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)

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

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

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.

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)

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.

Glandular dose and image quality control in mammography facilities with computerized radiography systems

International Nuclear Information System (INIS)

Dantas, Marcelino Vicente de Almeida

2010-01-01

Breast cancer is the most common cancer among women, and early detection is critical to its diagnosis and treatment. To date, the most effective method for early detection of breast cancer has been x-ray mammography for which the screen/film (SF) technique has been the gold standard. However, even though SF combinations have been improved and optimized over the years for breast imaging, there are some critical limitations, including a narrow exposure range, image artifacts, film processing problems, and inflexibility in image processing and film management. In recent years, digital mammography has been introduced in cancer screening programmes with the screen/film techniques gradually being phased out. Computed radiography (CR), also commonly known as photostimulable phosphor (PSP) imaging or storage phosphor, employs reusable imaging plates and associated hardware and software to acquire and to display digital projection radiographs. In this work, a protocol model was tested for performing image quality control and average glandular dose (AGD) evaluation in 19 institutions with computed radiography systems for mammography. The protocol was validated through tests at the Laboratorio de Radioprotecao Aplicada a Mamografia (LARAM) from the Centro de Desenvolvimento da Tecnologia Nuclear (CDTN). The image quality visual evaluation of CDMAM phantom showed that 53% of the facilities were able to produce images of excellent quality. Furthermore, the automated evaluation of image quality, using the analyze software cdcom.exe, showed that 57% of the images were considered to be of good quality. The detector linearity test showed that the CR response is very linear, where 95% of facilities evaluated were considered to be compliant. For the image noise was found that only 20% of facilities are in agreement with the parameters established for this test. The average glandular doses, which patients may be getting to perform an examination, were below the action levels

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)

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.)

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.

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.

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

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

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

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.

Radiation doses and some aspects of image quality in mammography facilities in New Zealand

International Nuclear Information System (INIS)

Williamson, B.D.P.; Poletti, J.L.

1990-02-01

Until recently, mammography in New Zealand was performed largely with adapted conventional x-ray machines with tungsten anode x-ray tubes. Over the last several years these have virtually all been replaced by dedicated mammography machines with molybdenum anode x-ray tubes. To assess current trends in radiation doses to patients and central aspects of image quality, some 37 mammography x-ray machines were surveyed during 1988-89. The mean glandular dose per film for 30 and 45 mm thick breast-equivalent phantoms was determined using thermoluminescent dosimetry. Imagings of simulated microcalcifications (specks) and a contrast-detail phantom were assessed. Accuracy of calibration of the x-ray machines and quality of film processing were also tested. Details of the survey results are given. Mean glandular tissue doses per cranio-caudal films were generally well within the recommended guidelines. Mammography facilities differed in their ability to delete simulated calcification specks. Mammographic equipment was found to be generally well adjusted. Speed and contrast of film processing were found to vary widely implying that this is a major cause of the variations in dose and image quality. An annex outlines a quality assurance programme for maintenance of optimal physical image quality and control of radiation doses. 55 refs., 21 tabs., 17 figs., 2 ills

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

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.

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

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.

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

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.)

Drywall plates evaluation as protection barriers in dental X-rays and mammography facilities

International Nuclear Information System (INIS)

Guevara R, V. Y.; Romero C, N.; Berrocal T, M.

2014-08-01

In the dental X-rays and mammography facilities, usually lead shielded walls as protective barriers are used. Lead is a good attenuator for X-rays, but has toxic properties and its cost is high. Mammography equipment s emit low-energy photons in the range of 25 keV to 35 keV, on current computers; the primary radiation beam is intercepted by the image receptor. Peri apical dental equipment s emit photons in the range of 50 to 90 keV, their filtration is fixed. These devices emit a collimated beam whose diameter is slightly larger than the diagonal dimension of a standard film of dental X-rays. When a dental x-ray is performed, the radiation beam is partially attenuated by the patient. Drywall is a material consisting of plasterboard between two cardboard layers, being its components gypsum and cellulose generally. It is used in construction for execution of interior walls, ceilings and wall coverings, could also serve as a replacement for lead as well as other materials. In this paper three drywall prototypes (Giplac), formed with 02, 04 and 06 drywall layers (13, 16 and 20 cm of thickness respectively) were tested as barriers against primary and secondary X-ray radiation that come from dental and mammography equipment s. The results show that the drywall prototype, 02 layers, efficiently attenuates the secondary radiation beam produced by conventional mammography equipment. And the prototype 04 and 06 layers, efficiently attenuates the primary radiation beam produced by peri apical dental equipment. (author)

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.

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

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.

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)

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

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.

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

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.

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.

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

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.

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

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.)

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.)

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

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)

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)

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

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.)

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.)

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.

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)

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...

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.)

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

Radiation protection program for early detection of breast cancer in a mammography facility

Science.gov (United States)

Villagomez Casimiro, Mariana; Ruiz Trejo, Cesar; Espejo Fonseca, Ruby

2014-11-01

Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1-4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systems (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (radiation protection program in this work is applied.

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.

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

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)

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.

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

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.)

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

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

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

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)

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.

In-service diagnostics of pumping facilities

International Nuclear Information System (INIS)

Jaros, I.

1987-01-01

The potential is discussed of technical diagnostics in increasing operating reliability of pumping facilities of conventional and nuclear power plants, and in rationalizing the system of their maintenance. Attention is focused on the selection of diagnostic parameters in which the so-called subjective expert methodology is applied, and on the diagnostic system design. At this stage, the construction of the respective facility and the analysis of the failure rate of its individual assemblies should be considered. The selection of diagnostic means directly depends on the selection of diagnostic parameters and is conditional on other factors, such as availability, cost, technical service, and operator's training. Briefly characterized are Czechoslovak standards assessing the mechanical condition of rotary machines from the measurement of the effective value of the rate of their oscillations. (Z.M.)

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

The evaluation of the performance of the automatic exposure control system of some selected mammography facilities in the Greater Accra Region, Ghana

International Nuclear Information System (INIS)

Amesimenu, R.

2013-07-01

Mammography aids in the early detection of breast cancer. X-rays has an associated risk of inducing cancer though very useful and as such mammography procedures should be optimized through the appropriate processes such as the selection of exposure factors for an optimum image and minimal dose to patients. The automatic exposure control (AEC) aids in the selection of exposure factors thus controlling the amount of radiation to the breast and automatically compensates for differences in the breast thickness and density. The performance of the automatic exposure control system of mammography equipment and the status of quality management systems including quality assurance and quality controls of four (4) mammography facilities within the Greater Accra Region were assessed. In assessing the performance of the automatic exposure control system, the short term reproducibility test, thickness and voltage compensation test were carried out using breast equivalent phantom of various thicknesses. Half value layer test, film reject analysis and patient dose assessment were also performed. Analysis of the responses of the questionnaire administered to radiographers and supervisors of the selected facilities revealed that three (3) of the facilities have some aspect of quality management system programme in place but not effectively implemented. Measured optical densities from the various tests performed to evaluate the performance of the automatic exposure control systems revealed that the AEC compensates for the different phantom thickness and tube voltage (KV) by producing comparable optical densities for the various phantom thickness and tube voltages. Some of the measured optical densities were within the recommended optical density range of 1.5 OD - 1.9 OD. The highest optical density value was 0.13 OD above the highest limit of 1.9 OD. The film reject analysis showed that patient motion accounted for the large part (28%) of film rejects. Other factors such as too light

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

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

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.

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)

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

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.)

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.

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)

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.

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)

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.

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.

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.

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

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...

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.)

Calibration procedures for mammography dosemeters in Poland

International Nuclear Information System (INIS)

Gwiazdowska, B.; Ulkowski, P.; Tolwinski, J.; Bulski, W.

2002-01-01

Breast cancer is the most frequent tumour in women and the effectiveness of the treatment depends dramatically on the early detection of the disease. That is the reason why in Poland the mammography control examinations are strongly supported by the Centre of Oncology. In Poland there are over 400 mammography units which account for about 300,000 examinations per year. An investigation performed by the Medical Physics Department of the Centre of Oncology in Warsaw at about 100 mammography facilities proved that in most cases the doses absorbed by the patients could be reduced without decrease of image quality. This is one of the reasons why the Polish Secondary Standard Dosimetry Laboratory (SSDL) dealing mainly with calibration of radiotherapy dosemeters is extending its activities and therefore new facilities and equipment adapted for calibration of mammographic dosemeters have been installed. The mammography dosimetry calibration equipment is permanently installed in the same laboratory room where the radiotherapy dosemeters are calibrated. A base of a mammography unit no longer in clinical use, together with its movable system has been adapted to handle ionization chamber holders. An X-ray tube with a 50 kV high frequency generator was also installed. The tube, a Varian type OEG-50-2, (designed for laboratory applications) with molybdenum anode of an anode angle 23,7 deg. and with a large focus, effective size approximately 5 mm 2 , has an inherent filtration of 0,25 mm beryllium. It is installed in a housing with 2mm lead shielding; a cone shaped beam is formed by a system of three collimators

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

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.

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

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.

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.

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.

Constancy check of beam quality in conventional diagnostic X-ray equipment

International Nuclear Information System (INIS)

Costa, Alessandro M.; Badin, Romulo S.; Leite, Marina S.; Caldas, Linda V.E.

2008-01-01

A tandem ionization chamber was developed for quality control programs of X-ray equipment used in conventional radiography and mammography. A methodology for the use of the tandem chamber in the constancy check of diagnostic X-ray beam qualities was established. The application at a medical X-ray imaging facility of this established methodology is presented. The use of the tandem chamber in the constancy check of diagnostic X-ray beam qualities is a useful method to control the performance of the X-ray equipment

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)

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.

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

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.

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

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

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.

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

[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.

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).

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.

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

Radiation protection program for early detection of breast cancer in a mammography facility

International Nuclear Information System (INIS)

Mariana, Villagomez Casimiro; Cesar, Ruiz Trejo; Ruby, Espejo Fonseca

2014-01-01

Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1–4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systems (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (<3 mGy per projection). The image quality test showed that most images (70%)– presented artifacts. A brief summary of the results of quality control tests applied to the equipment and film processor are presented. To maintain an adequate level of quality and safety at FUCAM-AC is necessary that the proposed radiation protection program in this work is applied

Radiation protection program for early detection of breast cancer in a mammography facility

Energy Technology Data Exchange (ETDEWEB)

Mariana, Villagomez Casimiro, E-mail: marjim10-66@ciencias.unam.mx, E-mail: cesar@fisica.unam.mx; Cesar, Ruiz Trejo, E-mail: marjim10-66@ciencias.unam.mx, E-mail: cesar@fisica.unam.mx [Instituto de Física, UNAM. Cd. Universitaria, CP 04510 (Mexico); Ruby, Espejo Fonseca [Instituto de Enfermedades de la Mama FUCAM-AC, CP 04980 (Mexico)

2014-11-07

Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1–4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systems (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (<3 mGy per projection). The image quality test showed that most images (70%)– presented artifacts. A brief summary of the results of quality control tests applied to the equipment and film processor are presented. To maintain an adequate level of quality and safety at FUCAM-AC is necessary that the proposed radiation protection program in this work is applied.

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.

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.

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.

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.

The personal costs and convenience of screening mammography.

Science.gov (United States)

Suter, Lisa Gale; Nakano, Connie Y; Elmore, Joann G

2002-09-01

Few studies have examined the impact of women's personal costs on obtaining a screening mammogram in the United States. All women obtaining screening mammograms at nine Connecticut mammography facilities during a 2-week study period were asked to complete a questionnaire. Facilities included urban and rural fixed sites and mobile sites. The survey included questions about insurance coverage, mammogram payment, and personal costs in terms of transportation, family care, parking, and lost work time from the women's perspective. The response rate was 62% (731 of 1189). Thirty-two percent of respondents incurred some type of personal cost, including lost work time, family care, and parking. Women incurring personal costs were more likely than those without personal costs to attend an urban facility (46% vs. 23%, p convenience and 17% listed cost as a reason for choosing a mammography facility; 23% reported that cost might prevent them from obtaining a future mammogram. One third of women obtaining mammograms may be incurring personal costs. These personal costs should be considered in future cost-effectiveness analyses.

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.

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

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.

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. 

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.

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...

Target diagnostic system for the National Ignition Facility (NIF)

International Nuclear Information System (INIS)

Leeper, R.J.; Chandler, G.A.; Cooper, G.W.; Derzon, M.S.

1996-01-01

A review of recent progress on the design of a diagnostic system proposed for ignition target experiments on the National Ignition Facility (NIF) will be presented. This diagnostic package contains an extensive suite of optical, x-ray, gamma-ray, and neutron diagnostics that enable measurements of the performance of both direct and indirect driven NIF targets. The philosophy used in designing all of the diagnostics in the set has emphasized redundant and independent measurement of fundamental physical quantities relevant to the operation of the NIF target. A unique feature of these diagnostics is that they are being designed to be capable of operating, in the high radiation, EMP, and debris backgrounds expected on the NIF facility. The diagnostic system proposed can be categorized into three broad areas: laser characterization, hohlraum characterization, and capsule performance diagnostics. The operating principles of a representative instrument from each class of diagnostic employed in this package will be summarized and illustrated with data obtained in recent prototype diagnostic tests

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.

Accuracy of CESM versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation

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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

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.)

Object characterization simulator for estimating compressed breast during mammography

International Nuclear Information System (INIS)

Pinheiro, Luciana de J.S.; Rio, Margarita Chevalier del

2011-01-01

The measurement of the thickness of a compressed breast during the mammography test is necessary in order to calculate the glandular dose in mammography procedures, in an analysis of risk/benefit, given that the target organ in these procedures is highly sensitive to ionising radiation. However, mammography is a test of utmost importance in diagnosis. In theory, it may be possible to calculate the thickness of the compressed breast through the measurements of the focus object distance by using projections of radio opaque objects fixed to the compression tray. The facilities of the Laboratory of Applied Radioprotection to Mammography - LARAM were used for this study, as well as breast simulators with well defined thickness, in the assembly of the techniques for the measurement of the thickness of the compressed breast. The results showed that it is possible to determine this thickness through calculations and simulators through this method which is susceptible to be adequate to the dosimetry. (author)

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

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.

Forge: a short pulse x-ray diagnostic development facility

International Nuclear Information System (INIS)

Stradling, G.L.; Hurry, T.R.; Denbow, E.R.; Selph, M.M.; Ameduri, F.P.

1985-01-01

A new short pulse x-ray calibration facility has been brought on line at Los Alamos. This facility is being used for the development, testing and calibration of fast x-ray diagnostic systems. The x-ray source consists of a moderate size, sub-nanosecond laser focused at high intensity on an appropriate target material to generate short pulses of x-ray emission from the resulting plasma. Dynamic performance parameters of fast x-ray diagnostic instruments, such as x-ray streak cameras, can be conveniently measured using this facility

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

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

[Diagnostic imaging of breast cancer : An update].

Science.gov (United States)

Funke, M

2016-10-01

Advances in imaging of the female breast have substantially influenced the diagnosis and probably also the therapy and prognosis of breast cancer in the past few years. This article gives an overview of the most important imaging modalities in the diagnosis of breast cancer. Digital mammography is considered to be the gold standard for the early detection of breast cancer. Digital breast tomosynthesis can increase the diagnostic accuracy of mammography and is used for the assessment of equivocal or suspicious mammography findings. Other modalities, such as ultrasound and contrast-enhanced magnetic resonance imaging (MRI) play an important role in the diagnostics, staging and follow-up of breast cancer. Percutaneous needle biopsy is a rapid and minimally invasive method for the histological verification of breast cancer. New breast imaging modalities, such as contrast-enhanced spectral mammography, diffusion-weighted MRI and MR spectroscopy can possibly further improve breast cancer diagnostics; however, further studies are necessary to prove the advantages of these methods so that they cannot yet be recommended for routine clinical use.

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)

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.)

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

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

MR mammography (MRM)

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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.

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

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

Assessment of Mammography Experiences and Satisfaction among American Indian/Alaska Native Women

Science.gov (United States)

Ndikum-Moffor, Florence M.; Braiuca, Stacy; Daley, Christine Makosky; Gajewski, Byron J.; Engelman, Kimberly K.

2013-01-01

BACKGROUND American Indian/Alaska Native (AI/AN) women have lower breast cancer (BCA) screening and 5-year survival rates than non-Hispanic Whites. Understanding reasons for low screening rates is important to combat later stage diagnoses. The purpose of this study was to assess mammography experiences and satisfaction among AI/AN women. METHODS Nine focus groups were held with rural (N=15) and urban (N=38) AI/AN women 40 years and older in Kansas and Kansas City, Missouri, living both near and far from Indian Health Service (IHS) and tribal facilities, to examine experiences and satisfaction with mammography. Transcripts were coded and themes identified using a community-based participatory research approach. FINDINGS Themes were classified under knowledge, communication, and awareness of breast cancer, barriers to mammography, mammogram facility size, impressions of mammogram technologist, motivations to getting a mammogram, and how to improve the mammogram experience. Participants had knowledge of prevention, but described cultural reasons for not discussing it and described better experiences in smaller facilities. Participants indicated having a mammogram technologist who was friendly, knowledgeable, respectful, competent, and explained the test was a determining factor in satisfaction. Other factors included family history, physician recommendation, and financial incentives. Barriers included transportation, cost, perceptions of prejudice, and time constraints. Participants on reservations or near IHS facilities preferred IHS over mainstream providers. Suggestions for improvement included caring technologists, better machines with less discomfort, and education. CONCLUSIONS Interventions to enhance the professionalism, empathy, and cultural awareness of mammogram technologists, reduce barriers, and provide positive expectations and incentives could improve satisfaction and compliance with screening mammography. PMID:24183414

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.

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.

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

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)

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.)

Nike Facility Diagnostics and Data Acquisition System

Science.gov (United States)

Chan, Yung; Aglitskiy, Yefim; Karasik, Max; Kehne, David; Obenschain, Steve; Oh, Jaechul; Serlin, Victor; Weaver, Jim

2013-10-01

The Nike laser-target facility is a 56-beam krypton fluoride system that can deliver 2 to 3 kJ of laser energy at 248 nm onto targets inside a two meter diameter vacuum chamber. Nike is used to study physics and technology issues related to laser direct-drive ICF fusion, including hydrodynamic and laser-plasma instabilities, material behavior at extreme pressures, and optical and x-ray diagnostics for laser-heated targets. A suite of laser and target diagnostics are fielded on the Nike facility, including high-speed, high-resolution x-ray and visible imaging cameras, spectrometers and photo-detectors. A centrally-controlled, distributed computerized data acquisition system provides robust data management and near real-time analysis feedback capability during target shots. Work supported by DOE/NNSA.

Glandular dose and image quality control in mammography facilities with computerized radiography systems; Dose glandular e controle de qualidade da imagem em servicos de mamografia com sistema de radiografia computadorizada

Energy Technology Data Exchange (ETDEWEB)

Dantas, Marcelino Vicente de Almeida

2010-07-01

Breast cancer is the most common cancer among women, and early detection is critical to its diagnosis and treatment. To date, the most effective method for early detection of breast cancer has been x-ray mammography for which the screen/film (SF) technique has been the gold standard. However, even though SF combinations have been improved and optimized over the years for breast imaging, there are some critical limitations, including a narrow exposure range, image artifacts, film processing problems, and inflexibility in image processing and film management. In recent years, digital mammography has been introduced in cancer screening programmes with the screen/film techniques gradually being phased out. Computed radiography (CR), also commonly known as photostimulable phosphor (PSP) imaging or storage phosphor, employs reusable imaging plates and associated hardware and software to acquire and to display digital projection radiographs. In this work, a protocol model was tested for performing image quality control and average glandular dose (AGD) evaluation in 19 institutions with computed radiography systems for mammography. The protocol was validated through tests at the Laboratorio de Radioprotecao Aplicada a Mamografia (LARAM) from the Centro de Desenvolvimento da Tecnologia Nuclear (CDTN). The image quality visual evaluation of CDMAM phantom showed that 53% of the facilities were able to produce images of excellent quality. Furthermore, the automated evaluation of image quality, using the analyze software cdcom.exe, showed that 57% of the images were considered to be of good quality. The detector linearity test showed that the CR response is very linear, where 95% of facilities evaluated were considered to be compliant. For the image noise was found that only 20% of facilities are in agreement with the parameters established for this test. The average glandular doses, which patients may be getting to perform an examination, were below the action levels

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.

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

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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

Travel Times for Screening Mammography: Impact of Geographic Expansion by a Large Academic Health System.

Science.gov (United States)

Rosenkrantz, Andrew B; Liang, Yu; Duszak, Richard; Recht, Michael P

2017-09-01

This study aims to assess the impact of off-campus facility expansion by a large academic health system on patient travel times for screening mammography. Screening mammograms performed from 2013 to 2015 and associated patient demographics were identified using the NYU Langone Medical Center Enterprise Data Warehouse. During this time, the system's number of mammography facilities increased from 6 to 19, reflecting expansion beyond Manhattan throughout the New York metropolitan region. Geocoding software was used to estimate driving times from patients' homes to imaging facilities. For 147,566 screening mammograms, the mean estimated patient travel time was 19.9 ± 15.2 minutes. With facility expansion, travel times declined significantly (P travel times between such subgroups. However, travel times to pre-expansion facilities remained stable (initial: 26.8 ± 18.9 minutes, final: 26.7 ± 18.6 minutes). Among women undergoing mammography before and after expansion, travel times were shorter for the postexpansion mammogram in only 6.3%, but this rate varied significantly (all P travel burden and reduce travel time variation among sociodemographic populations. Nonetheless, existing patients strongly tend to return to established facilities despite potentially shorter travel time locations, suggesting strong site loyalty. Variation in travel times likely relates to various factors other than facility proximity. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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.

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

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.

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

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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.

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

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

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.)

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

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

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.

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

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

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.

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.

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

International Nuclear Information System (INIS)

1994-01-01

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-12-31

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs.

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)

ICF in the U.S.: Facilities and diagnostics

International Nuclear Information System (INIS)

Coleman, L.W.

