WorldWideScience

Sample records for digital mammography trial

  1. Quality control for digital mammography: Part II recommendations from the ACRIN DMIST trial

    International Nuclear Information System (INIS)

    Yaffe, Martin J.; Bloomquist, Aili K.; Mawdsley, Gordon E.

    2006-01-01

    The Digital Mammography Imaging Screening Trial (DMIST), conducted under the auspices of the American College of Radiology Imaging Network (ACRIN), is a clinical trial designed to compare the accuracy of digital versus screen-film mammography in a screening population [E. Pisano et al., ACRIN 6652--Digital vs. Screen-Film Mammography, ACRIN (2001)]. Part I of this work described the Quality Control program developed to ensure consistency and optimal operation of the digital equipment. For many of the tests, there were no failures during the 24 months imaging was performed in DMIST. When systems failed, they generally did so suddenly rather than through gradual deterioration of performance. In this part, the utility and effectiveness of those tests are considered. This suggests that after verification of proper operation, routine extensive testing would be of minimal value. A recommended set of tests is presented including additional and improved tests, which we believe meet the intent and spirit of the Mammography Quality Standards Act regulations to ensure that full-field digital mammography systems are functioning correctly, and consistently producing mammograms of excellent image quality

  2. 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.)

  3. Experience with digital mammography

    Directory of Open Access Journals (Sweden)

    G. P. Korzhenkova

    2011-01-01

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

  4. 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.

  5. 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

  6. 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.

  7. 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.)

  8. 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

  9. 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.)

  10. 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

  11. 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.

  12. 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).

  13. 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.)

  14. 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)

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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

  1. Computer assisted visualization of digital mammography images

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  2. Digital breast tomosynthesis plus synthesised images versus standard full-field digital mammography in population-based screening (TOSYMA): protocol of a randomised controlled trial.

    Science.gov (United States)

    Weigel, Stefanie; Gerss, Joachim; Hense, Hans-Werner; Krischke, Miriam; Sommer, Alexander; Czwoydzinski, Jörg; Lenzen, Horst; Kerschke, Laura; Spieker, Karin; Dickmaenken, Stefanie; Baier, Sonja; Urban, Marc; Hecht, Gerold; Heidinger, Oliver; Kieschke, Joachim; Heindel, Walter

    2018-05-14

    Development of digital breast tomosynthesis (DBT) provides a technology that generates three-dimensional data sets, thus reducing the pitfalls of overlapping breast tissue. Observational studies suggest that the combination of two-dimensional (2D) digital mammography and DBT increases diagnostic accuracy. However, because of duplicate exposure, this comes at the cost of an augmented radiation dose. This undesired adverse impact can be avoided by using synthesised 2D images reconstructed from the DBT data (s2D).We designed a diagnostic superiority trial on a high level of evidence with the aim of providing a comparison of screening efficacy parameters resulting from DBT+s2D versus the current screening standard 2D full-field digital mammography (FFDM) in a multicentre and multivendor setting on the basis of the quality-controlled, population-based, biennial mammography screening programme in Germany. 80 000 women in the eligible age 50-69 years attending the routine mammography screening programme and willing to participate in the TOSYMA trial will be assigned by 1:1 randomisation to either the intervention arm (DBT+s2D) or the control arm (FFDM) during a 12-month recruitment period in screening units of North Rhine-Westphalia and Lower Saxony. State cancer registries will provide the follow-up of interval cancers.Primary endpoints are the detection rate of invasive breast cancers at screening examination and the cumulative incidence of interval cancers in the 2 years after a negative examination. Secondary endpoints are the detection rate of ductal carcinoma in situ and of tumour size T1, the recall rate for assessment, the positive predictive value of recall and the cumulative 12-month incidence of interval cancers. An adaptive statistical design with one interim analysis provides the option to modify the design. This protocol has been approved by the local medical ethical committee (2016-132-f-S). Results will be submitted to international peer

  3. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Bezzon, Elisabetta; Pescarini, Luigi; Polico, Ilaria; Proietti, Alessandro; Baldan, Enrica; Pomerri, Fabio; Muzzio, Pier Carlo [Veneto Institute of Oncology (IRCCS), Padua (Italy); Hendrick, R.E. [University of Colorado-Denver, Department of Radiology, School of Medicine, Aurora, CO (United States); Toledano, Alicia [Biostatistics Consulting, LLC, Kensington, MD (United States); Paquelet, Jean R. [Advanced Medical Imaging Consultants, Fort Collins, CO (United States); Breast Imaging, McKee Medical Center, Loveland, CO (United States); Chersevani, Roberta [Private Medical Practice, Gorizia (Italy); Di Maggio, Cosimo [Private Medical Practice, Padua (Italy); La Grassa, Manuela [Department of Radiology, Oncological Reference Center (IRCCS), Aviano (Italy)

    2013-08-15

    To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography. The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT{sub (MLO)}+MX{sub (CC)}, was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT{sub (MLO)}+MX{sub (CC)} was non-inferior to two-view MX for malignant lesions. This study shows that readers' capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography. (orig.)

