsten Ammitzbøl

    Abstract Purpose: The aim of this systematic review is to present an overview of the available studies concerning the use of computer-aided detection (CAD) systems in screening mammography for early detection of breast cancer and compare the diagnostic accuracy and recall rates of single reading....... The literature search resulted in 1522 records after duplicates were removed. 1491 records were excluded by abstract and 18 were excluded after assessing the eligibility by full text reading. A total of 13 articles were included in this study. Results: The results for the single reading vs. single reading...... with CAD group indicate that the addition of CAD increases sensitivity and cancer detection rate (CDR). For the double reading vs. single reading with CAD group none of the studies reported significant differences in sensitivity and CDR. Adding CAD to single reading increased the recall rates and decreased...

  8. Determination of the effective energy in X-rays standard beams, mammography level

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Eduardo de Lima; Vivolo, Vitor; Potiens, Maria da Penha A., E-mail: Vivolo@ipen.b, E-mail: mppalbu@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    The X-rays beams used in diagnostic radiology are heterogeneous. This means that, in a radiological beam, it can be found photons with different energies. Because of that is common to work with the concept of effective energy. In this study the effective energy of an X-rays system used in instruments calibration was determined, as part of the mammography radiation qualities establishment. The procedure presented here was developed based on information found in the literature. The X-ray mass attenuation coefficients for aluminum, given by NIST web site, were used and the mathematical adjusts were done using the Origin 8.0 program. The results are part of the mammographic X-rays beams characteristics determination and it is important to keep the quality of this reference system. (author)

  9. MRI to X-ray mammography registration using a volume-preserving affine transformation.

    NARCIS (Netherlands)

    Mertzanidou, T.; Hipwell, J.; Cardoso, M.J.; Zhang, X.; Tanner, C.; Ourselin, S.; Bick, U.; Huisman, H.J.; Karssemeijer, N.; Hawkes, D.

    2012-01-01

    X-ray mammography is routinely used in national screening programmes and as a clinical diagnostic tool. Magnetic Resonance Imaging (MRI) is commonly used as a complementary modality, providing functional information about the breast and a 3D image that can overcome ambiguities caused by the

  10. Bovine paratuberculosis: a review of the advantages and disadvantages of different diagnostic tests.

    Science.gov (United States)

    Gilardoni, Liliana R; Paolicchi, Fernando A; Mundo, Silvia L

    2012-01-01

    Paratuberculosis (PTB), or Johne's disease, is a chronic infectious granulomatous enteritis of ruminants, caused by Mycobacterium avium subspecies paratuberculosis (Map). It is characterized by diarrhea and progressive cachexia, which may cause the death of the animal. Calves are the most susceptible to infection. Infected animals excrete Map mainly by the feces. PTB is endemic worldwide, with high prevalence levels, strong economic impact and public health relevance because of its possible association with Crohn's disease. Although the current reference diagnostic test is identification of Map in the bacterial culture, there are different diagnostic tests to identify infected individuals and/or herds. The sensitivity and specificity of these tests vary according to the stage of the disease in the animals to be evaluated. The correct choice and application of each of these diagnostic tests will ensure their success and may allow to establish a control program. The aim of this work is to review and discuss the different diagnostic tests used in the detection of Map-infected animals, focusing on their advantages and disadvantages.

  11. The study of diagnostic accuracy of chest nodules by using different compression methods

    International Nuclear Information System (INIS)

    Liang Zhigang; Kuncheng, L.I.; Zhang Jinghong; Liu Shuliang

    2005-01-01

    Background: The purpose of this study was to compare the diagnostic accuracy of small nodules in the chest by using different compression methods. Method: Two radiologists with 5 years experience twice interpreted 39 chest images by using lossless and lossy compression methods. The time interval was 3 weeks. Each time the radiologists interpreted one kind of compressed images. The image browser used the Unisight software provided by Atlastiger Company in Shanghai. The interpreting results were analyzed by the ROCKIT software and the ROC curves were painted by Excel 2002. Results: In studies of receiver operating characteristics for scoring the presence or absence of nodules, the images with lossy compression method showed no statistical difference as compared with the images with lossless compression method. Conclusion: The diagnostic accuracy of chest nodules by using the lossless and lossy compression methods had no significant difference, we could use the lossy compression method to transmit and archive the chest images with nodules

  12. The self-referred mammography patient

    International Nuclear Information System (INIS)

    Reynolds, H.E.; Jackson, V.P.

    1990-01-01

    This paper compares the demographics, knowledge, and attitudes of women who refer themselves for screening mammography with those who undergo mammography on the advice of their physicians. Four hundred eighty-five consecutive mammography patients (437 doctor preferred [DR], 48 self-referred [SR]) completed a survey during their mammography appointment. The sample population contained a wide range of socioeconomic groups. While similar in age, race, and employment status to DR patients, SR patients were significantly more likely to have a family income of more than 30,000 per year, be college graduates, and report that they were in good or excellent health

  13. Update on new technologies in digital mammography

    Directory of Open Access Journals (Sweden)

    Patterson SK

    2014-08-01

    Full Text Available Stephanie K Patterson, Marilyn A Roubidoux Division of Breast Imaging, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA Abstract: Despite controversy regarding mammography's efficacy, it continues to be the most commonly used breast cancer-screening modality. With the development of digital mammography, some improved benefit has been shown in women with dense breast tissue. However, the density of breast tissue continues to limit the sensitivity of conventional mammography. We discuss the development of some derivative digital technologies, primarily digital breast tomosynthesis, and their strengths, weaknesses, and potential patient impact. Keywords: screening mammography, breast cancer, contrast media, digital breast tomosynthesis

  14. [Controversial attitude to mammography screening in asymptomatic women between 40 and 50 years of age].

    Science.gov (United States)

    Frischbier, H J

    1994-01-01

    The results of screening studies conducted in the United States and in Europe in females between the ages of 40 and 50 are analysed. It is shown, that the results of this study on mortality reduction are less favourable, the poorer the technique of mammography (foregoing of general two-view mammography) and the longer the time interval between two mammography screenings. Arguments are presented, that are brought forward when declining to perform general mammography screening in this age group. The author's own results, obtained in the Hamburg mammography screening study, which included from 1971 to 1986 also premenopausal women, show, that the survival rates of patients below 50 years of age with mammographically detected carcinomas of the breast do not differ from those in patients older than 50 years, according to a relevant age group classification. The advances in the technique of mammography in recent years are analysed on the basis of the author's own patient material. It is evident, that the positive predictive value has been doubled, especially in the age group between 40 and 50. An analysis of the distribution of diagnosed noninvasive carcinomas compared with the invasive carcinomas reveals, that particularly this age group has the highest percentage of identification of prognostically favourable carcinoma stages. Further analyses show, why the randomised European mammography studies could not yield a significant mortality rate improvement. A prerequisite for the inclusion of mammography screening in the legally prescribed early detection of carcinoma examinations, however, are the quality controls, whose realisation, in our health system, will have to be confirmed by the German mammography study.

  15. European radiographers' challenges from mammography education and clinical practice - an integrative review.

    Science.gov (United States)

    Metsälä, Eija; Richli Meystre, Nicole; Pires Jorge, José; Henner, Anja; Kukkes, Tiina; Sá Dos Reis, Cláudia

    2017-06-01

    This study aims to identify European radiographers' challenges in clinical performance in mammography and the main areas of mammography that require more and better training. An extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis. A total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers' mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness. The introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process. • Radiographers' awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers' responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

  16. Comparison of synthetic mammography, reconstructed from digital breast tomosynthesis, and digital mammography: evaluation of lesion conspicuity and BI-RADS assessment categories.

    Science.gov (United States)

    Mariscotti, Giovanna; Durando, Manuela; Houssami, Nehmat; Fasciano, Mirella; Tagliafico, Alberto; Bosco, Davide; Casella, Cristina; Bogetti, Camilla; Bergamasco, Laura; Fonio, Paolo; Gandini, Giovanni

    2017-12-01

    To compare the interpretive performance of synthetic mammography (SM), reconstructed from digital breast tomosynthesis (DBT), and full-field digital mammography (FFDM) in a diagnostic setting, covering different conditions of breast density and mammographic signs. A retrospective analysis was conducted on 231 patients, who underwent FFDM and DBT (from which SM images were reconstructed) between September 2014-September 2015. The study included 250 suspicious breast lesions, all biopsy proven: 148 (59.2%) malignant and 13 (5.2%) high-risk lesions were confirmed by surgery, 89 (35.6%) benign lesions had radiological follow-up. Two breast radiologists, blinded to histology, independently reviewed all cases. Readings were performed with SM alone, then with FFDM, collecting data on: probability of malignancy for each finding, lesion conspicuity, mammographic features and dimensions of detected lesions. Agreement between readers was good for BI-RADS classification (Cohen's k-coefficient = 0.93 ± 0.02) and for lesion dimension (Wilcoxon's p = 0.76). Visibility scores assigned to SM and FFDM for each lesion were similar for non-dense and dense breasts, however, there were significant differences (p = 0.0009) in distribution of mammographic features subgroups. SM and FFDM had similar sensitivities in non-dense (respectively 94 vs. 91%) and dense breasts (88 vs. 80%) and for all mammographic signs (93 vs. 87% for asymmetric densities, 96 vs. 75% for distortion, 92 vs. 85% for microcalcifications, and both 94% for masses). Based on all data, there was a significant difference in sensitivity for SM (92%) vs. FFDM (87%), p = 0.02, whereas the two modalities yielded similar results for specificity (SM: 60%, FFDM: 62%, p = 0.21). SM alone showed similar interpretive performance to FFDM, confirming its potential role as an alternative to FFDM in women having tomosynthesis, with the added advantage of halving the patient's dose exposure.

  17. Implications of Overdiagnosis: Impact on Screening Mammography Practices

    Science.gov (United States)

    Morris, Elizabeth; Feig, Stephen A.; Drexler, Madeline

    2015-01-01

    Abstract This review article explores the issue of overdiagnosis in screening mammography. Overdiagnosis is the screen detection of a breast cancer, histologically confirmed, that might not otherwise become clinically apparent during the lifetime of the patient. While screening mammography is an imperfect tool, it remains the best tool we have to diagnose breast cancer early, before a patient is symptomatic and at a time when chances of survival and options for treatment are most favorable. In 2015, an estimated 231,840 new cases of breast cancer (excluding ductal carcinoma in situ) will be diagnosed in the United States, and some 40,290 women will die. Despite these data, screening mammography for women ages 40–69 has contributed to a substantial reduction in breast cancer mortality, and organized screening programs have led to a shift from late-stage diagnosis to early-stage detection. Current estimates of overdiagnosis in screening mammography vary widely, from 0% to upwards of 30% of diagnosed cancers. This range reflects the fact that measuring overdiagnosis is not a straightforward calculation, but usually one based on different sets of assumptions and often biased by methodological flaws. The recent development of tomosynthesis, which creates high-resolution, three-dimensional images, has increased breast cancer detection while reducing false recalls. Because the greatest harm of overdiagnosis is overtreatment, the key goal should not be less diagnosis but better treatment decision tools. (Population Health Management 2015;18:S3–S11) PMID:26414384

  18. Control of quality in mammography

    International Nuclear Information System (INIS)

    2006-10-01

    The present protocol of quality control/quality assurance in mammography is the result of the work of two regional projects realised in Latin America within the frame of ARCAL with the support of the IAEA. The first is ARCAL LV (RLA/6/043) project on quality assurance/quality control in mammography studies which analysed the present situation of the mammography in the member countries of the project which include: Bolivia, Colombia, Costa Rica, Cuba, El Salvador, Guatemala, Nicaragua, Panama, Paraguay, Peru, Dominican Republic and Republic of Venezuela and the second is ARCAL XLIX (RLA/9/035) project, whose members were Brazil, Colombia, Cuba, Chile, Mexico, and Peru, worked the application of Basic Safety Standards for the protection against ionising radiation with the aim to improve radiation protection in X-ray diagnosis medical practices through the implementation of the Basic Safety Standards (BSS) related to x-ray diagnosis in selected hospitals located in each country involved in the project. The work of both projects had been consolidated and harmonized in the present publication

  19. Refractive index gradient diagnostics: analysis of different optical systems and application to COBRA ion diode

    Energy Technology Data Exchange (ETDEWEB)

    Knyazev, B A; Greenly, J B; Hammer, D A; Krastelev, E G [Cornell Univ., Ithaca, NY (United States). Laboratory of Plasma Studies; Cuneo, M E [Sandia National Laboratories, Albuquerque, NM (United States)

    1997-12-31

    Different optical system variations for refractive index gradient diagnostics with a laser beam probe have been analyzed. A `three-telescope` optical system which permits simultaneous measurement of both the laser beam centroid deflection by a bi-cell photodiode and the spatial Fourier spectrum of the deflected beam by a streak camera has been implemented on the COBRA ion diode. The dynamics of the anode plasma layer was studied with these techniques. (author). 3 figs., 8 refs.

  20. Quantitative dynamic MR-mammography for diagnosis of breast cancer

    International Nuclear Information System (INIS)

    Klengel, S.; Hietschold, V.; Koehler, K.

    1997-01-01

    Problems of screening X-mammography are mainly the so-called 'dense breast', the postoperative status and suspect focal densities. Contrast enhanced MRI was hoped to further improve diagnostic specificity. Unfortunately, contrast enhancement appears in an overlapping manner in both malignant and benign lesions. A restrospective parameter analysis of dynamic early and late phase contrast enhancement showed a threshold based on a linear combination of early and late phase parameters best suited for lesion characterisation. In a prospective study this threshold offered a high specificity without loss of sensitivity in classification of suspect densities. A reduction of unnecessary operations should be possible in future relevant exclusion criteria. (orig.)

  1. Postmortem validation of breast density using dual-energy mammography

    Energy Technology Data Exchange (ETDEWEB)

    Molloi, Sabee, E-mail: symolloi@uci.edu; Ducote, Justin L.; Ding, Huanjun; Feig, Stephen A. [Department of Radiological Sciences, University of California, Irvine, California 92697 (United States)

    2014-08-15

    Purpose: Mammographic density has been shown to be an indicator of breast cancer risk and also reduces the sensitivity of screening mammography. Currently, there is no accepted standard for measuring breast density. Dual energy mammography has been proposed as a technique for accurate measurement of breast density. The purpose of this study is to validate its accuracy in postmortem breasts and compare it with other existing techniques. Methods: Forty postmortem breasts were imaged using a dual energy mammography system. Glandular and adipose equivalent phantoms of uniform thickness were used to calibrate a dual energy basis decomposition algorithm. Dual energy decomposition was applied after scatter correction to calculate breast density. Breast density was also estimated using radiologist reader assessment, standard histogram thresholding and a fuzzy C-mean algorithm. Chemical analysis was used as the reference standard to assess the accuracy of different techniques to measure breast composition. Results: Breast density measurements using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean algorithm, and dual energy were in good agreement with the measured fibroglandular volume fraction using chemical analysis. The standard error estimates using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean, and dual energy were 9.9%, 8.6%, 7.2%, and 4.7%, respectively. Conclusions: The results indicate that dual energy mammography can be used to accurately measure breast density. The variability in breast density estimation using dual energy mammography was lower than reader assessment rankings, standard histogram thresholding, and fuzzy C-mean algorithm. Improved quantification of breast density is expected to further enhance its utility as a risk factor for breast cancer.

  2. Postmortem validation of breast density using dual-energy mammography

    International Nuclear Information System (INIS)

    Molloi, Sabee; Ducote, Justin L.; Ding, Huanjun; Feig, Stephen A.

    2014-01-01

    Purpose: Mammographic density has been shown to be an indicator of breast cancer risk and also reduces the sensitivity of screening mammography. Currently, there is no accepted standard for measuring breast density. Dual energy mammography has been proposed as a technique for accurate measurement of breast density. The purpose of this study is to validate its accuracy in postmortem breasts and compare it with other existing techniques. Methods: Forty postmortem breasts were imaged using a dual energy mammography system. Glandular and adipose equivalent phantoms of uniform thickness were used to calibrate a dual energy basis decomposition algorithm. Dual energy decomposition was applied after scatter correction to calculate breast density. Breast density was also estimated using radiologist reader assessment, standard histogram thresholding and a fuzzy C-mean algorithm. Chemical analysis was used as the reference standard to assess the accuracy of different techniques to measure breast composition. Results: Breast density measurements using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean algorithm, and dual energy were in good agreement with the measured fibroglandular volume fraction using chemical analysis. The standard error estimates using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean, and dual energy were 9.9%, 8.6%, 7.2%, and 4.7%, respectively. Conclusions: The results indicate that dual energy mammography can be used to accurately measure breast density. The variability in breast density estimation using dual energy mammography was lower than reader assessment rankings, standard histogram thresholding, and fuzzy C-mean algorithm. Improved quantification of breast density is expected to further enhance its utility as a risk factor for breast cancer

  3. Quality-of-Life Differences among Diagnostic Subgroups of Children Receiving Ventilating Tubes for Otitis Media.

    Science.gov (United States)

    Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse; Faber, Christian Emil; Johansen, Eva Charlotte Jung; Godballe, Christian

    2015-10-01

    The pathological picture may differ considerably between diagnostic subgroups of children with otitis media receiving ventilating tubes. The aims of this study are to investigate differences in quality of life among diagnostic subgroups of children treated with ventilating tubes and to investigate possible predictors for clinical success. Longitudinal observational study. Secondary care units. Four hundred ninety-one families were enrolled in the study. The Otitis Media-6 questionnaire was applied in the assessment of child quality of life. Caregivers completed questionnaires at 7 time points from before treatment to 18-month follow-up. Logistic regression analysis was used to investigate possible predictors for clinical success. Response rates ranged from 96% to 81%; diagnostic distribution: 15% recurrent acute otitis media (rAOM), 47% otitis media with effusion (OME), and 38% mixed diagnosis of rAOM and OME (rAOM/OME). There were no significant differences between children diagnosed with rAOM and children diagnosed with rAOM/OME. However, these children had a significantly poorer quality of life at baseline compared with children diagnosed with only OME. Factors associated with clinical success included a diagnosis of rAOM, number of interrupted nights, physician visits, and canceled social activities due to OM. Results highlight the importance of distinguishing between diagnostic subgroups of children having ventilating tube treatment. A diagnosis of rAOM was found to predict baseline quality of life. Children with rAOM with or without OME were found to suffer significantly more than children with only OME before treatment. Factors associated with disease severity were found to predict clinical success. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  4. Comparative effectiveness of combined digital mammography and tomosynthesis screening for women with dense breasts.

    Science.gov (United States)

    Lee, Christoph I; Cevik, Mucahit; Alagoz, Oguzhan; Sprague, Brian L; Tosteson, Anna N A; Miglioretti, Diana L; Kerlikowske, Karla; Stout, Natasha K; Jarvik, Jeffrey G; Ramsey, Scott D; Lehman, Constance D

    2015-03-01

    To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. An established, discrete-event breast cancer simulation model was used to estimate the comparative clinical effectiveness and cost-effectiveness of biennial screening with both digital mammography and tomosynthesis versus digital mammography alone among U.S. women aged 50-74 years with dense breasts from a federal payer perspective and a lifetime horizon. Input values were estimated for test performance, costs, and health state utilities from the National Cancer Institute Breast Cancer Surveillance Consortium, Medicare reimbursement rates, and medical literature. Sensitivity analyses were performed to determine the implications of varying key model parameters, including combined screening sensitivity and specificity, transient utility decrement of diagnostic work-up, and additional cost of tomosynthesis. For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis. Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50-74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations vs $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice.

  5. Barriers to Mammography among Inadequately Screened Women

    Science.gov (United States)

    Stoll, Carolyn R. T.; Roberts, Summer; Cheng, Meng-Ru; Crayton, Eloise V.; Jackson, Sherrill; Politi, Mary C.

    2015-01-01

    Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography…

  6. At what age should screening mammography be recommended for Asian women?

    International Nuclear Information System (INIS)

    Tsuchida, Junko; Nagahashi, Masayuki; Rashid, Omar M; Takabe, Kazuaki; Wakai, Toshifumi

    2015-01-01

    Although regular screening mammography has been suggested to be associated with improvements in the relative survival of breast cancer in recent years, the appropriate age to start screening mammography remains controversial. In November 2009, the United States Preventive Service Task Force published updated guidelines for breast cancer, which no longer support routine screening mammography for women aged 40–49 years, but instead, defer the choice of screening in that age group to the patient and physician. The age to begin screening differs between guidelines, including those from the Task Force, the American Cancer Society and the World Health Organization. It remains unclear how this discrepancy impacts patient survival, especially among certain subpopulations. Although the biological characteristics of breast cancer and peak age of incidence differ among different ethnic populations, there have been few reports that evaluate the starting age for screening mammography based on ethnicity. Here, we discuss the benefits and harm of screening mammography in the fifth decade, and re-evaluate the starting age for screening mammography taking ethnicity into account, focusing on the Asian population. Breast cancer incidence peaked in the fifth decade in Asian women, which has been thought to be due to a combination of biological and environmental factors. Previous reports suggest that Asian women in their 40s may receive more benefit and less harm from screening mammography than the age-matched non-Asian US population. Therefore, starting screening mammography at age 40 may be beneficial for women of Asian ethnicity in well-resourced countries, such as Japanese women who reside in Japan

  7. At what age should screening mammography be recommended for Asian women?

    Science.gov (United States)

    Tsuchida, Junko; Nagahashi, Masayuki; Rashid, Omar M; Takabe, Kazuaki; Wakai, Toshifumi

    2015-07-01

    Although regular screening mammography has been suggested to be associated with improvements in the relative survival of breast cancer in recent years, the appropriate age to start screening mammography remains controversial. In November 2009, the United States Preventive Service Task Force published updated guidelines for breast cancer, which no longer support routine screening mammography for women aged 40-49 years, but instead, defer the choice of screening in that age group to the patient and physician. The age to begin screening differs between guidelines, including those from the Task Force, the American Cancer Society and the World Health Organization. It remains unclear how this discrepancy impacts patient survival, especially among certain subpopulations. Although the biological characteristics of breast cancer and peak age of incidence differ among different ethnic populations, there have been few reports that evaluate the starting age for screening mammography based on ethnicity. Here, we discuss the benefits and harm of screening mammography in the fifth decade, and re-evaluate the starting age for screening mammography taking ethnicity into account, focusing on the Asian population. Breast cancer incidence peaked in the fifth decade in Asian women, which has been thought to be due to a combination of biological and environmental factors. Previous reports suggest that Asian women in their 40s may receive more benefit and less harm from screening mammography than the age-matched non-Asian US population. Therefore, starting screening mammography at age 40 may be beneficial for women of Asian ethnicity in well-resourced countries, such as Japanese women who reside in Japan. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  8. Breast Cancer Screening Coverage with clinical examination and Mammography Among insured women in Bogota

    International Nuclear Information System (INIS)

    Arboleda, Walter; Murillo Raul; Pinero, Marion

    2009-01-01

    The objective is to determine the coverage of clinical breast examination (CBE) and mammography for screening of breast cancer among a group of insured women in Bogota. Methods: A telephone survey was carried out with 4,526 women between the ages of 50 and 69, residing in Bogota or its suburbs, who were insured by one of three commercial health plans. Women with a history of breast cancer were excluded. Screening coverage was estimated as the proportion of women who had had a mammography or CBE. Estimates were established for lifetime frequency, two years prior the survey, and one year prior the survey. Factors associated with screening procedures were analyzed with calculations based on adjusted OR. Results: Lifetime frequency of CBE was 59.3% and 79.8% for mammography; and 49.7% and 65.6% of women respectively underwent the tests for screening purposes; the remainder, for diagnostic purposes (breast symptoms). CBE reported a 34.2% one year coverage and mammography reported a 54% two years coverage. Screening was associated to cancer education and family history of breast cancer. Conclusion: Coverage of CBE for screening purposes is low. Mammography coverage is above that required by the Colombian Health Ministry, but below that reported by developed countries.