1988-08-01

In the last few years there has been significant progress in ICF research in laboratories in the United States and elsewhere. These advances have occurred in areas that range from demonstrating an innovative laser beam smoothing techniques important for both directly and indirectly driven ICF, to achieving a more complete understanding of capsule implosions and related physics. This progress has been possible because of the capabilities provided by the ICF laser-target facilities currently in operation and the new developments in diagnostics, particularly for measurements of the implosion process and the conditions in the compressed capsule core. Both of these topics, facilities and selected new diagnostics capabilities in the US ICF Program, are summarized in this paper. 32 refs., 19 figs., 6 tabs

The usefulness of mammography and scintimammography in differential diagnosis of breast tumor

International Nuclear Information System (INIS)

Kang, Bong Joo; Chung, Young An; Jung, Hyun Seok; Jung, Jung Im; Yoo, Ie Ryung; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo; Hahn, Seong Tai; Lee, Jae Mun

2004-01-01

lt is very important to differentiate breast cancer from benign mass. There are many reports to evaluate the differential diagnosis under the several diagnostic tools. We evaluated the usefulness of mammography and Tc-99m MIBI scintimammography in the differential diagnosis of breast mass and correlated with pathologic findings. This study included 80 patients (age: 24-72, mean: 48.4) who underwent mammography and Tc-99m MlBI scintimammography for breast masses. Scintimammographies (anterior-posterior and lateral projections) were acquired in 10 minutes and 2 hours after intravenous injection of Tc-99m MlBl. Four specialists in diagnostic radiology and nuclear medicine evaluated the findings of breast masses under the mammography and Tc-99m MIBI scintimammography, and calculated the tumor to background (T/B) ratio. The pathologic results were obtained and we statistically analyzed the correlations between pathologic results and imaging findings under the mammography and Tc-99m MIBI scintimammography by chi-square and correlation test. The sensitivity, specificity, positive predictive value, and negative predictive value of mammography for detection of breast cancer were 87.5%, 56.3%, 75.0%, and 75.0% respectively. 45 cases of 80 patients were suspicious for breast cancer under the Tc-99m MIBI scintimammography. 41 cases of 45 patients were confirmed as breast cancer and the remaining 4 cases were confirmed as benign masses. The sensitivity, specificity, positive predictive value and negative predictive value of Tc-99m MIBI scintimammography for detection of breast cancer were 85.4%, 87.5%, 91.1%, and 80.8% respectively. The sensitivity of scintimammography was lower than that of mammography for detection of breast cancer, however the specificity, positive predictive value, and negative predictive value were higher. In the benign mass, the mean T/B ratio in 10 minutes was 1.409±0.30, and that in 2 hours was 1.267±0.42. The maximal T/B ratio of benign mass in 10

3-T breast magnetic resonance imaging in patients with suspicious microcalcifications on mammography

Energy Technology Data Exchange (ETDEWEB)

Stehouwer, B.L.; Merckel, L.G.; Verkooijen, H.M.; Peters, N.H.G.M.; Mali, W.P.T.M.; Veldhuis, W.B.; Bosch, M.A.A.J. van den [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Mann, R.M. [University Medical Center St Radboud, Departement of Radiology, Nijmegen (Netherlands); Duvivier, K.M. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Peeters, P.H.M. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands)

2014-03-15

To investigate the diagnostic value of 3-Tesla (T) breast MRI in patients presenting with microcalcifications on mammography. Between January 2006 and May 2009, 123 patients with mammographically detected BI-RADS 3-5 microcalcifications underwent 3-T breast MRI before undergoing breast biopsy. All MRIs of the histopathologically confirmed index lesions were reviewed by two breast radiologists. The detection rate of invasive carcinoma and ductal carcinoma in situ (DCIS) was evaluated, as well as the added diagnostic value of MRI over mammography and breast ultrasound. At pathology, 40/123 (33 %) lesions proved malignant; 28 (70 %) DCIS and 12 (30 %) invasive carcinoma. Both observers detected all invasive malignancies at MRI, as well as 79 % (observer 1) and 86 % (observer 2) of in situ lesions. MRI in addition to conventional imaging led to a significant increase in area under the receiver operating characteristic (ROC) curve from 0.67 (95 % CI 0.56-0.79) to 0.79 (95 % CI 0.70-0.88, observer 1) and to 0.80 (95 % CI 0.71-0.89, observer 2), respectively. 3-T breast MRI was shown to add significant value to conventional imaging in patients presenting with suspicious microcalcifications on mammography. (orig.)

Mammary carcinoma diagnostics and therapy; Diagnostik und Therapie des Mammakarzinoms

Energy Technology Data Exchange (ETDEWEB)

Fischer, Uwe; Baum, Friedemann (eds.) [Diagnostisches Brustzentrum Goettingen BZG, Goettingen(Germany)

2014-11-01

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.

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.

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)

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

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

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....

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.

Value of breast MRI as supplement to mammography and sonography for high risk breast cancer patients; Wertigkeit der Mamma-MRT als Ergaenzung zu Mammographie und Sonographie bei Patientinnen mit erhoehtem Mammakarzinomrisiko

Energy Technology Data Exchange (ETDEWEB)

Schlossbauer, T.; Hellerhoff, K.; Reiser, M. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany)

2008-04-15

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.) [German] Ziele der Arbeit sind die inhaltliche Einfuehrung in das Thema Frueherkennung des Mammakarzinoms bei Patientinnen mit erhoehtem Risiko und eine systematische Analyse der Wertigkeit von MRT und anderen bildgebenden Verfahren in diesem Zusammenhang. Es wurde eine systematische Literaturrecherche ueber die letzten 3 Jahre durchgefuehrt. Dabei wurden Vergleichsstudien der verschiedenen bildgebenden Verfahren in der Mammadiagnostik beruecksichtigt, bei denen die bildgesteuerte Biopsie als Goldstandard angegeben wurde. Von allen bildgebenden Verfahren zeigt die Mamma-MRT bei Patientinnen mit familiaerem Risiko die hoechste Sensitivitaet und diagnostische Genauigkeit bei der Detektion des Mammakarzinoms. Fuer MRT, Mammographie und Sonographie werden Sensitivitaeten zwischen 71 und 100%, 0 und 78% sowie 13 und 65% angegeben. Die Mamma-MRT ist ein etabliertes Verfahren zum Screening von Risikopatientinnen. Uebereinstimmend wird der diagnostische Nutzen der Mamma-MRT als ergaenzendes Verfahren zu Mammographie

Diagnostic development and support of MHD test facilities

Energy Technology Data Exchange (ETDEWEB)

1990-01-01

The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for MHD power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL's computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs. 25 figs., 6 tabs.

Diagnostic development and support of MHD test facilities

International Nuclear Information System (INIS)

Shepard, W.S.; Cook, R.L.

1990-01-01

The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for MHD power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/ Seed Recovery support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL's computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs

Investigation of breast dose in five screening mammography centres in Greece

International Nuclear Information System (INIS)

Tsapaki, V; Tsalafoutas, I A; Poga, V; Louizi, A; Kottou, S; Koulentianos, E

2008-01-01

The objectives of this study were to investigate the techniques currently used for screening mammography in Greece, to estimate the mean glandular dose (MGD) for establishing a baseline radiation dose database, to analyse the effects of various factors on MGD, and to compare the results with others in the literature. Five mammographic facilities and 250 women having as a routine screening mammogram one craniocaudal (CC) and one mediolateral oblique (MLO) projection in each breast were included in the study. The parameters recorded were age, weight, compressed breast thickness (CBT), tube potential (kV), tube loading (mA s) and MLO projection angle. Large differences were observed among the different mammography facilities, mainly in terms of the tube potential setting and the MLO angle used. The average MGD per exposure was 1.4 ± 0.6 mGy while the respective averages separately for the CC and MLO projections were 1.2 ± 0.5 and 1.5 ± 0.7 mGy, respectively. The average MGD values recorded in this study were below the limit of 2 mGy established for the reference medium-sized breast of 4.5 cm CBT. However, the variety of techniques observed revealed the need for a nationwide survey concerning screening mammography in Greece

Investigation of breast dose in five screening mammography centres in Greece

Energy Technology Data Exchange (ETDEWEB)

Tsapaki, V [Medical Physics Department, Konstantopoulio Hospital, Nea Ionia, 142 33, Athens (Greece); Tsalafoutas, I A [Medical Physics Department, Agios Savvas Hospital, 171 Alexandras Avenue, 115 22, Athens (Greece); Poga, V; Louizi, A; Kottou, S [Medical Physics Department, Medical School, Athens University, University of Athens, 75 Mikras Asias, 115 27, Athens (Greece); Koulentianos, E [Radiology Department, Konstantopoulio Hospital, Nea Ionia, 142 33, Athens (Greece)

2008-09-01

The objectives of this study were to investigate the techniques currently used for screening mammography in Greece, to estimate the mean glandular dose (MGD) for establishing a baseline radiation dose database, to analyse the effects of various factors on MGD, and to compare the results with others in the literature. Five mammographic facilities and 250 women having as a routine screening mammogram one craniocaudal (CC) and one mediolateral oblique (MLO) projection in each breast were included in the study. The parameters recorded were age, weight, compressed breast thickness (CBT), tube potential (kV), tube loading (mA s) and MLO projection angle. Large differences were observed among the different mammography facilities, mainly in terms of the tube potential setting and the MLO angle used. The average MGD per exposure was 1.4 {+-} 0.6 mGy while the respective averages separately for the CC and MLO projections were 1.2 {+-} 0.5 and 1.5 {+-} 0.7 mGy, respectively. The average MGD values recorded in this study were below the limit of 2 mGy established for the reference medium-sized breast of 4.5 cm CBT. However, the variety of techniques observed revealed the need for a nationwide survey concerning screening mammography in Greece.

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.

Assessment of radiological protection systems among diagnostic radiology facilities in North East India.

Science.gov (United States)

Singh, Thokchom Dewan; Jayaraman, T; Arunkumar Sharma, B

2017-03-01

This study aims to assess the adequacy level of radiological protection systems available in the diagnostic radiology facilities located in three capital cities of North East (NE) India. It further attempts to understand, using a multi-disciplinary approach, how the safety codes/standards in diagnostic radiology framed by the Atomic Energy Regulatory Board (AERB) and the International Atomic Energy Agency (IAEA) to achieve adequate radiological protection in facilities, have been perceived, conceptualized, and applied accordingly in these facilities. About 30 diagnostic radiology facilities were randomly selected from three capitals of states in NE India; namely Imphal (Manipur), Shillong (Meghalaya) and Guwahati (Assam). A semi-structured questionnaire developed based on a multi-disciplinary approach was used for this study. It was observed that radiological practices undertaken in these facilities were not exactly in line with safety codes/standards in diagnostic radiology of the AERB and the IAEA. About 50% of the facilities had registered/licensed x-ray equipment with the AERB. More than 80% of the workers did not use radiation protective devices, although these devices were available in the facilities. About 85% of facilities had no institutional risk management system. About 70% of the facilities did not carry out periodic quality assurance testing of their x-ray equipment or surveys of radiation leakage around the x-ray room, and did not display radiation safety indicators in the x-ray rooms. Workers in these facilities exhibited low risk perception about the risks associated with these practices. The majority of diagnostic radiology facilities in NE India did not comply with the radiological safety codes/standards framed by the AERB and IAEA. The study found inadequate levels of radiological protection systems in the majority of facilities. This study suggests a need to establish firm measures that comply with the radiological safety codes/standards of the

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

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

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.)

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.)

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

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.

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

Beam Diagnostics Systems for the National Ignition Facility

International Nuclear Information System (INIS)

Demaret, R D; Boyd, R D; Bliss, E S; Gates, A J; Severyn, J R

2001-01-01

The National Ignition Facility (NIF) laser focuses 1.8 megajoules of ultraviolet light (wavelength 351 nanometers) from 192 beams into a 600-micrometer-diameter volume. Effective use of this output in target experiments requires that the power output from all of the beams match within 8% over their entire 20-nanosecond waveform. The scope of NIF beam diagnostics systems necessary to accomplish this task is unprecedented for laser facilities. Each beamline contains 110 major optical components distributed over a 510-meter path, and diagnostic tolerances for beam measurement are demanding. Total laser pulse energy is measured with 2.8% precision, and the interbeam temporal variation of pulse power is measured with 4% precision. These measurement goals are achieved through use of approximately 160 sensor packages that measure the energy at five locations and power at three locations along each beamline using 335 photodiodes, 215 calorimeters, and 36 digitizers. Successful operation of such a system requires a high level of automation of the widely distributed sensors. Computer control systems provide the basis for operating the shot diagnostics with repeatable accuracy, assisted by operators who oversee system activities and setup, respond to performance exceptions, and complete calibration and maintenance tasks

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)

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).

How effective is mammography in detecting breast cancer recurrence in women after Breast Conservation Therapy (BCT) – A systematic literature review

International Nuclear Information System (INIS)

Curran, J.

2016-01-01

Breast Conservation Therapy (BCT) is now seen as the treatment of choice for early-stage breast cancer, leading to a rising demand for post-operative surveillance. Ongoing mammographic surveillance of the post-operative breast is necessary to minimise the morbidity risk from recurrence. This review evaluates the diagnostic value of mammography following BCT, and identifies the possible challenges with mammography regarding imaging, interpretation and test performance when investigating the treated breast. Relevant literature was reviewed and critically analysed. Three studies reported that surveillance mammography provided a significant survival advantage through early detection of recurrence. Five studies recognised the diagnostic challenges of surveillance mammography following BCT, reporting reduced sensitivity after breast surgery. The need for a more tailored screening strategy after treatment for breast cancer was highlighted in four studies. Although overall mammographic sensitivity is reduced after BCT, it is still proven to be effective in detecting recurrences, therefore remains an important surveillance tool. - Highlights: • Mammographic surveillance – survival advantage. • Sensitivity reduced post-surgery. • Tailored strategy needed.

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.

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.

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.

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)

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.

MO-AB-207-04: ACR Update in Mammography

International Nuclear Information System (INIS)

Berns, E.

2015-01-01

A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program

MO-AB-207-04: ACR Update in Mammography

Energy Technology Data Exchange (ETDEWEB)

Berns, E. [University of Colorado Health Science (United States)

2015-06-15

A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.

Position paper: recommendations for a digital mammography quality assurance program V4.0.

Science.gov (United States)

Heggie, J C P; Barnes, P; Cartwright, L; Diffey, J; Tse, J; Herley, J; McLean, I D; Thomson, F J; Grewal, R K; Collins, L T

2017-09-01

been addressed. Some additional testing for conventional projection imaging has been added in order that sites may have the capability to undertake dose surveys to confirm compliance with diagnostic reference levels (DRLs) that may be established at the National or State level. A key recommendation is that dosimetry calculations are now to be undertaken using the methodology of Dance et al. Some minor changes to existing facility QC tests have been made to ensure the suggested procedures align with those most recently adopted by the Royal Australian and New Zealand College of Radiologists and BreastScreen Australia. Future updates of this document may be provided as deemed necessary in electronic format on the ACPSEM's website ( https://www.acpsem.org.au/whatacpsemdoes/standards-position-papers and see also http://www.ranzcr.edu.au/quality-a-safety/radiology/practice-quality-activities/mqap ).

Exploratory survey of image quality on CR digital mammography imaging systems in Mexico

International Nuclear Information System (INIS)

Gaona, E.; Rivera, T.; Arreola, M.; Franco, J.; Molina, N.; Alvarez, B.; Azorín, C.G.; Casian, G.

2014-01-01

The purpose of this study was to assess the current status of image quality and dose in computed radiographic digital mammography (CRDM) systems. Studies included CRDM systems of various models and manufacturers which dose and image quality comparisons were performed. Due to the recent rise in the use of digital radiographic systems in Mexico, CRDM systems are rapidly replacing conventional film-screen systems without any regard to quality control or image quality standards. Study was conducted in 65 mammography facilities which use CRDM systems in the Mexico City and surrounding States. The systems were tested as used clinically. This means that the dose and beam qualities were selected using the automatic beam selection and photo-timed features. All systems surveyed generate laser film hardcopies for the radiologist to read on a scope or mammographic high luminance light box. It was found that 51 of CRDM systems presented a variety of image artefacts and non-uniformities arising from inadequate acquisition and processing, as well as from the laser printer itself. Undisciplined alteration of image processing settings by the technologist was found to be a serious prevalent problem in 42 facilities. Only four of them showed an image QC program which is periodically monitored by a medical physicist. The Average Glandular Dose (AGD) in the surveyed systems was estimated to have a mean value of 2.4 mGy. To improve image quality in mammography and make more efficient screening mammographic in early detection of breast cancer is required new legislation. - Highlights: • Radiation dose in CR digital mammography (CRDM) systems was determined. • Image quality related with dose in CR digital mammography (CRDM) systems was analysed. • Image processing artefacts were observed and correlated with dose. • Measured entrance dose by TL phosphors could be good parameter for radiation protection optimization in patient

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

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

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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.

Added Value of Contrast-Enhanced Spectral Mammography in Postscreening Assessment.

Science.gov (United States)

Tardivel, Anne-Marie; Balleyguier, Corinne; Dunant, Ariane; Delaloge, Suzette; Mazouni, Chafika; Mathieu, Marie-Christine; Dromain, Clarisse

2016-09-01

To assess the value on diagnostic and treatment management of contrast-enhanced spectral mammography (CESM), as adjunct to mammography (MG) and ultrasound (US) in postscreening in a breast cancer unit for patients with newly diagnosed breast cancer or with suspicious findings on conventional imaging. Retrospective review of routine use of bilateral CESM performed between September 2012 and September 2013 in 195 women with suspicious or undetermined findings on MG and/or US. CESM images were blindly reviewed by two radiologists for BI-RADS(®) assessment and probability of malignancy. Each lesion was definitely confirmed either with histopathology or follow-up. Two hundred and ninety-nine lesions were detected (221 malignant). CESM sensitivity, specificity, positive-predictive value and negative-predictive value were 94% (CI: 89-96%), 74% (CI: 63-83%), 91% (CI: 86-94%) and 81% (CI: 70-89%), respectively, with 18 false positive and 14 false negative. CESM changed diagnostic and treatment strategy in 41 (21%) patients either after detection of additional malignant lesions in 38 patients (19%)-with a more extensive surgery (n = 21) or neo-adjuvant chemotherapy (n = 1)-or avoiding further biopsy for 20 patients with negative CESM. CESM can be performed easily in a clinical assessment after positive breast cancer screening and may change significantly the diagnostic and treatment strategy through breast cancer staging. © 2016 Wiley Periodicals, Inc.

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.)

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.

The influence of travel time on breast cancer characteristics, receipt of primary therapy, and surveillance mammography.

Science.gov (United States)

Onega, Tracy; Cook, Andrea; Kirlin, Beth; Shi, Xun; Alford-Teaster, Jennifer; Tuzzio, Leah; Buist, Diana S M

2011-08-01

Travel time has been shown to influence some aspects of cancer characteristics at diagnosis and care for women with breast cancer, but important gaps remain in our understanding of its impact. We examined the influence of travel time to the nearest radiology facility on breast cancer characteristics, treatment, and surveillance for women with early-stage invasive breast cancer. We included 1,012 women with invasive breast cancer (stages I and II) who had access to care within an integrated health care delivery system in western Washington State. The travel times to the nearest radiology facility were calculated for all the U.S. Census blocks within the study area and assigned to women based on residence at diagnosis. We collected cancer characteristics, primary and adjuvant therapies, and surveillance mammography for at least 2.5 years post diagnosis and used multivariable analyses to test the associations of travel time. The majority of women (68.6%) lived within 20 min of the nearest radiology facility, had stage I disease (72.7%), received breast conserving therapy (68.7%), and had annual surveillance mammography the first 2 years after treatment (73.7%). The travel time was not significantly associated with the stage or surveillance mammography after adjusting for covariates. Primary therapy was significantly related to travel time, with greater travel time (>30 min vs. ≤ 10 min) associated with a higher likelihood of mastectomy compared to breast conserving surgery (RR = 1.53; 95% CI, 1.16-2.01). The travel time was not associated with the stage at diagnosis or surveillance mammography receipt. The travel time does seem to influence the type of primary therapy among women with breast cancer, suggesting that women may prefer low frequency services, such as mastectomy, if geographic access to a radiology facility is limited.

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

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

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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

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)

Primary ureteral carcinoma: MRI diagnosis and comparison with other diagnostic imaging facilities

International Nuclear Information System (INIS)

An Ningyu; Jiang Bo; Cai Youquan; Liang Yan

2004-01-01

Objective: To investigate MRI examination methods and imaging manifestations of primary ureteral carcinoma, and to evaluate its clinical values when comparing with other diagnostic imaging facilities. Methods: Eighty-seven cases of primary ureteral carcinoma who were operated within recent 8 years came into the study, among which, 35 cases had MRI examinations. For MRI examination, coronal heavy T 2 WI (water imaging) was performed to show the dilated ureter, then axial T 2 WI and T 1 WI were scanned at the obstruction level. 11 cases underwent additional Gd-DTPA dynamic contrast enhanced scans. The original pre-operative diagnostic reports of various imaging facilities were analyzed comparing with the results of operation and pathology. Results: MRI showed ureteral dilatation in 33 of 35 cases, no abnormal appearance in 1 case, and only primary kidney atrophy post renal transplantation in 1 case. Among the 33 cases with ureteral obstruction, soft mass at the obstruction level was detected on axial scans in 32 cases. The lesions showed gradual and homogeneous mild to moderate enhancement on contrast MRI. The overall employment rate of imaging facilities was as follows: ultrasound (94.3%), IVU (59.8%), CT (52.9%), MRI (40.2%), and RUP (35.6%). The accurate diagnostic rate was as follows :MRI (91.4%), RUP (80.6%), CT (63.0%), ultrasound (47.6%), and IVU (11.5%). Conclusion: Combination of MR water imaging and conventional sequences can demonstrate most primary ureteral carcinoma lesions and has a highest diagnostic accuracy among the current diagnostic imaging facilities. It should be taken as the first diagnostic imaging method of choice when primary ureteral carcinoma is suspected after ultrasound screening

Quality control, mean glandular dose estimate and room shielding calculation in mammography

International Nuclear Information System (INIS)

Rakotomalala, H.M.

2014-01-01

This study focuses in the importance of Radiation Protection in mammography. A good control of the radiological risk depends on the dose optimization, room shielding calculation and the quality of equipment. The work was carried out in the three private medical centers called A, B, and C. Dosimetry estimates were made on the equipment of the three centers. Values has been compared with the Diagnostic Reference Levels established by the International Atomic Energy Agency (IAEA). Conformity control of the radiological devices has also been done with the Mammographic Quality Control Kit of the INSTN-Madagascar. Verifications of shields of the room containing the mammography equipment were done by theoretical calculations using the method provided by NCRP 147. [fr

Barriers to Mammography Screening: How to Overcome Them

Directory of Open Access Journals (Sweden)

Yasmin Hassoun

2015-10-01

Full Text Available Background: Screening mammography is an established intervention that leads to early breast cancer detection and reduced mortality. The Lebanese Ministry of Health has initiated yearly awareness campaigns and provided free mammography in multiple centers around the country. Methods: The study took place in two major areas of Lebanon - Beirut and South Lebanon. This cross-sectional survey aimed to assess knowledge about breast cancer screening and screening behaviors in the Lebanese population. The primary outcome of the study was to assess the reasons that prevented women from performing screening mammography based on our categories of questions: lack of knowledge about breast cancer, lack of access to screening facilities, failure of primary care physician to encourage screening behavior, and other reasons. Results: The major barriers to seek screening that had statistically significant P-values, in order of prevalence, included: lack of knowledge about breast cancer, followed by social reasons and lack of access. Conclusion: Given the prevalence of breast cancer in our population, it is important to understand the pitfalls that we experience in promoting awareness. Our study is the first study to reach out to the community to assess perceived barriers against screening and provide solutions for such barriers.

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

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

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.

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.

With the Advent of Tomosynthesis in the Workup of Mammographic Abnormality, is Spot Compression Mammography Now Obsolete? An Initial Clinical Experience.

Science.gov (United States)

Ni Mhuircheartaigh, Neasa; Coffey, Louise; Fleming, Hannah; O' Doherty, Ann; McNally, Sorcha

2017-09-01

To determine if the routine use of spot compression mammography is now obsolete in the assessment of screen detected masses, asymmetries and architectural distortion since the availability of digital breast tomosynthesis. We introduced breast tomosynthesis in the workup of screen detected abnormalities in our screening center in January 2015. During an initial learning period with tomosynthesis standard spot compression views were also performed. Three consultant breast radiologists retrospectively reviewed all screening mammograms recalled for assessment over the first 6-month period. We assessed retrospectively whether there was any additional diagnostic information obtained from spot compression views not already apparent on tomography. All cases were also reviewed for any additional lesions detected by tomosynthesis, not detected on routine 2-view screening mammography. 548 women screened with standard 2-view digital screening mammography were recalled for assessment in the selected period and a total of 565 lesions were assessed. 341 lesions were assessed by both tomosynthesis and routine spot compression mammography. The spot compression view was considered more helpful than tomosynthesis in only one patient. This was because the breast was inadequately positioned for tomosynthesis and the area in question was not adequately imaged. Apart from this technical error there was no asymmetry, distortion or mass where spot compression provided more diagnostic information than tomosynthesis alone. We detected three additional cancers on tomosynthesis, not detected by routine screening mammography. From our initial experience with tomosynthesis we conclude that spot compression mammography is now obsolete in the assessment of screen detected masses, asymmetries and distortions where tomosynthesis is available. © 2017 Wiley Periodicals, Inc.

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

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

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.

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

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...

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

Soft x-ray power diagnostic improvements at the Omega Laser Facility

International Nuclear Information System (INIS)

Sorce, C.; Schein, J.; Weber, F.; Widmann, K.; Campbell, K.; Dewald, E.; Turner, R.; Landen, O.; Jacoby, K.; Torres, P.; Pellinen, D.