  5. 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.

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

    Science.gov (United States)

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

    2014-02-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  8. 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)

  9. 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)

  10. 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.

  11. 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.

  12. FDA & digital mammography: why has FDA required full field digital mammography systems to be regulated as potentially dangerous devices for more than 10 years?

    Science.gov (United States)

    Nields, Morgan W

    2010-05-01

    Digital mammography is routinely used in the US to screen asymptomatic women for breast cancer and currently over 50% of US screening centers employ the technology. In spite of FDAs knowledge that digital mammography requires less radiation than film mammography and that its equivalence has been proven in a prospective randomized trial, the agency has failed to allow the technology market access via the 510(k) pre market clearance pathway. As a result of the restrictive Pre Market Approval process, only four suppliers have received FDA approval. The resulting lack of a competitive market has kept costs high, restricted technological innovation, and impeded product improvements as a result of PMA requirements. Meanwhile, at least twelve companies are on the market in the EU and the resulting competitive market has lowered costs and provided increased technological choice. A cultural change with new leadership occurred in the early 90's at FDA. The historical culture at the Center for Devices and Radiological Health of collaboration and education gave way to one characterized by a lack of reliance on outside scientific expertise, tolerance of decision making by unqualified reviewers, and an emphasis on enforcement and punishment. Digital mammography fell victim to this cultural change and as a result major innovations like breast CT and computer aided detection technologies are also withheld from the market. The medical device law, currently under review by the Institute of Medicine, should be amended by the Congress so that new technologies can be appropriately classified in accordance with the risk based assessment classification system detailed in Chapter V of the Federal Food, Drug, and Cosmetic Act. A panel of scientific experts chartered by the NIH or IOM should determine the classification appropriate for new technologies that have no historical regulatory framework. This would be binding on FDA. Unless the law is changed we will likely again experience

  13. 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

  14. 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.)

  15. 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.

  16. 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)

  17. 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

  18. Image quality and radiation exposure in digital storage plate mammography with magnification technique

    International Nuclear Information System (INIS)

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

    1999-01-01

    Purpose: Comparison of image quality between digital phosphor storage plate mammography in magnification technique and a conventional film screen system regarding the special aspect of radiation exposure. Materials and Methods: Radiograms of a RMI-mammography phantom were acquired using a conventional film screen system and two digital storage plate systems. Additionally, the radiograms of one digital system were postprocessed emphasizing contrast and included in the comparison. Results: The detectability of details in storage plate mammographies with magnification technique is almost equal to that of film screen mammographies. Thereby, lower radiation exposures were necessary using the digital systems. Conclusions: Based on these results, storage plate mammography in magnification technique is used in clinical routine at our institution. The correct parameters in image postprocessing are of elementary importance for detail detectability. Future studies must show, whether the lower radiation exposure in digital radiograms of the breast, revealing much higher background noise, will allow the same detail detectability as film screen mammographies. (orig.) [de

  19. 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)

  20. Interval breast cancers in the 'screening with tomosynthesis or standard mammography' (STORM) population-based trial.

    Science.gov (United States)

    Houssami, Nehmat; Bernardi, Daniela; Caumo, Francesca; Brunelli, Silvia; Fantò, Carmine; Valentini, Marvi; Romanucci, Giovanna; Gentilini, Maria A; Zorzi, Manuel; Macaskill, Petra

    2018-04-01

    The prospective 'screening with tomosynthesis or standard mammography' (STORM) trial recruited women participating in biennial breast screening in Italy (2011-2012), and compared sequential screen-readings based on 2D-mammography alone or based on tomosynthesis (integrated 2D/3D-mammography). The STORM trial showed that tomosynthesis screen-reading significantly increased breast cancer detection compared to 2D-mammography alone. The present study completes reporting of the trial by examining interval breast cancers ascertained at two year follow-up. 9 interval breast cancers were identified; the estimated interval cancer rate was 1.23/1000 screens [9/7292] (95%CI 0.56 to 2.34) or 1.24/1000 negative screens [9/7235] (95%CI 0.57 to 2.36). In concurrently screened women who attended the same screening services and received 2D-mammography, interval cancer rate was 1.60/1000 screens [40/25,058] (95% CI 1.14 to 2.17) or 1.61/1000 negative screens [40/24,922] (95% CI 1.15 to 2.18). Estimated screening sensitivity for the STORM trial was 85.5% [59/69] (95%CI 75.0%-92.8%), and that for 2D-mammography screening was 77.3% [136/176] (95%CI 70.4%-83.2%). Interval breast cancer rate amongst screening participants in the STORM trial was marginally lower (and screening sensitivity higher) than estimates amongst 2D-screened women; these findings should be interpreted with caution given the small number of interval cases and the sample size of the trial. Much larger screening studies, or pooled analyses, are required to examine interval cancer rates arising after breast tomosynthesis screening versus digital mammography screening. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. 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