  9. Evaluation of the minimum iodine concentration for contrast-enhanced subtraction mammography

    International Nuclear Information System (INIS)

    Baldelli, P; Bravin, A; Maggio, C Di; Gennaro, G; Sarnelli, A; Taibi, A; Gambaccini, M

    2006-01-01

    Early manifestation of breast cancer is often very subtle and is displayed in a complex and variable pattern of normal anatomy that may obscure the disease. The use of dual-energy techniques, that can remove the structural noise, and contrast media, that enhance the region surrounding the tumour, could help us to improve the detectability of the lesions. The aim of this work is to investigate the use of an iodine-based contrast medium in mammography with two different double exposure techniques: K-edge subtraction mammography and temporal subtraction mammography. Both techniques have been investigated by using an ideal source, like monochromatic beams produced at a synchrotron radiation facility and a clinical digital mammography system. A dedicated three-component phantom containing cavities filled with different iodine concentrations has been developed and used for measurements. For each technique, information about the minimum iodine concentration, which provides a significant enhancement of the detectability of the pathology by minimizing the risk due to high dose and high concentration of contrast medium, has been obtained. In particular, for cavities of 5 and 8 mm in diameter filled with iodine solutions, the minimum concentration needed to obtain a contrast-to-noise ratio of 5 with a mean glandular dose of 2 mGy has been calculated. The minimum concentrations estimated with monochromatic beams and K-edge subtraction mammography are 0.9 mg ml -1 and 1.34 mg ml -1 for the biggest and smallest details, respectively, while for temporal subtraction mammography they are 0.84 mg ml -1 and 1.31 mg ml -1 . With the conventional clinical system the minimum concentrations for the K-edge subtraction mammography are 4.13 mg ml -1 (8 mm diameter) and 5.75 mg ml -1 (5 mm diameter), while for the temporal subtraction mammography they are 1.01 mg ml -1 (8 mm diameter) and 1.57 mg ml -1 (5 mm diameter)

  10. Barriers and incentives for choosing to specialise in mammography: Qualitative analysis

    International Nuclear Information System (INIS)

    Warren-Forward, H.M.; Taylor, J.

    2017-01-01

    Aim: There is a projected shortage of radiographers working in breast screening and this study aimed to examine comments from open response questions from a mixed methods survey of current diagnostic radiography students on their perceptions of working in mammography. Method: The survey asked three open ended questions: Justification of choice of modality in which they would want to specialise, why they believed there was a shortage of radiographers working in breast screening and any other comment about mammography. Results: Reasons given for specialising in any modality was interest, feature of a modality, amount of clinical exposure during the degree program, personal issues and career prospects. Few current diagnostic radiography students indicated that they would be interested in specialising in breast imaging. They considered there to be a shortage of radiographers as breast imaging was seen to be repetitive, high pressure, intimate and gender biased. Lack of education, clinical exposure, limited career prospects and low pay were also discussed. Conclusions: Increasing education to the modality during the degree, allowing males to be involved in breast imaging and promoting part-time work in mammography while also working in other modalities may alter the perception that mammography offers a limited career pathway. - Highlights: • Reasons to specialise in a modality include “interest”, “clinical exposure” and “career prospect”. • Reasons not to specialise include “availability of modality” and “gender of radiographer”. • Repetitive nature of mammography was cited as the most common reason for shortage of radiographers. • Restriction to female only radiographers was perceived to be a barrier. • Mammography perceived to be high stress due to pressure on getting correct diagnosis.

  11. Multiparameter optimization of mammography: an update

    Science.gov (United States)

    Jafroudi, Hamid; Muntz, E. P.; Jennings, Robert J.

    1994-05-01

    Previously in this forum we have reported the application of multiparameter optimization techniques to the design of a minimum dose mammography system. The approach used a reference system to define the physical imaging performance required and the dose to which the dose for the optimized system should be compared. During the course of implementing the resulting design in hardware suitable for laboratory testing, the state of the art in mammographic imaging changed, so that the original reference system, which did not have a grid, was no longer appropriate. A reference system with a grid was selected in response to this change, and at the same time the optimization procedure was modified, to make it more general and to facilitate study of the optimized design under a variety of conditions. We report the changes in the procedure, and the results obtained using the revised procedure and the up- to-date reference system. Our results, which are supported by laboratory measurements, indicate that the optimized design can image small objects as well as the reference system using only about 30% of the dose required by the reference system. Hardware meeting the specification produced by the optimization procedure and suitable for clinical use is currently under evaluation in the Diagnostic Radiology Department at the Clinical Center, NH.

  12. Speculation on improving personal dosimetry in mammography

    International Nuclear Information System (INIS)

    Nicoll, J.J.

    1996-01-01

    The increasing importance of radiation protection of the patient in diagnostic radiology has created an interest in the dose individuals receive from X-ray mammography, although this is an area where the most important aspect of protection is based on the inter comparison of machines using phantoms and standard conditions. In 1987 the ICRP established the critical quantity as being the average absorbed dose to the glandular tissue of the breast, and identified a composition of 50% adipose; 50% glandular tissue as a reference. Several authors have published experimental and monte carlo simulation resuluts to enable the determination of this quantity from output, beam quality and compressed breast thickness. Many centres, including ourselves, have studied the distribution of radiation dose on this basis. The result is however dependant on the assumption made about tissue composition. It is apparently common knowledge among pathologists and frequently mentioned in general anatomy texts, that the amount of glandular tissue is independent of breast size; that is larger breasts will have a higher adipose:glandular tissue ratio. Such a systematic variation would lead to an overestimate of the dose being received by women with larger breasts. I will review the availabe pathology and demonstrate the effect of applying the assumed breast composition on our own data. (author)

  13. A study of quality assurance in mammography

    International Nuclear Information System (INIS)

    Briquet, Claudia; Mota, Helvecio C.; Costa, Marcos R.

    1997-01-01

    Full text. Nowadays mammography has two definitive important roles: as a complementary tool to confirm clinical findings and for the detection of early breast cancer. To reach and maintain the standards of image quality within the frontiers of reasonable radiation doses, the facilities must follow a QA program. The objective of this study is to accomplish such a program in three school hospitals in Rio de Janeiro. We made assessment of clinical images using the Accreditation American Phantom and measured the patients skin entrance doses with TLD 100. In each facility we evaluated the technical parameters of the mammographic units using a Victoreen 4000 M+ and an evaluation of the compression devices. The 3 hospitals studied use film and screen Min R Kodak and have Kodak processors, none of them dedicated to mammograms. The tube voltage, measured was not significantly different from the indicated values, the variations were lesser than 5%. In one of the hospitals the kVp did not show reproducibility, the coefficient of variation was too high - 1,02. The same facility showed an exposure time with variation of 7% and we asked for corrective action. Measures of HVL showed the same value for the 3 hospitals the compression were adequate. The patients skin entrance doses were measured with TLD 100 and showed the range 3,25 a 10,26 mGy. This range is due to differences in density and thickness of the breast. The doses values were in accordance with the Quality Criteria for Mammography of the Commission of the European Communities

  14. Mapping of the radiation field of a mammography equipment using molybdenum and rhodium filters

    International Nuclear Information System (INIS)

    Barreira, Jacqueline S.; Campos, Daniela; Vivolo, Vitor

    2014-01-01

    The use of X rays for diagnostic radiology is very common and important to Medicine, including mammographic diagnosis focusing decreasing of the doses applied to the patients and preserving high quality of the diagnostic image. A quality control program of the irradiation systems it is very necessary. The Instruments Calibration Laboratory (LCI) of IPEN perform calibration in dosemeters used in radiation dosimetry (in diagnostic radiology) for many years. The objective of that paper is determining the point of greatest intensity of the beam issued by the mammography equipment. Exposures were made with filters Rhodium and Molybdenum. That mapping is important before applied a routine quality control program of the mammography equipment and the calibration of instruments in the diagnosis. (author)

  15. Influence of age and menstrual cycle on mammography and MR imaging of the breast

    International Nuclear Information System (INIS)

    Mueller-Schimpfle, M.; Ohmenhaeuser, K.; Claussen, C.D.

    1997-01-01

    Age and menstrual cycle have an important influence on the breast. This well-known fact is experienced in the daily routine of gynecologists and radiologists. The number of publications addressing the effect of these influences on imaging, however, is surprisingly low. The aim of this work is to describe the influences of age and menstrual cycle on the breast and to address their clinical relevance for mammography and MR mammography. Therefore, own data are presented concerning the age and menstrual cycle influences on breast parenchyma in dynamic MR mammography. Literature data are used to correlate mammography and MR imaging findings with these influences. The changes of the breast due to age and menstrual cycle have important direct implications on performing and reading conventional mammography and MR mammography. The knowledge of these changes is also helpful in the interpretation of findings when comparing different methods. Finally, the data gained by using imaging methods enable important basic insights into physiology and physiopathology of the breast in vivo. (orig.) [de

  16. The mammography screening employee inreach program.

    Science.gov (United States)

    Robinson, Joanne; Seltzer, Vicki; Lawrence, Loretta; Autz, George; Kostroff, Karen; Weiselberg, Lora; Colagiacomo, Maria

    2007-02-01

    To determine whether our health care employees were undergoing mammography screening according to American Cancer Society guidelines and to determine whether aggressive outreach, education and streamlining of mammography scheduling could improve compliance. All female employees at North Shore University Hospital (NSUH) and several other health system facilities (SF) were sent mailings to their homes that included breast health education and mammography screening guidelines, a questionnaire regarding their own mammography screening history and the opportunity to have their mammography screening scheduled by the Mammography Screening Employee Inreach Program (MSEIP) coordinator. Of the approximately 2,700 female employees aged 40 and over at NSUH and SF, 2,235 (82.7%) responded to the questionnaire, and 1,455 had a mammogram done via the MSEIP. Of the 1,455, 43% either were overdue for a mammogram or had never had one. During a second year of the MSEIP at NSUH and SF, an additional 1,706 mammograms were done. People employed in health care jobs do not necessarily avail themselves of appropriate health care screening. An aggressive program that utilized education, outreach and assistance with scheduling was effective in increasing compliance with mammography screening.

  17. Evaluation of low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria

    OpenAIRE

    Lalji, U. C.; Jeukens, C. R. L. P. N.; Houben, I.; Nelemans, P. J.; van Engen, R. E.; van Wylick, E.; Beets-Tan, R. G. H.; Wildberger, J. E.; Paulis, L. E.; Lobbes, M. B. I.

    2015-01-01

    Objective Contrast-enhanced spectral mammography (CESM) examination results in a low-energy (LE) and contrast-enhanced image. The LE appears similar to a full-field digital mammogram (FFDM). Our aim was to evaluate LE CESM image quality by comparing it to FFDM using criteria defined by the European Reference Organization for Quality Assured Breast Screening and Diagnostic Services (EUREF). Methods A total of 147 cases with both FFDM and LE images were independently scored by two experienced r...

  18. Evaluation of glandular dose in conventional and digital mammography systems

    International Nuclear Information System (INIS)

    Coutinho, Celia Maria Campos

    2009-01-01

    A survey was conducted to estimate the average glandular dose (D g ) for patients undergoing mammography and to report the distribution of incident air kerma (K i ), patient age, compressed breast thickness and glandular tissue content. From 1183 cranio caudal mammograms clinical data were collected and doses were measured. The survey data included mammograms from six mammography equipment: two screen/film units (SFM), two computed radiography units (CR) and two full-field digital (DR). Mean value for patient age and compressed breast thickness were 57 +-12 y and 5.4 +-1.4 cm, respectively. To investigate the importance of technical characteristics of three different mammography systems and breast glandularity, K i and D g were measured for individual breast of 392 patients from the original sample with compressed breast thickness in the range of 5.5 cm to 6.5 cm using tissue-equivalent phantoms of different glandularities manufactured in this study to mimic both the attenuation and the density of breast tissues. Mean K i value was 10.0 +-3.6 mGy for SFM systems, 12.0 +-3.6 mGy for CR systems and 4.9 +-1.3 mGy for DR systems. Mean D g value was 1.4 +-0.5 mGy for S/F systems, 1.7 +-0.5 mGy for CR systems and 0.9 +-0.2 mGy for D R systems. Statistical analysis for differences in mean values of K i and D g between mammography systems showed significant effect of their technical characteristics (p i and D g , it was observed statistically significant differences between the group of patients with 0 to 50% glandularity and the group of patients with 50 to 100% glandularity. (author)

  19. Mammography image compression using Wavelet

    International Nuclear Information System (INIS)

    Azuhar Ripin; Md Saion Salikin; Wan Hazlinda Ismail; Asmaliza Hashim; Norriza Md Isa

    2004-01-01

    Image compression plays an important role in many applications like medical imaging, televideo conferencing, remote sensing, document and facsimile transmission, which depend on the efficient manipulation, storage, and transmission of binary, gray scale, or color images. In Medical imaging application such Picture Archiving and Communication System (PACs), the image size or image stream size is too large and requires a large amount of storage space or high bandwidth for communication. Image compression techniques are divided into two categories namely lossy and lossless data compression. Wavelet method used in this project is a lossless compression method. In this method, the exact original mammography image data can be recovered. In this project, mammography images are digitized by using Vider Sierra Plus digitizer. The digitized images are compressed by using this wavelet image compression technique. Interactive Data Language (IDLs) numerical and visualization software is used to perform all of the calculations, to generate and display all of the compressed images. Results of this project are presented in this paper. (Author)

  20. Optical diagnostics of tumour cells at different stages of pathology development

    Energy Technology Data Exchange (ETDEWEB)

    Shcheglova, L S; Maryakhina, V S [Orenburg State University, Orenburg (Russian Federation); Abramova, L L [Orenburg State Agrarian University, Orenburg (Russian Federation)

    2013-11-30

    The differences in optical and biophysical properties between the cells of mammary gland tumour extracted from tumours of different diameter are described. It is shown that the spectral and spectrokinetic properties of fluorescent probes in the cells extracted from the tumours 1 – 3 cm in diameter are essentially different. Thus, the extinction coefficient of rhodamine 6G gradually increases with the pathology development. At the same time the rate of interaction of the triplet states of molecular probes with the oxygen, diluted in the tumour cells cytoplasm, decreases with the growth of the tumour capsule diameter. The observed regularities can be due to the changes in the cell structure, biochemical and biophysical properties. The reported data may be useful for developing optical methods of diagnostics of biotissue pathological conditions. (optical methods in biology and medicine)

  1. Study on patient exposure from mammography, 3

    International Nuclear Information System (INIS)

    Sato, Miyao

    1983-01-01

    Risks and benefits of the patient from mammography performed in Japan were estimated, and the indication of mammography were discussed. 1) Breast cancers induced by mammography were estimated based on the average breast dose, the average life span, risks of radiation-induced breast cancer and the breast cancer significant factor. 2) The breast cancer significant factor was calculated, similar to those of leukemia significant factor by Hashizume, from latent periods of radiation-induced breast cancer and the excess breast cancer induction rate in female A-bomb survivors. 3) Numbers of the deaths and Lost-years were calculated from risks of radiation-induced breast cancer, incidence of breast cancer by mammography, cure rate of breast cancer, average life span and latent period of radiation-induced breast cancer. 4) Numbers of the increased life and years saved were calculated from the improved rate of the ability of diagnosis, frequency of mammography, the average life span and cure rate of breast cancer. 5) Induction of leukemia, lung cancer and thyroid cancer by mammography also were investigated. Its contribution was not significant, compared to the induction of breast cancer. 6) Comparing risk and benefit, the latter was much higher than the former by factors of 71-76. This was suggested the efficacy of mammography. 7) From a pointview of risk and benefit, routine mammography is contraindicative for 10-19 years old women because of large risk, the indication must be scrutinized for 20-29 years old ones, and the benefit increases with age for over 30 years old ones so that mammography was positively admitted for the symptomatic women. (author)

  2. Comparative study of dose estimation in the change a conventional mammography to digital mammography

    International Nuclear Information System (INIS)

    Vazquez Vazquez, R.; Otero Martinez, C.; Soto Bua, M.; Santamarina Vazquez, F.; Carril Iglesias, S.; Lobato Busto, R.; Luna Vega, V.; Mosquera Sueiro, J.; Sqanchez Garcia, M.; Pombar Camean, M.

    2011-01-01

    Mammographic studies are now one of the most demanding radiological because of its effectiveness in detecting breast cancer early. The introduction of digital mammography has been a major advance because it has overcome some of the limitations of conventional systems. Due to the nature of the radiosensitive glandular tissue becomes very important control of the dose given to patients. In the present study is to analyze the variations in dosimetry that can exist between a conventional mammography and digital mammography.

  3. Needs assessment for next generation computer-aided mammography reference image databases and evaluation studies.

    Science.gov (United States)

    Horsch, Alexander; Hapfelmeier, Alexander; Elter, Matthias

    2011-11-01

    Breast cancer is globally a major threat for women's health. Screening and adequate follow-up can significantly reduce the mortality from breast cancer. Human second reading of screening mammograms can increase breast cancer detection rates, whereas this has not been proven for current computer-aided detection systems as "second reader". Critical factors include the detection accuracy of the systems and the screening experience and training of the radiologist with the system. When assessing the performance of systems and system components, the choice of evaluation methods is particularly critical. Core assets herein are reference image databases and statistical methods. We have analyzed characteristics and usage of the currently largest publicly available mammography database, the Digital Database for Screening Mammography (DDSM) from the University of South Florida, in literature indexed in Medline, IEEE Xplore, SpringerLink, and SPIE, with respect to type of computer-aided diagnosis (CAD) (detection, CADe, or diagnostics, CADx), selection of database subsets, choice of evaluation method, and quality of descriptions. 59 publications presenting 106 evaluation studies met our selection criteria. In 54 studies (50.9%), the selection of test items (cases, images, regions of interest) extracted from the DDSM was not reproducible. Only 2 CADx studies, not any CADe studies, used the entire DDSM. The number of test items varies from 100 to 6000. Different statistical evaluation methods are chosen. Most common are train/test (34.9% of the studies), leave-one-out (23.6%), and N-fold cross-validation (18.9%). Database-related terminology tends to be imprecise or ambiguous, especially regarding the term "case". Overall, both the use of the DDSM as data source for evaluation of mammography CAD systems, and the application of statistical evaluation methods were found highly diverse. Results reported from different studies are therefore hardly comparable. Drawbacks of the DDSM

  4. Radiogenic breast cancer risk and mammography

    International Nuclear Information System (INIS)

    Jayaprakash, Shobha; Nair, C.P.R.; Rao, B.S.; Sawant, S.G.

    2001-01-01

    There is a general concern that the risks from mammography screening in inducting radiogenic breast cancer may outweigh the possible benefits to be derived from it. A review of epidemiological, case-control and cohort studies of radiogenic breast cancer, age-specific incidence and dose and dose-rate relationship reveals that such a fear is unfounded. The dose to the breast tissues in a quality assured mammography screening programme falls far below the levels that were observed to produce increased relative risk. The age-specific incidence rates also indicate that the need for mammography is for the women of age at which the relative risk is minimum

  5. Adding the power of iodinated contrast media to the credibility of mammography in breast cancer diagnosis.

    Science.gov (United States)

    Tsigginou, Alexandra; Gkali, Christina; Chalazonitis, Athanasios; Feida, Eleni; Vlachos, Dimitrios Efthymios; Zagouri, Flora; Rellias, Ioannis; Dimitrakakis, Constantine

    2016-11-01

    Dual-energy contrast-enhanced spectral mammography (CESM) represents a relatively new diagnostic tool adjunct to mammography. The aim of this study was to strengthen the breast imaging-reporting and data system (BIRADS) classification score in order to improve early breast cancer diagnosis. For this reason, we propose a sum score, termed malignancy potential score (MPS), incorporating the standard BIRADS score and our proposed CESM score. From September 2014 to September 2015, 216 females (age range, 26-85 years; mean age 54.6 years) underwent CESM evaluation of mammographic findings that were primarily assessed as BIRADS 2-5. 10 of these patients had bilateral findings; a total of 226 lesions were examined. High-energy image evaluation was based on the intensity of contrast enhancement of the lesion compared with background enhancement, categorized as Type -1, 0, 1 or 2 enhancement. Histopathology reports were compared with imaging assessment. 98 of 226 lesions were malignant and 128 of 226 lesions were benign. The area under the curve was 0.843, 0.888 and 0.917 for mammographic BIRADS score, CESM score and MPS, respectively, with p-value mammography or CESM alone. MPS empowers the credibility of the digital mammography BIRADS score and our proposed type of enhancement in dual-energy CESM and is a diagnostic tool that increases the accuracy rate in early breast cancer diagnosis.