2006-01-01

Soft x-ray power diagnostics are essential for evaluating high temperature laser plasma experiments. The Dante soft x-ray spectrometer, a core diagnostic for radiation flux and temperature measurements of Hohlraums, installed on the Omega Laser Facility at the Laboratory for Laser Energetics has recently undergone a series of upgrades. Work performed at Brookhaven National Laboratory for the development of the National Ignition Facility (NIF) Dante spectrometer enables the Omega Dante to offer a total of 18 absolutely calibrated channels in the energy range from 50 eV to 20 keV. This feature provides Dante with the capability to measure higher, NIF relevant, radiation temperatures with increased accuracy including a differentiation of higher energy radiation such as the Au M and L bands. Diagnostic monitoring using experimental data from directly driven Au spherical shots is discussed

CHALLENGES IN SETTING UP QUALITY CONTROL IN DIAGNOSTIC RADIOLOGY FACILITIES IN NIGERIA.

Science.gov (United States)

Inyang, S O; Egbe, N O; Ekpo, E

2015-01-01

The Nigerian Nuclear Regulatory Authority (NNRA) was established to regulate and control the use of radioactive and radiation emitting sources in Nigeria. Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the authorization of diagnostic radiology facilities in the Country. Some quality control tests (output, exposure linearity and reproducibility) were measured on the x-ray machines in the facilities that took part in the study. Questionnaire was developed to evaluate the frequencies at which QC tests were conducted in the facilities and the challenges in setting up QC. Results show great variation in the values of the QC parameters measured. Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study. The responses on the frequencies at which QC tests should be conducted did not correspond to the recommended standards; indicating that personnel were not familiar with QC implementation and may require further training on QC.

Diagnostic development and support of MHD (magnetohydrodynamics) test facilities

Energy Technology Data Exchange (ETDEWEB)

1989-07-01

Mississippi State University (MSU) is developing diagnostic instruments for Magnetohydrodynamics (MHD) power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for HRSR support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with MHD Energy Center computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. MSU personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs.

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.

Development of an excel spreadsheet formean glandular dose in mammography

International Nuclear Information System (INIS)

Nagoshi, Kazuyo; Fujisaki, Tatsuya

2008-01-01

The purpose of this study was to develop an Excel spreadsheet to calculate mean glandular dose (D g ) in mammography using clinical exposure data. D g can be calculated as the product of incident air kerma (K a ) and D gN (i.e., D g =K a x D gN ). According to the method of Klein et al (Phys Med Biol 1997; 42: 651-671), K a was measured at the entrance surface with an ionization dosimeter. Normalized glandular dose (D gN ) coefficients, taking into account breast glandularity, were computed using Boone's method (Med Phys 2002; 29: 869-875). D gN coefficients can be calculated for any arbitrary X-ray spectrum. These calculation procedures were input into a Microsoft Excel spreadsheet. The resulting Excel spreadsheet is easy to use and is always applicable in the field of mammography. The exposure conditions concerning D g in clinical practice were also investigated in 22 women. Four exposure conditions (target/filter combination and tube voltage) were automatically selected in this study. This investigation found that average D g for each exposure was 1.9 mGy. Because it is recommended that quality control of radiation dose management in mammography is done using an American College of Radiology (ACR) phantom, information about patient dose is not obtained in many facilities. The present Excel spreadsheet was accordingly considered useful for optimization of exposure conditions and explanation of mammography to patients. (author)

The design of diagnostic medical facilities using ionizing radiation

International Nuclear Information System (INIS)

1988-03-01

This Code, setting out the general principles of radiological protection as applied to diagnostic radiation facilities in hospitals and clinics, is intended as a guide to architects and to works departments concerned with their design and construction, and with the modification of existing units

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.

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

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.

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)

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.

Mobile Versus Fixed Facility: Latinas' Attitudes and Preferences for Obtaining a Mammogram.

Science.gov (United States)

Scheel, John R; Tillack, Allison A; Mercer, Lauren; Coronado, Gloria D; Beresford, Shirley A A; Molina, Yamile; Thompson, Beti

2018-01-01

Mobile mammographic services have been proposed as a way to reduce Latinas' disproportionate late-stage presentation compared with white women by increasing their access to mammography. The aims of this study were to assess why Latinas may not use mobile mammographic services and to explore their preferences after using these services. Using a mixed-methods approach, a secondary analysis was conducted of baseline survey data (n = 538) from a randomized controlled trial to improve screening mammography rates among Latinas in Washington. Descriptive statistics and bivariate regression were used to characterize mammography location preferences and to test for associations with sociodemographic indices, health care access, and perceived breast cancer risk and beliefs. On the basis of these findings, a qualitative study (n = 18) was used to explore changes in perceptions after using mobile mammographic services. More Latinas preferred obtaining a mammogram at a fixed facility (52.3% [n = 276]) compared with having no preference (46.3% [n = 249]) and preferring mobile mammographic services (1.7% [n = 9]). Concerns about privacy and comfort (15.6% [n = 84]) and about general quality (10.6% [n = 57]) were common reasons for preferring a fixed facility. Those with no history of mammography preferred a fixed facility (P mobile mammographic services after obtaining a mammogram. Although most Latinas preferred obtaining a mammogram at a fixed facility, positive experiences with mobile mammography services changed their attitudes toward them. These findings highlight the need to include community education when using mobile mammographic service to increase screening mammography rates in underserved communities. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography.

Science.gov (United States)

Jeukens, Cécile R L P N; Lalji, Ulrich C; Meijer, Eduard; Bakija, Betina; Theunissen, Robin; Wildberger, Joachim E; Lobbes, Marc B I

2014-10-01

Contrast-enhanced spectral mammography (CESM) shows promising initial results but comes at the cost of increased dose as compared with full-field digital mammography (FFDM). We aimed to quantitatively assess the dose increase of CESM in comparison with FFDM. Radiation exposure-related data (such as kilovoltage, compressed breast thickness, glandularity, entrance skin air kerma (ESAK), and average glandular dose (AGD) were retrieved for 47 CESM and 715 FFDM patients. All examinations were performed on 1 mammography unit. Radiation dose values reported by the unit were validated by phantom measurements. Descriptive statistics of the patient data were generated using a statistical software package. Dose values reported by the mammography unit were in good qualitative agreement with those of phantom measurements. Mean ESAK was 10.5 mGy for a CESM exposure and 7.46 mGy for an FFDM exposure. Mean AGD for a CESM exposure was 2.80 mGy and 1.55 mGy for an FFDM exposure. Compared with our institutional FFDM, the AGD of a single CESM exposure is increased by 1.25 mGy (+81%), whereas ESAK is increased by 3.07 mGy (+41%). Dose values of both techniques meet the recommendations for maximum dose in mammography.

A recoverable gas-cell diagnostic for the National Ignition Facility

Energy Technology Data Exchange (ETDEWEB)

Ratkiewicz, A., E-mail: ratkiewicz1@llnl.gov; Berzak Hopkins, L.; Bleuel, D. L.; Cassata, W. S.; Velsko, C. A.; Yeamans, C. B. [Lawrence Livermore National Laboratory, Livermore, California 95440 (United States); Bernstein, L. A.; Bibber, K. van; Goldblum, B. L. [University of California, Berkeley, California 94720 (United States); Siem, S. [University of Oslo, N-0316 Oslo (Norway); Wiedeking, M. [iThemba LABS, Somerset West 7129 (South Africa)

2016-11-15

The high-fluence neutron spectrum produced by the National Ignition Facility (NIF) provides an opportunity to measure the activation of materials by fast-spectrum neutrons. A new large-volume gas-cell diagnostic has been designed and qualified to measure the activation of gaseous substances at the NIF. This in-chamber diagnostic is recoverable, reusable and has been successfully fielded. Data from the qualification of the diagnostic have been used to benchmark an Monte Carlo N-Particle Transport Code simulation describing the downscattered neutron spectrum seen by the gas cell. We present early results from the use of this diagnostic to measure the activation of {sup nat}Xe and discuss future work to study the strength of interactions between plasma and nuclei.

A recoverable gas-cell diagnostic for the National Ignition Facility.

Science.gov (United States)

Ratkiewicz, A; Berzak Hopkins, L; Bleuel, D L; Bernstein, L A; van Bibber, K; Cassata, W S; Goldblum, B L; Siem, S; Velsko, C A; Wiedeking, M; Yeamans, C B

2016-11-01

The high-fluence neutron spectrum produced by the National Ignition Facility (NIF) provides an opportunity to measure the activation of materials by fast-spectrum neutrons. A new large-volume gas-cell diagnostic has been designed and qualified to measure the activation of gaseous substances at the NIF. This in-chamber diagnostic is recoverable, reusable and has been successfully fielded. Data from the qualification of the diagnostic have been used to benchmark an Monte Carlo N-Particle Transport Code simulation describing the downscattered neutron spectrum seen by the gas cell. We present early results from the use of this diagnostic to measure the activation of nat Xe and discuss future work to study the strength of interactions between plasma and nuclei.

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.)

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).

Quality assurance programme in mammography of the Sociedad Espanola de Diagnosticos por Imagen de la Mama (SEDIM)

International Nuclear Information System (INIS)

Fernandez, B.; Gonzalez, C.; Hernando, I.; Iribar, M.; Lopez, J.A.; Salvador, R.; Vega, A.; Vizcaino

2001-01-01

The European Union Council Directive 97/43/Euratom of 30 June 1997 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure has been partially transposed to the Spanish national law by the Real Decreto 1976/1999, which establishes the quality criteria in Diagnostic Radiology. A key instrument in this legal regulation is the so-called Quality Assurance Program (QAP) which has to be implemented in each Diagnostic Radiology unit. The Spanish Breast Imaging Diagnostic Society (Sociedad Espanola de Diagnostico por Imagen de la Mama, SEDIM) has proposed a reference QAP to be used as a guide in all the mammography units in the country. Its main issues are displayed in the present paper. The SEDIM QAP includes some items related to justification and optimization of mammography exams as well as a proposal for the assignment of functions and responsibilities. A guide for the image and technical parameters quality evaluation is also included. Some keys on equipment acquisition, maintenance and on continuing education and information management can also be found in that document. (author)

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

Drywall plates evaluation as protection barriers in dental X-rays and mammography facilities; Evaluacion de placas de drywall como barreras de proteccion en instalaciones de rayos X dental y mamografia

Energy Technology Data Exchange (ETDEWEB)

Guevara R, V. Y.; Romero C, N. [Empresa QC DOSE S. A. C., Av. Tomas Marsano 1915, Surquillo, Lima 34 (Peru); Berrocal T, M., E-mail: vguevara@qcdose.com [Universidad Nacional Mayor de San Marcos, C. German Amezaga 375, Edif. Jorge Basadre, Ciudad Universitaria, Lima 1 (Peru)

2014-08-15

In the dental X-rays and mammography facilities, usually lead shielded walls as protective barriers are used. Lead is a good attenuator for X-rays, but has toxic properties and its cost is high. Mammography equipment s emit low-energy photons in the range of 25 keV to 35 keV, on current computers; the primary radiation beam is intercepted by the image receptor. Peri apical dental equipment s emit photons in the range of 50 to 90 keV, their filtration is fixed. These devices emit a collimated beam whose diameter is slightly larger than the diagonal dimension of a standard film of dental X-rays. When a dental x-ray is performed, the radiation beam is partially attenuated by the patient. Drywall is a material consisting of plasterboard between two cardboard layers, being its components gypsum and cellulose generally. It is used in construction for execution of interior walls, ceilings and wall coverings, could also serve as a replacement for lead as well as other materials. In this paper three drywall prototypes (Giplac), formed with 02, 04 and 06 drywall layers (13, 16 and 20 cm of thickness respectively) were tested as barriers against primary and secondary X-ray radiation that come from dental and mammography equipment s. The results show that the drywall prototype, 02 layers, efficiently attenuates the secondary radiation beam produced by conventional mammography equipment. And the prototype 04 and 06 layers, efficiently attenuates the primary radiation beam produced by peri apical dental equipment. (author)

Screening mammography among nursing home residents in the United States: Current guidelines and practice.

Science.gov (United States)

Mack, Deborah S; Epstein, Mara M; Dubé, Catherine; Clark, Robin E; Lapane, Kate L

2018-06-04

United States (US) guidelines regarding when to stop routine breast cancer screening remain unclear. No national studies to-date have evaluated the use of screening mammography among US long-stay nursing home residents. This cross-sectional study was designed to identify prevalence, predictors, and geographic variation of screening mammography among that population in the context of current US guidelines. Screening mammography prevalence, identified with Physician/Supplier Part B claims and stratified by guideline age classification (65-74, ≥75 years), was estimated for all women aged ≥65 years residing in US Medicare- and Medicaid- certified nursing homes (≥1 year) with an annual Minimum Data Set (MDS) 3.0 assessment, continuous Medicare Part B enrollment, and no clinical indication for screening mammography as of 2011 (n = 389,821). The associations between resident- and regional- level factors, and screening mammography, were estimated by crude and adjusted prevalence ratios from robust Poisson regressions clustered by facility. Women on average were 85.4 (standard deviation ±8.1) years old, 77.9% were disabled, and 76.3% cognitively impaired. Screening mammography prevalence was 7.1% among those aged 65-74 years (95% Confidence Interval (CI): 6.8%-7.3%) and 1.7% among those ≥75 years (95% CI, 1.7%-1.8%), with geographic variation observed. Predictors of screening in both age groups included race, cognitive impairment, frailty, hospice, and some comorbidities. These results shed light on the current screening mammography practices in US nursing homes. Thoughtful consideration about individual screening recommendations and the implementation of more clear guidelines for this special population are warranted to prevent overscreening. Copyright © 2018 Elsevier Inc. All rights reserved.

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)

Beam Diagnostics for the BNL Energy Recovery Linac Test Facility

International Nuclear Information System (INIS)

Cameron, Peter; Ben-Zvi, Ilan; Blaskiewicz, Michael; Brennan, Michael; Connolly, Roger; Dawson, William; Degen, Chris; DellaPenna, Al; Gassner, David; Kesselman, Martin; Kewish, Jorg; Litvinenko, Vladimir; Mead, Joseph; Oerter, Brian; Russo, Tom; Vetter, Kurt; Yakimenko, Vitaly

2004-01-01

An Energy Recovery Linac (ERL) test facility is presently under construction at BNL. The goals of this test facility are first to demonstrate stable intense CW electron beam with parameters typical for the RHIC e-cooling project (and potentially for eRHIC), second to test novel elements of the ERL (high current CW photo-cathode, superconducting RF cavity with HOM dampers, and feedback systems), and finally to test lattice dependence of stability criteria. Planned diagnostics include position monitors, loss monitors, transverse profile monitors (both optical and wires), scrapers/halo monitors, a high resolution differential current monitor, phase monitors, an energy spread monitor, and a fast transverse monitor (for beam break-up studies and the energy feedback system). We discuss diagnostics challenges that are unique to this project, and present preliminary system specifications. In addition, we include a brief discussion of the timing system

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).

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

One more hurdle to increasing mammography screening: pubescent, adolescent, and prior mammography screening experiences.

Science.gov (United States)

Thomas, Eileen; Usher, LaToya

2009-01-01

Approximately $8.1 billion dollars is spent each year in the United States alone on the treatment of breast cancer. Survival rates are dependent on access to, and utilization of, early detection services. The primary reason for disparity in breast cancer mortality is the delay in time to diagnosis, resulting in poor prognosis. Despite ongoing research to understand barriers to mammography screening, recent studies report a decrease in mammography screening among all racial groups. A qualitative approach was used to elicit information from 36 White non- Hispanic, African-American, Hispanic, and Native American women without a history of breast cancer. Women were invited to share written or audiotape-recorded narratives about experiences pertaining to their breasts and their mammography screening experiences. Major categories identified were: teasing, family norms and values, media/societal influence, body image, and mammography screening experiences. The resulting effects of these experiences left these women with feelings of shame and "conflict" regarding their breasts. The major theme identified was breast conflict. Findings suggest that breast conflict may persist throughout the lifespan and can have a negative influence on a woman's decision to participate in mammography screening. The authors hypothesize that experiences that occur during adolescence pertaining to young girls' breasts can influence a women's body image, which in turn can later in life affect health-seeking behaviors related to mammography screening. These findings have implications for public health practice in planning for breast cancer screening, education, and interventions for women from diverse racial/ethnics groups.

Effects of a risk-based online mammography intervention on accuracy of perceived risk and mammography intentions.

Science.gov (United States)

Seitz, Holli H; Gibson, Laura; Skubisz, Christine; Forquer, Heather; Mello, Susan; Schapira, Marilyn M; Armstrong, Katrina; Cappella, Joseph N

2016-10-01

This experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions. 2918 women ages 35-49 were stratified into two levels of 10-year breast cancer risk (<1.5%; ≥1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) x 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk. Risk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk ≤1.5%. For women with a risk≤1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen. A risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions. Interventions could be applied in online or clinical settings to help women understand risk and make mammography decisions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

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 ...

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 ...

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.)

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.

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.

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)

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.

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…

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

An Indian test facility to characterise diagnostic neutral beam for ITER

International Nuclear Information System (INIS)

Singh, M.J.; Bandyopadhyay, M.; Rotti, C.; Singh, N.P.; Shah, Sejal; Bansal, G.; Gahlaut, A.; Soni, J.; Lakdawala, H.; Waghela, Harshad; Ahmed, I.; Roopesh, G.; Baruah, U.K.; Chakraborty, A.K.

2011-01-01

The diagnostic neutral beam (DNB) line shall be used to diagnose the He ash content in the D-T phase of the ITER machine using the charge exchange recombination spectroscopy (CXRS). Implementation of a successful DNB at ITER requires several challenges related to the production, neutralization and transport of the neutral beam over path lengths of 20.665 m, to be overcome. The delivery is aided if the above effects are tested prior to onsite commissioning. As DNB is a procurement package for INDIA, an ITER approved Indian test facility, INTF, is under construction at Institute for Plasma Research (IPR), India and is envisaged to be operational in 2015. The timeline for this facility is synchronized with the RADI, ELISE (IPP, Garching), SPIDER (RFX, Padova) in a manner that best utilization of configurational inputs available from them are incorporated in the design. This paper describes the facility in detail and discusses the experiments planned to optimise the beam transmission and testing of the beam line components using various diagnostics.

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.

Comparative evaluation of average glandular dose and image of digital mammography and film mammography in Minas Gerais, Brazil

International Nuclear Information System (INIS)

Nogueira, M.; Leyton, F.; Rodrigue, L. L.C.; Oliveira, M.A.; Joana, G.S.; Silva, S.D.

2015-01-01

Breast cancer is the most common cancer among women, and early detection is critical to its diagnosis and treatment. Mammography is the best method for breast-cancer screening and is capable of reducing mortality rates To date, the most effective method for early detection of breast cancer has been x-ray mammography for which the screen/film (SF) technique has been the gold standard. Digital mammography has been proposed as a substitute for film mammography given the benefits inherent to digital technology. The purpose of our study was to compare the technical performance of digital mammographic and screen-film mammography. A PMMA phantom with objects to simulate breast structures. For the screen/film (SF) technique the results showed that 54% mammography units did not achieve the minimum acceptable performance as far the image quality. Besides, 67% services showed inadequate performance in their processing systems, which had significant influence on the image quality. At the mean glandular dose only 44% of digital systems evaluated were compliant in all thicknesses of PMMA. The average glandular dose AGD was 90 % higher than in screen/film systems. (authors)

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.

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)

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)

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.)

Readability assessment of internet-based patient education materials related to mammography for breast cancer screening.

Science.gov (United States)

AlKhalili, Rend; Shukla, Pratik A; Patel, Ronak H; Sanghvi, Saurin; Hubbi, Basil

2015-03-01

The US Department of Health and Human Services (USDHHS) recommends that Internet-based patient education materials (IPEMs) be written below the sixth-grade reading level to target the average American adult. This study was designed to determine the readability of IPEMs regarding mammography for breast cancer screening. Three-hundred mammography-related Web sites were reviewed for IPEMs. Forty-two IPEMs that met the Health on the Net Foundation Code of Conduct were assessed for readability level with four readability indices that use existing algorithms based on word and sentence length to quantitatively analyze Internet sources for language intricacy including the following: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (Gunning FOG; GFOG). Results were compared to national recommendations, and intergroup analysis was performed. No IPEMs (0%) regarding mammography were written at or below the sixth-grade reading level, based on FKGL. The mean readability scores were as follows: FRES, 49.04 ± 10.62; FKGL, 10.71 ± 2.01; SMOG, 13.33 ± 1.67; and Gunning FOG, 14.32 ± 2.18. These scores indicate that the readability of mammography IPEMs is written at a "difficult" level, significantly above the recommended sixth-grade reading level (P < .05) determined by the USDHHS. IPEMs related to mammography are written well above the recommended sixth-grade level and likely reflect other IPEMs in diagnostic radiology. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

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.)

Development of Diagnostic Technology for Substation Facilities

Energy Technology Data Exchange (ETDEWEB)

Kweon, D.J.; Yoon, J.Y. [Korea Electric Power Research Institute, Taejeon (Korea, Republic of)

1998-09-01

This report contains the conceptual design of predictive diagnostic system for KEPCO 765kV substation apparatus which will be operated in 2001. Various kinds of techniques in the world for power transformer and GIS monitoring were examined, then the integrated diagnosis system configuration which will be most effective in our future substation was suggested. In addition, the development of the optimum life management for substation facilities. development of a system to measure the ESDD of substation insulator surfaces at a distance and application study of the degradation sensor(PCS) were described also. (author) 55 refs., 27 figs., 68 tabs.

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

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

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

Image Quality and Patient Dose Optimisation in Mammography in Slovakia

International Nuclear Information System (INIS)

Horvathova, M.; Nikodemova, D.; Prikazska, M.

2003-01-01

Breast cancer represents also in Slovakia the greatest cancer risk for women, with great incidence and mortality. Conventional film-screen mammography is still the primary breast imaging modality with increasing number of mammography units and mammography examinations. From the radiation protection point of view achievement of good practice in mammography department by implementation of quality assurance play an important role for reduction of patients doses. Introduction of QA needs trained and experienced staff and requires close collaboration between radiologists, medical physicist and radiographers. At the beginning of nineties at the Institute of Preventive and Clinical Medicine we started with a survey of mean glandular doses at 15 existing mammography units in the country. On the basis of a questionnaire in the year 1991 were performed 10 488 mammography examinations, where due to out of date mammography units the mean glandular dose reached more as 3 mGy. In the following years the claim to the modern mammography units kept growing and in the year 1999 the total number of 63 mammography units were operating in Slovakia providing about 101 471 mammography examinations. According to the alarming increase of the number of mammography examinations it is absolutely necessary to work out criteria and principles for Quality Control at mammography workplaces in our country and make it obligatory for the staff of all mammography units. Summarising the CRP results it can be stated that they: 1) Initiated the suggestion of unified QA/QC criteria in mammography and the urgent need to implement them into the national program of radiology image quality improvement; 2) Remitted on unhomogenity not only in the equipment outfit but also in the procedure of evaluation of the measured parameters and imaging quality; 3) Revealed the shortcomings in the everyday practice of mammography units which can be removed only by comprehensive by training of personal in imaging radiology

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.

Mammary carcinoma – current diagnostic methods and symptomatology in imaging studies

International Nuclear Information System (INIS)

Popiel, Monika; Mróz-Klimas, Danuta; Kasprzak, Renata; Furmanek, Mariusz

2012-01-01

Breast cancer is the most common neoplasm of the female population and its incidence is constantly rising. Social campaigns educating the public about the importance of the problem have been conducted for the past several years. Women are encouraged to self-examine on a monthly basis. Women aged 50–69 years can have an x-ray mammography performed once every 2 years as part of a prophylactic screening program. Ultrasound studies or MR mammography are adjuvant or, in some cases, alternative to x-ray mammography. Nuclear medicine techniques with application of oncophilic markers and receptor studies (this publication will not cover nuclear medicine methods) are not routinely used. Other techniques, such as computed tomography and conventional radiography are of no significance in the diagnostics of mammary cancer. However, together with isotopic methods, they are helpful in staging of the disease. X-ray mammography is, up to date, the only method with proven value in decreasing mortality. It is also the best available method for visualization of microcalicifications. Ultrasound examination is complementary to x-ray mammography as it is a cheap, easily available method of imaging mammary glands with higher glandular tissue content. It is also the most commonly used modality aiding in targeted biopsy of mammary gland. To date, MR mammography, characterized by the highest sensitivity in cancer diagnostics, remained a method reserved for “special tasks”. MR is used for prophylaxis mainly in a population of women with particularly high risk of the disease and in cases where x-ray and ultrasound examinations are insufficient. Picture of mammary carcinoma in imaging studies is heterogeneous. However, it most often presents as an irregularly demarcated mass. Moreover, each modality can aid in visualization of additional features of a lesion such as typical shape of microcalcifications in x-ray mammography, characteristic pattern of contrast enhancement in MR examination

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.