  2. 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

  3. Study of signal-to-noise ratio in digital mammography

    Science.gov (United States)

    Kato, Yuri; Fujita, Naotoshi; Kodera, Yoshie

    2009-02-01

    Mammography techniques have recently advanced from those using analog systems (the screen-film system) to those using digital systems; for example, computed radiography (CR) and flat-panel detectors (FPDs) are nowadays used in mammography. Further, phase contrast mammography (PCM)-a digital technique by which images with a magnification of 1.75× can be obtained-is now available in the market. We studied the effect of the air gap in PCM and evaluated the effectiveness of an antiscatter x-ray grid in conventional mammography (CM) by measuring the scatter fraction ratio (SFR) and relative signal-to-noise ratio (rSNR) and comparing them between PCM and the digital CM. The results indicated that the SFRs for the CM images obtained with a grid were the lowest and that these ratios were almost the same as those for the PCM images. In contrast, the rSNRs for the PCM images were the highest, which means that the scattering of x-rays was sufficiently reduced by the air gap without the loss of primary x-rays.

  4. 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

  5. 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

  6. Frequently Asked Questions about Digital Mammography

    Science.gov (United States)

    ... at www.fda.gov/findmammography . Do private insurance companies, Medicare and Medicaid pay for digital mammography exams, ... Map Nondiscrimination Website Policies U.S. Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 ...

  7. Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.

    Science.gov (United States)

    Houssami, Nehmat; Lång, Kristina; Bernardi, Daniela; Tagliafico, Alberto; Zackrisson, Sophia; Skaane, Per

    2016-04-01

    This pictorial review highlights cancers detected only at tomosynthesis screening and screens falsely recalled in the course of breast tomosynthesis screening, illustrating both true-positive (TP) and false-positive (FP) detection attributed to tomosynthesis. Images and descriptive data were used to characterise cases of screen-detection with tomosynthesis, sourced from prospective screening trials that performed standard (2D) digital mammography (DM) and tomosynthesis (3D-mammography) in the same screening participants. Exemplar cases from four trials highlight common themes of relevance to screening practice including: the type of lesions frequently made more conspicuous or perceptible by tomosynthesis (spiculated masses, and architectural distortions); the histologic findings (both TP and FP) of tomosynthesis-only detection; and the need to extend breast work-up protocols (additional imaging including ultrasound and MRI, and tomosynthesis-guided biopsy) if tomosynthesis is adopted for primary screening. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Implementation of Synthesized Two-dimensional Mammography in a Population-based Digital Breast Tomosynthesis Screening Program

    Science.gov (United States)

    Zuckerman, Samantha P.; Keller, Brad M.; Maidment, Andrew D. A.; Barufaldi, Bruno; Weinstein, Susan P.; Synnestvedt, Marie; McDonald, Elizabeth S.

    2016-01-01

    Purpose To evaluate the early implementation of synthesized two-dimensional (s2D) mammography in a population screened entirely with s2D and digital breast tomosynthesis (DBT) (referred to as s2D/DBT) and compare recall rates and cancer detection rates to historic outcomes of digital mammography combined with DBT (referred to as digital mammography/DBT) screening. Materials and Methods This was an institutional review board–approved and HIPAA-compliant retrospective interpretation of prospectively acquired data with waiver of informed consent. Compared were recall rates, biopsy rates, cancer detection rates, and radiation dose for 15 571 women screened with digital mammography/DBT from October 1, 2011, to February 28, 2013, and 5366 women screened with s2D/DBT from January 7, 2015, to June 30, 2015. Two-sample z tests of equal proportions were used to determine statistical significance. Results Recall rate for s2D/DBT versus digital mammography/DBT was 7.1% versus 8.8%, respectively (P < .001). Biopsy rate for s2D/DBT versus digital mammography/DBT decreased (1.3% vs 2.0%, respectively; P = .001). There was no significant difference in cancer detection rate for s2D/DBT versus digital mammography/DBT (5.03 of 1000 vs 5.45 of 1000, respectively; P = .72). The average glandular dose was 39% lower in s2D/DBT versus digital mammography/DBT (4.88 mGy vs 7.97 mGy, respectively; P < .001). Conclusion Screening with s2D/DBT in a large urban practice resulted in similar outcomes compared with digital mammography/DBT imaging. Screening with s2D/DBT allowed for the benefits of DBT with a decrease in radiation dose compared with digital mammography/DBT. © RSNA, 2016 An earlier incorrect version of this article appeared online. This article was corrected on August 11, 2016. PMID:27467468

  9. 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.