  6. Barriers and incentives for choosing to specialise in mammography: Qualitative analysis.

    Science.gov (United States)

    Warren-Forward, H M; Taylor, J

    2017-02-01

    There is a projected shortage of radiographers working in breast screening and this study aimed to examine comments from open response questions from a mixed methods survey of current diagnostic radiography students on their perceptions of working in mammography. The survey asked three open ended questions: Justification of choice of modality in which they would want to specialise, why they believed there was a shortage of radiographers working in breast screening and any other comment about mammography. Reasons given for specialising in any modality was interest, feature of a modality, amount of clinical exposure during the degree program, personal issues and career prospects. Few current diagnostic radiography students indicated that they would be interested in specialising in breast imaging. They considered there to be a shortage of radiographers as breast imaging was seen to be repetitive, high pressure, intimate and gender biased. Lack of education, clinical exposure, limited career prospects and low pay were also discussed. Increasing education to the modality during the degree, allowing males to be involved in breast imaging and promoting part-time work in mammography while also working in other modalities may alter the perception that mammography offers a limited career pathway. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  7. Preliminary study of diagnostic workstation with different matrix size for detection of small pulmonary nodules

    International Nuclear Information System (INIS)

    Wu Jie; Wang Xuejian; Wang Bo; Tong Juan; Wei Yuqing; Shen Guiquan; Wang Limei; Cao Jun; Sui He

    2004-01-01

    Objective: To assess the influence in detecting small pulmonary nodules (SPNs) on soft-copy images displayed with different matrix sizes. Methods: Seventy-six chest compute radiographs were selected for the study. Of the 76 test images, 36 pulmonary nodules smaller than 20 mm in diameter were proven by CT, which were further divided into two groups: 1.0-2.0 cm and Z values and standard error of three kinds of view system for individual observers. Results: For 1.0-2.0 cm group, the mean A Z values were 0.7936 for DRCS with 2-fold magnification and window technique, 0.8225 for 1 K monitor with 2-fold magnification and window technique, and 0.8367 for 2 K monitor without magnification; for Z values increased slightly as the display matrix size improved, but there were no significant differences among the three sets in the detection of SPNs in the ROC analyses. Conclusion: It is acceptable to detect small pulmonary nodules of 1.0-2.0 cm in diameter on 1 K monitor and DRCS with magnification. High resolution diagnostic workstation is recommended for detecting small pulmonary nodules <1.0 cm in diameter. Reasonable equipment for the detection of subtle abnormality may result in better cost-efficacy and diagnostic accuracy

  8. Patient dose in digital mammography

    International Nuclear Information System (INIS)

    Chevalier, Margarita; Moran, Pilar; Ten, Jose I.; Fernandez Soto, Jose M.; Cepeda, T.; Vano, Eliseo

    2004-01-01

    In the present investigation, we analyze the dose of 5034 patients (20 137 images) who underwent mammographic examinations with a full-field digital mammography system. Also, we evaluate the system calibration by analyzing the exposure factors as a function of breast thickness. The information relevant to this study has been extracted from the image DICOM header and stored in a database during a 3-year period (March 2001-October 2003). Patient data included age, breast thickness, kVp, mAs, target/filter combination, and nominal dose values. Entrance surface air kerma (ESAK) without backscatter was calculated from the tube output as measured for each voltage used under clinical conditions and from the tube loading (mAs) included in the DICOM header. Mean values for the patient age and compressed breast thickness were 56 years (SD: 11) and 52 mm (SD: 13), respectively. The majority of the images was acquired using the STD (for standard) automatic mode (98%). The most frequent target/filter combination automatically selected for breast smaller than 35 mm was Mo/Mo (75%); for intermediate thicknesses between 35 and 65 mm, the combinations were Mo/Rh (54%) and Rh/Rh (38.5%); Rh/Rh was the combination selected for 91% of the cases for breasts thicker than 65 mm. A wide kVp range was observed for each target/filter combination. The most frequent values were 28 kVp for Mo/Mo, 29 kVp for Mo/Rh, and 29 and 30 kV for Rh/Rh. Exposure times ranged from 0.2 to 4.2 s with a mean value of 1.1 s. Average glandular doses (AGD) per exposure were calculated by multiplying the ESAK values by the conversion factors tabulated by Dance for women in the age groups 50 to 64 and 40 to 49. This approach is based on the dependence of breast glandularity on breast thickness and age. The total mean average glandular dose (AGD T ) was calculated by summing the values associated with the pre-exposure and with the main exposure. Mean AGD T per exposure was 1.88 mGy (CI 0.01) and the mean AGD T per

  9. A method for calculating effective lifetime risk of radiation-induced cancer from screening mammography

    International Nuclear Information System (INIS)

    Ali, R.M.; England, A.; McEntee, M.F.; Hogg, P.

    2015-01-01

    Purpose: To propose a method for evaluating the effective lifetime risk of radiation-induced cancer from screening mammography and to present initial data for the UK National Breast Screening Programme. Material and methods: The imaging was undertaken using a Hologic Selenia full field digital mammographic unit. The proposed method utilises an ATOM phantom containing thermoluminescent dosimeters and a perspex-polyethylene breast phantom to measure organ doses during a standard four view screening mammogram. Effective dose was calculated and effective risk was modelled for a range of client ages. The total lifetime effective risk was then calculated for the UK national screening programme. Calculation of effective risk includes the radiation dose to examined and contralateral breasts in addition to other body organs; this is an advantage over the mean glandular dose. Results: The contralateral breast, thyroid, thymus, brain, lung, salivary glands, and bone marrow all receive more than 1 μGy radiation dose during screening mammography. A major difference exists for total effective lifetime risk of radiation-induced cancer between clients with average and high breast cancer risk. Differences are attributed to the commencement age of screening and time interval between screens. Conclusion: This study proposes a method to evaluate effective lifetime risk of radiation-induced cancer from screening mammography in order to compare different mammography screening programmes. - Highlights: • We proposed a method for the calculation of radiation-induced cancer from screening mammography. • We measured the radiation absorbed dose of different organs during screening mammography. • There are major differences between mammography screening programme categories with regard to radiation effective risk.

  10. Radiation-Induced Breast Cancer Incidence and Mortality From Digital Mammography Screening: A Modeling Study.

    Science.gov (United States)

    Miglioretti, Diana L; Lange, Jane; van den Broek, Jeroen J; Lee, Christoph I; van Ravesteyn, Nicolien T; Ritley, Dominique; Kerlikowske, Karla; Fenton, Joshua J; Melnikow, Joy; de Koning, Harry J; Hubbard, Rebecca A

    2016-02-16

    Estimates of risk for radiation-induced breast cancer from mammography screening have not considered variation in dose exposure or diagnostic work-up after abnormal screening results. To estimate distributions of radiation-induced breast cancer incidence and mortality from digital mammography screening while considering exposure from screening and diagnostic mammography and dose variation among women. 2 simulation-modeling approaches. U.S. population. Women aged 40 to 74 years. Annual or biennial digital mammography screening from age 40, 45, or 50 years until age 74 years. Lifetime breast cancer deaths averted (benefits) and radiation-induced breast cancer incidence and mortality (harms) per 100,000 women screened. Annual screening of 100,000 women aged 40 to 74 years was projected to induce 125 breast cancer cases (95% CI, 88 to 178) leading to 16 deaths (CI, 11 to 23), relative to 968 breast cancer deaths averted by early detection from screening. Women exposed at the 95th percentile were projected to develop 246 cases of radiation-induced breast cancer leading to 32 deaths per 100,000 women. Women with large breasts requiring extra views for complete examination (8% of population) were projected to have greater radiation-induced breast cancer risk (266 cancer cases and 35 deaths per 100,000 women) than other women (113 cancer cases and 15 deaths per 100,000 women). Biennial screening starting at age 50 years reduced risk for radiation-induced cancer 5-fold. Life-years lost from radiation-induced breast cancer could not be estimated. Radiation-induced breast cancer incidence and mortality from digital mammography screening are affected by dose variability from screening, resultant diagnostic work-up, initiation age, and screening frequency. Women with large breasts may have a greater risk for radiation-induced breast cancer. Agency for Healthcare Research and Quality, U.S. Preventive Services Task Force, National Cancer Institute.

  11. Applicability and agreement of different diagnostic criteria for sarcopenia estimation in the elderly.

    Science.gov (United States)

    Pagotto, Valéria; Silveira, Erika Aparecida

    2014-01-01

    The purpose of this study cross-sectional study comprising 132 community dwelling elderly (≥ 60 years) was to identify sarcopenia prevalence in the Brazilian elderly, utilizing different diagnostic criteria and analyze agreement between criteria. Sarcopenia was assessed by nine muscle mass diagnostic criteria, by two muscle strength criteria and also by the combination of criteria. Prevalence was analyzed for each method, along with differences by gender and age group through calculation of the prevalence ratio (PR) and confidence interval (CI) 95%. The Kappa coefficient was used to analyze the level of agreement between all criteria. Sarcopenia prevalence varied between 60.6% and 8.3% with the application of muscle mass criteria, and between 54.2% and 48.8% with the application of strength criteria. The combination muscle mass+strength resulted in a decrease of prevalence in all criteria, varying between 36.6% and 6.1%. There was an increase in prevalence according to age groups for all methods. Prevalence was higher for men according to three muscle mass criteria, and higher in women for strength criteria and by two combined mass+strength criteria. The best level of agreement was obtained for two methods that utilized dual energy X-ray absorptiometry (DXA). The prevalence of sarcopenia differs by gender and age and definition criteria. The low agreement levels obtained between methods and the different prevalence values encountered indicate the necessities of an operational definition for the estimation of sarcopenia in different population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. On the possibility of reducing doses received by patients during mammography screening

    International Nuclear Information System (INIS)

    Tolwinski, J.; Fabiszewska, E.; Gwiazdowska, B.; Bulski, W.

    2005-01-01

    The aim of the study was to collect and to evaluate a set of data of a large group of patients examined with different mammography units, and to compare the individual doses (Di) with the standard average glandular dose (standard AGD) established for a particular mammography unit. The comparison was intended to allow to formulate recommendations of procedures in order to limit the exposure of patients, procedures which are beyond the scope of routine testing of mammography facilities. The presented analysis bases on the results of the measurements of the standard AGD, taken from 82 protocols of quality control of mammography equipment; - 16 histograms of dose distribution for individual patients (Di) examined with 16 different mammography units; - 2 histograms for patients examined with one mammography unit by the radiographer before and after training; - histograms of individual doses (Di), corresponding high-voltage (kV) and tube-loading (mAs) values, for one mammography unit (Elscint-Glory 2001) which was equipped with an automatic optimisation of contrast (AOC) system. The measurements were carried out according to the procedures of the American College of Radiology (ACR). Basing upon the constructed histograms we performed a comparison of the standard AGD values with the individual doses (Di). The frequency distribution of the standard AGDs (Figure 1) shows a considerable dispersion of values, ranging between 0.5 and 2.5 mGy. The histograms of the individual glandular doses (Di) calculated for individual patients, examined with different units (Figure 2) suggest that the choice of high voltage made by the radiographers may be incorrect i.e. the high voltage was not increased sufficiently with the increase of breast thickness. The incorrect value of the high voltage (low value) may be also set up by the AOC system (Figure 4). Two histograms for patients examined with one mammography unit by the radiographer before and after training (Figure 3) indicate the

  13. Radiation dose in mammography: an energy-balance approach

    International Nuclear Information System (INIS)

    Shrivastava, P.N.

    1981-01-01

    An energy-balance approach for calculation of mean, integral, and midpoint doses in mammography is introduced. Estimation of mean absorbed dose for individual applications is described. Differences in breast composition and thickness are accounted for by simple measurements of entrance and exit exposures. Calculations made for a range of xeromammographic techniques used at various breast cancer detection centers show that although increasing the beam h.v.l. dramatically decreases breast surface exposure, it is insignificant in lowering mean breast dose or radiation risk. Thus selection of a moderate h.v.l. to optimize image quality (soft-tissue contrast) in xeromammography may be more beneficial than unduly increasing h.v.l. merely to reduce surface exposure. The mean breast dose per mammogram with low-h.v.l. screen-film techniques was 3 to 9 times lower than for xeromammography, suggesting that general acceptance of screen-film techniques can significantly reduce the risk associated with mammography

  14. Latin American image quality survey in digital mammography studies

    International Nuclear Information System (INIS)

    Mora, Patricia; Khoury, Helen; Bitelli, Regina; Quintero, Ana Rosa; Garay, Fernando; Garcia Aguilar, Juan; Gamarra, Mirtha; Ubeda, Carlos

    2017-01-01

    Under International Atomic Energy Agency regional programme TSA3 Radiological Protection of Patients in Medical Exposures, Latin American countries evaluated the image quality and glandular doses for digital mammography equipment with the purpose of seeing the performance and compliance with international recommendations. Totally, 24 institutions participated from Brazil, Chile, Costa Rica, El Salvador, Mexico, Paraguay and Venezuela. Signal difference noise ratio results showed for CR poor compliance with tolerances; better results were obtained for full-field digital mammography equipment. Mean glandular dose results showed that the majority of units have values below the acceptable dose levels. This joint Latin American project identified common problems: difficulty in working with digital images and lack of specific training by medical physicists from the region. Image quality is a main issue not being satisfied in accordance with international recommendations; optimisation processes in which the doses are increased should be very carefully done in order to improve early detection of any cancer signs. (authors)

  15. Value of mammography in the early detection of breast cancer

    International Nuclear Information System (INIS)

    Sabate, J.; Molina, L.; Jimenez, A.; Fernandez, E.

    1997-01-01

    Breast cancer is the most prevalent malignant tumor in women; the etiopathogenesis is unknown and it is associated with high rates of morbidity and mortality. In the fifties, different screening programs were developed for the early detection of breast cancer in the attempt to reduce the mortality attributed to this disease process. Mammography is one of the cornerstones of these programs because of its efficacy in the detection of subclinical tumors. We carried out a retrospective review of nine campaigns for the early detection of breast cancer, studying 11, 328 case reports; among these patients, there were 43 cases of breast cancer. Mammography was positive in 90.6% of these cases. Only in two patients did the image fail to reveal changes indicative of possible neoplasm; in both cases, the breasts involved were very dense. (Author) 26 refs

  16. Screening mammography in women 65 years old and older

    International Nuclear Information System (INIS)

    Rubin, E.; Mulligan, S.A.; Han, S.Y.; Bernreuter, W.K.; Stanley, R.J.

    1990-01-01

    This paper compares the results of mammographic screening in women aged 65 years and older to those of women aged 50--64 years, to define risk factors and prior use of mammography in these women, and to determine whether mammographic abnormalities are managed differently in the two age groups. Historical data, mammographic findings, and biopsy results were analyzed for all women over 50 years of age screened during 1988 (2,862 patients) at a university hospital-based outpatient center and mobile van, excluding those referred by oncologists. The following factors were determined for patients screened at the outpatient center and the mobile van, with both groups divided according to patient age (50--64 vs ≥ 65 years): presence of risk factors, previous biopsy, exogenous hormones, percentage of black patients, previous mammography, biopsy rate, cancer detection rate, positive nodes, and presence of tumors smaller than 1 cm or ductal carcinoma in-situ

  17. The results of a quality-control programme in mammography

    International Nuclear Information System (INIS)

    Ramsdale, M.L.; Hiles, P.A.

    1989-01-01

    With the introduction of a breast screening programme in the UK, quality assurance in mammography is of paramount importance in assuring optimum imaging performance with low dose. Quality control checks are an essential part of the quality-assurance system. A quality-control programme at a breast screening clinic is described. Daily checks include film sensitometry for X-ray processor control and radiography of a lucite phantom to monitor the consistency of the X-ray machine automatic exposure control. Weekly checks include additional measurements on the performance of the automatic exposure control for different breast thickness and an overall assessment of image quality using a prototype mammography test phantom. The test phantom measures low-contrast sensitivity, high-contrast resolution and small-detail visibility. The results of the quality-control programme are presented with particular attention paid to tolerances and limiting values. (author)

  18. Information on mammography-screening - from deception to insight

    International Nuclear Information System (INIS)

    Muehlhauser, I.; Hoeldke, B.

    2002-01-01

    Information about mammography-screening as a basis for informed-decision making has to be evidence-based and presented in an unbiased format. This includes communication of results about effectiveness/lack of effectiveness of screening programmes (breast cancer mortality, total mortality), the quality of mammography as a screening test (sensitivity, specificity, positive and negative predictive values), and possible harm (consequences of false positive and false negative results, overdiagnosis of breast cancer, overtreatment). Outcome data have to be communicated as natural frequencies rather than relative differences. In order to avoid framing of data equal emphasis has to be put on the proportion of persons who are likely to benefit and those who are unlikely to benefit or likely to be harmed. (orig.) [de

  19. Diagnostic Performance of Ultrasonography for Pediatric Appendicitis: A Night and Day Difference?

    Science.gov (United States)

    Mangona, Kate Louise M; Guillerman, R Paul; Mangona, Victor S; Carpenter, Jennifer; Zhang, Wei; Lopez, Monica; Orth, Robert C

    2017-12-01

    For imaging pediatric appendicitis, ultrasonography (US) is preferred because of its lack of ionizing radiation, but is limited by operator dependence. This study investigates the US diagnostic performance during night shifts covered by radiology trainees compared to day shifts covered by attending radiologists. Appy-Scores (1 = completely visualized normal appendix; 2 = partially visualized normal appendix; 3 = nonvisualized appendix with no inflammatory changes in the expected region of the appendix; 4 = equivocal; 5a = nonperforated appendicitis; 5b = perforated appendicitis) from 2935 US examinations (2161:774, day-to-night) from July 2013 to 2014 were correlated with the intraoperative diagnoses and the clinical follow-up. The diagnostic performance of trainees and attendings was compared with Fisher exact test. Interobserver agreement was measured by Cohen kappa coefficient. Appendicitis prevalence was 25.3% (day) and 22.5% (night). Sensitivity, specificity, accuracy, negative predictive value, and positive predictive vale were 94.0%, 93.7%, 93.8%, 97.9%, and 83.4% during the day and 92.0%, 91.2%, 91.3%, 97.5%, and 75.2% at night. Specificity (P = .048) and positive predictive value (P = .011) differed, with more false positives at night (7%) than during the day (4.7%). Trainee and attending agreement was high (k = 0.995), with Appy-Scores of 1, 4, and 5a most frequently discordant. US has a high diagnostic performance and interobserver agreement for pediatric appendicitis when interpreted by radiology trainees during night shifts or attending radiologists during day shifts. However, lower specificity and positive predictive value at night warrants a thorough trainee education to avoid false-positive examinations. Published by Elsevier Inc.

  20. Volume perfusion CT imaging of cerebral vasospasm: diagnostic performance of different perfusion maps

    Energy Technology Data Exchange (ETDEWEB)

    Othman, Ahmed E. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Radiology, Tuebingen (Germany); Afat, Saif; Nikoubashman, Omid; Mueller, Marguerite; Wiesmann, Martin; Brockmann, Carolin [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Schubert, Gerrit Alexander [RWTH Aachen University, Department of Neurosurgery, Aachen (Germany); Bier, Georg [Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Brockmann, Marc A. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); University Hospital Mainz, Department of Neuroradiology, Mainz (Germany)

    2016-08-15

    In this study, we aimed to evaluate the diagnostic performance of different volume perfusion CT (VPCT) maps regarding the detection of cerebral vasospasm compared to angiographic findings. Forty-one datasets of 26 patients (57.5 ± 10.8 years, 18 F) with subarachnoid hemorrhage and suspected cerebral vasospasm, who underwent VPCT and angiography within 6 h, were included. Two neuroradiologists independently evaluated the presence and severity of vasospasm on perfusion maps on a 3-point Likert scale (0 - no vasospasm, 1 - vasospasm affecting <50 %, 2 - vasospasm affecting >50 % of vascular territory). A third neuroradiologist independently assessed angiography for the presence and severity of vasospasm on a 3-point Likert scale (0 - no vasospasm, 1 - vasospasm affecting < 50 %, 2 - vasospasm affecting > 50 % of vessel diameter). Perfusion maps of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to drain (TTD) were evaluated regarding diagnostic accuracy for cerebral vasospasm with angiography as reference standard. Correlation analysis of vasospasm severity on perfusion maps and angiographic images was performed. Furthermore, inter-reader agreement was assessed regarding findings on perfusion maps. Diagnostic accuracy for TTD and MTT was significantly higher than for all other perfusion maps (TTD, AUC = 0.832; MTT, AUC = 0.791; p < 0.001). TTD revealed higher sensitivity than MTT (p = 0.007). The severity of vasospasm on TTD maps showed significantly higher correlation levels with angiography than all other perfusion maps (p ≤ 0.048). Inter-reader agreement was (almost) perfect for all perfusion maps (kappa ≥ 0.927). The results of this study indicate that TTD maps have the highest sensitivity for the detection of cerebral vasospasm and highest correlation with angiography regarding the severity of vasospasm. (orig.)