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.

DIAGNOSTIC METHODS IN BREAST CANCER DETECTION

Directory of Open Access Journals (Sweden)

Kristijana Hertl

2018-02-01

Full Text Available Background. In the world as well as in Slovenia, breast cancer is the most frequent female cancer. Due to its high incidence, it appears to be a serious health and economic problem. Content. Among other, tumour size at diagnosis, is an important prognostic factors of the course of the disease. The probability of axillary lymph node involvement as well as distant metastases is greater in larger tumours. This is the reason that encouraged the development of various diagnostic methods for early detection of small, clinically non-palpable breast tumours. Mammography, however, remains the »golden standard« of early breast cancer detection. It is the basic diagnostic method applied in all symptomatic women over 35 years of age and in asymptomatic women over 40 years of age. Ultrasonography (US, additional projections, magnetic resonance imaging (MRI and ductography are regarded as complementary diagnostic breast imaging techniques in addition to mammography. The detected changes in the breast can be further confirmed by US-, MR-guided or stereotactic biopsy. If necessary, surgical biopsy and the excision of a tissue sample, after wire or isotope localisation of the nonpalpable lesion, can be performed. Conclusions. Any of the above mentioned diagnostic methods has advantages as well as drawbacks and only detailed knowledge and understanding of each of them may assure the best option.

A simplified edge illumination set-up for quantitative phase contrast mammography with synchrotron radiation at clinical doses

International Nuclear Information System (INIS)

Longo, Mariaconcetta; Rigon, Luigi; Lopez, Frances C M; Longo, Renata; Chen, Rongchang; Dreossi, Diego; Zanconati, Fabrizio

2015-01-01

This work presents the first study of x-ray phase contrast imaging based on a simple implementation of the edge illumination method (EIXPCi) in the field of mammography with synchrotron radiation. A simplified EIXPCi set-up was utilized to study a possible application in mammography at clinical doses. Moreover, through a novel algorithm capable of separating and quantifying absorption and phase perturbations of images acquired in EIXPCi modality, it is possible to extract quantitative information on breast images, allowing an accurate tissue identification. The study was carried out at the SYRMEP beamline of Elettra synchrotron radiation facility (Trieste, Italy), where a mastectomy specimen was investigated with the EIXPCi technique. The sample was exposed at three different energies suitable for mammography with synchrotron radiation in order to test the validity of the novel algorithm in extracting values of linear attenuation coefficients integrated over the sample thickness. It is demonstrated that the quantitative data are in good agreement with the theoretical values of linear attenuation coefficients calculated on the hypothesis of the breast with a given composition. The results are promising and encourage the current efforts to apply the method in mammography with synchrotron radiation. (note)

Diagnostic delay amongst tuberculosis patients in Jogjakarta Province, Indonesia is related to the quality of services in DOTS facilities.

Science.gov (United States)

Ahmad, Riris Andono; Mahendradhata, Yodi; Utarini, Adi; de Vlas, Sake J

2011-04-01

To understand determinants of care-seeking patterns and diagnostic delay amongst tuberculosis (TB) patients diagnosed at direct observed treatment short course (DOTS) facilities in Jogjakarta, Indonesia. Cross-sectional survey amongst newly diagnosed TB patients in 89 DOTS facilities whose history of care-seeking was reconstructed through retrospective interviews gathering data on socio-demographic determinants, onset of TB symptoms, type of health facilities visited, duration of each care-seeking action were recorded. Two hundred and fifty-three TB patients were included in the study whose median duration of patients' delay was 1 week and whose total duration of diagnostic delay was 5.4 weeks. The median number of visits was 4. Many of the patients' socio-demographic determinants were not associated with the care-seeking patterns, and no socio-demographic determinants were associated with the duration of diagnostic delay. More than 60% of TB patients started their care-seeking processes outside DOTS facilities, but the number of visits in DOTS facilities was greater during the overall care-seeking process. Surprisingly, patient's immediate visits to a DOTS facility did not correspond to shorter diagnostic delay. Diagnostic delay in Jogjakarta province was not associated with patients' socio demographic factors, but rather with the health system providing DOTS services. This suggests that strengthening the health system and improving diagnostic quality within DOTS services is now a more rational strategy than expanding the TB programme to engage more providers. © 2010 Blackwell Publishing Ltd.

WE-A-12A-01: Medical Physics 1.0 to 2.0, Session 2: Radiography, Mammography and Fluoroscopy

International Nuclear Information System (INIS)

Gingold, E; Karellas, A; Strauss, K

2014-01-01

Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidencebased medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. Radiography 2.0: The development of electronic capture in recent years has changed the landscape and spurred reinvestment by healthcare providers. The radiography presentation will explore how the diagnostic medical physicist must adapt to these changes to support radiographic imaging, and how she/he can add value in radiography practice over the next 5-10 years. Topics of discussion include new metrology of evaluation, new models of clinical engagement, and effective integration of new technologies. Mammography 2.0: Mammography has been an interesting testing ground on the effectiveness of close involvement of medical physicists with equipment in the past twenty years. The outcomes have clearly shown major improvements in image quality and significant reduction in the average glandular dose. However, the medical physicist's role in mammography has been largely focused to annual surveys and with limited input on operational issues with image artifacts, optimal mammographic acquisition mode and problems with image quality. This mammography presentation will address why and how medical physicists must be prepared to address the new models of practice that include new metrics of performance and the integration of new technologies (DBT, syncretized mammograms, contrast mammography, breast CT) into clinical practice

WE-A-12A-01: Medical Physics 1.0 to 2.0, Session 2: Radiography, Mammography and Fluoroscopy

Energy Technology Data Exchange (ETDEWEB)

Gingold, E [Thomas Jefferson University, Philadelphia, PA (United States); Karellas, A [University of Massachusetts Medical School, Worcester, MA (United States); Strauss, K [Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States)

2014-06-15

Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidencebased medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. Radiography 2.0: The development of electronic capture in recent years has changed the landscape and spurred reinvestment by healthcare providers. The radiography presentation will explore how the diagnostic medical physicist must adapt to these changes to support radiographic imaging, and how she/he can add value in radiography practice over the next 5-10 years. Topics of discussion include new metrology of evaluation, new models of clinical engagement, and effective integration of new technologies. Mammography 2.0: Mammography has been an interesting testing ground on the effectiveness of close involvement of medical physicists with equipment in the past twenty years. The outcomes have clearly shown major improvements in image quality and significant reduction in the average glandular dose. However, the medical physicist's role in mammography has been largely focused to annual surveys and with limited input on operational issues with image artifacts, optimal mammographic acquisition mode and problems with image quality. This mammography presentation will address why and how medical physicists must be prepared to address the new models of practice that include new metrics of performance and the integration of new technologies (DBT, syncretized mammograms, contrast mammography, breast CT) into clinical practice

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)

Efficacy of storage phosphor-based digital mammography in diagnosis of breast cancer

International Nuclear Information System (INIS)

Kitahama, Hiroyuki

1991-01-01

The aim of this study is to present efficacy of storage phosphor-based digital mammography (CR-mammography) in diagnosis of breast cancer. Ninety-seven cases with breast cancer including 44 cases less than 2 cm in macroscopic size (t1 cases) were evaluated using storage phosphor-based digital mammography (2000 x 2510 pixels by 10 bits). Abnormal findings on CR-mammography were detected in 86 cases (88.7%) of 97 women with breast cancer. Sensitivity of CR-mammography was 88.7%. It was superior to that of film-screen mammography. On t1 breast cancer cases, sensitivity on CR-mammography was 88.6%. False negative rate in t1 breast cancer cases was reduced by image processing using CR-mammography. To evaluate microcalcifications, CR-mammograms and film-screen mammograms were investigated in 22 cases of breast cancer proven pathologically the existence of microcalcifications and 11 paraffin tissue blocks of breast cancer. CR-mammography was superior to film-screen mammography in recognizing of microcalcifications. As regards the detectability for the number and the shape of microcalcifications, CR-mammography was equivalent to film-screen mammography. Receiver operating characteristic (ROC) analysis by eight observers was performed for CR-mammography and film-screen mammography with 54 breast cancer patients and 54 normal cases. The detectability of abnormal findings of breast cancer on CR-mammography (ROC area=0.91) was better than that on film-screen mammography (ROC area=0.88) (p<0.05). Efficacy of storage phosphor-based digital mammography in diagnosis of breast cancer was discussed and demonstrated in this study. (author)

A conversion method of air kerma from the primary, scatter, and leakage radiations to effective dose for calculating x-ray shielding barriers in mammography

International Nuclear Information System (INIS)

Kharrati, Hedi

2005-01-01

In this study, a new approach has been introduced for derivation of the effective dose from air kerma to calculate shielding requirements in mammography facilities. This new approach has been used to compute the conversion coefficients relating air kerma to the effective dose for the mammography reference beam series of the Netherlands Metrology Institute Van Swinden Laboratorium, National Institute of Standards and Technology, and International Atomic Energy Agency laboratories. The results show that, in all cases, the effective dose in mammography energy range is less than 25% of the incident air kerma for the primary and the scatter radiations and does not exceed 75% for the leakage radiation

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

Prospective study aiming to compare 2D mammography and tomosynthesis + synthesized mammography in terms of cancer detection and recall. From double reading of 2D mammography to single reading of tomosynthesis.

Science.gov (United States)

Romero Martín, Sara; Raya Povedano, Jose Luis; Cara García, María; Santos Romero, Ana Luz; Pedrosa Garriguet, Margarita; Álvarez Benito, Marina

2018-06-01

To evaluate tomosynthesis compared with 2D-mammography in cancer detection and recalls in a screening-programme, and assess performing synthesized instead of 2D, and compare double reading of 2D with single reading of tomosynthesis. Women (age 50-69 years) participating in the screening-programme were included. 2D-mammography and tomosynthesis were performed. There were four reading models: 2D-mammography (first); 2D-mammography (second); tomosynthesis + synthesized (third); tomosynthesis + synthesized + 2D (fourth reading). Paired double reading of 2D (first+second) and tomosynthesis (third+fourth) were analysed. In 16,067 participants, there were 98 cancers and 1,196 recalls. Comparing double reading of 2D with single reading of tomosynthesis, there was an increase of 12.6 % in cancer detection with the third reading (p= 0.043) and 6.9 % with the fourth reading (p=0.210), and a decrease in recalls of 40.5 % (ptomosynthesis. Single reading of tomosynthesis plus synthesized increased cancer detection and decreased recalls compared with double reading 2D. 2D did not improve results when added to tomosynthesis. • Tomosynthesis increases cancer detection and decreases recall rates versus 2D mammography. • Synthesized-mammography avoids performing 2D, showing higher cancer detection. • Single reading of tomosynthesis + synthesized is feasible as a new practice.

Contrast-enhanced spectral mammography: comparison with conventional mammography and histopathology in 152 women.

Science.gov (United States)

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 mammography.

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

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

Digital breast tomosynthesis versus mammography and breast ultrasound: a multireader performance study

International Nuclear Information System (INIS)

Thibault, Fabienne; Malhaire, Caroline; Tardivon, Anne; Dromain, Clarisse; Balleyguier, Corinne S.; Breucq, Catherine; Steyaert, Luc; Baldan, Enrica; Drevon, Harir

2013-01-01

To compare the diagnostic performance of single-view breast tomosynthesis (BT) with that of dual-view mammography (MX); to assess the benefit of adding the craniocaudal (CC) mammographic view to BT, and of adding BT to MX plus breast ultrasound, considered to be the reference work-up. One hundred and fifty-five consenting patients with unresolved mammographic and/or ultrasound findings or breast symptoms underwent conventional work-up plus mediolateral oblique-view BT of the affected breast. The final study set in 130 patients resulted in 55 malignant and 76 benign and normal cases. Seven breast radiologists rated the cases through five sequential techniques using a BIRADS-based scale: MX, MX + ultrasound, MX + ultrasound + BT, BT, BT + MX(CC). Multireader, multicase receiver operating characteristic (ROC) analysis was performed and performance of the techniques was assessed from the areas under ROC curves. The performance of BT and of BT + MX(CC) was tested versus MX; the performance of MX + ultrasound + BT tested versus MX + ultrasound. Tomosynthesis was found to be non-inferior to mammography. BT + MX(CC) did not appear to be superior to MX, and MX + ultrasound + BT not superior to MX + ultrasound. Overall, none of the five techniques tested outperformed the others. Further clinical studies are needed to clarify the role of BT as a substitute for traditional work-up in the diagnostic environment. (orig.)

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

OpenAIRE

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

2014-01-01

Objective The goal of the study was to compare conventional mammography (MG) and contrast-enhanced spectral mammography (CESM) in preoperative women. Materials and Methods 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...

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.

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

MO-AB-207-00: ACR Update in MR, CT, Nuclear Medicine, and Mammography

International Nuclear Information System (INIS)

2015-01-01

A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program

MO-AB-207-00: ACR Update in MR, CT, Nuclear Medicine, and Mammography

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.

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.)

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.)

Monochromatic x-rays for low-dose digital mammography: preliminary results.

Science.gov (United States)

Yoon, Kwon-Ha; Kwon, Young Man; Choi, Byoung-Jung; Son, Hyun Hwa; Ryu, Cheol Woo; Chon, Kwon Su; Park, Seong Hoon; Juhng, Sun Kwan

2012-12-01

The feasibility of using monochromatic x-ray imaging generated from an x-ray tube and a multilayer reflector for digital mammography with a low radiation dose was examined. A multilayer mirror was designed to select the x-ray peak with an energy of 21.5 keV generated from an x-ray tube with a tungsten target and was fabricated by the ion-beam sputtering deposition system. Monochromatic x-ray images were obtained from an experimental digital mammography setup with a scanning stage. The performance of the system was evaluated using a breast phantom, a spectrometer, and a radiation dosimeter. We measured the contrast-to-noise ratio and performed the 10% modulation function test to determine image quality and resolution. The monochromatic beam from the multilayer reflector had a full-width-at-half-maximum of 0.9 keV at 21.5 keV, and the reflectivity was 0.70, which was 90% of the designed value. The polychromatic and monochromatic x-rays showed radiation doses of 0.497 and 0.0415 mGy, respectively. The monochromatic x-ray image shows fibers, calcifications, and masses more clearly than the polychromatic x-ray images do. The image contrast of the monochromatic x-rays was 1.85 times higher than that of the polychromatic x-rays. The experimental mammography setup had a spatial resolution of 7 lp/mm with both x-rays. Monochromatic x-rays generated using a multilayer mirror may be a useful diagnostic tool for breast examination by providing high contrast imaging with a low radiation dose.

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...

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

Consolidated Laser-Induced Fluorescence Diagnostic Systems for the NASA Ames Arc Jet Facilities

Science.gov (United States)

Grinstead, Jay; Wilder, Michael C.; Porter, Barry; Brown, Jeff; Yeung, Dickson; Battazzo, Steve; Brubaker, Tim

2016-01-01

The spectroscopic diagnostic technique of two photon absorption laser-induced fluorescence (TALIF) of atomic species for non-intrusive arc jet flow property measurement was first implemented at NASA Ames in the mid-1990s. Use of TALIF expanded at NASA Ames and to NASA Johnsons arc jet facility in the late 2000s. In 2013-2014, NASA combined the agency's large-scale arc jet test capabilities at NASA Ames. Concurrent with that effort, the agency also sponsored a project to establish two comprehensive LIF diagnostic systems for the Aerodynamic Heating Facility (AHF) and Interaction Heating Facility (IHF) arc jets. The scope of the project enabled further engineering development of the existing IHF LIF system as well as the complete reconstruction of the original AHF LIF system. The updated LIF systems are identical in design and capability. They represent the culmination of over 20 years of development experience in transitioning a specialized laboratory research tool into a measurement system for large-scale, high-demand test facilities. This paper documents the overall system design from measurement requirements to implementation. Representative data from the redeveloped AHF and IHF LIF systems are also presented.

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.

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

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.)

Mirror fusion test facility plasma diagnostics system

International Nuclear Information System (INIS)

Thomas, S.R. Jr.; Coffield, F.E.; Davis, G.E.; Felker, B.

1979-01-01

During the past 25 years, experiments with several magnetic mirror machines were performed as part of the Magnetic Fusion Energy (MFE) Program at LLL. The latest MFE experiment, the Mirror Fusion Test Facility (MFTF), builds on the advances of earlier machines in initiating, stabilizing, heating, and sustaining plasmas formed with deuterium. The goals of this machine are to increase ion and electron temperatures and show a corresponding increase in containment time, to test theoretical scaling laws of plasma instabilities with increased physical dimensions, and to sustain high-beta plasmas for times that are long compared to the energy containment time. This paper describes the diagnostic system being developed to characterize these plasma parameters

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)

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)

Locally advanced breast cancer: comparison of mammography, sonography and MR imaging in evaluation of residual disease in women receiving neoadjuvant chemotherapy

International Nuclear Information System (INIS)

Londero, Viviana; Bazzocchi, Massimo; Del Frate, Chiara; Francescutti, Giuliana; Zuiani, Chiara; Puglisi, Fabio; Di Loreto, Carla

2004-01-01

The accuracy of mammography, sonography and magnetic resonance imaging (MRI) in identifying residual disease after neoadjuvant chemotherapy is evaluated and imaging findings are correlated with pathologic findings. Fifteen patients enrolled in an experimental protocol of preoperative neoadjuvant chemotherapy underwent clinical examination, mammography, sonography and dynamic MRI, performed in this order, before and respectively after 2 and 4 cycles of neoadjuvant chemotherapy. Four radiologists, two for mammography, one for sonography and one for MR, examined the images, blinded to the results of the other examinations. All patients underwent radical or conservative surgery, and imaging findings were compared with pathologic findings. MRI identified 2/15 (13.3.%) clinically complete response (CR), 9/15 (60%) partial response (PR), 3/15 (20%) stable disease (SD) and 1/15 (6.7%) progressive disease. Mammography identified 1/15 (6.7%) clinically CR, 8/15 (53.3%) PR and 4/15 (27%) SD, and was not able to evaluate the disease in 2/15 (13%) cases. Sonography presented the same results as MRI. Therefore, MRI and sonography compared to mammography correctly identified residual disease in 100 vs. 86%. MRI resulted in two false-negative results because of the presence of microfoci of in situ ductal carcinoma (DCIS) and invasive lobular carcinoma (LCI). MRI was superior to mammography in cases of multifocal or multicentric disease (83 vs. 33%). Sonography performed after MRI improves the accuracy in evaluation of uncertain foci of multifocal disease seen on MR images with an increase of diagnostic accuracy from 73 to 84.5%. MRI assesses response to neoadjuvant chemotherapy better than traditional methods of physical examination and mammography. (orig.)

Locally advanced breast cancer: comparison of mammography, sonography and MR imaging in evaluation of residual disease in women receiving neoadjuvant chemotherapy

Energy Technology Data Exchange (ETDEWEB)

Londero, Viviana; Bazzocchi, Massimo; Del Frate, Chiara; Francescutti, Giuliana; Zuiani, Chiara [Institute of Radiology, University of Udine, via Colugna 50, 33100, Udine (Italy); Puglisi, Fabio [Department of Oncology, University of Udine, via Colugna 50, 33100, Udine (Italy); Di Loreto, Carla [Institute of Pathology, University of Udine, via Colugna 50, 33100, Udine (Italy)

2004-08-01

The accuracy of mammography, sonography and magnetic resonance imaging (MRI) in identifying residual disease after neoadjuvant chemotherapy is evaluated and imaging findings are correlated with pathologic findings. Fifteen patients enrolled in an experimental protocol of preoperative neoadjuvant chemotherapy underwent clinical examination, mammography, sonography and dynamic MRI, performed in this order, before and respectively after 2 and 4 cycles of neoadjuvant chemotherapy. Four radiologists, two for mammography, one for sonography and one for MR, examined the images, blinded to the results of the other examinations. All patients underwent radical or conservative surgery, and imaging findings were compared with pathologic findings. MRI identified 2/15 (13.3.%) clinically complete response (CR), 9/15 (60%) partial response (PR), 3/15 (20%) stable disease (SD) and 1/15 (6.7%) progressive disease. Mammography identified 1/15 (6.7%) clinically CR, 8/15 (53.3%) PR and 4/15 (27%) SD, and was not able to evaluate the disease in 2/15 (13%) cases. Sonography presented the same results as MRI. Therefore, MRI and sonography compared to mammography correctly identified residual disease in 100 vs. 86%. MRI resulted in two false-negative results because of the presence of microfoci of in situ ductal carcinoma (DCIS) and invasive lobular carcinoma (LCI). MRI was superior to mammography in cases of multifocal or multicentric disease (83 vs. 33%). Sonography performed after MRI improves the accuracy in evaluation of uncertain foci of multifocal disease seen on MR images with an increase of diagnostic accuracy from 73 to 84.5%. MRI assesses response to neoadjuvant chemotherapy better than traditional methods of physical examination and mammography. (orig.)

Implementation of Quality Control Protocol in Mammography: A Serbian Experience

International Nuclear Information System (INIS)

Ciraj Bjelac, O.; Kosutic, D.; Arandjic, D.; Kovacevic, M.

2008-01-01

Mammography is method of choice for early detection of breast cancer. In Serbia, mammography is performed only clinically, although there is a long term plan to introduce mammography as screening method. Currently there are 60 mammography units in practice in Serbia, resulting with 70 000 mammographies annually. The purpose of this paper is preliminary evaluation of the mammography practice in Serbia, having in mind the annual number of examinations and fact that part of examination is performed on women without any clinical signs. For pilot implementation of Quality Control (QC) protocol in mammography, five hospitals with highest workload have been selected, representing the typical mammography practice in Serbia. Developed QC protocol, based on European guidelines for quality assurance in breast cancer screening and diagnosis, actual practice and resources, includes equipment testing and maintenance, staff training and QC management and allocation of responsibilities. Subsequently, it should be applied on the national scale. The survey demonstrated considerable variations in technical parameters that affect image quality and patients doses. Mean glandular doses ranged from 0.12 to 2.8 mGy, while reference optical density ranged from 1.2 to 2.8. Main problems were associated with film processing, viewing conditions and optical density control. The preliminary survey of mammography practice highlighted the need for optimization of radiation protection and training of operating staff, although the survey itself was very valuable learning process for all participants. Furthermore, systematic implementation of QC protocol should provide reliable performance of mammography units and maintain satisfactory image quality and keep patient doses as low as reasonably practical.(author)

Cost-effectiveness of annual versus biennial screening mammography for women with high mammographic breast density.