  10. Radiation dose with digital breast tomosynthesis compared to digital mammography: per-view analysis.

    Science.gov (United States)

    Gennaro, Gisella; Bernardi, D; Houssami, N

    2018-02-01

    To compare radiation dose delivered by digital mammography (FFDM) and breast tomosynthesis (DBT) for a single view. 4,780 FFDM and 4,798 DBT images from 1,208 women enrolled in a screening trial were used to ground dose comparison. Raw images were processed by an automatic software to determine volumetric breast density (VBD) and were used together with exposure data to compute the mean glandular dose (MGD) according to Dance's model. DBT and FFDM were compared in terms of operation of the automatic exposure control (AEC) and MGD level. Statistically significant differences were found between FFDM and DBT MGDs for all views (CC: MGD FFDM =1.366 mGy, MGD DBT =1.858 mGy; ptomosynthesis compared to FFDM. Given the emerging role of DBT, its use in conjunction with synthetic 2D images should not be deterred by concerns regarding radiation burden, and should draw on evidence of potential clinical benefit. • Most studies compared tomosynthesis in combination with mammography vs. mammography alone. • There is some concern about the dose increase with tomosynthesis. • Clinical data show a small increase in radiation dose with tomosynthesis. • Synthetic 2D images from tomosynthesis at zero dose reduce potential harm. • The small dose increase should not be a barrier to use of tomosynthesis.

  11. Our trial to improve patient positioning during mammography

    International Nuclear Information System (INIS)

    Nakayama, Takashi; Kotsuma, Yoshikazu; Hiramatsu, Sawako

    2007-01-01

    For effective breast cancer screening, reading of high-quality mammograms is essential, and for this purpose proper patient positioning during mammography is important. At our Shin-Osaka Mammography Seminar, which includes eight institutions, a physician and nine radiology technicians get together weekly in order to critically review mammogram reading and techniques for obtaining good mammograms. We have recognized that patient positioning has a great effect on mammogram quality, particularly for women in their 40 s who have dense mammary glands, and we have adopted a digital mammography system, or comparative mammography for such patients. Since July 2005, we have critically reviewed positioning every 3 or 4 months with the aim of improving our technique. Eight institutions have participated in this trial, each contributing mammograms taken recently from 20 to 30 consecutive participants, and the grade of positioning has been determined according to the Institutional Mammogram Estimation Standard (6 items, each scoring a maximum of 4 points, total 24 points) proposed by the Central Committee for Quality Control of Mammography Screening. The estimation has been done by both ourselves and committee members. When a total of 20 points or more is obtained and all 6 items score 3 points or more, it is considered that the positioning has been good, and this is termed ''Positioning A'' (P-A). On the other hand, if the total score is less than 20 points, and any one of the 6 items scores less than 3 points, it is considered that positioning has been inadequate, and this is termed ''Positioning-D'' (P-D). At the first review meeting, which was held before our critical study, P-A accounted for 48% of cases, and this had improved to 72% at the second meeting, and to 66% at the third. P-D accounted for 41% of cases at the first meeting, 20% at the second, and 21% at the third. Thus our trial involving discussion between a physician and technicians to critically review good

  12. 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.

  13. Dose reduction through gridless technique in digital full-field mammography

    International Nuclear Information System (INIS)

    Diekmann, F.; Diekmann, S.; Berzeg, S.; Blick, U.; Fischer, T.; Hamm, B.

    2003-01-01

    Purpose: To determine the role of the scatter grid in digital full-field mammography with respect to image quality and dose and to compare the experimental results with initial clinical experience. Materials and Methods: A phantom consisting of 205 fields that enclose gold dots of different thickness and size (CD-Mam phantom, Medical Department, Nijmegen, Netherlands) was used for digital full-field mammography with the conventional grid module and a special gridless module. Four different breast thicknesses were simulated using Plexiglas as scatter material. First, the phantom was exposed at the parameter and dose settings automatically selected in each experimental setup (with and without grid). Subsequently, the phantom was exposed at the different simulated breast thicknesses using the gridless module in combination with the parameters automatically selected for the grid module. This was followed by a series of phantom mammograms obtained with the experimental setup reversed. The 16 mammograms were evaluated by 3 readers and the results compared considering breast thickness, radiation dose, and quality. The gridless module was used for preoperative labeling in 16 patients for comparison of mammograms obtained with and without a grid. Results: For the same entrance dose used in routine mammography, digital mammography without grid is superior to digital mammography with grid when performed on simulated thin breasts (Plexiglas less than 3 cm), with no difference found when performed on simulated large breasts. The advantages of gridless mammography are more pronounced at a markedly reduced entrance dose (identical parenchymal dose without and with grid using the dose automatically selected for the gridless module). This tendency is confirmed by the initial clinical comparison. (orig.) [de

  14. Use of Iodine-based contrast media in digital full-field mammography - initial experience

    International Nuclear Information System (INIS)

    Diekmann, F.; Diekmann, S.; Taupitz, M.; Bick, U.; Winzer, K.-J.; Huettner, C.; Muller, S.; Jeunehomme, F.; Hamm, B.