  1. Optimization of the radiological protection of patients: Image quality and dose in mammography (co-ordinated research in Europe). Results of the coordinated research project on optimization of protection mammography in some eastern European States

    International Nuclear Information System (INIS)

    2005-05-01

    Mammography is an extremely useful non-invasive imaging technique with unparalleled advantages for the detection of breast cancer. It has played an immense role in the screening of women above a certain age or with a family history of breast cancer. The IAEA has a statutory responsibility to establish standards for the protection of people against exposure to ionizing radiation and to provide for the worldwide application of those standards. A fundamental requirement of the International Basic Safety Standards for Protection Against Ionizing Radiation (BSS) and for the Safety of Radiation Sources, issued by the IAEA and co-sponsored by FAO, ILO, WHO, PAHO and NEA, is the optimization of radiological protection of patients undergoing medical exposure. In keeping with its responsibility on the application of standards, the IAEA programme on Radiological Protection of Patients attempts to reduce radiation doses to patients while balancing quality assurance considerations. IAEA-TECDOC-796, Radiation Doses in Diagnostic Radiology and Methods for Dose Reduction (1995), addresses this aspect. The related IAEA-TECDOC-1423 on Optimization of the Radiological Protection of Patients undergoing Radiography, Fluoroscopy and Computed Tomography, (2004) constitutes the final report of the coordinated research in Africa, Asia and eastern Europe. The preceding publications do not explicitly consider mammography. Mindful of the importance of this imaging technique, the IAEA launched a Coordinated Research Project on Optimization of Protection in Mammography in some eastern European States. The present publication is the outcome of this project: it is aimed at evaluating the situation in a number of countries, identifying variations in the technique, examining the status of the equipment and comparing performance in the light of the norms established by the European Commission. A number of important aspects are covered, including: - quality control of mammography equipment; - imaging

  2. Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Bezzon, Elisabetta; Pescarini, Luigi; Polico, Ilaria; Proietti, Alessandro; Baldan, Enrica; Pomerri, Fabio; Muzzio, Pier Carlo [Veneto Institute of Oncology (IRCCS), Padua (Italy); Hendrick, R.E. [University of Colorado-Denver, Department of Radiology, School of Medicine, Aurora, CO (United States); Toledano, Alicia [Biostatistics Consulting, LLC, Kensington, MD (United States); Paquelet, Jean R. [Advanced Medical Imaging Consultants, Fort Collins, CO (United States); Breast Imaging, McKee Medical Center, Loveland, CO (United States); Chersevani, Roberta [Private Medical Practice, Gorizia (Italy); Di Maggio, Cosimo [Private Medical Practice, Padua (Italy); La Grassa, Manuela [Department of Radiology, Oncological Reference Center (IRCCS), Aviano (Italy)

    2013-08-15

    To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography. The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT{sub (MLO)}+MX{sub (CC)}, was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT{sub (MLO)}+MX{sub (CC)} was non-inferior to two-view MX for malignant lesions. This study shows that readers' capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography. (orig.)

  3. The use of ultrasonography and digital mammography in women under 40 years with symptomatic breast cancer: a 7-year Irish experience.

    Science.gov (United States)

    Redmond, C E; Healy, G M; Murphy, C F; O'Doherty, A; Foster, A

    2017-02-01

    Breast cancer in women under 40 years of age is rare and typically presents symptomatically. The optimal imaging modality for this patient group is controversial. Most women undergo ultrasonography with/without mammography. Young women typically have dense breasts, which can obscure the features of malignancy on film mammography, however, initial studies have suggested that digital mammography may have a more accurate diagnostic performance in younger women. Ultrasound generally performs well in this age group, although it is poor at detecting carcinoma in situ (DCIS). To evaluate the comparative diagnostic performance of ultrasonography and digital mammography in the initial diagnostic evaluation of women under 40 years of age with symptomatic breast cancer. Retrospective review of all women under the age of 40 years managed at our symptomatic breast cancer unit from January 2009 to December 2015. There were 120 patients that met the inclusion criteria for this study. The sensitivity of ultrasonography and digital mammography for breast cancer in this patient group was 95.8 and 87.5 %, respectively. The patients with a false negative mammographic examination were more likely to have dense breasts (p breast cancer in women under the age of 40 years, however, the results show that digital mammography has an important complimentary role in the comprehensive assessment of these patients, particularly in the diagnosis of DCIS.

  4. Contrast-enhanced spectral mammography in recalls from the Dutch breast cancer screening program: validation of results in a large multireader, multicase study.

    Science.gov (United States)

    Lalji, U C; Houben, I P L; Prevos, R; Gommers, S; van Goethem, M; Vanwetswinkel, S; Pijnappel, R; Steeman, R; Frotscher, C; Mok, W; Nelemans, P; Smidt, M L; Beets-Tan, R G; Wildberger, J E; Lobbes, M B I

    2016-12-01

    Contrast-enhanced spectral mammography (CESM) is a promising problem-solving tool in women referred from a breast cancer screening program. We aimed to study the validity of preliminary results of CESM using a larger panel of radiologists with different levels of CESM experience. All women referred from the Dutch breast cancer screening program were eligible for CESM. 199 consecutive cases were viewed by ten radiologists. Four had extensive CESM experience, three had no CESM experience but were experienced breast radiologists, and three were residents. All readers provided a BI-RADS score for the low-energy CESM images first, after which the score could be adjusted when viewing the entire CESM exam. BI-RADS 1-3 were considered benign and BI-RADS 4-5 malignant. With this cutoff, we calculated sensitivity, specificity and area under the ROC curve. CESM increased diagnostic accuracy in all readers. The performance for all readers using CESM was: sensitivity 96.9 % (+3.9 %), specificity 69.7 % (+33.8 %) and area under the ROC curve 0.833 (+0.188). CESM is superior to conventional mammography, with excellent problem-solving capabilities in women referred from the breast cancer screening program. Previous results were confirmed even in a larger panel of readers with varying CESM experience. • CESM is consistently superior to conventional mammography • CESM increases diagnostic accuracy regardless of a reader's experience • CESM is an excellent problem-solving tool in recalls from screening programs.

  5. Breast cancer - Early detection with mammography. Crushed stone-like calcifications - The most frequent malignant type

    International Nuclear Information System (INIS)

    Tabar, Laszlo; Central Hospital, Falun; Tot, Tibor; Central Hospital, Falun; Dean, Peter B.

    2008-01-01

    A comprehensive guide for analyzing the most common malignant type calcifications on the mammogram Internationally renowned breast cancer imagers Laszlo Tabar and Peter B. Dean and the eminent breast pathologist Tibor Tot distill decades of clinical expertise in this new volume covering the most frequently occurring malignant type calcifications: the pleomorphic, crushed stone-like calcifications. The book presents a systematic approach to using mammographic features to distinguish different subtypes of breast diseases originating within the terminal ductal lobular unit (TDLU). More than 800 images demonstrate abnormal findings with superb clarity, providing a state-of-the-art visual reference for interpreting mammograms in the clinical setting. Features: - Concise descriptions of mammographic and MRI findings correlated with high-quality histopathologic images to provide a reliable guide for accurate diagnosis and differential diagnosis, as well as prognostic classification - Extensive coverage of all aspects of the benign differential diagnostic counterparts of pleomorphic calcifications, including fibrocystic change, fibroadenoma, and papilloma - Straightforward discussion of terminology based on a thorough analysis of subgross anatomy, 3D histologic features, and long-term disease outcomes - 3D viewing glasses enclosed in the book for perceiving specially marked images in their true 3D form This book is ideal for all breast imagers and breast pathologists, as well as for surgeons and oncologists specializing in breast diseases. For the radiologist, this book is an indispensable reference for harnessing the power of mammography to detect breast cancer at the earliest stages possible. About the Breast Cancer: Early Detection with Mammography series: This series grew out of the bestselling book Breast Cancer: The Art and Science of Early Detection with Mammography. Written by the same authors, this series is based on 30 years of experience with more than one

  6. Breast cancer - Early detection with mammography. Crushed stone-like calcifications - The most frequent malignant type

    Energy Technology Data Exchange (ETDEWEB)

    Tabar, Laszlo [Univ. of Uppsala (Sweden). School of Medicine]|[Central Hospital, Falun (Sweden). Dept. of Mammography; Tot, Tibor [Univ. of Uppsala (Sweden). School of Medicine]|[Central Hospital, Falun (Sweden). Dept. of Pathology and Clinical Cytology; Dean, Peter B. [Turku Univ. (Finland). Dept. of Diagnostic Radiology

    2008-07-01

    A comprehensive guide for analyzing the most common malignant type calcifications on the mammogram Internationally renowned breast cancer imagers Laszlo Tabar and Peter B. Dean and the eminent breast pathologist Tibor Tot distill decades of clinical expertise in this new volume covering the most frequently occurring malignant type calcifications: the pleomorphic, crushed stone-like calcifications. The book presents a systematic approach to using mammographic features to distinguish different subtypes of breast diseases originating within the terminal ductal lobular unit (TDLU). More than 800 images demonstrate abnormal findings with superb clarity, providing a state-of-the-art visual reference for interpreting mammograms in the clinical setting. Features: - Concise descriptions of mammographic and MRI findings correlated with high-quality histopathologic images to provide a reliable guide for accurate diagnosis and differential diagnosis, as well as prognostic classification - Extensive coverage of all aspects of the benign differential diagnostic counterparts of pleomorphic calcifications, including fibrocystic change, fibroadenoma, and papilloma - Straightforward discussion of terminology based on a thorough analysis of subgross anatomy, 3D histologic features, and long-term disease outcomes - 3D viewing glasses enclosed in the book for perceiving specially marked images in their true 3D form This book is ideal for all breast imagers and breast pathologists, as well as for surgeons and oncologists specializing in breast diseases. For the radiologist, this book is an indispensable reference for harnessing the power of mammography to detect breast cancer at the earliest stages possible. About the Breast Cancer: Early Detection with Mammography series: This series grew out of the bestselling book Breast Cancer: The Art and Science of Early Detection with Mammography. Written by the same authors, this series is based on 30 years of experience with more than one

  7. Newly Diagnosed Breast Cancer: Comparison of Contrast-enhanced Spectral Mammography and Breast MR Imaging in the Evaluation of Extent of Disease.

    Science.gov (United States)

    Lee-Felker, Stephanie A; Tekchandani, Leena; Thomas, Mariam; Gupta, Esha; Andrews-Tang, Denise; Roth, Antoinette; Sayre, James; Rahbar, Guita

    2017-11-01

    Purpose To compare the diagnostic performances of contrast material-enhanced spectral mammography and breast magnetic resonance (MR) imaging in the detection of index and secondary cancers in women with newly diagnosed breast cancer by using histologic or imaging follow-up as the standard of reference. Materials and Methods This institutional review board-approved, HIPAA-compliant, retrospective study included 52 women who underwent breast MR imaging and contrast-enhanced spectral mammography for newly diagnosed unilateral breast cancer between March 2014 and October 2015. Of those 52 patients, 46 were referred for contrast-enhanced spectral mammography and targeted ultrasonography because they had additional suspicious lesions at MR imaging. In six of the 52 patients, breast cancer had been diagnosed at an outside institution. These patients were referred for contrast-enhanced spectral mammography and targeted US as part of diagnostic imaging. Images from contrast-enhanced spectral mammography were analyzed by two fellowship-trained breast imagers with 2.5 years of experience with contrast-enhanced spectral mammography. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated for both imaging modalities and compared by using the Bennett statistic. Results Fifty-two women with 120 breast lesions were included for analysis (mean age, 50 years; range, 29-73 years). Contrast-enhanced spectral mammography had similar sensitivity to MR imaging (94% [66 of 70 lesions] vs 99% [69 of 70 lesions]), a significantly higher PPV than MR imaging (93% [66 of 71 lesions] vs 60% [69 of 115 lesions]), and fewer false-positive findings than MR imaging (five vs 45) (P contrast-enhanced spectral mammography depicted 11 of the 11 secondary cancers (100%) and MR imaging depicted 10 (91%). Conclusion Contrast-enhanced spectral mammography is potentially as sensitive as MR imaging in the evaluation of extent of disease in newly diagnosed

  8. Combined assessment (aspiration cytology and mammography) of ...

    African Journals Online (AJOL)

    Combined assessment (aspiration cytology and mammography) of clinically suspicious breast masses. W.F. van Wyk, D Dent, E Anne Hacking, Genevieve Learmonth, R.E. Kottler, C Anne Gudgeon, A Tiltman ...

  9. Mammography: What You Need to Know

    Science.gov (United States)

    ... While standing in front of the machine, a technologist will position your breast on a small platform. ... mammography or additional 3D imaging methods, such as ultrasound or MRI, are options for you. Ochs adds: “ ...

  10. Mammography screening services: market segments and messages.

    Science.gov (United States)

    Scammon, D L; Smith, J A; Beard, T

    1991-01-01

    Mammography has become a vital tool for the early detection of breast cancer. Although many organizations and health care facilities are working to educate and motivate women to take advantage of the life saving opportunity that is offered through screening mammography, only twenty percent of women who should be screened actually have the procedure performed. In order to reach women who have not been screened, it is important to learn which factors most strongly motivate those women who do choose to have a mammogram. Depth interviews with 18 women attending a mobile mammography unit were conducted to explore the decision making process of women obtaining mammography screening services and to develop a profile of prevalent emotions, attitudes, and feelings associated with receiving breast cancer screening services. Analysis of the interview transcripts revealed several important themes to which health care professionals can direct marketing and health promotion strategies.

  11. Frequently Asked Questions about Digital Mammography

    Science.gov (United States)

    ... at www.fda.gov/findmammography . Do private insurance companies, Medicare and Medicaid pay for digital mammography exams, ... Map Nondiscrimination Website Policies U.S. Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 ...

  12. Application of the Inverse Square Law distance in conventional radiology and mammography

    International Nuclear Information System (INIS)

    Hoff, Gabriela; Lima, Nathan Willig

    2014-01-01

    The Inverse Square Law (ISL) is a mathematical rule largely used to adjust the KERMA and exposure to different distances of focal spot having as reference a determined point in space. Taking into account the limitations of this Mathematical Law and its application, we have as main objective to verify the applicability of the ISL to determine exposure on radio-diagnostic area (maximum tensions between 30kVp and 150kVp). Experimental data was collected, deterministic calculation and simulation using Monte Carlo Method (Geant4 toolkit) was applied. The experimental data was collected using a calibrated ionizing chamber TNT 12000 from Fluke. The conventional X-ray equipment used was a Multix Top of Siemens, with Tungsten track and total filtration equivalent to 2,5 mm of Aluminum; and the mammographic equipment was a Mammomat Inspiration from Siemens, presenting the track-add filtration combinations of Molybdenum-Molybdenum (25 μm), Molybdenum-Rhodium (30 μm), Tungsten-Rhodium (50 μm). Both equipment have the Quality Control testes in agreement to Brazilian regulations. On conventional radiology the measurements were performed at following focal spot-detector distance (FsDD): 40cm, 50 cm, 60 cm, 70 cm, 80 cm, 90 cm, 100 cm for peak tensions of 66 kVp, 81 kVp e 125 kVp. On mammography the measurements were performed at FsDD: 60cm, 50cm, 40 cm and 26 cm for peak tensions of 25kVp, 30kVp and 35kVp. Based on the results it is possible conclude that the ISL presents lower performance in correct measurement on Mammography spectra (induce to larger errors on estimate data), but it can cause significant impact on both areas depending on the spectra energy and distance to correct. (author)

  13. Comparison of Breast Density Between Synthesized Versus Standard Digital Mammography.

    Science.gov (United States)

    Haider, Irfanullah; Morgan, Matthew; McGow, Anna; Stein, Matthew; Rezvani, Maryam; Freer, Phoebe; Hu, Nan; Fajardo, Laurie; Winkler, Nicole

    2018-06-12

    To evaluate perceptual difference in breast density classification using synthesized mammography (SM) compared with standard or full-field digital mammography (FFDM) for screening. This institutional review board-approved, retrospective, multireader study evaluated breast density on 200 patients who underwent baseline screening mammogram during which both SM and FFDM were obtained contemporaneously from June 1, 2016, through November 30, 2016. Qualitative breast density was independently assigned by seven readers initially evaluating FFDM alone. Then, in a separate session, these same readers assigned breast density using synthetic views alone on the same 200 patients. The readers were again blinded to each other's assignment. Qualitative density assessment was based on BI-RADS fifth edition. Interreader agreement was evaluated with κ statistic using 95% confidence intervals. Testing for homogeneity in paired proportions was performed using McNemar's test with a level of significance of .05. For patients across the SM and standard 2-D data set, diagnostic testing with McNemar's test with P = 0.32 demonstrates that the minimal density transitions across FFDM and SM are not statistically significant density shifts. Taking clinical significance into account, only 8 of 200 (4%) patients had clinically significant transition (dense versus not dense). There was substantial interreader agreement with overall κ in FFDM of 0.71 (minimum 0.53, maximum 0.81) and overall SM κ average of 0.63 (minimum 0.56, maximum 0.87). Overall subjective breast density assignment by radiologists on SM is similar to density assignment on standard 2-D mammogram. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Specialized software for optimization of the quality control of the mammography units

    International Nuclear Information System (INIS)

    Stoeva, M.; Vassileva, J.

    2004-01-01

    Quality control is essential to ensure the equipment used is reliable and consistent in order to maintain radiation does as low as reasonably achievable whilst optimizing image quality and performance in mammography. The effectiveness of mammographic screening is highly dependent on the consistent production of high quality diagnostic images. Mammography is highly dependent on the equipment status, which requires an effective Quality Control (QC) program to provide tools for continuous assessment of the equipment performance and also data storage and analysis of the protocols' data. The objective of this paper is to present the specialized software for Quality Control of the Mammography Units, as tool providing additional functionality for optimizations of the Mammography QC data storage and management. The PC program was developed according to the requirements stated in the European protocol for Quality Control of the Mammography Screening and the data collected as a result of its application in several Bulgarian hospitals. The Structured Analysis method was used in order to perform a case, which resulted in the development of the specialized software with a database module, providing the following functionality: Data Storage, Preliminary Data Processing and Post-Processing, Manual Data Entry, Data Import from XLS format, Data Export to XLS format, Printing, Data Filters, Automated Calculation, Automated Graphical Representation, Archiving The development of specialized QC software with a database for mammography units facilitates the process of QC data storage and handling and minimizes the errors. The electronic format for data storage is especially useful in case of long-term storage and periodical data analysis/access. The integrated data processing functionality and the automated import/export features based on standard platform increase the compatibility of the data. (authors)

  15. The Future of Contrast-Enhanced Mammography.

    Science.gov (United States)

    Covington, Matthew F; Pizzitola, Victor J; Lorans, Roxanne; Pockaj, Barbara A; Northfelt, Donald W; Appleton, Catherine M; Patel, Bhavika K

    2018-02-01

    The purpose of this article is to discuss facilitators of and barriers to future implementation of contrast-enhanced mammography (CEM) in the United States. CEM provides low-energy 2D mammographic images analogous to digital mammography and contrast-enhanced recombined images that allow assessment of neovascularity similar to that offered by MRI. The utilization of CEM in the United States is currently low but could increase rapidly given the many potential indications for its clinical use.

  16. The Impact of Different Diagnostic Criteria on the Prevalence of Sarcopenia in Healthy Elderly Participants and Geriatric Outpatients.

    Science.gov (United States)

    Reijnierse, Esmee M; Trappenburg, Marijke C; Leter, Morena J; Blauw, Gerard Jan; Sipilä, Sarianna; Sillanpää, Elina; Narici, Marco V; Hogrel, Jean-Yves; Butler-Browne, Gillian; McPhee, Jamie S; Gapeyeva, Helena; Pääsuke, Mati; de van der Schueren, Marian A E; Meskers, Carel G M; Maier, Andrea B

    2015-01-01

    A consensus on the diagnostic criteria for sarcopenia, a common syndrome in the elderly, has not been reached yet. Prevalence rates vary between studies due to the use of different criteria encompassing different measures, correction factors and cutoff points. This study compared prevalence rates of sarcopenia using nine sets of diagnostic criteria applied in two different elderly populations. The study population encompassed 308 healthy elderly participants (152 males, 156 females; mean age 74 years) and 123 geriatric outpatients (54 males, 69 females; mean age 81 years). Diagnostic criteria included relative muscle mass, absolute muscle mass, muscle strength and physical performance. Prevalence rates of sarcopenia varied between 0 and 15% in healthy elderly participants and between 2 and 34% in geriatric outpatients. This study clearly demonstrates the dependency of sarcopenia prevalence rates on the applied diagnostic criteria. © 2015 S. Karger AG, Basel.

  17. Indicators of image quality and doses in mammography

    International Nuclear Information System (INIS)

    Gaona, E.; Franco E, J.G.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M.

    2007-01-01

    Full text: The purpose of the study was to determine the values of the image quality indicators and their relationship with the dose in mammography of screen-film that they allowed the detection of a bigger number of objects in the images obtained with the mannequin (phantom) authorized of the ACR/FDA. The study was carried out in four mammography services in a period of 12 months. The indicators of the image quality are the half optic density (DOM), contrast (differences of densities), the number of observed objects in the images and the dose for image. The minimum acceptable values by the ACR/FDA are a half optical density of 1.4, contrast of 0.4 and the one numbers minimum of objects observed in the image of the mannequin of mammography of 10 (4 fibers, 3 groups of calcifications and 3 masses), with a maximum dose by image of 3 mGy. The found results are half optical density of 1.9, contrast of 0.56 and the average number of objects observed in the images of 12, with a dose in the interval of 1.6 mGy to 2.4 mGy. The doses were measured by thermoluminescent dosimetry and ionization chamber. Once carried out the analysis of the tendencies of the indicators of image quality and their distributions is found that for a p < 0.05, the bigger number of objects observed in the images is in the interval from 1.8 to 1.9 of DOM. When comparing both mammography system, the system screen-film has a lower variability in the distribution of objects associated to a DOM. (Author)

  18. Finding the minimal intervention needed for sustained mammography adherence.

    Science.gov (United States)

    Gierisch, Jennifer M; DeFrank, Jessica T; Bowling, J Michael; Rimer, Barbara K; Matuszewski, Jeanine M; Farrell, David; Skinner, Celette Sugg

    2010-10-01

    Regular adherence to mammography screening saves lives, yet few women receive regular mammograms. RCT. Participants were recruited through a state employee health plan. All were women aged 40-75 years and had recent mammograms prior to enrollment (n=3547). Data were collected from 2004 to 2009. Trial tested efficacy of a two-step adaptively-designed intervention to increase mammography adherence over 4 years. The first intervention step consisted of three reminder types: enhanced usual care reminders (EUCR); enhanced letter reminders (ELR); both delivered by mail, and automated telephone reminders (ATR). After delivery of reminders, women who became off-schedule in any of the 4 years received a second step of supplemental interventions. Three supplemental intervention arms contained priming letters and telephone counseling: barriers only (BarriCall); barriers plus positive consequences of getting mammograms (BarriConCall+); and barriers plus negative consequences of not getting mammograms (BarriConCall-). Average cumulative number of days non-adherent to mammography over 4 years based on annual screening guidelines (analyses conducted in 2009). All reminders performed equally well in reducing number of days of non-adherence. Women randomized to receive supplemental interventions had significantly fewer days of non-adherence compared to women who received EUCR (p=0.0003). BarrConCall+ and BarrConCall- conditions did not significantly differ in days non-adherent compared to women in the barriers-only condition (BarriCon). The minimal intervention needed for sustained mammography use is a combination of a reminder followed by a priming letter and barrier-specific telephone counseling for women who become off-schedule. Additional costs associated with supplemental interventions should be considered by organizations deciding which interventions to use. NCT01148875. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. The efficacy of using computer-aided detection (CAD) for detection of breast cancer in mammography screening

    DEFF Research Database (Denmark)

    Henriksen, Emilie L; Carlsen, Jonathan F; Vejborg, Ilse Mm

    2018-01-01

    Background Early detection of breast cancer (BC) is crucial in lowering the mortality. Purpose To present an overview of studies concerning computer-aided detection (CAD) in screening mammography for early detection of BC and compare diagnostic accuracy and recall rates (RR) of single reading (SR......) with SR + CAD and double reading (DR) with SR + CAD. Material and Methods PRISMA guidelines were used as a review protocol. Articles on clinical trials concerning CAD for detection of BC in a screening population were included. The literature search resulted in 1522 records. A total of 1491 records were...... excluded by abstract and 18 were excluded by full text reading. A total of 13 articles were included. Results All but two studies from the SR vs. SR + CAD group showed an increased sensitivity and/or cancer detection rate (CDR) when adding CAD. The DR vs. SR + CAD group showed no significant differences...