Science.gov (United States)

Pataky, Reka; Ismail, Zahra; Coldman, Andrew J; Elwood, Mark; Gelmon, Karen; Hedden, Lindsay; Hislop, Greg; Kan, Lisa; McCoy, Bonnie; Olivotto, Ivo A; Peacock, Stuart

2014-12-01

The sensitivity of screening mammography is much lower among women who have dense breast tissue, compared with women who have largely fatty breasts, and they are also at much higher risk of developing the disease. Increasing mammography screening frequency from biennially to annually has been suggested as a policy option to address the elevated risk in this population. The purpose of this study was to assess the cost-effectiveness of annual versus biennial screening mammography among women aged 50-79 with dense breast tissue. A Markov model was constructed based on screening, diagnostic, and treatment pathways for the population-based screening and cancer care programme in British Columbia, Canada. Model probabilities and screening costs were calculated from screening programme data. Costs for breast cancer treatment were calculated from treatment data, and utility values were obtained from the literature. Incremental cost-effectiveness was expressed as cost per quality adjusted life year (QALY), and probabilistic sensitivity analysis was conducted. Compared with biennial screening, annual screening generated an additional 0.0014 QALYs (95% CI: -0.0480-0.0359) at a cost of $819 ($ = Canadian dollars) per patient (95% CI: 506-1185), resulting in an incremental cost effectiveness ratio of $565,912/QALY. Annual screening had a 37.5% probability of being cost-effective at a willingness-to-pay threshold of $100,000/QALY. There is considerable uncertainty about the incremental cost-effectiveness of annual mammography. Further research on the comparative effectiveness of screening strategies for women with high mammographic breast density is warranted, particularly as digital mammography and density measurement become more widespread, before cost-effectiveness can be reevaluated. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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)

Retrospective and comparative analysis of 99mTc-Sestamibi breast specific gamma imaging versus mammography, ultrasound, and magnetic resonance imaging for the detection of breast cancer in Chinese women

International Nuclear Information System (INIS)

Yu, Xiuyan; Hu, Guoming; Zhang, Zhigang; Qiu, Fuming; Shao, Xuan; Wang, Xiaochen; Zhan, Hongwei; Chen, Yiding; Deng, Yongchuan; Huang, Jian

2016-01-01

Diagnosing breast cancer during the early stage may be helpful for decreasing cancer-related mortality. In Western developed countries, mammographies have been the gold standard for breast cancer detection. However, Chinese women usually have denser and smaller-sized breasts compared to Caucasian women, which decreases the diagnostic accuracy of mammography. However, breast specific gamma imaging, a type of molecular functional breast imaging, has been used for the accurate diagnosis of breast cancer and is not influenced by breast density. Our objective was to analyze the breast specific gamma imaging (BSGI) diagnostic value for Chinese women. During a 2-year period, 357 women were diagnosed and treated at our oncology department and received BSGI in addition to mammography (MMG), ultrasound (US) and magnetic resonance imaging (MRI) for diagnostic assessment. We investigated the sensitivity and specificity of each method of detection and compared the biological profiles of the four imaging methods. A total of 357 women received a final surgical pathology diagnosis, with 168 malignant diseases (58.5 %) and 119 benign diseases (41.5 %). Of these, 166 underwent the four imaging tests preoperatively. The sensitivity of BSGI was 80.35 and 82.14 % by US, 75.6 % by MMG, and 94.06 % by MRI. Furthermore, the breast cancer diagnosis specificity of BSGI was high (83.19 % vs. 77.31 % vs. 66.39 % vs. 67.69 %, respectively). The BSGI diagnostic sensitivity for mammographic breast density in women was superior to mammography and more sensitive for non-luminal A subtypes (luminal A vs. non-luminal A, 68.63 % vs. 88.30 %). BSGI may help improve the ability to diagnose early stage breast cancer for Chinese women, particularly for ductal carcinoma in situ (DCIS), mammographic breast density and non-luminal A breast cancer

Retrospective and comparative analysis of (99m)Tc-Sestamibi breast specific gamma imaging versus mammography, ultrasound, and magnetic resonance imaging for the detection of breast cancer in Chinese women.

Science.gov (United States)

Yu, Xiuyan; Hu, Guoming; Zhang, Zhigang; Qiu, Fuming; Shao, Xuan; Wang, Xiaochen; Zhan, Hongwei; Chen, Yiding; Deng, Yongchuan; Huang, Jian

2016-07-11

Diagnosing breast cancer during the early stage may be helpful for decreasing cancer-related mortality. In Western developed countries, mammographies have been the gold standard for breast cancer detection. However, Chinese women usually have denser and smaller-sized breasts compared to Caucasian women, which decreases the diagnostic accuracy of mammography. However, breast specific gamma imaging, a type of molecular functional breast imaging, has been used for the accurate diagnosis of breast cancer and is not influenced by breast density. Our objective was to analyze the breast specific gamma imaging (BSGI) diagnostic value for Chinese women. During a 2-year period, 357 women were diagnosed and treated at our oncology department and received BSGI in addition to mammography (MMG), ultrasound (US) and magnetic resonance imaging (MRI) for diagnostic assessment. We investigated the sensitivity and specificity of each method of detection and compared the biological profiles of the four imaging methods. A total of 357 women received a final surgical pathology diagnosis, with 168 malignant diseases (58.5 %) and 119 benign diseases (41.5 %). Of these, 166 underwent the four imaging tests preoperatively. The sensitivity of BSGI was 80.35 and 82.14 % by US, 75.6 % by MMG, and 94.06 % by MRI. Furthermore, the breast cancer diagnosis specificity of BSGI was high (83.19 % vs. 77.31 % vs. 66.39 % vs. 67.69 %, respectively). The BSGI diagnostic sensitivity for mammographic breast density in women was superior to mammography and more sensitive for non-luminal A subtypes (luminal A vs. non-luminal A, 68.63 % vs. 88.30 %). BSGI may help improve the ability to diagnose early stage breast cancer for Chinese women, particularly for ductal carcinoma in situ (DCIS), mammographic breast density and non-luminal A breast cancer.

The Design of Diagnostic Medical Facilities where Ionising Radiation is used

International Nuclear Information System (INIS)

Malone, J.; O'Reilly, G.; O'Connor, U.; Gallagher, A.; Sheahan, N.; Fennell, S.

2009-06-01

The original Code of Practice on The Design of Diagnostic Medical Facilities Using Ionising Radiation was first published by the Nuclear Energy Board in 1988. In the intervening years the 'Blue Book' as it became known has served the medical community well as the sector has expanded and modernised and the late Dr Noel Nowlan, then Chief Executive of the Nuclear Energy Board, deserves much credit for initiating this pioneering contribution to radiation safety in Ireland. There have been significant developments since its publication in terms of the underlying radiation protection legislation, regulatory practice as well as developments in new technologies that have given rise to the need for a revision of the Code. This revised Code is based on a comprehensive draft document produced by the Haughton Institute under contract to the RPII and was finalised following extensive consultations with the relevant stakeholders. The revised Code includes a brief review of the current legislative framework and its specific impact on the management of building projects (Chapters 1 and 2), a presentation of the main types of radiological (Chapter 3) and nuclear medicine (Chapter 4) facilities, a treatment of the technical aspects of shielding calculations (Chapter 5) and a discussion of the practical aspects of implementing shielding solutions in a building context (Chapter 6). The primary purpose of the Code is to assist in the design of diagnostic facilities to the highest radiation protection standards in order to ensure the safety of workers and members of the public and the delivery of a safe service to patients. Diagnostic radiology is a dynamic environment and the Code is intended to be used in consultation with the current literature, an experienced Radiation Protection Advisor and a multidisciplinary project team

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)

Mammography calibration qualities establishment in a Mo-Mo clinical system

International Nuclear Information System (INIS)

Correa, E.L.; Santos, L.R. dos; Vivolo, V.; Potiens, M.P.A.

2015-01-01

In this study the mammography calibration qualities were established in a clinical mammography system. The objective is to provide the IPEN instruments calibration laboratory with both mammography calibration methods (using a clinical and an industrial system). The results showed a good behavior of mammography equipment, in terms of kVp, PPV and exposure time. The additional filtration of molybdenum is adequate, air-kerma rates were determined and spectra were obtained. (author)

Mammography calibration qualities establishment in a Mo-Mo clinical system

Energy Technology Data Exchange (ETDEWEB)

Correa, E.L.; Santos, L.R. dos; Vivolo, V.; Potiens, M.P.A., E-mail: educorrea1905@gmail.com [Instituto de Pesquisas Energeticas e Nucleres (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

2015-07-01

In this study the mammography calibration qualities were established in a clinical mammography system. The objective is to provide the IPEN instruments calibration laboratory with both mammography calibration methods (using a clinical and an industrial system). The results showed a good behavior of mammography equipment, in terms of kVp, PPV and exposure time. The additional filtration of molybdenum is adequate, air-kerma rates were determined and spectra were obtained. (author)

Image quality of mammography in Croatian nationwide screening program: Comparison between various types of facilities

International Nuclear Information System (INIS)

Brnić, Zoran; Blašković, Darko; Klasić, Branimir; Ramač, Jelena Popić; Flegarić-Bradić, Mirjana; Štimac, Damir; Lubina, Ivan Zvonimir; Brnić, Vedran; Faj, Dario

2012-01-01

Purpose: The study was aimed to provide objective evidence about the mammographic image quality in Croatia, to compare it between different types of MG facilities and to identify the most common deficiencies and possible reasons as well as the steps needed to improve image quality. Materials and methods: A total of 420 mammographic examinations collected from 84 mammographic units participating in the Croatian nationwide breast cancer screening program were reviewed in terms of four image quality categories: identification of patient and examination, breast positioning and compression, exposure and contrast, and artifacts. Those were rated using image evaluating system based on American College of Radiology and European Commission proposals. The results were compared among different types of mammographic units, and common image quality deficiencies were identified. Results: Total image quality scores of 12.8, 16.1, 13.0 and 13.7 were found for general hospitals, university hospitals, private clinics and public healthcare centres, respectively. Average score for all mammographic units was 13.5 (out of 25 points). University hospitals were significantly better than all other mammography units in overall image quality, which was mostly contributed by better breast positioning practices. Private clinics showed the worst results in identification, exposure, contrast and artifacts. Conclusions: Serious deficiencies in identification and breast positioning, which might compromise breast cancer screening outcome, were detected in our material. They occur mainly due to subjective reasons and could be corrected through additional staff training and improvement of working discipline.

Tomosynthesis in the Diagnostic Setting: Changing Rates of BI-RADS Final Assessment over Time.

Science.gov (United States)

Raghu, Madhavi; Durand, Melissa A; Andrejeva, Liva; Goehler, Alexander; Michalski, Mark H; Geisel, Jaime L; Hooley, Regina J; Horvath, Laura J; Butler, Reni; Forman, Howard P; Philpotts, Liane E

2016-10-01

Purpose To evaluate the effect of tomosynthesis in diagnostic mammography on the Breast Imaging Reporting and Data System (BI-RADS) final assessment categories over time. Materials and Methods This retrospective study was approved by the institutional review board. The authors reviewed all diagnostic mammograms obtained during a 12-month interval before (two-dimensional [2D] mammography [June 2, 2010, to June 1, 2011]) and for 3 consecutive years after (tomosynthesis year 1 [2012], tomosynthesis year 2 [2013], and tomosynthesis year 3 [2014]) the implementation of tomosynthesis. The requirement to obtain informed consent was waived. The rates of BI-RADS final assessment categories 1-5 were compared between the 2D and tomosynthesis groups. The positive predictive values after biopsy (PPV3) for BI-RADS category 4 and 5 cases were compared. The mammographic features (masses, architectural distortions, calcifications, focal asymmetries) of lesions categorized as probably benign (BI-RADS category 3) and those for which biopsy was recommended (BI-RADS category 4 or 5) were reviewed. The χ(2) test was used to compare the rates of BI-RADS final assessment categories 1-5 between the two groups, and multivariate logistic regression analysis was performed to compare all diagnostic studies categorized as BI-RADS 3-5. Results There was an increase in the percentage of cases reported as negative or benign (BI-RADS category 1 or 2) with tomosynthesis (58.7% with 2D mammography vs 75.8% with tomosynthesis at year 3, P tomosynthesis at year 3, P tomosynthesis (8.0% with 2D mammography vs 7.8% with tomosynthesis at year 3, P = .2), there was a significant increase in the PPV3 (29.6% vs 50%, respectively; P tomosynthesis use. Conclusion Tomosynthesis in the diagnostic setting resulted in progressive shifts in the BI-RADS final assessment categories over time, with a significant increase in the proportion of studies classified as normal, a continued decrease in the rate of studies

Performance of clinical mammography: a nationwide study from Denmark

DEFF Research Database (Denmark)

Jensen, Allan; Vejborg, Ilse; Severinsen, Niels

2006-01-01

that clinical mammography worked best in patient populations of purely symptomatic women. Our data indicate that to increase the accuracy of clinical mammography at the community level, the presence of an experienced radiologist should be prioritized ahead of raising the clinic size.......Clinical mammography is the key tool for breast cancer diagnosis, but little is known about the impact of the organisational set-up on the performance. We evaluated whether organisational factors influence the performance of clinical mammography. Clinical mammography data from all clinics...... in Denmark in the year 2000 were collected and linked to cancer outcome. Use of the National Institute of Radiation Hygiene register for identification of radiology clinics ensured comprehensive nationwide registration. We used the final mammographic assessment at the end of the imaging work-up to determine...

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

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.

Beam diagnostic tools for the negative hydrogen ion source test facility ELISE

International Nuclear Information System (INIS)

Nocentini, Riccardo; Fantz, Ursel; Franzen, Peter; Froeschle, Markus; Heinemann, Bernd; Riedl, Rudolf; Ruf, Benjamin; Wuenderlich, Dirk

2013-01-01

Highlights: ► We present an overview of beam diagnostic tools foreseen for the new testbed ELISE. ► A sophisticated diagnostic calorimeter allows beam profile measurement. ► A tungsten wire mesh in the beam path provides a qualitative picture of the beam. ► Stripping losses and beam divergence are measured by H α Doppler shift spectroscopy. -- Abstract: The test facility ELISE, presently being commissioned at IPP, is a first step in the R and D roadmap for the RF driven ion source and extraction system of the ITER NBI system. The “half-size” ITER-like test facility includes a negative hydrogen ion source that can be operated for 1 h. ELISE is expected to extract an ion beam of 20 A at 60 kV for 10 s every 3 min, therefore delivering a total power of 1.2 MW. The extraction area has a geometry that closely reproduces the ITER design, with the same width and half the height, i.e. 1 m × 1 m. This paper presents an overview of beam diagnostic tools foreseen for ELISE. For the commissioning phase, a simple beam dump with basic diagnostic capabilities has been installed. In the second phase, the beam dump will be substituted by a more sophisticated diagnostic calorimeter to allow beam profile measurement. Additionally, a tungsten wire mesh will be introduced in the beam path to provide a qualitative picture of beam size and position. Stripping losses and beam divergence will be measured by means of H α Doppler shift spectroscopy. An absolute calibration is foreseen in order to measure beam intensity

[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...

Evaluation of physical parameters and implementation of quality control in mammography diagnosed for a pilot of breast cancer screening in the Caja Costarricense de Seguro Social (CCSS)

International Nuclear Information System (INIS)

Hernandez Angulo, Carolina Maria

2012-01-01

The purpose of mammography has been to provide the contrast between the lesion and adjacent healthy tissue of the breast. The quality control which should be performed in mammography services is essential to obtain the necessary contrast in mammography and thus achieve a prompt detection of breast lesions. The quality control program has helped to obtain exact diagnosis in mammography and has contributed to reduce mortality from breast cancer in Costa Rica. The Caja Costarricense de Seguro Social (CCSS) has sought to improve the quality of mammograms performed in the different health centers by implementing quality control programs in the services. The evaluation of the physical parameters has had as aim to perform an assessment of the equipment used in mammography facilities. The image quality, dosimetry, optical density, performance, accuracy and repeatability of voltage applied to the tube, filtration and Half-value layer in system of screen film mammography have been evaluated. The usefulness of quality control programs and needs of the services to implement a pilot plan for breast screening, can be seen when comparing the obtained results. The protocol of Mammography Quality Control, TECDOC 1517 from the International Atomic Energy Agency (IAEA), is implemented with this project and the associated software in four of the six hospitals evaluated in this study. (author) [es

The effect of breast compression on mass conspicuity in digital mammography

International Nuclear Information System (INIS)

Saunders, Robert S. Jr; Samei, Ehsan

2008-01-01

This study analyzed how the inherent quality of diagnostic information in digital mammography could be affected by breast compression. A digital mammography system was modeled using a Monte Carlo algorithm based on the Penelope program, which has been successfully used to model several medical imaging systems. First, the Monte Carlo program was validated against previous measurements and simulations. Once validated, the Monte Carlo software modeled a digital mammography system by tracking photons through a voxelized software breast phantom, containing anatomical structures and breast masses, and following photons until they were absorbed by a selenium-based flat-panel detector. Simulations were performed for two compression conditions (standard compression and 12.5% reduced compression) and three photon flux conditions (constant flux, constant detector signal, and constant glandular dose). The results showed that reduced compression led to higher scatter fractions, as expected. For the constant photon flux condition, decreased compression also reduced glandular dose. For constant glandular dose, the SdNR for a 4 cm breast was 0.60±0.11 and 0.62±0.11 under standard and reduced compressions, respectively. For the 6 cm case with constant glandular dose, the SdNR was 0.50±0.11 and 0.49±0.10 under standard and reduced compressions, respectively. The results suggest that if a particular imaging system can handle an approximately 10% increase in total tube output and 10% decrease in detector signal, breast compression can be reduced by about 12% in terms of breast thickness with little impact on image quality or dose.

Sensitivity and specificity of MR mammography with histopathological correlation in 250 breasts

Energy Technology Data Exchange (ETDEWEB)

Bone, B. [Dept. of Diagnostic Radiology, Univ. Hospital, Malmoe (Sweden); Aspelin, P. [Dept. of Diagnostic Radiology, Univ. Hospital, Malmoe (Sweden); Bronge, L. [Dept. of Diagnostic Radiology, Univ. Hospital, Malmoe (Sweden); Isberg, B. [Dept. of Diagnostic Radiology, Univ. Hospital, Malmoe (Sweden); Perbeck, L. [Dept. of Surgery, Karolinska Inst., Huddinge Hospital (Sweden); Veress, B. [Dept. of Pathology, Univ. Hospital, Malmoe (Sweden)

1996-03-01

The aim of our prospective study was to determine the diagnostic accuracy of MR mammography (MRM) in detecting malignant disease. In 231 consecutive patients scheduled for surgery because of mammographic or palpable lesions suspected of malignancy, the breasts were examined with T1-weighted transversal images using a 3-D fast low angle shot (FLASH) sequence. On pre- and 2 post-contrast images were obtained. Histological examination of the surgical specimens showed carcinoma in 155 breasts, of which 138 were invasive and 17 in situ. MRM detected 144 of the 155 malignancies and was false-negative in 11 cases. Eight of these MRM-missed tumours were invasive and 3 were in situ cancers. Benign lesions were found at microscopy in 95 breasts, of which MRM correctly diagnosed 69. The cellular composition of the 26 false-positive lesions (myxomatous stromal change, high vascularity, and epithelial or apocrine hyperplasia) might explain the false positivity. The sentitivity and specificity of MRM were 93% and 73%, respectively. MRM should be interpreted with caution, and supplemented with e.g. mammography and ultrasonography. (orig.).

Racial and Ethnic Disparity in Symptomatic Breast Cancer Awareness despite a Recent Screen: The Role of Tumor Biology and Mammography Facility Characteristics.

Science.gov (United States)

Mortel, Mylove; Rauscher, Garth H; Murphy, Anne Marie; Hoskins, Kent; Warnecke, Richard B

2015-10-01

In a racially and ethnically diverse sample of recently diagnosed urban patients with breast cancer, we examined associations of patient, tumor biology, and mammography facility characteristics on the probability of symptomatic discovery of their breast cancer despite a recent prior screening mammogram. In the Breast Cancer Care in Chicago study, self-reports at interview were used to define patients as having a screen-detected breast cancer or having symptomatic awareness despite a recent screening mammogram (SADRS), in the past 1 or 2 years. Patients with symptomatic breast cancer who did not report a recent prior screen were excluded from these analyses. Characteristics associated with more aggressive disease [estrogen receptor (ER)- and progesterone receptor (PR)-negative status and higher tumor grade] were abstracted from medical records. Mammogram facility characteristics that might indicate aspects of screening quality were defined and controlled for in some analyses. SADRS was more common among non-Hispanic black and Hispanic than among non-Hispanic white patients (36% and 42% vs. 25%, respectively, P = 0.0004). SADRS was associated with ER/PR-negative and higher-grade disease. Patients screened at sites that relied on dedicated radiologists and sites that were breast imaging centers of excellence were less likely to report SADRS. Tumor and facility factors together accounted for two thirds of the disparity in SADRS (proportion mediated = 70%, P = 0.02). Facility resources and tumor aggressiveness explain much of the racial/ethnic disparity in symptomatic breast cancer among recently screened patients. A more equitable distribution of high-quality screening would ameliorate but not eliminate this disparity. ©2015 American Association for Cancer Research.

Mammography practices for radiation protection in Kenya

International Nuclear Information System (INIS)

Shadrack, Anthony K.

2008-01-01

All mammography units in the country, totaling fourteen in number at the time, were evaluated on the basis of performance and practice to come up with useful data for summing up the mammography practice in Kenya. The study was carried out by performing hands-on quality control tests on the units using internationally established protocols. Image quality and dose measurement data were generated in all the centers and clearly indicated that the practice of mammography, more so on optimization viewpoint is so much varied. A standard method was used to obtain these data by use of mammography accreditation phantom. Data from actual patients was also collected in three major centers in Nairobi. On the criteria used for evaluating phantom image quality, ten out of fourteen units did satisfy the set criterion. The average glandular dose was 2.79 mGy per cranio caudal (cc) view of the phantom and 3.27 mGy per cc view for the sampled patients. The internationally recommended dose level for such a view is 3.0 mGy. One worrying observation made was that most units failed on one of the easiest test of mammographic unit assembly. Of most concern was the lack of technique charts for the practice detailing the imaging parameters being employed for the procedure. Most centers do not take the servicing of equipment seriously and others merely ignore even the crucial issues of equipment performance like the automatic exposure control and viewing conditions of the reporting areas.The results of this study calls for the setting up of a programme of optimization of radiological protection in mammography using the experience of other countries that have put in place quality assurance programs, setting and adoption of Dose Reference Levels (DRLs) as part of Quality Assurance (QA). This practice needs an effective quality control program which should start with the selection of appropriate equipment for mammography and the use of qualified personnel including the radiologist, radiographer

Risks, radiation dose and image quality of mammography

International Nuclear Information System (INIS)

Menges, V.

1979-01-01

For some time to come, early detection of breast cancer will remain the only way to improve the therapeutical success. Mammography is an absolutely indispensible way to take advantage of this opportunity. Today, mammography is undoubtedly the most reliable method of examination for an early detection of breast cancer. Only mammography can detect carcinomas smaller than the critical tumour size of 1cm. If carried out properly and with present dose levels, it involves hardly any radiation risk. (orig.) [de

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

Mammography discomfort: a holistic perspective derived from women's experiences

International Nuclear Information System (INIS)

Poulos, Ann; Llewellyn, Gwynnyth

2005-01-01

Purpose: Mammography discomfort has the potential to deter women from attending for regular breast screening. Previous studies have focussed on the pain/discomfort of the mammography procedure itself. The purpose of this study was to consider discomfort from a holistic perspective of the mammography experience derived from the women themselves. Methods: Qualitative research methods were employed. Using theoretical sampling, 12 women who had recently experienced mammography were interviewed. The interview questions aimed to explore the experience of women attending for a mammogram from arrival to departure and beyond in order to identify aspects which potentially increase discomfort. Data analysis involved coding and categorisation and identification of key concepts and their relationships. Results: A conceptual framework was developed that demonstrates the contributors to mammography discomfort and the relationships between these as identified by the women. Conclusions: The conceptual framework has important implications for clinical practice and future research

Dose reduction in mammography as a consequence of quality assurance programme

International Nuclear Information System (INIS)

Staniszewska, M. A.; Jankowski, J.