    2003-01-01

    Aim: To investigate the use of iodine-based contrast media in digital full-field mammography. Methods: After performing initial phantom studies, seven patients underwent digital mammography (Senographe 2000D, GE Medical Systems, Milwaukee, USA) using a specially filtered beam before as well as 60, 120, and 180 seconds after injection of 80 ml of iodine contrast medium (Ultravist 370, Schering AG, Germany). The precontrast mammograms were then subtracted from the postcontrast mammograms and the resulting images compared with a contrast-enhanced dynamic MRI study, performed on all women. Results: Contrast medium accumulation within the tumors was visualized with a good quality in all cases. The conditions under which successful contrast-enhanced digital mammography can be performed were determined in phantom studies. Conclusions: Contrast-enhanced digital mammography has a potential for improving the visualization of breast tumors in mammography using special beam filtering, adjusted X-ray parameters, proper timing, and suitable subtraction software. (orig.) [de

  15. Technical quality control - constancy controls for digital mammography systems

    International Nuclear Information System (INIS)

    Pedersen, K.; Landmark, I.D.; Bredholt, K.; Hauge, I.H.R.

    2009-04-01

    To ensure the quality of mammographic images, so-called constancy control tests are performed frequently. The report contains a programme for constancy control of digital mammography systems, encompassing the mammography unit, computed radiography (CR) systems, viewing conditions and displays, printers, and procedures for data collection for patient dose calculations. (Author)

  16. 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.)

  17. The influence of software filtering in digital mammography image quality

    Science.gov (United States)

    Michail, C.; Spyropoulou, V.; Kalyvas, N.; Valais, I.; Dimitropoulos, N.; Fountos, G.; Kandarakis, I.; Panayiotakis, G.

    2009-05-01

    Breast cancer is one of the most frequently diagnosed cancers among women. Several techniques have been developed to help in the early detection of breast cancer such as conventional and digital x-ray mammography, positron and single-photon emission mammography, etc. A key advantage in digital mammography is that images can be manipulated as simple computer image files. Thus non-dedicated commercially available image manipulation software can be employed to process and store the images. The image processing tools of the Photoshop (CS 2) software usually incorporate digital filters which may be used to reduce image noise, enhance contrast and increase spatial resolution. However, improving an image quality parameter may result in degradation of another. The aim of this work was to investigate the influence of three sharpening filters, named hereafter sharpen, sharpen more and sharpen edges on image resolution and noise. Image resolution was assessed by means of the Modulation Transfer Function (MTF).In conclusion it was found that the correct use of commercial non-dedicated software on digital mammograms may improve some aspects of image quality.

  18. The influence of software filtering in digital mammography image quality

    International Nuclear Information System (INIS)

    Michail, C; Spyropoulou, V; Valais, I; Panayiotakis, G; Kalyvas, N; Fountos, G; Kandarakis, I; Dimitropoulos, N

    2009-01-01

    Breast cancer is one of the most frequently diagnosed cancers among women. Several techniques have been developed to help in the early detection of breast cancer such as conventional and digital x-ray mammography, positron and single-photon emission mammography, etc. A key advantage in digital mammography is that images can be manipulated as simple computer image files. Thus non-dedicated commercially available image manipulation software can be employed to process and store the images. The image processing tools of the Photoshop (CS 2) software usually incorporate digital filters which may be used to reduce image noise, enhance contrast and increase spatial resolution. However, improving an image quality parameter may result in degradation of another. The aim of this work was to investigate the influence of three sharpening filters, named hereafter sharpen, sharpen more and sharpen edges on image resolution and noise. Image resolution was assessed by means of the Modulation Transfer Function (MTF).In conclusion it was found that the correct use of commercial non-dedicated software on digital mammograms may improve some aspects of image quality.

  19. Comparison of average glandular dose in screen-film and digital mammography using breast tissue-equivalent phantom

    International Nuclear Information System (INIS)

    Shin, Gwi Soon; Kim, Jung Min; Kim, You Hyun; Choi, Jong Hak; Kim, Chang Kyun

    2007-01-01

    In recent years, mammography system is changed rapidly from conventional screen-film system to digital system for application to screening and diagnosis. Digital mammography system provides several advantages over screen-film mammography system. According to the information provided by the manufacturer, digital mammography system offers radiation dose reduction in comparison with screen-film mammography system, because of digital detector, particularly direct digital detector has higher x-ray absorption efficiency than screen-film combination or imaging plate (IP). We measured average glandular doses (ADG) in screen-film mammography (SFM) system with slow screen-film combination, computed mammography (CM) system, indirect digital mammography (IDM) system and direct digital mammography (DDM) system using breast tissue-equivalent phantom (glandularity 30%, 50% and 70%). The results were shown as follows: AGD values for DDM system were highest than those for other systems. Although automatic exposure control (AEC) mode was selected, the curve of the AGD values against thickness or glandularity increased significantly for the SFM system with the uniform target/filter (Mo/Mo) combination. Therefore, the AGD values for the high energy examinations were highest in the SFM system, and those for the low energy examinations were highest in the DDM system. But the curve of the AGD values against thickness and glandularity increased gently for CM system with the automatic selection of the target/filter combination (from Mo/Mo to Mo/Rh or from Mo/Rh to Rh/Rh), and the AGD values were lowest. Consequently, the parameters in mammography for each exposure besides detection efficiency play an important role in order to estimate a patient radiation dose

  20. 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.