  20. Mammography image assessment; validity and reliability of current scheme

    International Nuclear Information System (INIS)

    Hill, C.; Robinson, L.

    2015-01-01

    Mammographers currently score their own images according to criteria set out by Regional Quality Assurance. The criteria used are based on the ‘Perfect, Good, Moderate, Inadequate’ (PGMI) marking criteria established by the National Health Service Breast Screening Programme (NHSBSP) in their Quality Assurance Guidelines of 2006 1 . This document discusses the validity and reliability of the current mammography image assessment scheme. Commencing with a critical review of the literature this document sets out to highlight problems with the national approach to the use of marking schemes. The findings suggest that ‘PGMI’ scheme is flawed in terms of reliability and validity and is not universally applied across the UK. There also appear to be differences in schemes used by trainees and qualified mammographers. Initial recommendations are to be made in collaboration with colleagues within the National Health Service Breast Screening Programme (NHSBSP), Higher Education Centres, College of Radiographers and the Royal College of Radiologists in order to identify a mammography image appraisal scheme that is fit for purpose. - Highlights: • Currently no robust evidence based marking tools in use for the assessment of images in mammography. • Is current system valid, reliable and robust? • How can the current image assessment tool be improved? • Should students and qualified mammographers use the same tool? • What marking criteria are available for image assessment?

  1. Comparison between different methods of magnetic field diagnostics in beam emission spectroscopy

    International Nuclear Information System (INIS)

    Voslamber, D.

    1995-01-01

    Magnetic field diagnostics in tokamaks using the motional Stark effect in fast neutral beams have been based on two kinds of polarimetry which are called 'static' and 'dynamic'. It is shown that static polarimetry presents a number of advantages over dynamic polarimetry, provided it is made complete in the sense that a sufficient number of polarisation analysers is installed and different parts of the spectrum are explored to yield full information on the set of unknowns inherent in the problem. A detailed scheme of self-calibrating static polarimetry is proposed, including the case where an in-vessel mirror with changing characteristics (coating by impurities) is placed in front of the optical detection system. (author) 5 refs.; 2 figs

  2. Variability of breast density assessment in short-term reimaging with digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Hwa [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Sun Mi [Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do (Korea, Republic of); Yi, Ann [Department of Radiology, Seoul Metropolitan Government Seoul National University, Boramae Medical Center, Seoul (Korea, Republic of); Chang, Jung Min; Koo, Hye Ryoung; Lee, Su Hyun; Cho, Nariya [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2013-10-01

    Objective: To evaluate the variability of breast density assessments in short-term reimaging with digital mammography. Materials and methods: In 186 women, short term (mean interval, 27.6 days) serial digital mammograms including CC and MLO views were obtained without any treatment. Mammographic density assessments were performed by three blinded radiologists for Breast Imaging Report and Data System (BI-RADS, grades 1–4) and visual percentage density (PD) estimation, and by one radiologist for computer-aided PD estimation. The variability of assessments was analyzed according to the age, breast density, and mammography types by multivariate logistic regression. Results: In BI-RADS assessments, 29% (161 of 558) of breast density categories were assessed differently after short-term reimaging and the mean absolute difference in PD for CC and MLO view was 7.6% and 8.1% for visual assessments, and 7.4% and 6.4% for computer-aided assessments, respectively. Among all computer-aided assessments, 29% (54 of 186) of CC view and 22% (41 of 186) of MLO view assessments had discrepancy over 10% in PD. Younger age (<50), greater breast density (grades 3 and 4), and different mammography types were significantly associated with the variability. Conclusion: Considerable variability in breast density assessments occurred in short-term reimaging with digital mammography, particularly in women with younger age and greater breast density and when examined using different types of mammography.

  3. Variability of breast density assessment in short-term reimaging with digital mammography

    International Nuclear Information System (INIS)

    Kim, Won Hwa; Moon, Woo Kyung; Kim, Sun Mi; Yi, Ann; Chang, Jung Min; Koo, Hye Ryoung; Lee, Su Hyun; Cho, Nariya

    2013-01-01

    Objective: To evaluate the variability of breast density assessments in short-term reimaging with digital mammography. Materials and methods: In 186 women, short term (mean interval, 27.6 days) serial digital mammograms including CC and MLO views were obtained without any treatment. Mammographic density assessments were performed by three blinded radiologists for Breast Imaging Report and Data System (BI-RADS, grades 1–4) and visual percentage density (PD) estimation, and by one radiologist for computer-aided PD estimation. The variability of assessments was analyzed according to the age, breast density, and mammography types by multivariate logistic regression. Results: In BI-RADS assessments, 29% (161 of 558) of breast density categories were assessed differently after short-term reimaging and the mean absolute difference in PD for CC and MLO view was 7.6% and 8.1% for visual assessments, and 7.4% and 6.4% for computer-aided assessments, respectively. Among all computer-aided assessments, 29% (54 of 186) of CC view and 22% (41 of 186) of MLO view assessments had discrepancy over 10% in PD. Younger age (<50), greater breast density (grades 3 and 4), and different mammography types were significantly associated with the variability. Conclusion: Considerable variability in breast density assessments occurred in short-term reimaging with digital mammography, particularly in women with younger age and greater breast density and when examined using different types of mammography

  4. Mammography

    Science.gov (United States)

    ... to those found in digital cameras and their efficiency enables better pictures with a lower radiation dose. ... greater accuracy in pinpointing the size, shape and location of breast abnormalities fewer unnecessary biopsies or additional ...

  5. Mammography

    International Nuclear Information System (INIS)

    Oliveira, S.B.

    1988-01-01

    The mamma anatomy are showed with the main characteristics for the mamography examination. The energy band, the additional filtration, the half-value thickness are also mentioned. The evaluation in the exposure and the doses in the mamography examination are described with a quality control for obtention the best image. (C.G.C.) [pt

  6. Pulmonary Capillary Hemorrhage Induced by Different Imaging Modes of Diagnostic Ultrasound.

    Science.gov (United States)

    Miller, Douglas L; Dong, Zhihong; Dou, Chunyan; Raghavendran, Krishnan

    2018-05-01

    The induction of pulmonary capillary hemorrhage (PCH) is a well-established non-thermal biological effect of pulsed ultrasound in animal models. Typically, research has been done using laboratory pulsed ultrasound systems with a fixed beam and, recently, by B-mode diagnostic ultrasound. In this study, a GE Vivid 7 Dimension ultrasound machine with 10 L linear array probe was used at 6.6 MHz to explore the relative PCH efficacy of B-mode imaging, M-mode (fixed beam), color angio mode Doppler imaging and pulsed Doppler mode (fixed beam). Anesthetized rats were scanned in a warmed water bath, and thresholds were determined by scanning at different power steps, 2 dB apart, in different groups of six rats. Exposures were performed for 5 min, except for a 15-s M-mode group. Peak rarefactional pressure amplitude thresholds were 1.5 MPa for B-mode and 1.1 MPa for angio Doppler mode. For the non-scanned modes, thresholds were 1.1 MPa for M-mode and 0.6 MPa for pulsed Doppler mode with its relatively high duty cycle (7.7 × 10 -3 vs. 0.27 × 10 -3 for M-mode). Reducing the duration of M-mode to 15 s (from 300 s) did not significantly reduce PCH (area, volume or depth) for some power settings, but the threshold was increased to 1.4 MPa. Pulmonary sonographers should be aware of this unique adverse bio-effect of diagnostic ultrasound and should consider reduced on-screen mechanical index settings for potentially vulnerable patients. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

  7. Do Different Diagnostic Criteria Impact Polycystic Ovary Syndrome Diagnosis for Adolescents?

    Science.gov (United States)

    Akgül, Sinem; Düzçeker, Yasemin; Kanbur, Nuray; Derman, Orhan

    2018-06-01

    Although early diagnosis of polycystic ovary syndrome (PCOS) in adolescents might allow for earlier treatment and prevention of chronic disorders, incorrect or premature diagnosis carries risks of unnecessary treatment and psychological distress. There is no consensus concerning which diagnostic criteria to use for adolescents and current criteria vary. The objective of this study was to determine whether using different diagnostic criteria will affect PCOS diagnosis in adolescents. Fifty-two patients aged 13-18 years with at least 2 of the following criteria were included in the study: (1) oligomenorrhea or amenorrhea; (2) Clinical or biochemical hyperandrogenism; and (3) polycystic ovaries on ultrasonography. Patients were then categorized according to the 6 different criteria for PCOS. National Institutes of Health, Rotterdam criteria, Androgen Excess Society, Amsterdam criteria, Endocrine Society criteria, and the Pediatric Endocrine Society criteria. The characteristics of adolescents who were diagnosed with PCOS were also evaluated. Forty-one patients out of 52 (78.8%) received diagnosis with National Institutes of Health and Endocrine Society criteria, all with Rotterdam criteria, 45/52 (86.5%) with Androgen Excess Society criteria, 36/52 (69.2%) with Amsterdam criteria and 34/52 (65.4%) with the Pediatric Endocrine Society criteria. This study shows that the choice of guideline used does have a great effect on whether an adolescent received the PCOS diagnosis or not. For physicians using the broader criteria, care should be taken to ensure the patient does not receive diagnosis because of the physiological changes seen during puberty, which might mimic PCOS. For those using stricter criteria, close monitoring of patients who do not receive diagnosis is necessary to prevent chronic complications. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  8. The use of different diagnostic tools for Babesia and Theileria parasites in cattle in Menofia, Egypt.

    Science.gov (United States)

    Nayel, Mohamed; El-Dakhly, Khaled Mohamed; Aboulaila, Mahmoud; Elsify, Ahmed; Hassan, Hany; Ibrahim, Elsayed; Salama, Akram; Yanai, Tokuma

    2012-09-01

    Bovine piroplasmosis is caused by tick-borne hemoprotozoans of the genera Babesia and Theileria and is the most prevalent in tropical and subtropical countries, causing a major economic impact worldwide. In the current study, a total of 405 cattle of different ages, sexes, and breeds were randomly sampled for surveying and diagnosis of babesiosis and theileriosis using three methods: direct microscopy (blood smears), indirect fluorescent antibody test (IFAT) and polymerase chain reaction (PCR). Giemsa-stained blood smears revealed that, out of 405 examined cattle, 33 (8.15 %) were infected with Babesia sp. and 65 (16.05 %) with Theileria sp. (total number of infected cattle was 98). Mixed infection was seen in 11 (2.72 %) animals. Moreover, application of the three diagnostic assays on 158 randomly sampled cattle indicated that 17 (10.76 %) and 33 (20.89 %) were positive for Babesia and Theileria spp. by the direct smear technique, 25 (15.82 %) and 33 (20.89 %) by IFAT (fluorescence was greenish yellow for Babesia and yellowish for Theileria), and 20 (12.66 %) and 38 (24.05 %) by PCR. Using primers specific for Babesia and Theileria spp., we found that diagnostic bands appeared at ~350 and ~370 bp, respectively indicating the presence of these piroplasms. Statistically, there was a non-significant difference of the positivity in response to the three techniques; thus, any of these methods can be described as useful for diagnosing blood parasites in both domesticated animals and birds. On the basis of the obtained results, it could be concluded that direct microscopy can be used in acute infections, whereas IFAT and PCR are useful in chronicity.

  9. Combined staging at one stop using MR mammography. Evaluation of an extended protocol to screen for distant metastasis in primary breast cancer. Initial results and diagnostic accuracy in a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Dietzel, M.; Zoubi, R.; Burmeister, H.P.; Kaiser, W.A.; Baltzer, P.A.T. [Jena Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Runnebaum, I.B. [University Hospital Jena (Germany). Dept. of Gynecology and Obstetrics

    2012-07-15

    Purpose: Accurate staging of primary breast cancer is essential for the therapeutic approach. Modern whole-body MR scanners would allow local and distant staging during a single examination. Accordingly, we designed a dedicated protocol for this purpose and prospectively evaluated the diagnostic accuracy. Materials and Methods: 65 consecutive breast cancer patients underwent pre-therapeutic MRI (1.5 T). A bilateral breast protocol (axial: T1w/GRE dynamic contrast-enhanced, T2w/TSE; TA: 10 min) was extended to screen for distant metastasis at one stop without repositioning (coronal: T2w/HASTE, T1w/VIBE; FOV: thorax, abdomen and spine; TA: 90 sec; multichannel surface coils). The standard of reference was S3 guideline-compliant staging examinations. Global assessment regarding the presence of distant metastasis was performed independently by two experienced and blinded radiologists (five-level confidence score). Inter-rater agreement (weighted kappa) and observer scoring were analyzed (contingency tables). Results: The prevalence of synchronous metastases was 7.7 % (n = 5). The protocol enabled global assessment regarding the presence of distant metastasis with high accuracy (sensitivity: 100 %; specificity: 98.3 %) and inter-rater agreement (kappa: 0.92). Conclusion: Applying the extended MRI protocol, accurate screening for distant metastasis was possible in combination with a dedicated breast examination. (orig.)

  10. Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists

    International Nuclear Information System (INIS)

    Torres-Mejía, Gabriela; Smith, Robert A.; Carranza-Flores, María de la Luz; Bogart, Andy; Martínez-Matsushita, Louis; Miglioretti, Diana L.; Kerlikowske, Karla; Ortega-Olvera, Carolina; Montemayor-Varela, Ernesto; Angeles-Llerenas, Angélica; Bautista-Arredondo, Sergio; Sánchez-González, Gilberto; Martínez-Montañez, Olga G.; Uscanga-Sánchez, Santos R.; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

    2015-01-01

    An alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries. We evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed. Radiographer’s sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7–86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7–57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6–0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms. Given the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists

  11. Solid-state dosimeters: A new approach for mammography measurements

    International Nuclear Information System (INIS)

    Brateman, Libby F.; Heintz, Philip H.

    2015-01-01

    Purpose: To compare responses of modern commercially available solid-state dosimeters (SStDs) used in mammography medical physics surveys for two major vendors of current digital mammography units. To compare differences in dose estimates among SStD responses with ionization chamber (IC) measurements for several target/filter (TF) combinations and report their characteristics. To review scientific bases for measurements of quantities required for mammography for traditional measurement procedures and SStDs. Methods: SStDs designed for use with modern digital mammography units were acquired for evaluation from four manufacturers. Each instrument was evaluated under similar conditions with the available mammography beams provided by two modern full-field digital mammography units in clinical use: a GE Healthcare Senographe Essential (Essential) and a Hologic Selenia Dimensions 5000 (Dimensions), with TFs of Mo/Mo, Mo/Rh; and Rh/Rh and W/Rh, W/Ag, and W/Al, respectively. Measurements were compared among the instruments for the TFs over their respective clinical ranges of peak tube potentials for kVp and half-value layer (HVL) measurements. Comparisons for air kerma (AK) and their associated relative calculated average glandular doses (AGDs), i.e., using fixed mAs, were evaluated over the limited range of 28–30 kVp. Measurements were compared with reference IC measurements for AK, reference HVLs and calculated AGD, for two compression paddle heights for AK, to evaluate scatter effects from compression paddles. SStDs may require different positioning from current mammography measurement protocols. Results: Measurements of kVp were accurate in general for the SStDs (within −1.2 and +1.1 kVp) for all instruments over a wide range of set kVp’s and TFs and most accurate for Mo/Mo and W/Rh. Discrepancies between measurements and reference values were greater for HVL and AK. Measured HVL values differed from reference values by −6.5% to +3.5% depending on the SStD and

  12. An evaluation of musculoskeletal discomfort experience by radiographers performing mammography

    International Nuclear Information System (INIS)

    Gale, A.G.; May, J.

    1997-01-01

    The aim of this study was to establish whether breast screening radiographers experience any problems of musculoskeletal discomfort, and if so the nature and extent of these problems. The study was then further extended to investigate and determine possible occupational, causal or contributory factors, and to suggest recommendations to help alleviate any discomfort. To investigate this problem five main approaches were undertaken. These consisted of; a national survey, an observational study, the comparison of the physical measurements of the mammography units with anthropometric data, a detailed task analysis, and a body mapping study. The national survey set out to determine if the nature and frequency of such problems were higher in mammography than in other areas of radiography or in the general population. Additionally, comparisons were made with non-radiographic staff working at the same breast screening centres. Video recordings of radiographers performing breast screening were also made and posture analysis performed on these data. A detailed task analysis was conducted to identify interaction points and possible problems between the radiographer and the equipment which she is required to use. Physical measurements of the mammography units were made and compared with anthropometric measurements and guidelines. The body mapping study measured the build up of discomfort throughout the working day on several different mammography units. The results from the survey questionnaire indicated that some breast screening radiographers do experience musculoskeletal problems, and that these are different in nature and prevalence from the musculoskeletal discomfort reported by the two control groups. The prevalence of back pain reported by radiographers undertaking mammography was higher than that present in the normal population. No comparison could be made with other body areas as data regarding other types of musculoskeletal discomfort in the general population are

  13. An evaluation of musculoskeletal discomfort experience by radiographers performing mammography

    Energy Technology Data Exchange (ETDEWEB)

    Gale, A.G.; May, J

    1997-10-01

    The aim of this study was to establish whether breast screening radiographers experience any problems of musculoskeletal discomfort, and if so the nature and extent of these problems. The study was then further extended to investigate and determine possible occupational, causal or contributory factors, and to suggest recommendations to help alleviate any discomfort. To investigate this problem five main approaches were undertaken. These consisted of; a national survey, an observational study, the comparison of the physical measurements of the mammography units with anthropometric data, a detailed task analysis, and a body mapping study. The national survey set out to determine if the nature and frequency of such problems were higher in mammography than in other areas of radiography or in the general population. Additionally, comparisons were made with non-radiographic staff working at the same breast screening centres. Video recordings of radiographers performing breast screening were also made and posture analysis performed on these data. A detailed task analysis was conducted to identify interaction points and possible problems between the radiographer and the equipment which she is required to use. Physical measurements of the mammography units were made and compared with anthropometric measurements and guidelines. The body mapping study measured the build up of discomfort throughout the working day on several different mammography units. The results from the survey questionnaire indicated that some breast screening radiographers do experience musculoskeletal problems, and that these are different in nature and prevalence from the musculoskeletal discomfort reported by the two control groups. The prevalence of back pain reported by radiographers undertaking mammography was higher than that present in the normal population. No comparison could be made with other body areas as data regarding other types of musculoskeletal discomfort in the general population are

  14. Analysis and Interpretation of the Plasma Dynamic Response to Additional Heating Power using different Diagnostics

    International Nuclear Information System (INIS)

    Manini, A.

    2002-07-01

    The main goal in the research of nuclear fusion, and therefore in tokamak research as well, is the development of a high power, steady-state power plant. To obtain the high power required for igniting the plasma, the size of the device must be very large. The performance of the tokamak plasma depends in particular on the plasma shape and on the internal plasma profiles. These profiles include those of the current density and the pressure, two quantities that can be modified by means of auxiliary heating methods such as Electron Cyclotron Heating (ECH). ECH is a very important tool due to its capability of injecting highly localised and intense power. Off-axis ECH and Electron Cyclotron Current Drive (ECCD) modify both current density and electron temperature profiles, leading to modification of confinement and stability properties. in particular, complete stabilisation of magnetohydrodynamic modes using ECCD is feasible. Furthermore, ECH is crucial as a mean of increasing the bootstrap current fraction through the formation of internal transport barriers, so that confinement is also improved. Finally, it is also noted that modulated ECH (MECH) is a very effective tool for perturbative energy transport experiments in many different regimes. Experiments performed in the TCV and the ASDEX Upgrade tokamaks are presented. The role of TCV is very important due to its flexibility of varying the plasma shape, its versatile high power ECH system at both the second and third electron cyclotron harmonics, and due to the numerous diagnostics installed, e.g. the two soft X-ray (SXR) diagnostics which simultaneously allow high temporal and spatial resolutions. The importance of ASDEX Upgrade is related to its large size, which makes it a reactor-relevant experimental facility, and to the Neutral Beam Injection (NBI) and ECH heating facilities, which allow a study of heat and particle transport in either mostly ion-heated or mostly electron-heated regimes. Moreover, for the

  15. Registration of Vibro-acoustography Images and X-ray Mammography.

    Science.gov (United States)

    Gholam Hosseini, H; Fatemi, M; Alizad, A

    2005-01-01

    Image registration has been widely used for generating more diagnostic and clinical values in medical imaging. On the other hand, inaccurate image registration and incorrect localization of region of interest risks a potential impact on patients. Vibro-acoustography (VA) is a new imaging modality that has been applied to both medical and industrial imaging. Combining unique diagnostic information of VA with other medical imaging is one of our research interests. In this work, we studied the VA and x-ray image pairs and adopted a flexible control-point selection technique for image registration. A modified second-order polynomial, which leads to a scale/rotation/translation invariant registration, was used. The results of registration were used to spatially transform the breast VA images to map with the x-ray mammography with a registration error of less than 1.65 mm. These two completely different modalities were combined to generate an image including a ratio of each image pixel value. Therefore, the proposed technique allows clinicians to maximize their insight by combining the information from x-ray mammogram and VA modalities into a single image.