2003-01-01

Mammography became one of more frequent radiological examinations in the most of European countries. This is accepted as a sensitive method for detection of early breast cancers. On the other hand, this is the special imaging technique, where reliability of result is strongly influenced by technical conditions. Hence, the exposure parameters should have been chosen in dependence on image recording system. In opposite, an informative quality of the produced image is not sufficient for a true clinical diagnosis. Thus, optimisation of the practice is not achieved and a benefit for patient is none. Implementation of Quality Assurance programme can prevent the situation: systematic quality control of mammographic x-ray units allows finding the technical and methodological incorrectness. If these findings are followed by the appropriate remedial actions, the main aim will be achieved, i.e. good quality of image with reasonable low doses to patients. This approach was verified on 15 mammographic units in Lodz, covered by full cycle of quality control programme. Doses were measured during CC projection for over 100 patients. Quality of image was evaluated for RMI 156 accreditation phantom as a standard object. The main technical incorrectness was found for automatic exposure control system, and especially for compensation of object thickness. The available remedial actions allowed reducing the doses to patients by 21% (on average). Additionally, after the remedial action quality of phantom image was found better for 3 facilities where primary had been below the acceptance level. The main points of Quality Assurance programme are available for most of x-ray diagnostic facilities and should have been obligatory. (authors)

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

Material decomposition through weighted imaged subtraction in dual-energy spectral mammography with an energy-resolved photon-counting detector using Monte Carlo Simulation

Energy Technology Data Exchange (ETDEWEB)

Eom, Ji Soo; Kang, Soon Cheol; Lee, Seung Wan [Konyang University, Daejeon (Korea, Republic of)

2017-09-15

Mammography is commonly used for screening early breast cancer. However, mammographic images, which depend on the physical properties of breast components, are limited to provide information about whether a lesion is malignant or benign. Although a dual-energy subtraction technique decomposes a certain material from a mixture, it increases radiation dose and degrades the accuracy of material decomposition. In this study, we simulated a breast phantom using attenuation characteristics, and we proposed a technique to enable the accurate material decomposition by applying weighting factors for the dual-energy mammography based on a photon-counting detector using a Monte Carlo simulation tool. We also evaluated the contrast and noise of simulated breast images for validating the proposed technique. As a result, the contrast for a malignant tumor in the dual-energy weighted subtraction technique was 0.98 and 1.06 times similar than those in the general mammography and dual-energy subtraction techniques, respectively. However the contrast between malignant and benign tumors dramatically increased 13.54 times due to the low contrast of a benign tumor. Therefore, the proposed technique can increase the material decomposition accuracy for malignant tumor and improve the diagnostic accuracy of mammography.

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)

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

Eight years of quality control in Bulgaria: impact on mammography practice.

Science.gov (United States)

Avramova-Cholakova, S; Lilkov, G; Kaneva, M; Terziev, K; Nakov, I; Mutkurov, N; Kovacheva, D; Ivanova, M; Vasilev, D

2015-07-01

The requirements for quality control (QC) in diagnostic radiology were introduced in Bulgarian legislation in 2005. Hospital medical physicists and several private medical physics groups provide QC services to radiology departments. The aim of this study was to analyse data from QC tests in mammography and to investigate the impact of QC introduction on mammography practice in the country. The study was coordinated by the National Centre of Radiobiology and Radiation Protection. All medical physics services were requested to fill in standardised forms with information about most important parameters routinely measured during QC. All QC service providers responded. Results demonstrated significant improvement of practice since the introduction of QC, with reduction of established deviations from 65 % during the first year to 7 % in the last year. The systems that do not meet the acceptability criteria were suspended from use. Performance of automatic exposure control and digital detectors are not regularly tested because of the absence of requirements in the legislation. The need of updated guidance and training of medical physicists to reflect the change in technology was demonstrated. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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…

Image quality in conventional film screen system, digital phosphor storage plate mammography in magnification technique and digital mammography in CCD-technique

International Nuclear Information System (INIS)

Schulz-Wendtland, R.; Aichinger, U.; Boehner, C.; Dobritz, M.; Bautz, W.; Saebel, M.

2000-01-01

Purpose: Comparison of image quality between conventional film screen system, digital phosphor storage plate mammography in magnification technique and digital mammography in CCD-technique. Materials and Methods: Radiograms of a RMI-mammography phantom were acquired using a conventional film screen system, two digital storage plate systems and two digital systems in CCD-technique. Additionally, the radiograms of one digital phosphor storage plate system were post-processed emphasizing contrast and included in the comparison. Results: The detectability of details was the best with the digital mammography in CCD-technique in comparison with the conventional film screen technique resp. digital phosphor storage plate in magnification technique. Conclusions: Based on these results there is the possibility to replace the conventional film screen system by further studies - this has to be confirmed. (orig.) [de

Breast Imaging: How We Manage Diagnostic Technology at a Multidisciplinary Breast Center

Directory of Open Access Journals (Sweden)

Alejandro Tejerina Bernal

2012-01-01

Full Text Available This paper discusses the most important aspects and problems related to the management of breast cancer imaging, at a center specialized in breast pathology. We review the established and emerging diagnostic techniques, their indications, and peculiarities: digital mammography, CAD systems, and the recent digital breast tomosynthesis, ultrasound and complementary elastography, molecular imaging techniques, magnetic resonance imaging, advanced sequences (diffusion, and positron emission mammography (PEM. The adequate integration and rational management of these techniques is essential, but this is not always easy, in order to achieve a successful diagnosis.

Traceability and quality control in mammography: measurements and models

International Nuclear Information System (INIS)

Peixoto, Jose Guilherme Pereira

2002-10-01

The success of a treatment or diagnosis using radiation, depends on the optimization of the dose determination to be administered for the patient and on the beam radiation quality. It is recognized by the international guidelines that it is necessary to improve calibration services for mammography beams in order to improve the quality of clinical diagnosis. Major efforts have been made by several laboratories in order to establish an appropriate and traceable calibration infrastructure and to provide the basis for a quality control program in mammography. The contribution of the radiation metrology network to the mammography services is reviewed in this work. Steps required for the implementation of a mammography calibration system using a constant potential x-ray and a clinical mammography x-ray machine are presented. The various qualities of mammography radiation discussed in this work are in accordance with the IEC 61674 and the AAPM recommendations. This work also presents the methodology and the procedures to maintain and to disseminate the traceability at the x-ray mammography range, describing the interlaboratory comparison performed at LNMRI/IRD/CNEN and at the IPEN/CNEN using the secondary standard ionization chambers traceable with the international standard. It assesses the inter-laboratory comparison consistency and decides whether a questionable value should or not be accepted, using the residual method. This thesis discusses the uncertainties involved in all steps of the calibration chain in accord once with the ISO recommendations. (author)

3.0 Tesla breast magnetic resonance imaging in patients with nipple discharge when mammography and ultrasound fail.

Science.gov (United States)

Lubina, Nóra; Schedelbeck, Ulla; Roth, Anne; Weng, Andreas Max; Geissinger, Eva; Hönig, Arnd; Hahn, Dietbert; Bley, Thorsten Alexander

2015-05-01

To compare 3.0 Tesla breast magnetic resonance imaging (MRI) with galactography for detection of benign and malignant causes of nipple discharge in patients with negative mammography and ultrasound. We prospectively evaluated 56 breasts of 50 consecutive patients with nipple discharge who had inconspicuous mammography and ultrasound, using 3.0 Tesla breast MRI with a dedicated 16-channel breast coil, and then compared the results with galactography. Histopathological diagnoses and follow-ups were used as reference standard. Lesion size estimated on MRI was compared with the size at histopathology. Sensitivity and specificity of MRI vs. galactography for detecting pathologic findings were 95.7 % vs. 85.7 % and 69.7 % vs. 33.3 %, respectively. For the supposed concrete pathology based on MRI findings, the specificity was 67.6 % and the sensitivity 77.3 % (PPV 60.7 %, NPV 82.1 %). Eight malignant lesions were detected (14.8 %). The estimated size at breast MRI showed excellent correlation with the size at histopathology (Pearson's correlation coefficient 0.95, p 3.0 Tesla is an accurate imaging test and can replace galactography in the workup of nipple discharge in patients with inconspicuous mammography and ultrasound. • Breast MRI is an excellent diagnostic tool for patients with nipple discharge. • MRI of the breast reveals malignant lesions despite inconspicuous mammography and ultrasound. • MRI of the breast has greater sensitivity and specificity than galactography. • Excellent correlation of lesion size measured at MRI and histopathology was found.

Mammography screening among Arab American women in metropolitan Detroit.

Science.gov (United States)

Schwartz, Kendra; Fakhouri, Monty; Bartoces, Monina; Monsur, Joseph; Younis, Amani

2008-12-01

Mammography screening behavior has not been well studied among Middle Eastern immigrant women. We conducted a telephone survey of 365 Arab American women residing in metropolitan Detroit, home to one of the largest populations of Middle Eastern immigrants in the US, to determine prevalence of factors associated with mammography, and attitudes and beliefs regarding mammography screening. Of 365 participants, only five were born in the US. Mean age was 53.2 years (SD 10.8). Two hundred twelve (58.1%) reported having mammogram every 1-2 years; 70% ever had mammogram. Age 50-64 years, having health insurance, married status, being in the US over 10 years, and being Lebanese were associated with mammography every 1-2 years. After adjusting for demographic factors, perceived seriousness of disease, general health motivation, and having fewer barriers were associated with more frequent screening. Appropriate mammography screening is decreased in this group. Targeted outreach regarding screening is appropriate for this population; however, lack of insurance may prevent adequate follow-up.

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.

Potential clinical applications of {sup 18}F-fluorodeoxyglucose position emission tomography/magnetic resonance mammography in breast cancer

Energy Technology Data Exchange (ETDEWEB)

Cho, Ihn Ho; Kong, Eun Jung [Dept. of Nuclear Medicine, Yeugnam University Hospital, Daegu (Korea, Republic of)

2017-09-15

The whole-body positron emission tomography (PET)/magnetic resonance (MR) scan is a cutting edge technology providing comprehensive structural information from MR imaging and functional features from PET in a single session. Recent research findings and clinical experience have shown that 18F-fluorodeoxyglucose (FDG) whole-body PET/MR imaging has a diagnostic performance comparable with or superior to that of PET/CT in the field of oncology, including for breast cancer. In particular, FDG PET/MR mammography in the prone position with the breast hanging in a pendant manner can provide more comprehensive information about the metabolism, anatomy, and functional features of a breast lesion than a whole-body PET/MR scan. This article reports on current state-of-the-art PET/MR mammography in patients with breast cancer and the prospects for potential application in the future.

First set of gated x-ray imaging diagnostics for the Laser Megajoule facility

Energy Technology Data Exchange (ETDEWEB)

Rosch, R.; Trosseille, C.; Caillaud, T.; Allouche, V.; Bourgade, J. L.; Briat, M.; Brunel, P.; Burillo, M.; Casner, A.; Depierreux, S.; Gontier, D.; Jadaud, J. P.; Le Breton, J. P.; Llavador, P.; Loupias, B.; Miquel, J. L.; Oudot, G.; Perez, S.; Raimbourg, J.; Rousseau, A. [CEA-DAM Ile de France, Bruyères-le-Châtel, 91297 Arpajon Cedex (France); and others

2016-03-15

The Laser Megajoule (LMJ) facility located at CEA/CESTA started to operate in the early 2014 with two quadruplets (20 kJ at 351 nm) focused on target for the first experimental campaign. We present here the first set of gated x-ray imaging (GXI) diagnostics implemented on LMJ since mid-2014. This set consists of two imaging diagnostics with spatial, temporal, and broadband spectral resolution. These diagnostics will give basic measurements, during the entire life of the facility, such as position, structure, and balance of beams, but they will also be used to characterize gas filled target implosion symmetry and timing, to study x-ray radiography and hydrodynamic instabilities. The design requires a vulnerability approach, because components will operate in a harsh environment induced by neutron fluxes, gamma rays, debris, and shrapnel. Grazing incidence x-ray microscopes are fielded as far as possible away from the target to minimize potential damage and signal noise due to these sources. These imaging diagnostics incorporate microscopes with large source-to-optic distance and large size gated microchannel plate detectors. Microscopes include optics with grazing incidence mirrors, pinholes, and refractive lenses. Spatial, temporal, and spectral performances have been measured on x-ray tubes and UV lasers at CEA-DIF and at Physikalisch-Technische Bundesanstalt BESSY II synchrotron prior to be set on LMJ. GXI-1 and GXI-2 designs, metrology, and first experiments on LMJ are presented here.

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

Understanding women's mammography intentions: a theory-based investigation.

Science.gov (United States)

Naito, Mikako; O'Callaghan, Frances V; Morrissey, Shirley

2009-01-01

The present study compared the utility of two models (the Theory of Planned Behavior and Protection Motivation Theory) in identifying factors associated with intentions to undertake screening mammography, before and after an intervention. The comparison was made between the unique components of the two models. The effect of including implementation intentions was also investigated. Two hundred and fifty-one women aged 37 to 69 years completed questionnaires at baseline and following the delivery of a standard (control) or a protection motivation theory-based informational intervention. Hierarchical multiple regressions indicated that theory of planned behavior variables were associated with mammography intentions. Results also showed that inclusion of implementation intention in the model significantly increased the association with mammography intentions. The findings suggest that future interventions aiming to increase screening mammography participation should focus on the theory of planned behavior variables and that implementation intention should also be targeted.

Los Alamos contribution to target diagnostics on the National Ignition Facility

Energy Technology Data Exchange (ETDEWEB)

Mack, J.M.; Baker, D.A.; Caldwell, S.E. [and others

1994-07-01

The National Ignition Facility (NIF) will have a large suite of sophisticated target diagnostics. This will allow thoroughly diagnosed experiments to be performed both at the ignition and pre-ignition levels. As part of the national effort Los Alamos National Laboratory will design, construct and implement a number of diagnostics for the NIF. This paper describes Los Alamos contributions to the ``phase I diagnostics.`` Phase I represents the most fundamental and basic measurement systems that will form the core for most work on the NIF. The Los Alamos effort falls into four categories: moderate to hard X-ray (time resolved imaging neutron spectroscopy- primarily with neutron time of flight devices; burn diagnostics utilizing gamma ray measurements; testing measurement concepts on the TRIDENT laser system at Los Alamos. Because of the high blast, debris and radiation environment, the design of high resolution X-ray imaging systems present significant challenges. Systems with close target proximity require special protection and methods for such protection is described. The system design specifications based on expected target performance parameters is also described. Diagnosis of nuclear yield and burn will be crucial to the NIF operation. Nuclear reaction diagnosis utilizing both neutron and gamma ray detection is discussed. The Los Alamos TRIDENT laser system will be used extensively for the development of new measurement concepts and diagnostic instrumentation. Some its potential roles in the development of diagnostics for NIF are given.

Los Alamos contribution to target diagnostics on the National Ignition Facility

International Nuclear Information System (INIS)

Mack, J.M.; Baker, D.A.; Caldwell, S.E.

1994-01-01

The National Ignition Facility (NIF) will have a large suite of sophisticated target diagnostics. This will allow thoroughly diagnosed experiments to be performed both at the ignition and pre-ignition levels. As part of the national effort Los Alamos National Laboratory will design, construct and implement a number of diagnostics for the NIF. This paper describes Los Alamos contributions to the ''phase I diagnostics.'' Phase I represents the most fundamental and basic measurement systems that will form the core for most work on the NIF. The Los Alamos effort falls into four categories: moderate to hard X-ray (time resolved imaging neutron spectroscopy- primarily with neutron time of flight devices; burn diagnostics utilizing gamma ray measurements; testing measurement concepts on the TRIDENT laser system at Los Alamos. Because of the high blast, debris and radiation environment, the design of high resolution X-ray imaging systems present significant challenges. Systems with close target proximity require special protection and methods for such protection is described. The system design specifications based on expected target performance parameters is also described. Diagnosis of nuclear yield and burn will be crucial to the NIF operation. Nuclear reaction diagnosis utilizing both neutron and gamma ray detection is discussed. The Los Alamos TRIDENT laser system will be used extensively for the development of new measurement concepts and diagnostic instrumentation. Some its potential roles in the development of diagnostics for NIF are given

Diagnostic radiology 1987

International Nuclear Information System (INIS)

Margulis, A.R.; Gooding, C.A.

1987-01-01

This is the latest version of the continuing education course on diagnostic radiology given yearly by the Department of Radiology at the University of California, San Francisco. The lectures are grouped into sections on gastrointestinal radiology, mammography, uroradiology, magnetic resonance, hepatobiliary radiology, pediatric radiology, ultrasound, interventional radiology, chest radiology, nuclear medicine, cardiovascular radiology, and skeletal radiology. Each section contains four to eight topics. Each of these consists of text that represents highlights in narrative form, selected illustrations, and a short bibliography. The presentation gives a general idea of what points were made in the lecture

Cancer of the breast: induction by radiation and role of mammography

Energy Technology Data Exchange (ETDEWEB)

Simon, N

1977-10-01

Conflict in the management of cancer of the breast exists. Diagnosis by x-ray mammography provides early effective treatment, but x-ray exposure to the breast is cancerogenic. Prudence requires the use of low dose x-rays in mammography, and limits the use of x-ray mammography in the young. Guide lines for the indications for mammography are changing, and large scale population exposure to radiation should await results of demonstration projects in the United States.

Retrospective analysis on malignant calcification previously misdiagnosed as benign on screening mammography

International Nuclear Information System (INIS)

Ha, Su Min; Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung

2017-01-01

The purpose of our study was to investigate the morphology and distribution of calcifications initially interpreted as benign or probably benign, but proven to be malignant by subsequent stereotactic biopsy, and to identify the reason for misinterpretation or underestimation at the initial diagnosis. Out of 567 women who underwent stereotactic biopsy for calcifications at our hospital between January 2012 and December 2014, 167 women were diagnosed with malignancy. Forty-six of these 167 women had previous mammography assessed as benign or probably benign which was changed to suspicious malignancy on follow-up mammography. Of these 46 women, three women with biopsy-proven benign calcifications at the site of subsequent cancer were excluded, and 43 patients were finally included. The calcifications (morphology, distribution, extent, associated findings) in the previous and follow-up mammography examinations were analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and assessment category. We classified the patients into two groups: 1) group A patients who were still retrospectively re-categorized as less than or equal to BI-RADS 3 and 2) group B patients who were re-categorized as equal to or higher than BI-RADS 4a and whose results should have prompted previous diagnostic assessment. In the follow-up mammography examinations, change in calcification morphology (n = 27, 63%) was the most frequent cause of assessment change. The most frequent previous mammographic findings of malignant calcification were amorphous morphology (n = 26, 60%) and grouped distribution (n = 36, 84%). The most frequent calcification findings at reassessment were amorphous morphology (n = 4, 9%), fine pleomorphic calcification (n = 30, 70%), grouped distribution (n = 23, 53%), and segmental calcification (n = 12, 28%). There were 33 (77%) patients in group A, and 10 patients (23%) in group B. Amorphous morphology and grouped distribution were the most frequent

Retrospective analysis on malignant calcification previously misdiagnosed as benign on screening mammography

Energy Technology Data Exchange (ETDEWEB)

Ha, Su Min [Dept. of Radiology, Research Institute of Radiology, Chung Ang University Hospital, Seoul(Korea, Republic of); Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung [Dept. of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2017-04-15

The purpose of our study was to investigate the morphology and distribution of calcifications initially interpreted as benign or probably benign, but proven to be malignant by subsequent stereotactic biopsy, and to identify the reason for misinterpretation or underestimation at the initial diagnosis. Out of 567 women who underwent stereotactic biopsy for calcifications at our hospital between January 2012 and December 2014, 167 women were diagnosed with malignancy. Forty-six of these 167 women had previous mammography assessed as benign or probably benign which was changed to suspicious malignancy on follow-up mammography. Of these 46 women, three women with biopsy-proven benign calcifications at the site of subsequent cancer were excluded, and 43 patients were finally included. The calcifications (morphology, distribution, extent, associated findings) in the previous and follow-up mammography examinations were analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and assessment category. We classified the patients into two groups: 1) group A patients who were still retrospectively re-categorized as less than or equal to BI-RADS 3 and 2) group B patients who were re-categorized as equal to or higher than BI-RADS 4a and whose results should have prompted previous diagnostic assessment. In the follow-up mammography examinations, change in calcification morphology (n = 27, 63%) was the most frequent cause of assessment change. The most frequent previous mammographic findings of malignant calcification were amorphous morphology (n = 26, 60%) and grouped distribution (n = 36, 84%). The most frequent calcification findings at reassessment were amorphous morphology (n = 4, 9%), fine pleomorphic calcification (n = 30, 70%), grouped distribution (n = 23, 53%), and segmental calcification (n = 12, 28%). There were 33 (77%) patients in group A, and 10 patients (23%) in group B. Amorphous morphology and grouped distribution were the most frequent

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

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.

Exposure and roentgen-area-product in xeromammography and conventional mammography

Energy Technology Data Exchange (ETDEWEB)

Baxt, J H; Bushong, S C; Glaze, S; Kothari, S [Baylor Univ., Houston, Tex. (USA). Coll. of Medicine

1976-01-01

X-ray mammography is assuming increasing importance in the early detection of breast cancer. The principal disadvantage to conventional mammography is high patient dose. Xeromammography offers three advantages over conventional mammography: (a) lower patient dose, (b) better image quality and (c) no special mammography tube required. A transmission ionization chamber and thermoluminescent dosimeters were used to measure the roentgen-area-product and the exposure for three view examination. Average roentgen-area-product values of 6500 and 4200 R-cm/sup 2/ were observed for conventional mammography and xeromammography respectively. The medial surface of the breast received the highest radiation exposure for both types of examinations and this was shown to be 11.5 and 5.1 R respectively. Omission of the axillary view from the examination reduces the patient dose in both types by approximately 60 %.

Targeted Ultrasound of an Indeterminate Breast Lesion on Mammography: When Does It Influence Management?

Science.gov (United States)

Sohail, Saba; Masroor, Imrana; Afzal, Shaista

2015-08-01

To determine the change over mammographic diagnosis, BI-RADS category and management following targeted ultrasound of an indeterminate lesion seen on mammography and associated factors, if any. Descriptive, analytical study. Radiology Department, The Aga Khan University Hospital and Clifton Medical Services, Karachi, from April 2010 to May 2011. Patients referred for targeted breast ultrasound following X-ray mammography were selected regardless of age. Targeted Ultrasound (TUS) was defined as a limited ultrasound of a specific lesion or breast part as indicated by the referring source. Comparison was made between the post mammography and post TUS lesion characterization, diagnosis and BI-RADS category (0-5) which was taken as a measure of management change. Those were evaluated to determine significance of age, marital status, parity, breast parenchymal pattern ( dense, fatty, heterogeneous), referring source for the TUS (radiology resident, radiologist or surgeon), lesion characteristics (density, echogenecity, shape, location, margins, size, depth-to-width ratio, enhancement or shadowing), presenting symptoms or signs and reason for TUS. Ap-value of 0.05 or less was taken as significant. There were a total of 342 patients with mean age of 49.7 ±13.5 years. It assigned a definite category in 232 patients with an indefinite category (0) on mammography requiring further investigation. It decreased the suspicion for malignancy in 180 (77.58%) by assigning a low BI-RADS category and increased the suspicion in 52 (22.41%). The factors significantly associated with this changes included clinical indication being diagnostic (p management of an indeterminate breast lesion in a high number of patients, particularly when there was a lump as indication for imaging in the presence of risk factors in a patient with otherwise heterogeneously dense breast parenchyma.

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

Does health status influence intention regarding screening mammography?

International Nuclear Information System (INIS)

Park, Keeho; Park, Jong-Hyock; Park, Jae-Hyun; Kim, Hui-Jeong; Park, Bo-Yoon

2010-01-01

We analyzed information surveyed from a community-based sample of Korean women older than 40 years of age to understand the relationships between health status and screening behavior. In a cross-sectional population-based study, a two-stage, geographically stratified household-based sampling design was used for assembly of a probability sample of women aged 40-69 years living in Gunpo in Korea, resulting in a total sample size of 503 women. The primary outcome variable for this analysis was the respondent's intention to obtain a mammogram. Predictor variables included health status and other factors known to influence the use of cancer screening, such as age, education, income, marital status and the presence of co-morbid illnesses. Health status was assessed by using the EuroQol (EQ-5D). The median EQ visual analogue scale score was 75.0, ranging from 20 to 100. In bivariate analyses, the percentage of women reporting to have intention toward mammography use decreased with worsening health status. Women who had problems with mobility or anxiety/depression showed lower intention to undergo future screening mammography. Multivariate logistic regression confirmed that health status was significantly associated with intention toward mammography use. Anxiety or depression was an independent predictor of future screening mammography use. Health status is significantly associated with intention regarding screening mammography use. Physicians or other health professionals should be aware that health status is an important component for health promotion, and should pay more attention to clients' possible vulnerability in screening mammography use due to their poor health status. (author)

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.