  1. Digital information management: a progress report on the National Digital Mammography Archive

    Science.gov (United States)

    Beckerman, Barbara G.; Schnall, Mitchell D.

    2002-05-01

    Digital mammography creates very large images, which require new approaches to storage, retrieval, management, and security. The National Digital Mammography Archive (NDMA) project, funded by the National Library of Medicine (NLM), is developing a limited testbed that demonstrates the feasibility of a national breast imaging archive, with access to prior exams; patient information; computer aids for image processing, teaching, and testing tools; and security components to ensure confidentiality of patient information. There will be significant benefits to patients and clinicians in terms of accessible data with which to make a diagnosis and to researchers performing studies on breast cancer. Mammography was chosen for the project, because standards were already available for digital images, report formats, and structures. New standards have been created for communications protocols between devices, front- end portal and archive. NDMA is a distributed computing concept that provides for sharing and access across corporate entities. Privacy, auditing, and patient consent are all integrated into the system. Five sites, Universities of Pennsylvania, Chicago, North Carolina and Toronto, and BWXT Y12, are connected through high-speed networks to demonstrate functionality. We will review progress, including technical challenges, innovative research and development activities, standards and protocols being implemented, and potential benefits to healthcare systems.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  3. 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.

  4. 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.

  5. 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.

  6. Organisational aspects of mammography screening in digital settings: First experiences of Luxembourg

    International Nuclear Information System (INIS)

    Shannoun, F.; Schanck, J. M.; Scharpantgen, A.; Wagnon, M. C.; Ben Daoud, M.; Back, C.

    2008-01-01

    Luxembourg has been conducting a breast cancer screening programme since 1992, like a large number of other European countries, as early detection and treatment of breast cancer have been proven to reduce mortality. The majority of these screening programmes are based on analogue X-ray technology and have optimised their organisation of transporting, archiving and reading with respect to films. Last decade is marked by enormous developments in digital mammography. Different technologies such as flat panel-, computed radiography- and scanning systems became available. Digital mammography is expected to have a major impact on quality and organisation of breast cancer screening programmes. Screening programmes are now faced with a huge challenge of incorporating the digital technology, including implementation of electronic image exchange, conception of new electronic work-flow, establishing adapted quality assurance programmes and training of radiologists and technical personnel. Initial experiences of the Luxembourg approach in organising digital mammography screening and its quality assurance are reported. (authors)

  7. 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.

  8. 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

  9. Digital versus screen-film mammography: impact of mammographic density and hormone therapy on breast cancer detection.

    Science.gov (United States)

    Chiarelli, Anna M; Prummel, Maegan V; Muradali, Derek; Shumak, Rene S; Majpruz, Vicky; Brown, Patrick; Jiang, Hedy; Done, Susan J; Yaffe, Martin J

    2015-11-01

    Most studies that have examined the effects of mammographic density and hormone therapy use on breast cancer detection have included screen-film mammography. This study further examines this association in post-menopausal women screened by digital mammography. Approved by the University of Toronto Research Ethics Board, this study identified 688,418 women of age 50-74 years screened with digital or screen-film mammography from 2008 to 2009 within the Ontario Breast Screening Program. Of 2993 eligible women with invasive breast cancer, 2450 were contacted and 1421 participated (847 screen-film mammography, 574 digital direct radiography). Mammographic density was measured by study radiologists using the standard BI-RADS classification system and by a computer-assisted method. Information on hormone therapy use was collected by a telephone-administered questionnaire. Logistic regression and two-tailed tests for significance evaluated associations between factors and detection method by mammography type. Women with >75 % radiologist-measured mammographic density compared to those with diagnosed with an interval than screen-detected cancer, with the difference being greater for those screened with screen-film (OR = 6.40, 95 % CI 2.30-17.85) than digital mammography (OR = 2.41, 95 % CI 0.67-8.58) and aged 50-64 years screened with screen-film mammography (OR = 10.86, 95 % CI 2.96-39.57). Recent former hormone therapy users were also at an increased risk of having an interval cancer with the association being significant for women screened with digital mammography (OR = 2.08, 95 % CI 1.17-3.71). Breast screening using digital mammography lowers the risk of having an interval cancer for post-menopausal women aged 50-64 with greater mammographic density.

  10. Control and monitoring of doses to patients in a team of digital mammography

    International Nuclear Information System (INIS)

    Agulla Otero, M.; Torres Cabrera, R.; Hernando Gonzalez, I.