  16. Family/Friend Recommendations and Mammography Intentions: The Roles of Perceived Mammography Norms and Support

    Science.gov (United States)

    Molina, Yamile; Ornelas, India J.; Doty, Sarah L.; Bishop, Sonia; Beresford, Shirley A. A.; Coronado, Gloria D.

    2015-01-01

    Identifying factors that increase mammography use among Latinas is an important public health priority. Latinas are more likely to report mammography intentions and use, if a family member or friend recommends that they get a mammogram. Little is known about the mechanisms underlying the relationship between social interactions and mammography…

  17. Overview of patient dosimetry in diagnostic radiology in the USA for the past 50 years

    International Nuclear Information System (INIS)

    Huda, Walter; Nickoloff, Edward L.; Boone, John M.

    2008-01-01

    This review covers the role of medical physics in addressing issues directly related to patient dosimetry in radiography, fluoroscopy, mammography, and CT. The sections on radiography and fluoroscopy radiation doses review the changes that have occurred during the last 50 to 60 years. A number of technological improvements have contributed to both a significant reduction in patient and staff radiation doses and improvements to the image quality during this period of time. There has been a transition from film-screen radiography with hand dip film processing to electronic digital imaging utilizing CR and DR. Similarly, fluoroscopy has progressed by directly viewing image intensifiers in darkened rooms to modern flat panel image receptor systems utilizing pulsed radiation, automated variable filtration, and digitally processed images. Mammography is one of the most highly optimized imaging procedures performed, because it is a repetitive screening procedure that results in annual radiation exposure. Mammography is also the only imaging procedure in the United States in which the radiation dose is regulated by the federal government. Consequently, many medical physicists have studied the dosimetry associated with screen-film and digital mammography. In this review, a brief history of mammography dose assessment by medical physicists is discussed. CT was introduced into clinical practice in the early 1970s, and has grown into one of the most important modalities available for diagnostic imaging. CT dose quantities and measurement techniques are described, and values of radiation dose for different types of scanner are presented. Organ and effective doses to adult patients are surveyed from the earliest single slice scanners, to the latest versions that include up to two x-ray tubes and can incorporate as many as 256 detector channels. An overview is provided of doses received by pediatric patients undergoing CT examinations, as well as methods, and results, of studies

  18. Accuracy of CESM versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation

    Directory of Open Access Journals (Sweden)

    Maha Helal

    2017-09-01

    Full Text Available Aim: Assess accuracy of contrast enhanced spectral mammography (CESM versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation. Patients and methods: Thirty female patients with 35 breast lesions diagnosed by conventional imaging as BI-RADS 3 and 4, presented to Women’s Imaging Unit of Radiology Department between January and December 2015, age ranged from 23 to 70 years. All patients underwent conventional mammography and ultrasound then CESM. Results: Patients divided into two groups, benign and malignant lesions group according to histological analysis. Mammography results that malignant lesions detected in 18/35 (51.4% while benign lesions 17/35 (48.6%. Ultrasound revealed 27/35 (77.1% lesions were malignant and 8/35 (22.9% lesions benign. But CESM, revealed 25/35 (71.4% lesions were malignant & 10/35 (28.6% lesions benign. Among 7 patients with multifocal/ multi-centric histologically proven malignant lesions, all detected by CESM 7/7 cases (100% versus 2/7 cases (28.6% and 6/7 cases (85.7% detected by mammography and ultrasound respectively. Based on, CESM had 95.2% sensitivity and 82.9% diagnostic accuracy. Conclusion: CESM has better diagnostic accuracy than mammography alone and mammography plus ultrasound. CESM has 82.9% diagnostic accuracy in comparison to 51.4% for mammography and 77.1% for ultrasound. Keywords: Breast lesions, CESM, BI-RADS lexicon

  19. Digital versus screen-film mammography: impact of mammographic density and hormone therapy on breast cancer detection.

    Science.gov (United States)

    Chiarelli, Anna M; Prummel, Maegan V; Muradali, Derek; Shumak, Rene S; Majpruz, Vicky; Brown, Patrick; Jiang, Hedy; Done, Susan J; Yaffe, Martin J

    2015-11-01

    Most studies that have examined the effects of mammographic density and hormone therapy use on breast cancer detection have included screen-film mammography. This study further examines this association in post-menopausal women screened by digital mammography. Approved by the University of Toronto Research Ethics Board, this study identified 688,418 women of age 50-74 years screened with digital or screen-film mammography from 2008 to 2009 within the Ontario Breast Screening Program. Of 2993 eligible women with invasive breast cancer, 2450 were contacted and 1421 participated (847 screen-film mammography, 574 digital direct radiography). Mammographic density was measured by study radiologists using the standard BI-RADS classification system and by a computer-assisted method. Information on hormone therapy use was collected by a telephone-administered questionnaire. Logistic regression and two-tailed tests for significance evaluated associations between factors and detection method by mammography type. Women with >75 % radiologist-measured mammographic density compared to those with diagnosed with an interval than screen-detected cancer, with the difference being greater for those screened with screen-film (OR = 6.40, 95 % CI 2.30-17.85) than digital mammography (OR = 2.41, 95 % CI 0.67-8.58) and aged 50-64 years screened with screen-film mammography (OR = 10.86, 95 % CI 2.96-39.57). Recent former hormone therapy users were also at an increased risk of having an interval cancer with the association being significant for women screened with digital mammography (OR = 2.08, 95 % CI 1.17-3.71). Breast screening using digital mammography lowers the risk of having an interval cancer for post-menopausal women aged 50-64 with greater mammographic density.

  20. Full-field digital mammography versus computed radiology mammography: comparison in image quality and radiation dose

    International Nuclear Information System (INIS)

    Zhao Yongxia; Song Shaojuan; Liu Chuanya; Qi Hengtao; Qin Weichang

    2008-01-01

    Objective: To investigate the differences in image quality and radiation dose between full- field digital mammography (FFDM) system and compute radiology mammography (CRM) system. Methods: The ALVIM mammographic phantom was exposed by FFDM system with automatic exposure control (AEC) and then exposed by CRM system with the unique imaging plank on the same condition. The FFDM system applied the same kV value and the different mAs values (14, 16, 18, 22 and 24 mAs), and the emission skin dose (ESD) and the average gland dose (AGD) were recorded for the above-mentioned exposure factors. All images were read by five experienced radiologists under the same condition and judged based on 5-point scales. And then receive operating characteristic (ROC) curve was drawn and the probability (P det ) values were calculated. The data were statistically processed with ANOVA. Results: The P det values of calcifications and lesion lump were higher with FFDM system than with CRM system at the same dose (1.36 mGy). Especially, for microcalcifications and lesion lump, the largest difference of the P det value was 0.215, and that of lesion lump was 0.245. In comparison with CRM system, the radiation dose of FFDM system could be reduced at the same P det value. The ESD value was reduced by 26%, and the ACD value was reduced by 41%. When the mAs value exceed AEC value, the P det value almost had no change, though the radiation dose was increased. Conclusions: The detection rates of microcalcifications and lesion lump with FFDM system are proven to be superior to CRM system at the same dose. The radiation dose of FFDM system was less than CRM system for the same image quality. (authors)

  1. CT coronary angiography: Influence of different cardiac reconstruction intervals on image quality and diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Department of Radiology, Charite Medical School, Humboldt-Universitaet zu Berlin (Germany)], E-mail: marc.dewey@charite.de; Teige, Florian [Department of Radiology, Charite Medical School, Humboldt-Universitaet zu Berlin (Germany); Rutsch, Wolfgang [Department of Cardiology, Charite Medical School, Humboldt-Universitaet zu Berlin (Germany)], E-mail: wolfgang.rutsch@charite.de; Schink, Tania [Department of Medical Biometry, Charite Medical School, Humboldt-Universitaet zu Berlin (Germany)], E-mail: peter.martus@charite.de; Hamm, Bernd [Department of Radiology, Charite Medical School, Humboldt-Universitaet zu Berlin (Germany)

    2008-07-15

    Purpose: To prospectively analyze image quality and diagnostic accuracy of different reconstruction intervals of coronary angiography using multislice computed tomography (MSCT). Materials and methods: For each of 47 patients, 10 ECG-gated MSCT reconstructions were generated throughout the RR interval from 0 to 90%, resulting in altogether 470 datasets. These datasets were randomly analyzed for image quality and accuracy and compared with conventional angiography. Statistical comparison of intervals was performed using nonparametric analysis for repeated measurements to account for clustering of arteries within patients. Results: Image reconstruction intervals centered at 80, 70, and 40% of the RR interval resulted (in that order) in the best overall image quality for all four main coronary vessels. Eighty percent reconstructions also yielded the highest diagnostic accuracy of all intervals. The combination of the three best intervals (80, 70, and 40%) significantly reduced the nondiagnostic rate as compared with 80% alone (p = 0.005). However, the optimal reconstruction interval combination achieved significantly improved specificities and nondiagnostic rates (p < 0.05). The optimal combination consisted of 1.7 {+-} 0.9 reconstruction intervals on average. In approximately half of the patients (49%, 23/47) a single reconstruction was optimal. In 18 (38%), 3 (6%), and 3 (6%) patients one, two, and three additional reconstruction intervals were required, respectively, to achieve optimal quality. In 28% of the patients the optimal combination consisted of reconstructions other than the three best intervals (80, 70, and 40%). Conclusion: Multiple image reconstruction intervals are essential to ensure high image quality and accuracy of CT coronary angiography.

  2. Reliability of measuring abductor hallucis muscle parameters using two different diagnostic ultrasound machines

    Directory of Open Access Journals (Sweden)

    Cameron Alyse FM

    2009-11-01

    Full Text Available Abstract Background Diagnostic ultrasound provides a method of analysing soft tissue structures of the musculoskeletal system effectively and reliably. The aim of this study was to evaluate within and between session reliability of measuring muscle dorso-plantar thickness, medio-lateral length and cross-sectional area, of the abductor hallucis muscle using two different ultrasound machines, a higher end Philips HD11 Ultrasound machine and clinically orientated Chison 8300 Deluxe Digital Portable Ultrasound System. Methods The abductor hallucis muscle of both the left and right feet of thirty asymptomatic participants was imaged and then measured using both ultrasound machines. Interclass correlation coefficients (ICC with 95% confidence intervals (CI were used to calculate both within and between session intra-tester reliability. Standard error of the measurement (SEM calculations were undertaken to assess difference between the actual measured score across trials and the smallest real difference (SRD was calculated from the SEM to indicate the degree of change that would exceed the expected trial to trial variability. Results The ICCs, SEM and SRD for dorso-plantar thickness and medial-lateral length were shown to have excellent to high within and between-session reliability for both ultrasound machines. The between-session reliability indices for cross-sectional area were acceptable for both ultrasound machines. Conclusion The results of the current study suggest that regardless of the type ultrasound machine, intra-tester reliability for the measurement the abductor hallucis muscle parameters is very high.

  3. Comparison between breast MRI and contrast-enhanced spectral mammography.

    Science.gov (United States)

    Łuczyńska, Elżbieta; Heinze-Paluchowska, Sylwia; Hendrick, Edward; Dyczek, Sonia; Ryś, Janusz; Herman, Krzysztof; Blecharz, Paweł; Jakubowicz, Jerzy

    2015-05-12

    The main goal of this study was to compare contrast-enhanced spectral mammography (CESM) and breast magnetic resonance imaging (MRI) with histopathological results and to compare the sensitivity, accuracy, and positive and negative predictive values for both imaging modalities. After ethics approval, CESM and MRI examinations were performed in 102 patients who had suspicious lesions described in conventional mammography. All visible lesions were evaluated independently by 2 experienced radiologists using BI-RADS classifications (scale 1-5). Dimensions of lesions measured with each modality were compared to postoperative histopathology results. There were 102 patients entered into CESM/MRI studies and 118 lesions were identified by the combination of CESM and breast MRI. Histopathology confirmed that 81 of 118 lesions were malignant and 37 were benign. Of the 81 malignant lesions, 72 were invasive cancers and 9 were in situ cancers. Sensitivity was 100% with CESM and 93% with breast MRI. Accuracy was 79% with CESM and 73% with breast MRI. ROC curve areas based on BI-RADS were 0.83 for CESM and 0.84 for breast MRI. Lesion size estimates on CESM and breast MRI were similar, both slightly larger than those from histopathology. Our results indicate that CESM has the potential to be a valuable diagnostic method that enables accurate detection of malignant breast lesions, has high negative predictive value, and a false-positive rate similar to that of breast MRI.

  4. Evaluation of patient dose in some mammography centres in Iran

    International Nuclear Information System (INIS)

    Paknyat, A.; Samarin, E. R. P.; Jeshvaghane, N. A.; Paydar, R.; Fasaei, B.; Karamloo, A.; Khosravi, H. R.; Deevband, M. R.

    2011-01-01

    High diagnostic sensitivity and specificity while maintaining the least dose to the patient is the ideal mammography. The objective of this work was to evaluate patient dose and image quality of mammograms to propose corrective actions. The image quality for 1242 patient in 7 mammography facilities in Tehran city was evaluated based on selected image quality criteria using a three-point scale. Clinical image quality, the entrance surface air kerma, the average glandular dose and optical density of films for standard PMMA phantom of 4.5 cm thickness were evaluated. The results showed that up to 72 % of mammograms were in good condition to be diagnosed, and only about 3.4 % of the images were unacceptable or with suboptimal quality. The entrance surface air kerma values were in the range of 3.8-10.5 mGy, average glandular dose 0.5-1.8 mGy and optical density of films 0.74-2.03. The image quality evaluation after correction actions, periodic image quality evaluation and using the correct equipment certainly will improve patient dose. (authors)

  5. Factors associated with breast arterial calcification on mammography

    International Nuclear Information System (INIS)

    Zafar, A.N.; Khan, S.; Zafar, S.N.

    2013-01-01

    Objective: To determine the frequency of breast arterial calcifications (BAC) as seen on mammographic examination and to determine the association between BAC and hypertension, age, parity and weight of the person. Study Design: Cross-sectional analytic study. Place and Duration of Study: Department of Diagnostic Radiology, Military Hospital, Rawalpindi, from January 2006 to January 2007. Methodology: Two hundred patients undergoing mammography were studied to evaluate the association of BAC with raised blood pressure, age and parity. Previous history of lactation and the patients' weight were also recorded. Proportions of classes were compared using chi-square test. Results: 13.5% of the subjects (n = 200) were positive for BAC on mammograms. Mean age of the BAC positive subjects was higher than their counterparts found negative for BAC. Women bearing 5 - 6 children showed the highest frequency of BAC. Seventy seven (10.38%) of the BAC positive cases had previous history of lactation, whereas 15.44% (n = 123) had not breast fed their children and showed BAC. No significant association of presence of BAC was noted with the weight of the subjects. Conclusion: The frequency of presence of BAC on mammography was associated with systemic hypertension and higher age. It also increased with the reproductive parameters of a woman. (author)

  6. Compositional breast imaging using a dual-energy mammography protocol

    International Nuclear Information System (INIS)

    Laidevant, Aurelie D.; Malkov, Serghei; Flowers, Chris I.; Kerlikowske, Karla; Shepherd, John A.

    2010-01-01

    Purpose: Mammography has a low sensitivity in dense breasts due to low contrast between malignant and normal tissue confounded by the predominant water density of the breast. Water is found in both adipose and fibroglandular tissue and constitutes most of the mass of a breast. However, significant protein mass is mainly found in the fibroglandular tissue where most cancers originate. If the protein compartment in a mammogram could be imaged without the influence of water, the sensitivity and specificity of the mammogram may be improved. This article describes a novel approach to dual-energy mammography, full-field digital compositional mammography (FFDCM), which can independently image the three compositional components of breast tissue: water, lipid, and protein. Methods: Dual-energy attenuation and breast shape measures are used together to solve for the three compositional thicknesses. Dual-energy measurements were performed on breast-mimicking phantoms using a full-field digital mammography unit. The phantoms were made of materials shown to have similar x-ray attenuation properties of the compositional compartments. They were made of two main stacks of thicknesses around 2 and 4 cm. Twenty-six thickness and composition combinations were used to derive the compositional calibration using a least-squares fitting approach. Results: Very high accuracy was achieved with a simple cubic fitting function with root mean square errors of 0.023, 0.011, and 0.012 cm for the water, lipid, and protein thicknesses, respectively. The repeatability (percent coefficient of variation) of these measures was tested using sequential images and was found to be 0.5%, 0.5%, and 3.3% for water, lipid, and protein, respectively. However, swapping the location of the two stacks of the phantom on the imaging plate introduced further errors showing the need for more complete system uniformity corrections. Finally, a preliminary breast image is presented of each of the compositional

  7. A study of the response of ionization chambers to mammography beams

    International Nuclear Information System (INIS)

    Kessler, G.; Burns, D.T.; Buermann, L.; Prez, L.A. de

    2007-03-01

    Some simulated mammography radiation beams have been established at the BIPM using a low-energy x-ray tube with a tungsten anode and molybdenum as a filter. The response of two ionization chambers of different types to these beams is compared with that obtained in mammography beams at the PTB and the NMi which were produced with x-ray tubes with molybdenum anodes and molybdenum filters. The relative differences between the chamber responses to these two different types of beams were less than 7 x 10 -3 which implies the uncertainty for the transfer of a calibration from one type of beam to the other. (authors)

  8. Diagnostic imaging of lobular carcinoma of the breast. Mammographic, US and MR findings

    International Nuclear Information System (INIS)

    Bazzocchi, M.; Facecchia, I.; Zuiani, C.; Smania, S.; Puglisi, F.; Di Loreto, C.

    2000-01-01

    Purpose of this article is to evaluate the most frequent mammographic, US and MR findings of invasive lobular carcinoma and the role of MRI in defining multifocality and/or multi centricity of this tumor histotype. 45 lobular carcinomas in 39 patients were studied and selected from 421 breast cancers. Core biopsy with a 14G needle was performed in 39 cases, under US guidance in 36/39 and under mammographic guidance in 3/39 cases. Surgical biopsy was performed in 2 cases and the diagnosis could be made only after mastectomy in 5 cases. All patients were examined with mammography and US and (10-13 MHz) and 8 also with MRI. 28/46 palpable lesions (60.9%). Core biopsy correctly diagnosed 38/39 lesions (97.4%). The most frequent mammographic findings was that of a nodular opacity without microcalcifications (34.8%), followed by a mass with spiculate d borders (30.4%). Microcalcifications were seen in one case only (2.2%). Mammography detected no abnormalities in 15.2% of cases, but US showed a lesion in 2 of these cases. The most frequent US pattern was that of a hypoechoic lesion (43.5%), followed by posterior US beam attenuation. No US signs of abnormality were seen 15.2%. MRI correctly detected 13 lesions. Contrast enhancement was greater than 70% at one minute in 10 cases and greater than 40% in one case; two lesions exhibited atypical slow contrast enhancement, peaking at 5 minutes. MRI detected 5 lesions missed both mammography and US and showed multifocal (3 and 2) lesions where the other techniques had detected one lesion only. At mammography and US invasive lobular carcinoma exhibits no different features than ductal carcinoma but is difficult to identify especially in its early stages. US is a useful tool especially to characterize mammography-detected lesions but in the experience it also demonstrated 2 lesions missed at mammography. MRI is a precious examination to define the multifocal, multi centric or bilateral character of invasive lobular carcinoma

  9. Accuracy of different diagnostic tests for early, delayed and late prosthetic joint infection.

    Science.gov (United States)

    Fernández-Sampedro, M; Fariñas-Alvarez, C; Garces-Zarzalejo, C; Alonso-Aguirre, M A; Salas-Venero, C; Martínez-Martínez, L; Fariñas, M C

    2017-08-25

    A combination of laboratory, histopathological and microbiological tests for diagnosis of prosthetic joint infection (PJI) have been strongly recommended. This study aims to characterize the accuracy of individual or group tests, such as culture of sonicate fluid, synovial fluid and peri-implant tissue, C-reactive protein (CRP) and histopathology for detection of early, delayed and late PJI. A prospective study of patients undergoing hip or knee arthroplasty from February 2009 to February 2014 was performed in a Spanish tertiary health care hospital. The diagnostic accuracy of the different methods was evaluated constructing receiver-operating-characteristic (ROC) curve areas. One hundred thirty consecutive patients were included: 18 (13.8%) early PJI, 35 (27%) delayed PJI and 77 (59.2%) late PJI. For individual parameters, the area under the ROC curve for peri-implant tissue culture was larger for early (0.917) than for delayed (0.829) and late PJI (0.778), p = 0.033. There was a significantly larger difference for ROC area in the synovial fluid culture for delayed (0.803) than for early (0.781) and late infections (0.679), p = 0.039. The comparison of the areas under the ROC curves for the two microbiological tests showed that sonicate fluid was significantly different from peri-implant tissue in delayed (0.951 vs 0.829, p = 0.005) and late PJI (0.901 vs 0.778, p = 0.000). The conjunction of preoperative parameters, synovial fluid culture and CRP, improved the accuracy for late PJI (p = 0.01). The conjunction of histopathology and sonicate fluid culture increased the area under ROC curve of sonication in early (0.917 vs 1.000); p = 0.06 and late cases (0.901 vs 0.999); p < 0.001. For early PJI, sonicate fluid and peri-implant tissue cultures achieve the same best sensitivity. For delayed and late PJI, sonicate fluid culture is the most sensitive individual diagnostic method. By combining histopathology and peri-implant tissue, all early, 97% of

  10. Atlas and toolbook of MR mammography; Lehratlas der MR-Mammographie

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U. [Universitaetsklinikum Goettingen (Germany). Abt. Roentgendiagnostik I; Brinck, U. [Universitaetsklinikum Goettingen (Germany). Abt. Pathologie und Pathologische Anatomie

    2000-07-01

    This richly illustrated toolbook and atlas contains information on all aspects of nmr diagnostic imaging of benign or malignant neoplasms of female and male mammary glands. It offers pinpointed guidance and insight for vocational training and continuing training of radiology assistants, students and medical radiologists. (orig./AJ) [German] Die MRT als hochaufloesendes und schaedigungsfreies Diagnostikum gewinnt gerade in der emotional stark besetzten Mammadiagnostik zunehmend an Bedeutung. Dennoch beherrschen nur wenige Zentren im deutschsprachigen Raum diese Technik, die - eine hohe Reproduzierbarkeit bei fehlender Belastung fuer die Patientin bietet, - invasive Karzinome bereits ab einer Groesse von 5 mm mit hoher Zuverlaessigkeit ausschliessen kann und - gerade bei widerspruechlichen Befunden zwischen klinischer Untersuchung, Roentgenmammographie und perkutaner Biopsie eine wesentliche Entscheidungshilfe bieten kann. Aus einem der fuehrenden Zentren in der MR-Mammographie wurde daher dieser praxisnahe, opulent ausgestattete und weit ueber die reine Bildinformation hinausgehende 'Einstiegs- und Lehratlas' entwickelt. Er bietet Radiologen in Fort- und Weiterbildung, aber auch Gynaekologen mit ueber 400 Abbildungen klare Antworten auf die Fragen. (orig./AJ)

  11. COMPARISON OF CR MAMMOGRAPHY, SONOMAMMOGRAPHY AND REAL-TIME ELASTOGRAPHY IN EVALUATING BREAST LESIONS

    Directory of Open Access Journals (Sweden)

    Onteddu Joji Reddy

    2016-11-01

    Full Text Available BACKGROUND Breast cancer is the most common cause of cancer deaths in women worldwide. As early detection can decrease the deaths due to breast cancer, high sensitive and specific tests are necessary to evaluate breast lesions. MATERIALS AND METHODS 80 patients with complaint of pain or lump in the breast or nipple discharge were evaluated by mammography, sonomammography and real-time elastography. Imaging studies were compared with the FNAC/biopsy of lesions. RESULTS Mammography has sensitivity, specificity, PPV, NPV as 80%, 95.5%, 93.3%, 86%, respectively. Sonomammography has sensitivity, specificity, PPV, NPV as 74.2%, 91%, 86%, 82%, respectively. Real-time elastography has sensitivity, specificity, PPV, NPV as 91.4%, 94.4%, 94.1%, 91.8%, respectively. Combined mammography and sonomammography has sensitivity, specificity, PPV, NPV as 82.8%, 93.3%, 90.6%, 87.5%, respectively. Combined sonomammography and elastography has sensitivity, specificity, PPV, NPV as 91.4%, 97.2%, 96.96%, 92.1%, respectively. CONCLUSIONS Combination of CR mammography, sonomammography and real-time elastography has high diagnostic sensitivity and specificity in the diagnosis of benign and malignant breast masses obviating the use of higher modalities like MRI, CAD and digital tomosynthesis, which is very useful in resource poor countries like India.