Dual-energy mammography: simulation studies

International Nuclear Information System (INIS)

Bliznakova, K; Kolitsi, Z; Pallikarakis, N

2006-01-01

This paper presents a mammography simulator and demonstrates its applicability in feasibility studies in dual-energy (DE) subtraction mammography. This mammography simulator is an evolution of a previously presented x-ray imaging simulation system, which has been extended with new functionalities that are specific for DE simulations. The new features include incident exposure and dose calculations, the implementation of a DE subtraction algorithm as well as amendments to the detector and source modelling. The system was then verified by simulating experiments and comparing their results against published data. The simulator was used to carry out a feasibility study of the applicability of DE techniques in mammography, and more precisely to examine whether this modality could result in better visualization and detection of microcalcifications. Investigations were carried out using a 3D breast software phantom of average thickness, monoenergetic and polyenergetic beam spectra and various detector configurations. Dual-shot techniques were simulated. Results showed the advantage of using monoenergetic in comparison with polyenergetic beams. Optimization studies with monochromatic sources were carried out to obtain the optimal low and high incident energies, based on the assessment of the figure of merit of the simulated microcalcifications in the subtracted images. The results of the simulation study with the optimal energies demonstrated that the use of the DE technique can improve visualization and increase detectability, allowing identification of microcalcifications of sizes as small as 200 μm. The quantitative results are also verified by means of a visual inspection of the synthetic images

Study of the performance of diagnostic radiology instruments during calibration

International Nuclear Information System (INIS)

Freitas, Rodrigo N. de; Vivolo, Vitor; Potiens, Maria da Penha A.

2008-01-01

Full text: The instruments used in diagnostic radiology measurements represent 8 % of the tested instruments by the calibration laboratory of IPEN annually (approximately 1600 in 2007). Considering that the calibration of this kind of instrument is performed biannually it is possible to conclude that almost 300 instruments are being used to measure the air kerma in diagnostic radiology clinics to determine the in beam values (in front of the patient), attenuated measurements (behind the patient) and scattered radiation. This work presents the results of the calibration of the instruments used in mammography, computed tomography, dental and conventional diagnostic radiology dosimetry, performed during the period of 2005 to 2007. Their performances during the calibrations measurements were evaluated. Although at the calibration laboratory there are three available series of radiation quality to this type of calibration (RQR, N and M, according to standards IEC 61267 and ISO 4037-1.), the applications can be assorted (general radiology, computed tomography, mammography, radiation protection and fluoroscopy). Depending on its design and behaviour , one kind of instrument can be used for one or more type of applications. The instruments normally used for diagnostic radiology measurements are ionization chambers with volumes varying from 3 to 1800 cm 3 , and can be cylindrical, spherical or plane parallel plates kind. They usually are sensitive to photon particles, with energies greater than 15 keV and can be used up to 1200 keV. In this work they were tested in X radiation fields from 25 to 150 kV, in specific qualities depending on the utilization of the instrument. The calibration results of 390 instruments received from 2005 to 2007 were analyzed. About 20 instruments were not able to be calibrated due to bad functioning. The calibration coefficients obtained were between 0.88 and 1.24. The uncertainties were always less than ± 3.6% to instruments used in scattered

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.

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.

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.

Signing with harpoon of mammary lesions not palpable demonstrated by mammography

International Nuclear Information System (INIS)

Patino P, Jairo Hernando; Correa R, Ramiro; Hincapie U, Ana Lucia; Munera G, Felipe

1993-01-01

It was done a pre-surgery mark with harpoon of 61 non-palpable mammary lesions. They were classified by mammography as indeterminate probably benign (IBP) 39 injuries (63.9%) and the remaining 22 injuries as indeterminate probably malign. 12 malign lesions were found. The positive and predictive value of the marked injuries was of 19.7%, the sensitivity of 83.3%, the specificity of 75.5%, with a high significance statistics (p=0.0003). We can conclude according to the results obtained that in the group of injuries classified, as IBP should be considered the use of other complementary diagnostic methods or the periodical mammographic follow-up

Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis

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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.)

Current perspectives on indications and limitations of mammography

International Nuclear Information System (INIS)

Pope, T.L. Jr.

1983-01-01

Women have a 7 percent natural lifetime risk of developing breast cancer, which is the leading cause of death in women aged 40 to 50 years. Most data suggest that the earlier the disease is diagnosed, the better the chance for cure. Women with ''minimal breast cancer'' have an actuarial 20-year survival rate of 93.2 percent. The majority of these breast cancers are diagnosed by mammography. The radiation doses from this technique have been dramatically decreased over the last ten years to about 0.1 to 0.6 rads per study. The two largest breast cancer screening studies, the Health Insurance Plan of Greater New York and the Breast Cancer Detection Demonstration Project, have shown conclusively that women over 50 years old can benefit from annual mammography and that certain groups can benefit from mammography at close intervals before the age of 50 years. This article describes the development of mammography and outlines current perspectives on its indications and limitations

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)

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)

Influence of the radiographer on the pain felt during mammography

International Nuclear Information System (INIS)

Goethem, M. van; Verslegers, I.; Biltjes, I.; De Schepper, A.; Mortelmans, D.; Bruyninckx, E.; Hove, E. Van

2003-01-01

Mammography is the only useful examination in screening for breast cancer. Mortality from breast cancer can be reduced if women go regularly for a screening mammography. Moreover, it is still the key examination in diagnosis of breast diseases and in the follow-up of patients treated for breast cancer. Pain with mammography can deter women from going for regular screening or follow-up; therefore, it is important to reduce pain experience or discomfort from mammography. In this study we evaluate the impact of the ''radiographer'' on the pain risk during mammography by analysing questionnaires filled in by women and radiographers. Study results reveal that the opinion of the radiographer, the information and communication during the examination and the number of years of experience are important factors in pain and discomfort experience. The attitude of the radiographer plays an important role in the pain experience. (orig.)

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

Optical system for the Protein Crystallisation Diagnostics Facility (PCDF) on board the ISS

Science.gov (United States)

Joannes, Luc; Dupont, Olivier; Dewandel, Jean-Luc; Ligot, Renaud; Algrain, Hervé

2004-06-01

The Protein Crystallisation Diagnostic Facility (PCDF) is a multi-user facility to study the protein crystallisation under the conditions of micro-gravity onboard the International Space Station (ISS) Columbus facility. Large size protein crystals will growth under reduced gravity in thermally controlled reactors. A combination of diagnostic tools like video system, microscope, interferometer, and light scattering device shall help to understand the growth phenomena. Common methods of protein crystallisation shall be performed in PCDF: Dialysis where the protein solution and the salt solution are separated by a semi-permeable membrane. Extended Length Dialysis Batch where the saturation to get crystals is achieved by changing the concentration of the protein in the sample liquid. The overall ESA project is leaded by EADS Space Transportation, Friedrichshafen, Germany. Lambda-X is responsible for the Optical System (OS), with Verhaert Design and Development as sub-contractor for the mechanical design. The OS includes different compact parts: Original illumination systems based on LEDs of difference colours; Quantitative Mach-Zehnder interferometers to measure the concentration distribution around crystals; Imaging assemblies to visualize the protein volume with different field of views. The paper concentrates on the description of each part, and in particular on the imaging assembly which allow switching from one field of view to another by passive elements only.

Evaluation of the performance characteristic for mammography by using edge device

Energy Technology Data Exchange (ETDEWEB)

Kim, Ki Won [Dept. of Radiology, Kyung Hee University Hospital at Gang-dong, Seoul (Korea, Republic of); Choi, Jwan Woo [Dept. of Radiology, Asan Medical Center, Seoul (Korea, Republic of); Jeong, Hoi Woun [Dept. of Radiological Technology, The Baekseok Culture University, Cheonan (Korea, Republic of); Jang, Seo Goo [Dept. of Medical Science, The Soonchunhyang University, Asan (Korea, Republic of); Lee, Eul Kyu [Dept. of Radiology, Inje Paik University Hospital Jeo-dong, Seoul (Korea, Republic of); Son, Soon Yong [Dept. of Radiological Technology, The Wonkwang Health Science University, Iksan (Korea, Republic of); Son, Jin Hyun; Min, Jung Whan [Dept. of Radiological Technology, The Shingu University, Sungnam (Korea, Republic of)

2016-09-15

The purpose of this study was to evaluation of the performance characteristic for mammography by using edge device that mammography equipment improves essential in the correct diagnosis for the maintenance. We measured the modulation transfer function (MTF), the noise power spectrum (NPS), and the detective quantum efficiency (DQE) using the 61267 RQA-M2 based on commission standard international electro-technical commission (IEC). As a results, spatial resolution of dimensions tomo and lorad selenia mammography were maintained at 10 mm-1 and NPS and DQE including the low nyquist frequency indicated to 6.0 mm-1. Therefore, regularly QA of mammography system should be necessary. This study can be contribute to evaluate QA for performance characteristic of mammography of DDR system.

Imaging mammary diagnostics. Diagnostic techniques, archetypical findings, differential diagnostcs and interventions. 2. rev. and enl. ed.

International Nuclear Information System (INIS)

Heywang-Koebrunner, S.; Schreer, I.

2008-01-01

The book includes the following chapters: I. Methodology: anamnesis and interview; clinical evidence, mammography, sonography, magnetic resonance tomography, new imaging techniques (scintigraphy, PET), transcutaneous biopsy, pre-operative marking; II. phenotypes: normal mammary glands, mastopathics, cysts, benign tumors, inflammatory diseases, in-situ carcinomas, invasive carcinomas, lymphomas, other semi-malign and malign tumors, post-traumatic, post-surgical and post-therapeutic changes, skin changes, male mamma, screening, continuative diagnostics of screening evidence and problem solving for symptomatic patients

Tests with films and film-screens using grid-mammography

International Nuclear Information System (INIS)

Wolf, G.; Kallinger, G.

1982-01-01

A comparison was made between mammography using grid-technique with a film-screen-system and mammography without grid, and with film-screens and also using industrial films. The image-quality of grid mammography looks like the same than using conventional techniques and industrial films. The problem of soft tissue grid techniques lies in the dose requirements, which was more than using film-screen-techniques without grid. New and improved recording systems, which reduce radiation dose when using the grid technique were analyzed. (orig.) [de

Pain during mammography: Implications for breast screening programmes

International Nuclear Information System (INIS)

Andrews, F.J.

2001-01-01

Pain experienced during mammography can deter women from attending for breast cancer screening. Review of the current literature on pain experienced during mammography reveals three main areas of interest: reports of the frequency of pain, identification of predictors of pain and strategies for responding to pain. Implications of this literature for breast screening programmes include the need for appropriate measurements of pain during mammography that are valid for screening populations, a further understanding of organizational factors involved in screening programmes that may be predictors of pain and for the development of valid strategies for responding to pain within breast screening programmes. Copyright (2001) Blackwell Science Pty Ltd

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.

The clinical use of mammography in the male; Klinische Relevanz der Mammographie beim Mann

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Merkle, E [Ulm Univ. (Germany). Abt. Radiologie; Mueller, M [Ulm Univ. (Germany). Abt. Radiologie; Vogel, J [Ulm Univ. (Germany). Abt. Radiologie; Klatt, S [Ulm Univ. (Germany). Abt. Innere Medizin I; Goerich, J [Ulm Univ. (Germany). Abt. Radiologie; Berger, H G [Ulm Univ. (Germany). Allgemeinchirurgische Abt.; Brambs, H J [Ulm Univ. (Germany). Abt. Radiologie

1996-01-01

During a period of four years 104 mammograms were performed in 89 men. Mastectomies were carried out on 23 men (group 1). 66 patients (group 2) were followed up clinically and in 15 patients serial mammograms were obtained. In group 1 there were 5 patients with bilateral gynaecomastia, 9 with unilateral gynaecomastia and two with pseudogynaecomastia and there were 7 patients with malignancies. In group 2 there were 46 patients with bilateral gynaecomastia and 10 patients with unilateral gynaecomastia. Pseudogynaecomastia was found in 25 patients. There were 7 malignancies, of which 5 had been suspected clinically and one had been diagnosed as gynaecomastia by mammography. Two carcinomas in situ were missed clinically and also by mammography. When malignancy is not suspected on clinical grounds the first examination should be sonography. Where, however, malignancy is suspected, and for follow-up, mammography retains its primary position. (orig./MG) [Deutsch] In einem 4-Jahres-Zeitraum wurden bei 89 Maennern insgesamt 104 Mammogramme angefertigt. 23 Maenner (=Gruppe 1) wurden mastektomiert. 66 Patienten (=Gruppe 2) wurden klinisch und zum Teil mammographisch kontrolliert. Alle Mammogramme wurden in Unkenntnis des klinischen Befundes retrospektiv ausgewertet und, wenn moeglich, dem histologischen Ergebnis gegenuebergestellt. In der Gruppe 1 fand sich eine beidseitige Gynaekomastie in 5/23 Faellen, eine einseitige Form in 9/23 Faellen, eine Pseudogynaekomastie in 2/23 Faellen und ein Malignom in 7/23 Faellen. In Gruppe 2 ergab sich eine beidseitige Gynaekomastie in 46/81 Faellen gegenueber einer einseitigen Form in 10/81 Faellen. Eine Pseudogynaekomastie fand sich in 25/81 Faellen. Von 7 Malignomen waren 5 klinisch suspekt, wobei eines mammographisch als Gynaekomastie imponierte. Zwei In-situ-Karzinome waren sowohl mammographisch als auch klinisch okkult. Klinisch nicht malignomsuspekte Befunde sollten primaer der Mammasonographie zugefuehrt werden. Bei

Breast Cancer Detection: Mammography and other methods in breast imaging, second edition

International Nuclear Information System (INIS)

Bassett, L.W.; Gold, R.H.

1987-01-01

The text addresses mammography and the advantages and limitations of other breast imaging methods presently available. The establishment of X-ray mammography as the safest and most accurate noninvasive method of early, nonpalpable breast cancer detection is addressed in the first section of the book. The second section emphasizes the signs of early cancer, the complete mammographic examination, and the team approach to diagnosis. The advantages and limitations of film-screen mammography, zero mammography, breast ultrasound, thermography, light scanning, magnetic resonance imaging, and ductography are highlighted as alternate methods of detection. The benefits of mammography, and its unmatched value in screeening for breast cancer, are presented in the final section

Belief Elicitation to Populate Health Economic Models of Medical Diagnostic Devices in Development

NARCIS (Netherlands)

Haakma, Wieke; Steuten, Lotte Maria Gertruda; Bojke, Laura; IJzerman, Maarten Joost

2014-01-01

Background and Objective Bayesian methods can be used to elicit experts’ beliefs about the clinical value of healthcare technologies. This study investigates a belief–elicitation method for estimating diagnostic performance in an early stage of development of photoacoustic mammography (PAM) imaging

Response costs of mammography adherence: Iranian women's perceptions.

Science.gov (United States)

Khodayarian, Mahsa; Mazloomi-Mahmoodabad, Seyed Saied; Lamyian, Minoor; Morowatisharifabad, Mohammad Ali; Tavangar, Hossein

2016-01-01

Mammography as the most common secondary prevention method has known to be helpful in detecting breast cancer at the early stages. Low level of participation among women toward mammography uptake due to cultural beliefs is a great concern. This study aimed at exploring the perceptions of women about response costs of mammography adherence (MA) in Yazd, Iran. A qualitative study using semi-structured interviews was performed. Fourteen women,one oncology nurse, and a breast cancer survivor were purposefully interviewed. Interviews were transcribed verbatim and analyzed by directed content analysis method based on protection motivation theory (PMT). One main theme was emerged from the analysis namely called "response costs".Two main categories were also emerged from the data; (1) psychological barriers with six subcategories including "embarrassment," "worry about being diagnosed with cancer," "preoccupation with underlying disease," "misconception about mammography," "need for an accompanying person," and "internalizing the experiences of the others," and (2) maladaptive coping modes which encompassed three subcategories: "religious faith," "fatalism," and"avoidance and denial." Useful information was provided about the response costs of mammography utilization based on the perceptions of women. Cognitive barriers may be decreased by conducting modifications in women's awareness and attitude toward MA as well as changing the national health system infrastructures. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended.

Study of mammography in mass screening for breast cancer

International Nuclear Information System (INIS)

Kitada, Masahiro; Sakai, Hiroko; Kubo, Yoshihiko; Samejima, Natsuki; Kurowarabi, Kunio; Iwabuchi, Shuji.

1995-01-01

In order to examine the rate of correct diagnosis by mammography at initial mass screening for breast cancer, we carried out a retrospective study of mammography findings in 267 cases of breast cancer detected at Asahikawa Cancer Screening Center. The screening was performed by physical examination, and in cases where disease was suspected, mammography, ultrasonography, and needle biopsy were done. Mammographically, 172 cases (64.4%) were cancer-positive, 58 cases (21.7%) were suspicious for cancer, and 37 cases (13.9%) were cancer-negative. Patients below 50 years of age and those with tumors of small diameter (<20 mm) showed a significantly lower rate of cancer positivity than patients aged 50 years or more and those with tumors 20 mm or more in diameter. Mammographic abnormalities were not specific, since these changes were also found in normal subjects and patients with benign diseases. Therefore, we concluded that mammography without physical examination at initial mass screening has a high risk of missing breast cancer. Mass screening for breast cancer should be performed by physical examination involving inspection and palpation at the first instance. If any suspicious findings are obtained, mammography, ultrasonography, and needle biopsy should be done. (author)

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

Relative and combined performance of mammography and ultrasonography for breast cancer screening in the general population. A pilot study in Tochigi prefecture, Japan

International Nuclear Information System (INIS)

Honjo, Satoshi; Ando, Jiro; Tsukioka, Takeo

2007-01-01

Breast cancer screening by mammography is thought to be effective in reducing breast cancer mortality while ultrasonography is not accepted as a population screening modality, although the latter has been suggested to be useful in detection of cancer in the dense breast, relatively more typical for a younger woman. Mammography with medio-lateral oblique view was offered on trial in 1999-2000 for 3453 female residents in Tochigi prefecture who also underwent clinical breast examination and ultrasonography. The municipalities that provided cancer screening were informed of the final diagnosis for women with positive findings in the screening trial by doctors who performed the diagnostic evaluation. Linkage was also made between the list of participants in the trial and registrations at Tochigi Cancer Registry for breast cancer cases diagnosed during 1999-2001. Thirteen cases with breast cancer were identified during a 2-year follow-up period: 10 were diagnosed subsequent to positive finding in the trial; two were negative in the trial and diagnosed 23 and 24 months after, respectively; and one had a positive finding at the trial but was undiagnosed at first and then diagnosed 18 months after the trial. Among the 11 cases judged as positive in the trial, four were judged only by mammography while three were judged only by ultrasonography. Those mammography alone-detected cases were relatively young, at 36, 40, 47 and 54 years of age, respectively, while the ultrasonography alone-detected cases were aged 50, 55 and 68, respectively. Combined screening with mammography and ultrasonography may be feasible. A larger study is required to evaluate relative performance of mammography and ultrasonography in detail by characteristics of examinees and their breasts. (author)

Screen-film mammography versus full-field digital mammography in a population-based screening program: The Sogn and Fjordane study

International Nuclear Information System (INIS)

Juel, Inger-Marie; Johannessen, Gunnar; Skaane, Per; Roth Hoff, Solveig; Hofvind, Solveig

2010-01-01

Background: Studies comparing analog and digital mammography in breast cancer screening have shown conflicting results. Little is known about the use of digital photon-counting detectors. Purpose: To retrospectively compare performance indicators in screen-film (SFM) and full-field digital mammography (FFDM) using a photon-counting detector in a population-based screening program. Material and Methods: The Norwegian Social Science Data Services approved the study, which was part of the Norwegian Breast Cancer Screening Program. The program invites women aged 50-69 years to two-view mammography biannually. The study period was January 2005 to June 2006 for SFM and August 2006 to December 2007 for FFDM. Independent double reading was performed using a five-point rating scale for probability of cancer. Recalls due to abnormal mammography were retrospectively reviewed by an expert panel. Performance indicators for the two techniques were compared. Attendance rate was 83.6% (7442/8901) for SFM and 82.0% (6932/8451) for FFDM. Results: The recall rate due to abnormal mammography, cancer detection rate and positive predictive value did not differ significantly between SFM and FFDM: recall 2.3% (174/7442) versus 2.4% (168/6932), cancer detection 0.39% (29/7442) versus 0.48% (33/6932), positive predictive value 16.7% (29/174) versus 19.6% (33/168), respectively (P>0.05 for all). The recall rate due to technically inadequate mammograms was 0.3% (19/7442) for SFM and 0.01% (1/6932) for FFDM. In the retrospective review, a significantly higher proportion of calcifications and asymmetric density were categorized as normal or definitively benign in FFDM compared with SFM. The average glandular dose was 2.17 mGy for SFM and 1.25 mGy for FFDM. Conclusion: Performance indicators show that FFDM using photon-counting detector is suitable for breast cancer screening. The lower radiation dose and lower recalls due to technically inadequate mammograms are of importance in mammography

Differential Effects of Social Networks on Mammography Use by Poverty Status.

Science.gov (United States)

Yeo, Younsook

2016-01-01

This study examines whether social networks have differential effects on mammography use depending on poverty status. Data were analyzed on US women (40+), employing logistic regression and simple slope analyses for a post hoc probing of moderating effects. Among women not in poverty, living with a spouse/partner and attending church, regardless of frequency, were positively associated with mammography use; family size was negatively associated. Among women living in poverty, mammography showed a positive association only with weekly church attendance. Mammography was negatively associated with health-related social interactions occurring through the Internet. Post hoc probing showed significant moderating effects of poverty on the relationship between online health-related interactions and mammography use. To make the Internet a meaningful health empowerment tool for women in poverty, future research should identify how health-related interactions that occur online affect women in poverty's psychological and behavioral reactions that will contribute to our understanding of why they are discouraged from having mammograms. The mechanisms behind the differential effects of church attendance and poverty status on mammography also need further clarification.

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

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.)

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

Determinants of mammography screening behavior in Iranian women: A population-based study

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Mitra Moodi

2012-01-01

Full Text Available Background: Breast cancer remains a substantial health concern in Iran due to delay and late stage at diagnosis and treatment. Despite the potential benefits of mammography screening for early detection of breast cancer, the performance of this screening among Iranian women is low. For planning appropriate intervention, this study was carried out to identify mammography rates and explore determinants of mammography screening behavior in females of Isfahan, Iran. Materials and Methods: In this population-based study, 384 women of 40 years and older were interviewed by telephone. The Farsi version of Champion′s Health Belief Model scale (CHBMS was used to examine factors associated with mammography screening. The obtained data were analyzed by SPSS (version 16.0 using statistical Chi-square, Fisher Exact test, t-test and multiple logistic regression model to identify the importance rate of socio-demographic and Health Belief Model (HBM variables to predict mammography screening behavior. In all of tests, the level of significant was considered a = 0.05. Results: Mean age ΁ SD of women was 52.24 ΁ 8.2 years. Of the 384 participants, 44.3% reported at least one mammogram in their lifetime. Logistic regression analysis indicated that women were more likely to have mammography if they heard/read about breast cancer (OR = 4.17, 95% CI 2.09, 8.34, menopause in lower age (OR = 0.2, 95% CI 0.87, 0.99 and history of breast problem (OR = 0.9, 95% CI 0.12, 0.32. Also, women who perceived more benefits of mammography (OR = 1.84, 95% CI 1.63, 2.09, fewer barriers of mammography (OR = 0.91, 95% CI 0.86, 0.96 and had more motivation for health (OR = 0.94, 95% CI 0.89, 1 were more likely to have mammography. Conclusion: The findings indicated that the rate of mammography screening among women in Isfahan province is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the first

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)

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

Tc-99m Methoxy Isobutyl Isonitrile (MIBI) scintimammography for detection of loco-regional recurrence of breast cancer: A comparative study of scintimammography, X-ray mammography and breast ultrasound imaging

International Nuclear Information System (INIS)

Usmani, S.; Niaz, K.; Ahmed, N.; Niyaz, K.; Khan, H.A.; Javed, A.; Mohannadi, S.A.; Huda, F.A.