    2013-01-01

    In recent years is widespread use of imaging devices digital mammography. One of the advantages associated with this scanning is the ability to access a large amount of information contained in the headwaters of own digital images. The exploitation of this information allows the calculation of doses received by patients. This paper describes the methodology employed for this purpose and are presented the results of the control and monitoring of doses given in a digital mammography equipment. (Author)

  11. Analysis of medical exposures in digital mammography; Analise das exposicoes medicas em mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Sergio R., E-mail: oliveirasr@fiocruz.br [Escola Politecnica de Saude Joaquim Venancio (EPSJV/FIOCRUZ), Rio de Janeiro, RJ (Brazil); Mantuano, Natalia O.; Albrecht, Afonso S., E-mail: nataliamantuano@gmail.com, E-mail: afonsofismed@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Instituto de Fisica; Flor, Leonardo S., E-mail: leonardo.flor@hsvp.org.br [Hospital Sao Vicente de Paulo (HSVP), Rio de Janeiro, RJ (Brazil)

    2014-07-01

    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.

  12. Abbreviated Breast MRI and Digital Tomosynthesis Mammography in Screening Women With Dense Breasts | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase II trial studies how well abbreviated breast magnetic resonance imaging (MRI) and digital tomosynthesis mammography work in detecting cancer in women with dense breasts. Abbreviated breast MRI is a low cost procedure in which radio waves and a powerful magnet linked to a computer and used to create detailed pictures of the breast in less than 10 minutes.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  14. Variability of breast density assessment in short-term reimaging with digital mammography

    International Nuclear Information System (INIS)

    Kim, Won Hwa; Moon, Woo Kyung; Kim, Sun Mi; Yi, Ann; Chang, Jung Min; Koo, Hye Ryoung; Lee, Su Hyun; Cho, Nariya

    2013-01-01

    Objective: To evaluate the variability of breast density assessments in short-term reimaging with digital mammography. Materials and methods: In 186 women, short term (mean interval, 27.6 days) serial digital mammograms including CC and MLO views were obtained without any treatment. Mammographic density assessments were performed by three blinded radiologists for Breast Imaging Report and Data System (BI-RADS, grades 1–4) and visual percentage density (PD) estimation, and by one radiologist for computer-aided PD estimation. The variability of assessments was analyzed according to the age, breast density, and mammography types by multivariate logistic regression. Results: In BI-RADS assessments, 29% (161 of 558) of breast density categories were assessed differently after short-term reimaging and the mean absolute difference in PD for CC and MLO view was 7.6% and 8.1% for visual assessments, and 7.4% and 6.4% for computer-aided assessments, respectively. Among all computer-aided assessments, 29% (54 of 186) of CC view and 22% (41 of 186) of MLO view assessments had discrepancy over 10% in PD. Younger age (<50), greater breast density (grades 3 and 4), and different mammography types were significantly associated with the variability. Conclusion: Considerable variability in breast density assessments occurred in short-term reimaging with digital mammography, particularly in women with younger age and greater breast density and when examined using different types of mammography

  15. Variability of breast density assessment in short-term reimaging with digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Hwa [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Sun Mi [Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do (Korea, Republic of); Yi, Ann [Department of Radiology, Seoul Metropolitan Government Seoul National University, Boramae Medical Center, Seoul (Korea, Republic of); Chang, Jung Min; Koo, Hye Ryoung; Lee, Su Hyun; Cho, Nariya [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2013-10-01

    Objective: To evaluate the variability of breast density assessments in short-term reimaging with digital mammography. Materials and methods: In 186 women, short term (mean interval, 27.6 days) serial digital mammograms including CC and MLO views were obtained without any treatment. Mammographic density assessments were performed by three blinded radiologists for Breast Imaging Report and Data System (BI-RADS, grades 1–4) and visual percentage density (PD) estimation, and by one radiologist for computer-aided PD estimation. The variability of assessments was analyzed according to the age, breast density, and mammography types by multivariate logistic regression. Results: In BI-RADS assessments, 29% (161 of 558) of breast density categories were assessed differently after short-term reimaging and the mean absolute difference in PD for CC and MLO view was 7.6% and 8.1% for visual assessments, and 7.4% and 6.4% for computer-aided assessments, respectively. Among all computer-aided assessments, 29% (54 of 186) of CC view and 22% (41 of 186) of MLO view assessments had discrepancy over 10% in PD. Younger age (<50), greater breast density (grades 3 and 4), and different mammography types were significantly associated with the variability. Conclusion: Considerable variability in breast density assessments occurred in short-term reimaging with digital mammography, particularly in women with younger age and greater breast density and when examined using different types of mammography.

  16. Digital mammography screening: average glandular dose and first performance parameters

    International Nuclear Information System (INIS)

    Weigel, S.; Girnus, R.; Czwoydzinski, J.; Heindel, W.; Decker, T.; Spital, S.