  12. Costs, charges, and revenues for hospital diagnostic imaging procedures: differences by modality and hospital characteristics.

    Science.gov (United States)

    Sistrom, Christopher Lee; McKay, Niccie L

    2005-06-01

    This study examined financial data reported by Florida hospitals concerning costs, charges, and revenues related to imaging services. Financial reports to the Florida Hospital Uniform Reporting System by all licensed acute care facilities for fiscal year 2002 were used to calculate four financial indices on a per procedure basis. These included charge, net revenue, operating expense (variable cost), and contribution margin. Analysis, stratified by cost center (imaging modality), tested the effects of bed size, ownership, teaching status, and urban or rural status on the four indices. The mean operating expense and charge per procedure were as follows: computed tomography (CT): $51 and $1565; x-ray and ultrasound: $55 and $410; nuclear medicine (NM): $135 and $1138; and magnetic resonance imaging (MRI): $165 and $2048. With all four modalities, for-profit hospitals had higher charges than not-for-profit and public facilities. Excepting NM, however, the difference by ownership disappeared when considering net revenue. Operating expense did not differ by ownership type or bed size. Operating expense (variable cost) per procedure is considerably lower for CT than for MRI. Consequently, when diagnostically equivalent, CT is preferable to MRI in terms of costs for hospitals. If the cost structure of nonhospital imaging is at all similar to hospitals, the profit potential for performing CT and MRI seems to be substantial, which has relevance to the issue of imaging self-referral.

  13. Film quality in film mammography. Pt. 2

    International Nuclear Information System (INIS)

    Friedrich, M.; Weskamp, P.; Freie Univ. Berlin

    1976-01-01

    During consideration of three film mammographic systems, the concept of signal/noise ratio is developed as a quantitative measure of film quality. The ability to recognise detail related to detail size, film blackening and exposure geometry was studied for various systems, and the quality profiles are discussed. There is a considerable difference in quality between industrial films without screens and film-screen combinations; however, exposure geometry during mammography has a considerable effect which tends to reduce the difference. Consequently, detail sizes of 200 μ to 1,000 μ (including the majority of mammographic micro-calcifications) are shown about equally well. Contrast for the lo-dose system is somewhat less than for adequately exposed industrial film. Over-exposure with the lo-dose system, contrary to industrial film, rapidly leads to unsatisfactory results. On the other hand it is often not possible to obtain an adequate exposure when using industrial film. For these reasons it is often an advantage to examine large breasts and the dense breasts of young women with a film-screen combination which requires approximately one eighth of the dose necessary for industrial film. For small or easily compressable breasts best results are obtained, using an adequate exposure by employing industril film; radiation dose it then acceptable. (orig./ORU) [de

  14. SU-E-I-88: Mammography Imaging: Does Positioning Matter?

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, J; Szabunio, M [University of Kentucky, Lexington, KY (United States)

    2014-06-01

    Purpose: In mammography, compression is imperative for quality images and glandular radiation exposure dose. The thickness of the compressed breast directly determines mammography acquisition parameters. The compressed thickness varies due to variation in technologist practice, even for the same patient imaged at different time. This study is to investigate potential effect of the variation in breast positioning on radiation dose and image quality. Methods: Radiation dose at different thicknesses was measured with a BR-12 breast phantom for both conventional craniocaudal view and tomosynthesis in a Hologic Tomosynthesis mammography system. The CIRS stereotactic needle biopsy training phantom embedded dense masses and microcalcification in various sizes were imaged for image quality evaluation. Radiologists evaluated images. Clinical mammograms from the same patient but acquired at different time were retrospectively retrieved to evaluate potential effects of variation in positioning. Results: Acquisition parameters (kVp and mAs) increase with the increased phantom thickness. Radiation exposure increases following an exponential trend. The stereotactic phantom images showed loss of spatial and contrast resolution with inappropriate positioning. The compressed pressure may not be a good indicator for appropriate positioning. The inclusion of different amount of pectoralis muscle may lead to the same compressed pressure but different compressed thickness. The initial retrospective study of 3 patients showed that there were potential large variations in positioning the same patient at different examination time, resulting in large variations in patient radiation dose and image quality. Conclusion: Variations in patient positioning potentially influence patient radiation dose and image quality. The technologist has the critical responsibility to position patient to provide quality images in spite of different breast and body types. To reduce intra and inter practice

  15. Malignant and benign diseases of the breast in 41 male patients: mammography, sonography and pathological correlations; Maligne und benigne Erkrankungen der Brust bei 41 maennlichen Patienten: Mammographie und Sonographie mit histopathologischer Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Partik, B.; Mallek, R.; Pokieser, P.; Wunderbaldinger, P.; Helbich, T.H. [Vienna Univ. (Austria). Klinik fuer Radiodiagnostik; Rudas, M. [Vienna Univ. (Austria). Inst. fuer Klinische Pathologie

    2001-11-01

    Aim: The goal of our study was to evaluate findings in mammography and sonography in male patients with pathohistologically proven diseases of the breast. Material and Methods: Mammographies and sonographies, which were obtained in 41 male patients in a 6-year period, were retrospectively evaluated in accordance with the BI-RADS trademark classification. Results: Histologically 13 carcinomas, 21 gynecomastias, 3 pseudogynecomastias, 2 epithelial inclusion cysts and 2 other benign lesions were diagnosed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of mammography in differentiation of benign versus malignant disease were 92%, 89%, 80%, 96% and 90%, respectively. Additional sonography did not change these results. However, sonography increased diagnostic confidence in 18.2% (2/11) of suspicious lesions. Conclusion: In our study the invasive ductal carcinoma of male patients was a predominantly lobulated, ill-defined lesion in mammography and sonography. The differentiation of carcinoma to pseudogynecomastia and diffuse or dendritic gynecomastia was securely feasible. However, we could not reliably distinguish between carcinoma and some benign mass lesions. In cases of mammographically diagnosed masses or unclear mammography, additional sonography should be performed to increase the diagnostic confidence. (orig.) [German] Ziel: Die Befunde von Mammographie und Sonographie bei histologisch gesicherten malignen und benignen Mammaerkrankungen maennlicher Patienten zu evaluieren. Material und Methode: Retrospektiv wurden die in einem Zeitraum von 6 Jahren durchgefuehrten Mammographien und Sonographien bei 41 maennlichen Patienten in Anlehnung an die BI-RADS trademark Klassifikation ausgewertet. Resultate: Es wurden 13 Karzinome, 21 Gynaekomastien, 3 Pseudogynaekomastien, 2 Atherome und 2 weitere benigne Laesionen histologisch diagnostiziert. Die Mammographie zeigte in der Differenzierung maligne versus benigne Laesion

  16. Screening mammography interpretation test: more frequent mistakes

    International Nuclear Information System (INIS)

    Gozzi, Gino; Ganzetti, Alessandra; Martinoli, Carlo; Bacigalupo, Lorenzo; Bodini, Maria; Fiorentino, Carla; Marini, Ugo Paolo; Santini, Dolores

    2005-01-01

    Purpose: To present the mammographic cases most commonly misinterpreted by the participants in the mammography self-test proposed by the Italian Society of Medical Radiology (SIRM) National Congress in Rimini, Italy, 2002, by analysing the findings responsible for errors, suggesting reasons for the errors, and assessing possible inadequacies in the format of the test. Materials and methods: The self-test was performed on the mammograms of 160 cases (32 positive and 128 negative for cancer as confirmed by histology). The mammograms had been taken in the four standard projections and placed on four multi-panel diaphanoscopes, each displaying a set of 40 cases comprising benign and malignant cases in equal proportions. The participants were given pre-printed forms on which to note down their diagnostic judgement. We evaluated a total of 134 fully-completed forms. Among these, we identified the 23 cases most frequently misread by over 15 participants in percentages varying between 40-90%. Of these cases, 10 were malignancies and 13 were negative mammograms. On review, we also assessed the diagnostic contribution of complementary investigations (not available the participants). The 134 fully-completed forms (all of the 40 cases) yielded a total of 5360 responses, 1180 of which (22.01%) were incorrect. Of these 823 out of the 4288 cases expected to be negative (19.2%) were false positive, and 357 out of the 1072 cases expected to be positive (33.3%) were false negative. As regards the 23 most frequently misread cases, these were 10/32 (31.25%) mammograms positive for malignancy and 13/128 (10.15%) negative mammograms or mammograms showing benign disease. The 10 malignancies included 7 infiltrating ductal carcinomas, 1 infiltrating cribriform carcinoma, 1 infiltrating tubular carcinoma, and 1 carcinoma in situ. The 13 cases of benign disease - as established by histology or long-term follow-up - mistaken for malignancies by the test participants were fibrocystic breast

  17. Diagnostic accuracy of new imaging techniques in breast diseases

    Energy Technology Data Exchange (ETDEWEB)

    Gordenne, W; Bauduin, E [Liege Univ. (Belgium)

    1989-01-01

    During the last decade, the hypothetical carcinogenic effects of mammography have lead to new technical developments in X-ray diagnosis and to use of other imaging techniques such as ultrasonography (US), transillumination, magnetic resonance imaging (MRI). Many preliminary studies were published but few clinical trials are really convincing. According to the definition of a diagnostic tool, none of these new modalities is supposed to supplant mammography in the diagnosis of breast cancer. Improvements are expected by digital mammography in the near future. (Authors).

  18. Evaluation of patient dose saving in grid-less x-ray mammography acquisition compared with full field digital mammography (FFDMG) acquisition

    DEFF Research Database (Denmark)

    Abdi, Ahmed Jibril; Mussmann, Bo Redder

    2017-01-01

    to investigate the dose saving in grid-less acquisition compared with conventional full-field digital mammography (FFDMG) acquisitions. A Piranha 657 was used to measure the entrance exposure. The entrance exposure was directly measured on different PMMA thicknesses of 20-70mm in steps of 10mm. The PMMA block...

  19. Data on the cost-benefit analysis of mammography

    International Nuclear Information System (INIS)

    Zarand, P.; Pentek, Z.

    1982-01-01

    The radiation exposure and the cost per examination are compared in the case of three methods: non-screen film mammography, 10-dose mammography and xeromammography. 10-dose mammography results in the lowest radiation exposure whereas xeromammography has the lowest cost. (L.E.)

  20. Cost-effective mammography screening in Korea. High incidence of breast cancer in young women

    International Nuclear Information System (INIS)

    Lee, Soon-Young; Jeong, Seong-Hwa; Kim, Youn-Nam; Kim, Jinheum; Kang, Dae-Ryong; Kim, Hyeon-Chang; Nam, Chung-Mo

    2009-01-01

    The epidemiological characteristics of breast cancer in Korean women are different from the characteristics reported in Western women. The highest incidence rate occurs in Korean women in their 40s. The purpose of this study was to determine the most cost-effective screening interval and target age range for Korean women from the perspective of the national healthcare system. A stochastic model was used to simulate breast cancer screenings by varying both the screening intervals and the age ranges. The effectiveness of mammography screening was defined as the probability of detecting breast cancer in the preclinical state and the cost was based on the direct cost of mammography screening and the confirmative tests. The age-specific mean sojourn times and the sensitivity of the mammography were applied in the stochastic model. An optimal cost-effectiveness was determined by the incremental cost-effectiveness ratio and lifetime schedule sensitivity. Sensitivity analyses were undertaken to assess parameter uncertainty. The selected cost-effective strategies were: the current biennial mammography screenings for women who are at least 40 years old; biennial screening for women between the ages of 35 and 75 years; and a combination strategy consisting of biennial screening for women aged between 45 and 54 years, and 3-year interval screening for women aged between 40 and 44 years and 55 and 65 years. Further studies should follow to investigate the effectiveness of mammography screening in women younger than 40 years in Asia as well as in Korea. (author)

  1. A comparison of the performance of modern screen-film and digital mammography systems

    Energy Technology Data Exchange (ETDEWEB)

    Monnin, P [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Gutierrez, D [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Bulling, S [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Lepori, D [Department of Radiology, University Hospital Center (CHUV), CH-1011 Lausanne (Switzerland); Valley, J-F [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Verdun, F R [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland)

    2005-06-07

    This work compares the detector performance and image quality of the new Kodak Min-R EV mammography screen-film system with the Fuji CR Profect detector and with other current mammography screen-film systems from Agfa, Fuji and Kodak. Basic image quality parameters (MTF, NPS, NEQ and DQE) were evaluated for a 28 kV Mo/Mo (HVL = 0.646 mm Al) beam using different mAs exposure settings. Compared with other screen-film systems, the new Kodak Min-R EV detector has the highest contrast and a low intrinsic noise level, giving better NEQ and DQE results, especially at high optical density. Thus, the properties of the new mammography film approach those of a fine mammography detector, especially at low frequency range. Screen-film systems provide the best resolution. The presampling MTF of the digital detector has a value of 15% at the Nyquist frequency and, due to the spread size of the laser beam, the use of a smaller pixel size would not permit a significant improvement of the detector resolution. The dual collection reading technology increases significantly the low frequency DQE of the Fuji CR system that can at present compete with the most efficient mammography screen-film systems.

  2. Diagnostic accuracy of different display types in detection of recurrent caries under restorations by using CBCT.

    Science.gov (United States)

    Baltacıoĝlu, İsmail H; Eren, Hakan; Yavuz, Yasemin; Kamburoğlu, Kıvanç

    To assess the in vitro diagnostic ability of CBCT images using seven different display types in the detection of recurrent caries. Our study comprised 128 extracted human premolar and molar teeth. 8 groups each containing 16 teeth were obtained as follows: (1) Black Class I (Occlusal) amalgam filling without caries; (2) Black Class I (Occlusal) composite filling without caries; (3) Black Class II (Proximal) amalgam filling without caries; (4) Black Class II (Proximal) composite filling without caries; (5) Black Class I (Occlusal) amalgam filling with caries; (6) Black Class I (Occlusal) composite filling with caries; (7) Black Class II (Proximal) amalgam filling with caries; and (8) Black Class II (Proximal) composite filling with caries. Teeth were imaged using 100 × 90 mm field of view at three different voxel sizes of a CBCT unit (Planmeca ProMax(®) 3D ProFace™; Planmeca, Helsinki, Finland). CBCT TIFF images were opened and viewed using custom-designed software for computers on different display types. Intra- and interobserver agreements were calculated. The highest area under the receiver operating characteristic curve (Az) values for each image type, observer, reading and restoration were compared using z-tests against Az = 0.5. The significance level was set at p = 0.05. We found poor and moderate agreements. In general, Az values were found when software and medical diagnostic monitor were utilized. For Observer 2, Az values were statistically significantly higher when software was used on medical monitor [p = 0.036, p = 0.015 and p = 0.002, for normal-resolution mode (0.200 mm(3) voxel size), high-resolution mode (0.150 mm(3) voxel size) and low-resolution mode (0.400 mm(3) voxel size), respectively]. No statistically significant differences were found among other display types for all modes (p > 0.05). In general, no difference was found among 3 different voxel sizes (p > 0.05). In general, higher Az values were

  3. Diagnostic accuracy of different display types in detection of recurrent caries under restorations by using CBCT

    Science.gov (United States)

    Baltacıoĝlu, İsmail H; Eren, Hakan; Yavuz, Yasemin

    2016-01-01

    Objectives: To assess the in vitro diagnostic ability of CBCT images using seven different display types in the detection of recurrent caries. Methods: Our study comprised 128 extracted human premolar and molar teeth. 8 groups each containing 16 teeth were obtained as follows: (1) Black Class I (Occlusal) amalgam filling without caries; (2) Black Class I (Occlusal) composite filling without caries; (3) Black Class II (Proximal) amalgam filling without caries; (4) Black Class II (Proximal) composite filling without caries; (5) Black Class I (Occlusal) amalgam filling with caries; (6) Black Class I (Occlusal) composite filling with caries; (7) Black Class II (Proximal) amalgam filling with caries; and (8) Black Class II (Proximal) composite filling with caries. Teeth were imaged using 100 × 90 mm field of view at three different voxel sizes of a CBCT unit (Planmeca ProMax® 3D ProFace™; Planmeca, Helsinki, Finland). CBCT TIFF images were opened and viewed using custom-designed software for computers on different display types. Intra- and interobserver agreements were calculated. The highest area under the receiver operating characteristic curve (Az) values for each image type, observer, reading and restoration were compared using z-tests against Az = 0.5. The significance level was set at p = 0.05. Results: We found poor and moderate agreements. In general, Az values were found when software and medical diagnostic monitor were utilized. For Observer 2, Az values were statistically significantly higher when software was used on medical monitor [p = 0.036, p = 0.015 and p = 0.002, for normal-resolution mode (0.200 mm3 voxel size), high-resolution mode (0.150 mm3 voxel size) and low-resolution mode (0.400 mm3 voxel size), respectively]. No statistically significant differences were found among other display types for all modes (p > 0.05). In general, no difference was found among 3 different voxel sizes (p > 0.05). In general

  4. The Impact of Different Diagnostic Criteria on the Prevalence of Sarcopenia in Healthy Elderly Participants and Geriatric Outpatients

    NARCIS (Netherlands)

    Reijnierse, E.M.; Trappenburg, M.C.; Leter, M.J.; Blauw, G. J.; Sipila, S.; Sillanpaa, E.; Narici, M.V.; Hogrel, J.Y.; Butler-Browne, G.; McPhee, J.S.; Gapeyeva, H.; Paasuke, M.; van Bokhorst-de van der Schueren, M.A.E.; Meskers, C.G.M.; Maier, A.B.

    2015-01-01

    Background: A consensus on the diagnostic criteria for sarcopenia, a common syndrome in the elderly, has not been reached yet. Prevalence rates vary between studies due to the use of different criteria encompassing different measures, correction factors and cutoff points. Objective: This study

  5. Baseline Screening Mammography: Performance of Full-Field Digital Mammography Versus Digital Breast Tomosynthesis.

    Science.gov (United States)

    McDonald, Elizabeth S; McCarthy, Anne Marie; Akhtar, Amana L; Synnestvedt, Marie B; Schnall, Mitchell; Conant, Emily F

    2015-11-01

    Baseline mammography studies have significantly higher recall rates than mammography studies with available comparison examinations. Digital breast tomosynthesis reduces recalls when compared with digital mammographic screening alone, but many sites operate in a hybrid environment. To maximize the effect of screening digital breast tomosynthesis with limited resources, choosing which patient populations will benefit most is critical. This study evaluates digital breast tomosynthesis in the baseline screening population. Outcomes were compared for 10,728 women who underwent digital mammography screening, including 1204 (11.2%) baseline studies, and 15,571 women who underwent digital breast tomosynthesis screening, including 1859 (11.9%) baseline studies. Recall rates, cancer detection rates, and positive predictive values were calculated. Logistic regression estimated the odds ratios of recall for digital mammography versus digital breast tomosynthesis for patients undergoing baseline screening and previously screened patients, adjusted for age, race, and breast density. In the baseline subgroup, recall rates for digital mammography and digital breast tomosynthesis screening were 20.5% and 16.0%, respectively (p = 0.002); digital breast tomosynthesis screening in the baseline subgroup resulted in a 22% reduction in recall compared with digital mammography, or 45 fewer patients recalled per 1000 patients screened. Digital breast tomosynthesis screening in the previously screened patients resulted in recall reduction of 14.3% (p tomosynthesis than from digital mammography alone.

  6. Doses in mammography. Preliminary study

    International Nuclear Information System (INIS)

    Marquez P, F.; Acosta R, N.; Universidad Nacional Mayor de San Marcos, Lima; Benavente, T.; Universidad Nacional Mayor de San Marcos, Lima; Poma, M.