2007-01-01

Breast cancer is the most common cancer among women and the second leading cause of death in women after lung cancer. Local recurrence rate is about 1-2% per year. It is important to find a sensitive and accurate diagnostic method for early detection of recurrent tumor for planning subsequent management. The principal aim of the present study was to assess the utility of Tc-99m MIBI scintimammography in the detection of loco-regional recurrence of breast cancer in comparison with the conventionally used methods like x-ray mammography and ultrasonography. A total number of 42 patients (Age: mean= 45.55 yrs; median = 43.5; range, 22-77 yrs) suspected to have loco-regional recurrence of breast cancer on the basis of clinical examination and/or conventional imaging procedures were included in this study. All patients were subjected to planar scintimammography (SMM), SPECT imaging of the breast, x-ray mammography and Ultrasound scanning. The results were correlated with the final diagnosis arrived at by fine needle aspiration cytology (FNAC), core biopsy or definite wide local excision. Sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) of scintimammography in the diagnosis of recurrent disease were found to be 82.75, 92.3, 96.0, 70.58 and 85.71% respectively; compared to 45.83, 66.6, 78.57, 31.57, 51.51 for x-ray mammography and 65.51, 69.23, 82.6, 47.36, 66.66 for Ultrasonography. Scintimammography results were correlated with x-ray mammography and ultrasonography by applying Pearson correlation. No significant correlation was found between SMM and XMM (r=0.27) or SMM and US (r=0.23). Based on the results of this study it is concluded that SMM has better diagnostic accuracy than mammography and ultrasonography in the detection of loco-regional recurrence of breast cancer. (author)

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.

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.

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

through the image plate in the procedure of CR imaging, the method of subtraction of the two images which were taken in the same time with one exposure can increase the diagnostic information. Image registration for mammography with CR imaging is usually ignored because the two images are taken in one exposure time. This dissertation investigated the necessity of image registration for image energy subtraction in CR mammography imaging. A novel method for image registration that can reduce the computing time is established, based on the features of CR imaging for mammography

Decision making and counseling around mammography screening for women aged 80 or older.

Science.gov (United States)

Schonberg, Mara A; Ramanan, Radhika A; McCarthy, Ellen P; Marcantonio, Edward R

2006-09-01

Despite uncertain benefit, many women over age 80 (oldest-old) receive screening mammography. To explore decision-making and physician counseling of oldest-old women around mammography screening. Qualitative research using in-depth semi-structured interviews. Twenty-three women aged 80 or older who received care at a large academic primary care practice (13 had undergone mammography screening in the past 2 years) and 16 physicians at the same center. We asked patients and physicians to describe factors influencing mammography screening decisions of oldest-old women. We asked physicians to describe their counseling about screening to the oldest-old. Patients and/or physicians identified the importance of physician influence, patient preferences, system factors, and social influences on screening decisions. Although physicians felt that patient's health affected screening decisions, few patients felt that health mattered. Three types of elderly patients were identified: (1) women enthusiastic about screening mammography; (2) women opposed to screening mammography; and (3) women without a preference who followed their physician's recommendation. However, physician counseling about mammography screening to elderly women varies; some individualize discussions; others encourage screening; few discourage screening. Physicians report that discussions about stopping screening can be uncomfortable and time consuming. Physicians suggest that more data could facilitate these discussions. Some oldest-old women have strong opinions about screening mammography while others are influenced by physicians. Discussions about stopping screening are challenging for physicians. More data about the benefits and risks of mammography screening for women aged 80 or older could inform patients and improve provider counseling to lead to more rational use of mammography.

Overview of radiation protection programme in nuclear medicine facility for diagnostic procedures

International Nuclear Information System (INIS)

Ahmed, Ezzeldein Mohammed Nour Mohammed

2015-02-01

This project was conducted to review Radiation Protection Program in Nuclear Medicine facility for diagnostic procedures which will provide guide for meeting the standard and regulatory requirements in diagnostic nuclear medicine. The main objective of this project is to keep dose to staff, patient and public as low as reasonably achievable (ALARA). The specific objectives were to review the Radiation Protection Program (RPP) in diagnostic nuclear medicine and to make some recommendation for improving the level of radiation protection in diagnostic nuclear medicine that will help to control normal exposure and prevent or mitigate potential exposure. The methodology used is review of various documents. The review showed that if the Radiation Protection Program is inadequate it leads to unjustified exposure to radiation. Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a qualified Radiation Protection Officer (RPO) should be appointed to lay down and oversee a radiation protection in the nuclear medicine department. The RPO must be given the full authority and the adequate time to enable him to perform his duties effectively. (au)

MODERN CAPABILITIES OF BREAST PATHOLOGY DIAGNOSTICS

Directory of Open Access Journals (Sweden)

I. V. Vysotskaya

2015-01-01

Full Text Available Every year more than 1 million new cases of breast cancer are being recorded worldwide. Choice of appropriate tactics of treatment depends on the timely diagnosis and correct assessment of the prevalence of cancer.The algorithm of patient»s examination includes clinical examination, X-ray mammography and ultrasonic diagnosis of breast. However, this is not sufficient for a complete interpretation of the patient»s condition in case of non-palpable breast formations, ambiguous interpretation of imaging under structural changes, increased density of breast tissue, etc.In this regard, the introduction of new technologies and their evaluation in terms of practicality is a logical and developing method of early diagnosis of breast pathology.One of the methods that enables enhancing the information capability of ultrasonic diagnosis of breast is elastography. It allows for the differential diagnosis of benign and malignant changes not only in the breast tissue, but also in the areas of regional lymph drainage.Promising method of modern diagnostic breast care is digital mammography tomosynthesis. However, in spite of the first and very optimisticdata, this technique is still far from standard.Complex diagnostics of breast pathology, in addition to clinical data and imaging results, are based on information obtained from biopsies. At the present stage core-biopsy is considered as the best way of verification, where the resulting material is subjected to immunohistochemical studies.Thus, the spectrum of diagnostic capabilities is constantly expanding. Highly informative techniques included in the daily practice today enable clinicians to achieve optimal results in curing even greater number of patients.

Nuclear Diagnostics at the National Ignition Facility, 2013-2015

Science.gov (United States)

Yeamans, C. B.; Cassata, W. S.; Church, J. A.; Fittinghoff, D. N.; Gatu Johnson, M.; Gharibyan, N.; Határik, R.; Sayre, D. B.; Sio, H. W.; Bionta, R. M.; Bleuel, D. L.; Caggiano, J. A.; Cerjan, C. J.; Cooper, G. W.; Eckart, M. J.; Edwards, E. R.; Faye, S. A.; Forrest, C. J.; Frenje, J. A.; Glebov, V. Yu; Grant, P. M.; Grim, G. P.; Hartouni, E. P.; Herrmann, H. W.; Kilkenny, J. D.; Knauer, J. P.; Mackinnon, A. J.; Merrill, F. E.; Moody, K. J.; Moran, M. J.; Petrasso, R. D.; Phillips, T. W.; Rinderknecht, H. G.; Schneider, D. H. G.; Sepke, S. M.; Shaughnessy, D. A.; Stoeffl, W.; Velsko, C. A.; Volegov, P.

2016-05-01

The National Ignition Facility (NIF) relies on a suite of nuclear diagnostics to measure the neutronic output of experiments. Neutron time-of-flight (NTOF) and neutron activation diagnostics (NAD) provide performance metrics of absolute neutron yield and neutron spectral content: spectral width and non-thermal content, from which implosion physical quantities of temperature and scattering mass are inferred. Spatially-distributed flange- mounted NADs (FNAD) measure, with nearly identical systematic uncertainties, primary DT neutron emission to infer a whole-sky neutron field. An automated FNAD system is being developed. A magnetic recoil spectrometer (MRS) shares few systematics with comparable NTOF and NAD devices, and as such is deployed for independent measurement of the primary neutronic quantities. The gas-Cherenkov Gamma Reaction History (GRH) instrument records four energy channels of time-resolved gamma emission to measure nuclear bang time and burn width, as well as to infer carbon areal density in experiments utilizing plastic or diamond capsules. A neutron imaging system (NIS) takes two images of the neutron source, typically gated to create coregistered 13-15 MeV primary and 6-12 MeV downscattered images. The radiochemical analysis of gaseous samples (RAGS) instrument pumps target chamber gas to a chemical reaction and fractionation system configured with gamma counters, allowing measurement of radionuclides with half-lives as short as 8 seconds. Solid radiochemistry collectors (SRC) with backing NAD foils collect target debris, where activated materials from the target assembly are used as indicators of neutron spectrum content, and also serve as the primary diagnostic for nuclear forensic science experiments. Particle time-of-flight (PTOF) measures compression-bang time using DT- or DD-neutrons, as well as shock bang-time using D3He-protons for implosions with lower x-ray background. In concert, these diagnostics serve to measure the basic and advanced

THE VALUE OF ULTRASOUND MAMMOGRAPHY IN PALPABLE BREAST MASSES

NARCIS (Netherlands)

VANOORD, JC; VANDERVLIET, AM; THYN, CJP; MAK, B; HOOGEBOOM, GJ

Between January 1987 and May 1988 a prospective study was carried out on 232 women with a palpable breast mass. They underwent physical examination, x-ray mammography and ultrasound mammography. The results of each study were interpreted independently by separate observers, and consensus was

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.

Situational quality evaluation of mammography services at state of Minas Gerais, Brazil

International Nuclear Information System (INIS)

Joana, Georgia S.; Oliveira, Mauricio de; Andrade, Mauricio C. de; Cesar, Adriana C.Z.; Peixoto, Joao E.

2011-01-01

Breast cancer is the leading cause of cancer deaths in women. Currently, the most effective method for early detection of this cancer is the mammography, and to achieve the standard definition and contrast, the whole system of imaging must operate under optimal conditions. This paper presents the results of the assessment of mammography centers in the state of Minas Gerais, which was held with the aim of supporting the actions of the State Program of Quality Control in Mammography. These results indicated that less than half of mammography achieved the minimum standard of image quality, endorsing the need of a monitoring more efficient and effective, which led to the establishment, in Minas Gerais, of the monthly monitoring of image quality in mammography. (author)

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

Patterns and determinants of mammography screening in Lebanese women

Directory of Open Access Journals (Sweden)

Nadia Elias

2017-03-01

Providing mammography free-of-charge may alleviate some obstacles among women with socio-economic disadvantage. Stressing that good results one year do not make the cancer less likely or repeating the test less important, as well as improving the comfort of mammography testing could ensure test repeating.

The relationship of social support concept and repeat mammography among Iranian women.

Science.gov (United States)

Farhadifar, Fariba; Taymoori, Parvaneh; Bahrami, Mitra; Zarea, Shamsy

2015-10-24

Breast cancer ranks as the first most common cancer among the Iranian women. The regular repeat of mammography with 1-2 year intervals leads to the increased efficiency of early detection of breast cancer. The present study examined the predictors of repeat mammography. It was hypothesized that higher social support is connected with mammography repeat. A cross-sectional study was carried out among 400 women 50 years and older in Sanandaj, Iran. Data was collected by the questionnaire including information on socio demographical variables and measuring social support level. Data was analyzed by SPSS16 software. Multiple logistic regression was used to determine the predictive power of demographic variables and dimensions of social support for repeat mammography. Women aged 50-55 years had three times odds of repeat mammography compared to women aged 56-60 years) OR, 3.02). Married women had greater odds of repeat mammography compared to single women (P women with higher social support was 0.93 times greater than the women with lower social support (OR, 0.93; 95 % CI, 0.91-0.95; P women are less likely repeat mammography than other Asian women. Identifying the associations between perceived social support and repeat mammography may offer detailed information to allow for future study and guide the development of interventions not only for Iranian women but also for similar cultural that received pay too little attention to date in the breast cancer literature.

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.

Mammography in Norway: Image quality and total performance

International Nuclear Information System (INIS)

Olsen, J.B.; Skretting, A.; Widmark, A.

1997-04-01

This report describes a method for assessing the total performance in mammography based on Receiver Operating Characteristic (ROC) analysis. In the time period from December 1993 to March 1994 the method was applied to assess the total performance of all the 45 Norwegian mammography laboratories operative at that time. Image quality characteristics in each laboratory was established by use of well-known phantoms

Estimation of patient dose in mammography screening examinations

International Nuclear Information System (INIS)

Suzuki, S.; Fujii, S.; Orito, T.; Asada, Y.; Koga, S.; Horita, K.; Kido, C.

1996-01-01

Mammography is one of the most effective examinations for detecting breast carcinoma. Although the dose is usually much higher than that in other types of X-ray examination, that is accepted by the patient because for fears of suffering cancer. Benefit of relatively high doses derived from mammographic examinations is considered to well exceed the risk of cancer induction by radiation exposure. The purpose of this study is to investigate patient dose of mammography in Japan by questionnaire sent to 531 institutions selected from whole Japan and direct measurements carried out in 28 hospitals in Aichi Prefecture. The user's guide in mammography published by NCRP and Quality Assurance Program of American College of Radiology were used to assess the exposure and image quality of mammogram. (author)

Dual-energy contrast-enhanced spectral mammography (CESM).

Science.gov (United States)

Daniaux, Martin; De Zordo, Tobias; Santner, Wolfram; Amort, Birgit; Koppelstätter, Florian; Jaschke, Werner; Dromain, Clarisse; Oberaigner, Willi; Hubalek, Michael; Marth, Christian

2015-10-01

Dual-energy contrast-enhanced mammography is one of the latest developments in breast care. Imaging with contrast agents in breast cancer was already known from previous magnetic resonance imaging and computed tomography studies. However, high costs, limited availability-or high radiation dose-led to the development of contrast-enhanced spectral mammography (CESM). We reviewed the current literature, present our experience, discuss the advantages and drawbacks of CESM and look at the future of this innovative technique.

Filter-fluorescer diagnostic system for the National Ignition Facility

International Nuclear Information System (INIS)

McDonald, J.W.; Kauffman, R.L.; Celeste, J.R.; Rhodes, M.A.; Lee, F.D.; Suter, L.J.; Lee, A.P.; Foster, J.M.; Slark, G.

2004-01-01

An early filter-fluorescer diagnostic system is being fielded at the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory (LLNL) to measure the amount of hard x rays (20< hν<150 keV) generated in laser fusion experiments. From these measurements we hope to quantify the number of hot electrons produced in laser fusion experiments. The measurement of hot electron production is important for ignition experiments because these electrons can preheat the fuel capsule. Hot electrons can also be employed in experimentation by preheating hydrodynamic packages or by driving plasmas out of equilibrium. The experimental apparatus, data collection, analysis and calibration issues are discussed. Expected data signal levels are predicted and discussed

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

Promoting mammography screening among Chinese American women using a message-framing intervention.

Science.gov (United States)

Sun, Yiyuan; Sarma, Elizabeth A; Moyer, Anne; Messina, Catherine R

2015-07-01

This study examined the role of women's perceptions about the relative pros versus cons (decisional balance) of mammography in moderating Chinese American women's responses to gain- and loss-framed messages that promote mammography. One hundred and forty-three Chinese American women who were currently nonadherent to guidelines for receiving annual screening mammograms were randomly assigned to read either a gain- or loss-framed culturally appropriate print brochure about mammography screening. Mammography screening was self-reported at a 2-month follow-up. Although there was not a main effect for message frame, the hypothesized interaction between message frame and decisional balance was significant, indicating that women who received a framed message that matched their decisional balance were significantly more likely to have obtained a mammogram by the follow-up than women who received a mismatched message. Results suggest that decisional balance, and more generally, perceptions about mammography, may be an important moderator of framing effects for mammography among Chinese American women. The match between message frame and decisional balance should be considered when attempting to encourage Chinese American women to receive mammography screening, as a match between the two may be most persuasive. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cultural views, language ability, and mammography use in Chinese American women.

Science.gov (United States)

Liang, Wenchi; Wang, Judy; Chen, Mei-Yuh; Feng, Shibao; Yi, Bin; Mandelblatt, Jeanne S

2009-12-01

Mammography screening rates among Chinese American women have been reported to be low. This study examines whether and how culture views and language ability influence mammography adherence in this mostly immigrant population. Asymptomatic Chinese American women (n = 466) aged 50 and older, recruited from the Washington, D.C. area, completed a telephone interview. Regular mammography was defined as having two mammograms at age-appropriate recommended intervals. Cultural views were assessed by 30 items, and language ability measured women's ability in reading, writing, speaking, and listening to English. After controlling for risk perception, worry, physician recommendation, family encouragement, and access barriers, women holding a more Chinese/Eastern cultural view were significantly less likely to have had regular mammograms than those having a Western cultural view. English ability was positively associated with mammography adherence. The authors' results imply that culturally sensitive and language-appropriate educational interventions are likely to improve mammography adherence in this population.

Patterns and determinants of mammography screening in Lebanese women.

Science.gov (United States)

Elias, Nadia; Bou-Orm, Ibrahim R; Adib, Salim M

2017-03-01

The associations of ever using and/or repeating a mammography test with psychosocial and socio-demographic factors were surveyed in 2014 among Lebanese women ≥ 40. A sample of 2400 women was selected across Lebanon. Variables with significant bivariate associations with various types of behaviors were entered in multivariate analysis. Of the total, 105 women (4·4%) had never heard of mammography as a tool for early breast cancer detection. Among the remaining 2295, 45% had ever used it, of whom 10% had obtained it for the first time within the 12 months preceding the survey. Repeaters were 67% of 926 women who had the time opportunity to do so (median lifetime frequency: 2). Older age, higher socio-economic status (SES) and living within the Greater Beirut (GB) area were significantly associated with ever-use. Within GB, psychosocial factors such as perceived susceptibility and benefits were most strongly associated with ever-use. Outside GB, socio-economic advantage seemed to mostly affect ever-use. Only 4% reported opposition from husbands to their mammography, and husband's support was significant for adherence to mammography guidelines mostly outside GB. Higher education emerged also as a significant socio-demographic determinant for ever-repeating in all regions. Perceived comfort of the previous test strongly affected the likelihood of repeating it. Providing mammography free-of-charge may alleviate some obstacles among women with socio-economic disadvantage. Stressing that good results one year do not make the cancer less likely or repeating the test less important, as well as improving the comfort of mammography testing could ensure test repeating.

A computerized expert system for mammography

International Nuclear Information System (INIS)

Jackson, V.P.; Dines, K.A.; Bassett, L.W.

1988-01-01

The authors have developed a computer-based expert system to aid in the interpretation of mammograms, breast sonograms, and clinical findings. The radiologist enters clinical and image data into the artificial intelligence system and receives a prediction of the etiology of lesions seen on breast imaging studies. This prototype interactive system has undergone preliminary clinical testing and evaluation. Ultimately, a more refined and complex system will be of value in mammography education, for general radiologists without ready access to mammography experts, for paramedical personnel, and for all mammographers in need of a breast imaging database and reporting systems

MR mammography: influence of menstrual cycle on the dynamic contrast enhancement of fibrocystic disease

International Nuclear Information System (INIS)

Rieber, A.; Nuessle, K.; Merkle, E.; Tomczak, R.; Brambs, H.J.; Kreienberg, R.

1999-01-01

Magnetic resonance mammography (MRM) provides data regarding the nature of tumours based on contrast medium dynamics; fibrocystic changes in the breast, however, may lead to false-positive results. This study investigated whether the contrast medium dynamics of fibrocystic changes are dependent on the menstrual cycle. Twenty-four patients with palpable lumps but normal mammographies and ultrasound studies were examined. The MRM technique was performed during the first and second part of the menstrual cycle using a FLASH 3D sequence, both native and at 1, 2, 3 and 8 min after intravenous application of 0.15 mmol/kg body weight of gadodiamide. The calculated time-intensity curves were evaluated based on the following criteria: early percentage of contrast medium uptake in relation to the native value; formation of a plateau phenomenon after the second minute; the point of maximal contrast medium uptake; and calculation of the contrast enhancing index. During the second half of the menstrual cycle, a generally greater contrast medium uptake was observed. Nevertheless, when further diagnostic criteria, such as continuous contrast medium increase as a function of time, were considered, there was no increased rate of false-positive findings. The phase of the menstrual cycle may affect the specificity of the examination, if only the quantitative contrast medium uptake and the percentage of contrast medium uptake in the first 2 min are considered. A control MRM during the other half of the cycle may then be indicated and additional diagnostic criteria may improve specificity. (orig.)

MR mammography: influence of menstrual cycle on the dynamic contrast enhancement of fibrocystic disease

Energy Technology Data Exchange (ETDEWEB)

Rieber, A.; Nuessle, K.; Merkle, E.; Tomczak, R.; Brambs, H.J. [Ulm Univ. (Germany). Abt. Radiologie 1 (Roentgendiagnostik); Kreienberg, R. [Ulm Univ. (Germany). Dept. of Gynecology

1999-08-01

Magnetic resonance mammography (MRM) provides data regarding the nature of tumours based on contrast medium dynamics; fibrocystic changes in the breast, however, may lead to false-positive results. This study investigated whether the contrast medium dynamics of fibrocystic changes are dependent on the menstrual cycle. Twenty-four patients with palpable lumps but normal mammographies and ultrasound studies were examined. The MRM technique was performed during the first and second part of the menstrual cycle using a FLASH 3D sequence, both native and at 1, 2, 3 and 8 min after intravenous application of 0.15 mmol/kg body weight of gadodiamide. The calculated time-intensity curves were evaluated based on the following criteria: early percentage of contrast medium uptake in relation to the native value; formation of a plateau phenomenon after the second minute; the point of maximal contrast medium uptake; and calculation of the contrast enhancing index. During the second half of the menstrual cycle, a generally greater contrast medium uptake was observed. Nevertheless, when further diagnostic criteria, such as continuous contrast medium increase as a function of time, were considered, there was no increased rate of false-positive findings. The phase of the menstrual cycle may affect the specificity of the examination, if only the quantitative contrast medium uptake and the percentage of contrast medium uptake in the first 2 min are considered. A control MRM during the other half of the cycle may then be indicated and additional diagnostic criteria may improve specificity. (orig.) With 2 figs., 2 tabs., 24 refs.

Assessment of mean glandular dose to patients from digital mammography systems

International Nuclear Information System (INIS)

Pwamang, Caroline K.

2016-07-01

Mean glandular dose assessment of patients undergoing digital mammography examination has been done. A total of 297 patient data was used for the study. Basic Quality Control tests were done to ascertain the performance of the equipment used. The results of Quality Control tests indicated that the three Mammography units used for this study were functioning within the internationally acceptable performance criteria. Patients with a breast thickness of 30 mm within the two age groups of 40-49 yrs and 50-64 yrs received doses slightly higher than the acceptable dose levels. A patient in the category 40-49 yrs with breast thickness of 30 mm received 1.83 mGy as calculated Mean Glandular Dose, 2.10 mGy was the recorded dose and 1.58 mGy was recorded under the age group 50-64 yrs. These values have deviated by -22%, -40%, and -5.33% respectively from 1.5 mGy which is the recommended dose for a breast thickness of 30 mm. Also patients with breast thickness of 70 mm under the age group 40–49 yrs had a recorded dose of 6.58 mGy, which deviated by -1.21% from the recommended value of 6.5 mGy for that breast thickness. Aside these values, all the other values were within the recommended dose values. The percentage deviation between the recommended values and the calculated values was within ±25% which was a working limit that was set for this work. Doses delivered by the Full-field Digital mammography equipment were higher than doses delivered by the Computered Radiography equipment. The calculated Mean Glandular Doses for the three facilities were within recommended dose values. (author)

Comparison of TLD air kerma measurements in mammography

International Nuclear Information System (INIS)

Pernicka, F.

2002-01-01