    2002-01-01

    Mammography is the most important method to detect lesions in the breast with this technique one can detect small tumours before clear clinical symptoms appear. Mammographic image of require high quality standards due that the extremely low contrast between the normal and pathological areas in the breast, eg.g., they have similar attenuation and absorption coefficient. The x-ray mammographic systems, used in this study are Senographe 500t and Senographe DMR, a detector with a RadCal ionization chambers calibrated to the qualities of mammographic x-ray beams, and a breast simulator that is a phantoms of polymethylmethacrylate (PMMA) of several thicknesses with the equivalence of 50% of the glandular tissue. The results obtained indicate that the values of doses at the entrance surface of a breast (DES) are greater the reference value 20 mGy to 5,0 cm of PMMA and the values of the mean glandular dose (MGD) exceed the reference value of 2,1 mGy for 5,1 cm of compressed thick breast. We consider that the values high of the EDS and MGD are due that the x-ray systems no meeting in good condition or for used of x-ray spectra no suitable, so is recommendable be carried out test of quality control to the x-ray systems and also realize studies, or characterize the of x-ray mammographic spectra

  7. Prevalence of sarcopenia in elderly maintenance hemodialysis patients: the impact of different diagnostic criteria.

    Science.gov (United States)

    Lamarca, F; Carrero, J J; Rodrigues, J C D; Bigogno, F G; Fetter, R L; Avesani, C M

    2014-07-01

    The prevalence of sarcopenia on elderly maintenance hemodialysis (MHD) has been scarcely investigated. To investigate the prevalence of decreased muscle mass and strength alone or combined (true sarcopenia) in elderly patients on MHD according to different methods and cutoff limits. Additionally, we evaluated the agreement between dual energy x-ray absorptiometry (DXA) and surrogate methods for the assessment of muscle mass. Observational and cross-sectional study. Non-institutionalized 102 elderly (age > 60 years) patients on MHD. Sarcopenia was considered when the patient fit one criteria for low muscle mass assessed by DXA, bioelectrical impedance (BIA), sum of skinfold thicknesses (SKF), calf circumference and mid-arm muscle circumference (MAMC) and one for low muscle strength evaluated by handgrip dynamometer. Decreased muscle strength was found in 85% of the patients. The prevalence of decreased muscle mass varied from 4 to 73.5% and of sarcopenia (decreased muscle mass and strength combined) from 4 to 63%, depending on the method and cutoff limit applied. A small percentage of patients (2 to 15%) were classified as sarcopenic by more than one diagnostic criteria. The agreement between DXA and the surrogate methods to assess muscle mass showed better kappa coefficients with BIA (r=0.36; Psarcopenia is observed depending on the method and cutoff limit applied. This may limit extrapolate on to clinical practice. BIA and SKF were the surrogate methods to assess muscle mass with the best concordance with DXA in elderly MHD patients.

  8. Different letter-processing strategies in diagnostic subgroups of developmental dyslexia.

    Science.gov (United States)

    Lachmann, Thomas; van Leeuwen, Cees

    2008-07-01

    Normally reading adults (N = 15) and primary school children (N = 24) and two diagnostic subgroups of children with developmental dyslexia (N = 21)-all native German speakers-performed a successive same-different task with pairs of letters and nonletters (pseudoletters or geometrical shapes). The first item of a pair was always presented on its own, and the second either on its own or surrounded by a congruent or incongruent nontarget shape. Adults showed congruence effects with nonletters but not with letters, and children with both types of stimuli. Frequent-word reading-impaired dyslexics (N = 11) in addition showed dramatically slower overall reaction times. Nonword reading-impaired dyslexics (N = 10) showed congruence effects with nonletters but negative congruence effects with letters. The results support the notion that normal readers have established a special visual processing strategy for letters. Processing speed rather than reading expertise seems crucial for this strategy to emerge. The contrasting effects between subgroups of dyslexics reveal specific underlying deficits.

  9. MR first pass perfusion of benign and malignant cardiac tumours - significant differences and diagnostic accuracy

    International Nuclear Information System (INIS)

    Bauner, K.U.; Picciolo, M.; Theisen, D.; Sandner, T.A.; Reiser, M.F.; Huber, A.M.; Sourbron, S.; Schmitz, C.

    2012-01-01

    To determine the diagnostic value of magnetic resonance (MR) first pass perfusion in the differentiation of benign and malignant cardiac tumours. 24 patients with cardiac tumours (11 malignant, histopathological correlation present in all cases) were examined using MRI. In addition to morphological sequences a saturation-recovery T1w-GRE technique was implemented for tumour perfusion. The maximum relative signal enhancement (RSE[%]) and the slope of the RSE t -curve (slopeRSE[%/s]) of tumour tissue were assessed. A t-test was used to identify significant differences between benign and malignant tumours. Sensitivities and specificities were calculated for detection of malignant lesions and were compared with the sensitivity and specificity based on solely morphological image assessment. The RSE and slopeRSE of malignant cardiac tumours were significantly higher compared with benign lesions (p < 0.001 and p < 0.001). The calculated sensitivities and specificities of RSE and slopeRSE for identification of malignant lesions were 100% and 84.6% and 100% and 92.3%, respectively with cut-off values of 80% and 6%/s. The sensitivity and specificity for identification of malignant lesions on the basis of morphological imaging alone were 90.9% and 69.2%. With first pass perfusion, malignant cardiac masses can be identified with higher sensitivity and specificity compared with morphological image assessment alone. (orig.)

  10. Characterization of radiation qualities used in diagnostic X-ray

    International Nuclear Information System (INIS)

    Bero, M.; Zahili, M.; Al Ahmad, M.

    2013-12-01

    This study aims to adjust the radiation beams emitted from X-ray tubes installed at the National Radiation Metrology Laboratory in the field of diagnostic radiology (radiology and mammography) according to the IAEA protocol code number TRS 457, the second goal of this study is to establish various radiation qualities used fordiagnostic radiology applications: RQR, RQA and RQT and the radiation qualities related to mammography applications: RQA-M and RQR-M (author).

  11. Dose reduction through gridless technique in digital full-field mammography

    International Nuclear Information System (INIS)

    Diekmann, F.; Diekmann, S.; Berzeg, S.; Blick, U.; Fischer, T.; Hamm, B.

    2003-01-01

    Purpose: To determine the role of the scatter grid in digital full-field mammography with respect to image quality and dose and to compare the experimental results with initial clinical experience. Materials and Methods: A phantom consisting of 205 fields that enclose gold dots of different thickness and size (CD-Mam phantom, Medical Department, Nijmegen, Netherlands) was used for digital full-field mammography with the conventional grid module and a special gridless module. Four different breast thicknesses were simulated using Plexiglas as scatter material. First, the phantom was exposed at the parameter and dose settings automatically selected in each experimental setup (with and without grid). Subsequently, the phantom was exposed at the different simulated breast thicknesses using the gridless module in combination with the parameters automatically selected for the grid module. This was followed by a series of phantom mammograms obtained with the experimental setup reversed. The 16 mammograms were evaluated by 3 readers and the results compared considering breast thickness, radiation dose, and quality. The gridless module was used for preoperative labeling in 16 patients for comparison of mammograms obtained with and without a grid. Results: For the same entrance dose used in routine mammography, digital mammography without grid is superior to digital mammography with grid when performed on simulated thin breasts (Plexiglas less than 3 cm), with no difference found when performed on simulated large breasts. The advantages of gridless mammography are more pronounced at a markedly reduced entrance dose (identical parenchymal dose without and with grid using the dose automatically selected for the gridless module). This tendency is confirmed by the initial clinical comparison. (orig.) [de

  12. The clinical value of bilateral breast MR imaging: is it worth performing on patients showing suspicious microcalcifications on mammography?

    Energy Technology Data Exchange (ETDEWEB)

    Akita, Ayano; Tanimoto, Akihiro; Kuribayashi, Sachio [Keio University, Department of Diagnostic Radiology, School of Medicine, Tokyo (Japan); Jinno, Hiromitsu [Keio University, Department of Surgery, School of Medicine, Tokyo (Japan); Kameyama, Kaori [Keio University, Division of Diagnostic Pathology, School of Medicine, Tokyo (Japan)

    2009-09-15

    The purpose of this study was to evaluate the clinical value of bilateral breast magnetic resonance (MR) imaging (MRI) in patients showing suspicious microcalcifications on mammography and negative ultrasound findings. Fifty patients underwent MRI before stereotactic vacuum-assisted breast biopsy (SVAB). MR findings were classified into five types for interpretation, and types 4 and 5 were considered malignant. SVAB revealed 13 carcinomas and 37 benign lesions. Malignant lesions were more frequently found in cases of positive MRI diagnoses than in negative MRI diagnoses (P < 0.001). Mammography had a sensitivity of 100%, a specificity of 24% and an accuracy of 44%, whereas mammography plus MRI had a sensitivity of 85%, a specificity of 100% and an accuracy of 96%. In the evaluation of mammographically detected microcalcifications, bilateral breast MRI is of good diagnostic value and may alter the indications for SVAB. (orig.)

  13. Semiconductor pixel detectors for digital mammography

    International Nuclear Information System (INIS)

    Novelli, M.; Amendolia, S.R.; Bisogni, M.G.; Boscardin, M.; Dalla Betta, G.F.; Delogu, P.; Fantacci, M.E.; Quattrocchi, M.; Rosso, V.; Stefanini, A.; Venturelli, L.; Zucca, S.

    2003-01-01

    We present some results obtained with silicon and gallium arsenide pixel detectors to be applied in the field of digital mammography. Even though GaAs is suitable for medical imaging applications thanks to its atomic number, which allows a very good detection efficiency, it often contains an high concentrations of traps which decrease the charge collection efficiency (CCE). So we have analysed both electrical and spectroscopic performance of different SI GaAs diodes as a function of concentrations of dopants in the substrate, in order to find a material by which we can obtain a CCE allowing the detection of all the photons that interact in the detector. Nevertheless to be able to detect low contrast details, efficiency and CCE are not the only parameters to be optimized; also the stability of the detection system is fundamental. In the past we have worked with Si pixel detectors; even if its atomic number does not allow a good detection efficiency at standard thickness, it has a very high stability. So keeping in mind the need to increase the Silicon detection efficiency we performed simulations to study the behaviour of the electrical potential in order to find a geometry to avoid the risk of electrical breakdown

  14. Semiconductor pixel detectors for digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Novelli, M. E-mail: marzia.novelli@pi.infn.it; Amendolia, S.R.; Bisogni, M.G.; Boscardin, M.; Dalla Betta, G.F.; Delogu, P.; Fantacci, M.E.; Quattrocchi, M.; Rosso, V.; Stefanini, A.; Venturelli, L.; Zucca, S

    2003-08-21

    We present some results obtained with silicon and gallium arsenide pixel detectors to be applied in the field of digital mammography. Even though GaAs is suitable for medical imaging applications thanks to its atomic number, which allows a very good detection efficiency, it often contains an high concentrations of traps which decrease the charge collection efficiency (CCE). So we have analysed both electrical and spectroscopic performance of different SI GaAs diodes as a function of concentrations of dopants in the substrate, in order to find a material by which we can obtain a CCE allowing the detection of all the photons that interact in the detector. Nevertheless to be able to detect low contrast details, efficiency and CCE are not the only parameters to be optimized; also the stability of the detection system is fundamental. In the past we have worked with Si pixel detectors; even if its atomic number does not allow a good detection efficiency at standard thickness, it has a very high stability. So keeping in mind the need to increase the Silicon detection efficiency we performed simulations to study the behaviour of the electrical potential in order to find a geometry to avoid the risk of electrical breakdown.

  15. Quality assurance and quality control in mammography: A review

    International Nuclear Information System (INIS)

    BenComo, Jose A.

    2000-01-01

    A mammogram is among the most technically demanding radiographic procedures. The early detection of breast cancer relies on the radiologist's ability to perceive subtle changes in the image that are only perceptible with high-quality imaging. Early detection of breast cancer is only as reliable as the mammogram with which a diagnosis is made, and a mammogram is only as accurate as the system that produces it. A quality assurance (QA) program maximizes the likelihood that the mammographic images will provide adequate diagnostic information for the least possible radiation exposure and cost to the patient. The QA program monitors each phase of operation of the imaging facility beginning with the request for an examination and ending with the interpretation of the referring physician and ensures that the imaging equipment used for the examination will yield the information desired. Because image quality is the most important technical aspect of mammography, this review summarizes the most important QA and quality control issues

  16. Macromolecular contrast agents for MR mammography: current status

    International Nuclear Information System (INIS)

    Daldrup-Link, Heike E.; Brasch, Robert C.

    2003-01-01

    Macromolecular contrast media (MMCM) encompass a new class of diagnostic drugs that can be applied with dynamic MRI to extract both physiologic and morphologic information in breast lesions. Kinetic analysis of dynamic MMCM-enhanced MR data in breast tumor patients provides useful estimates of tumor blood volume and microvascular permeability, typically increased in cancer. These tumor characteristics can be applied to differentiate benign from malignant lesions, to define the angiogenesis status of cancers, and to monitor tumor response to therapy. The most immediate challenge to the development of MMCM-enhanced mammography is the identification of those candidate compounds that demonstrate the requisite long intravascular distribution and have the high tolerance necessary for clinical use. Potential mammographic applications and limitations of various MMCM, defined by either experimental animal testing or clinical testing in patients, are reviewed in this article. (orig.)

  17. Comparison of Different Matrices as Potential Quality Control Samples for Neurochemical Dementia Diagnostics

    NARCIS (Netherlands)

    Lelental, Natalia; Brandner, Sebastian; Kofanova, Olga; Blennow, Kaj; Zetterberg, Henrik; Andreasson, Ulf; Engelborghs, Sebastiaan; Mroczko, Barbara; Gabryelewicz, Tomasz; Teunissen, Charlotte; Mollenhauer, Brit; Parnetti, Lucilla; Chiasserini, Davide; Molinuevo, Jose Luis; Perret-Liaudet, Armand; Verbeek, Marcel M.; Andreasen, Niels; Brosseron, Frederic; Bahl, Justyna M. C.; Herukka, Sanna-Kaisa; Hausner, Lucrezia; Froelich, Lutz; Labonte, Anne; Poirier, Judes; Miller, Anne-Marie; Zilka, Norbert; Kovacech, Branislav; Urbani, Andrea; Suardi, Silvia; Oliveira, Catarina; Baldeiras, Ines; Dubois, Bruno; Rot, Uros; Lehmann, Sylvain; Skinningsrud, Anders; Betsou, Fay; Wiltfang, Jens; Gkatzima, Olymbia; Winblad, Bengt; Buchfelder, Michael; Kornhuber, Johannes; Lewczuk, Piotr

    2016-01-01

    Background: Assay-vendor independent quality control (QC) samples for neurochemical dementia diagnostics (NDD) biomarkers are so far commercially unavailable. This requires that NDD laboratories prepare their own QC samples, for example by pooling leftover cerebrospinal fluid (CSF) samples.

  18. Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning.

    Science.gov (United States)

    Gabriel, Adel; Violato, Claudio

    2013-01-01

    The purpose of this study was to examine and compare diagnostic success and its relationship with the diagnostic reasoning process between novices and experts in psychiatry. Nine volunteers, comprising five expert psychiatrists and four clinical clerks, completed a think-aloud protocol while attempting to make a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of a selected case with both Axis I and Axis III diagnoses. Expert psychiatrists made significantly more successful diagnoses for both the primary psychiatric and medical diagnoses than clinical clerks. Expert psychiatrists also gave fewer differential options. Analyzing the think-aloud protocols, expert psychiatrists were much more organized, made fewer mistakes, and utilized significantly less time to access their knowledge than clinical clerks. Both novices and experts seemed to use the hypothetic-deductive and scheme-inductive approaches to diagnosis. However, experts utilized hypothetic-deductive approaches significantly more often than novices. The hypothetic-deductive diagnostic strategy was utilized more than the scheme-inductive approach by both expert psychiatrists and clinical clerks. However, a specific relationship between diagnostic reasoning and diagnostic success could not be identified in this small pilot study. The author recommends a larger study that would include a detailed analysis of the think-aloud protocols.

  19. Establish radiation protection programme for diagnostic radiology

    International Nuclear Information System (INIS)

    Mboya, G.

    2014-01-01

    Mammography is an effective method used for breast diagnostics and screening. The aim of this project is to review the literature on how to establish radiation protection programme for mammography in order to protect the patients, the occupationally exposed workers and the members of the public from harmful effects of ionizing radiation. It reviews some of the trends in mammography doses and dosimetric principles such as average glandular dose in the glandular tissue which is used for description of radiation risk, also the factors affecting patient doses are discussed. However, the average glandular dose should not be used directly to estimate the radiation risk from mammography. Risk is calculated under certain assumptions from determined entrance surface air kerma. Given the increase in population dose, emphasis is placed on the justification and optimization of the mammographic procedures. Protection is optimized by the radiation dose being appropriate with the purpose of the mammographic examination. The need to establish diagnostic reference levels as an optimization is also discussed. In order to obtain high quality mammograms at low dose to the breast, it is necessary to use the correct equipment and perform periodic quality control tests on mammography equipment. It is noted that in order to achieve the goal of this project, the application of radiation protection should begin at the time of requesting for mammography examination, positioning of the patient, irradiation, image processing and interpretation of mammogram. It is recommended that close cooperation between radiology technologists, radiologist, medical physicists, regulatory authority and other support workers be required and established to obtain a consistent and effective level of radiation protection in a mammography facility. (author)

  20. Analysis of mammography on breast fibroadenoma

    International Nuclear Information System (INIS)

    Fu Xiaomin; Han Benyi; Zhao Yae

    2009-01-01

    Objective: To study the imaging characteristics of breast fibroadenoma on mammograms. Methods: Mammography of 70 patients with breast fibroadenoma confirmed by pathology were analyzed retrospectively. All patients took breast X-ray of mediolateral oblique projection and craniocaudal projection before operation. Results: In 70 cases with fibroadenoma, mammography revealed 74 foci (36 left breast, 38 right breast) of 62 cases, and failed to reveal lesions in 8 cases. The shape of the lesions was round or round-like lesion in 60(31%). The border was well-defined in 46 masses, partly well-outlined in 14 and ill-defined in 4. 'Membranoid sign' can be seen in 40 cases. Conclusion: Typical X-ray findings of breast fibroadenoma is very important, mammography is a good method of choice in diagnosis of fibroadenoma. (authors)

  1. Anxiety in mammography: mammographers' and clients' perspectives

    International Nuclear Information System (INIS)

    Galletta, S.; Joel, N.; Maguire, R.; Weaver, K.; Poulos, A.

    2003-01-01

    The aim of this study was to identify causes of anxiety experienced by mammographers and clients during mammography and strategies to decrease the anxiety generated by the mammographic procedure. Two questionnaires were distributed: one to mammographers in public and private centres within NSW, the other to women (clients) who have experienced mammography. Mammographers' and clients' rankings of causes of clients' anxiety demonstrated many similarities indicating the mammographers' acknowledgement of factors contributing to client anxiety. Thematic analysis provided important qualitative data concerning anxiety experienced by both mammographers and clients and the influence of mammographer and client behaviour on that anxiety. The results of this study have provided important new knowledge for mammographic practice and mammography education. By understanding the causes of anxiety experienced by clients, mammographers can provide an informed, empathetic approach to the mammographic process. By acknowledging factors which increase their own anxiety mammographers can reduce the impact of this on themselves and on their clients. Copyright (2003) Australian Institute of Radiography

  2. Contrast-enhanced spectral mammography based on a photon-counting detector: quantitative accuracy and radiation dose

    Science.gov (United States)

    Lee, Seungwan; Kang, Sooncheol; Eom, Jisoo

    2017-03-01

    Contrast-enhanced mammography has been used to demonstrate functional information about a breast tumor by injecting contrast agents. However, a conventional technique with a single exposure degrades the efficiency of tumor detection due to structure overlapping. Dual-energy techniques with energy-integrating detectors (EIDs) also cause an increase of radiation dose and an inaccuracy of material decomposition due to the limitations of EIDs. On the other hands, spectral mammography with photon-counting detectors (PCDs) is able to resolve the issues induced by the conventional technique and EIDs using their energy-discrimination capabilities. In this study, the contrast-enhanced spectral mammography based on a PCD was implemented by using a polychromatic dual-energy model, and the proposed technique was compared with the dual-energy technique with an EID in terms of quantitative accuracy and radiation dose. The results showed that the proposed technique improved the quantitative accuracy as well as reduced radiation dose comparing to the dual-energy technique with an EID. The quantitative accuracy of the contrast-enhanced spectral mammography based on a PCD was slightly improved as a function of radiation dose. Therefore, the contrast-enhanced spectral mammography based on a PCD is able to provide useful information for detecting breast tumors and improving diagnostic accuracy.

  3. Organisational aspects of mammography screening in digital settings: First experiences of Luxembourg

    International Nuclear Information System (INIS)

    Shannoun, F.; Schanck, J. M.; Scharpantgen, A.; Wagnon, M. C.; Ben Daoud, M.; Back, C.

    2008-01-01

    Luxembourg has been conducting a breast cancer screening programme since 1992, like a large number of other European countries, as early detection and treatment of breast cancer have been proven to reduce mortality. The majority of these screening programmes are based on analogue X-ray technology and have optimised their organisation of transporting, archiving and reading with respect to films. Last decade is marked by enormous developments in digital mammography. Different technologies such as flat panel-, computed radiography- and scanning systems became available. Digital mammography is expected to have a major impact on quality and organisation of breast cancer screening programmes. Screening programmes are now faced with a huge challenge of incorporating the digital technology, including implementation of electronic image exchange, conception of new electronic work-flow, establishing adapted quality assurance programmes and training of radiologists and technical personnel. Initial experiences of the Luxembourg approach in organising digital mammography screening and its quality assurance are reported. (authors)

  4. Comparing sensitivity and specificity of screening mammography in the United States and Denmark

    DEFF Research Database (Denmark)

    Kemp Jacobsen, Katja; O'Meara, Ellen S; Key, Dustin

    2015-01-01

    Delivery of screening mammography differs substantially between the United States (US) and Denmark. We evaluated whether there are differences in screening sensitivity and specificity. We included screens from women screened at age 50-69 y