    2007-01-01

    Purpose: The Radiation Protection Commission demanded structured implementation of digital mammography screening in Germany. The main requirements were the installation of digital reference centers and separate evaluation of the fully digitized screening units. Digital mammography screening must meet the quality standards of the European guidelines and must be compared to analog screening results. We analyzed early surrogate indicators of effective screening and dosage levels for the first German digital screening unit in a routine setting after the first half of the initial screening round. Materials and Methods: We used three digital mammography screening units (one full-field digital scanner [DR] and two computed radiography systems [CR]). Each system has been proven to fulfill the requirements of the National and European guidelines. The radiation exposure levels, the medical workflow and the histological results were documented in a central electronic screening record. Results: In the first year 11,413 women were screened (participation rate 57.5 %). The parenchymal dosages for the three mammographic X-ray systems, averaged for the different breast sizes, were 0.7 (DR), 1.3 (CR), 1.5 (CR) mGy. 7 % of the screened women needed to undergo further examinations. The total number of screen-detected cancers was 129 (detection rate 1.1 %). 21 % of the carcinomas were classified as ductal carcinomas in situ, 40 % of the invasive carcinomas had a histological size ≤ 10 mm and 61 % < 15 mm. The frequency distribution of pT-categories of screen-detected cancer was as follows: pTis 20.9 %, pT1 61.2 %, pT2 14.7 %, pT3 2.3 %, pT4 0.8 %. 73 % of the invasive carcinomas were node-negative. (orig.)

  17. Method for simulating dose reduction in digital mammography using the Anscombe transformation

    OpenAIRE

    Borges, Lucas R.; de Oliveira, Helder C. R.; Nunes, Polyana F.; Bakic, Predrag R.; Maidment, Andrew D. A.; Vieira, Marcelo A. C.

    2016-01-01

    Purpose: This work proposes an accurate method for simulating dose reduction in digital mammography starting from a clinical image acquired with a standard dose. Methods: The method developed in this work consists of scaling a mammogram acquired at the standard radiation dose and adding signal-dependent noise. The algorithm accounts for specific issues relevant in digital mammography images, such as anisotropic noise, spatial variations in pixel gain, and the effect of dose reduction on the d...

  18. Latin American image quality survey in digital mammography studies

    International Nuclear Information System (INIS)

    Mora, Patricia; Khoury, Helen; Bitelli, Regina; Quintero, Ana Rosa; Garay, Fernando; Garcia Aguilar, Juan; Gamarra, Mirtha; Ubeda, Carlos

    2017-01-01

    Under International Atomic Energy Agency regional programme TSA3 Radiological Protection of Patients in Medical Exposures, Latin American countries evaluated the image quality and glandular doses for digital mammography equipment with the purpose of seeing the performance and compliance with international recommendations. Totally, 24 institutions participated from Brazil, Chile, Costa Rica, El Salvador, Mexico, Paraguay and Venezuela. Signal difference noise ratio results showed for CR poor compliance with tolerances; better results were obtained for full-field digital mammography equipment. Mean glandular dose results showed that the majority of units have values below the acceptable dose levels. This joint Latin American project identified common problems: difficulty in working with digital images and lack of specific training by medical physicists from the region. Image quality is a main issue not being satisfied in accordance with international recommendations; optimisation processes in which the doses are increased should be very carefully done in order to improve early detection of any cancer signs. (authors)

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

    International Nuclear Information System (INIS)

    Alvarenga, Frederico L.; Nogueira, Maria do Socorro

    2008-01-01

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

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

    Science.gov (United States)

    Gossner, Johannes

    2016-03-01

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

  1. Experimental investigations of image quality in X-ray mammography with conventional screen film system (SFS), digital phosphor storage plate in/without magnification technique (CR) and digital CCD-technique (CCD)

    International Nuclear Information System (INIS)

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

    2001-01-01

    Comparison of image quality in X-ray mammography between conventional film screen film system (SFS), digital phosphor storage plate in and without magnification technique (CR) and digital CCD-technique (CCD). Radiograms of an RMI-mammography phantom were acquired using a conventional screen film system, three digital storage plate systems and two digital systems in CCD-technique. Additionally the radiograms of one digital phosphor storage plate system were post-processed regarding contrast and included in the comparison. The detectability of details was best with the digital mammography in CCD-technique. After confirming these promising results in clinical studies, digital mammography should be able to replace conventional screen film technique. (orig.)

  2. Dual-energy imaging in full-field digital mammography: a phantom study

    International Nuclear Information System (INIS)

    Taibi, A; Fabbri, S; Baldelli, P; Maggio, C di; Gennaro, G; Marziani, M; Tuffanelli, A; Gambaccini, M

    2003-01-01

    A dual-energy technique which employs the basis decomposition method is being investigated for application to digital mammography. A three-component phantom, made up of plexiglas, polyethylene and water, was doubly exposed with the full-field digital mammography system manufactured by General Electric. The 'low' and 'high' energy images were recorded with a Mo/Mo anode-filter combination and a Rh/Rh combination, respectively. The total dose was kept within the acceptable levels of conventional mammography. The first hybrid images obtained with the dual-energy algorithm are presented in comparison with a conventional radiograph of the phantom. Image-quality characteristics at contrast cancellation angles between plexiglas and water are discussed. Preliminary results show that a combination of a standard Mo-anode 28 kV radiograph with a Rh-anode 49 kV radiograph provides the best compromise between image-quality and dose in the hybrid image

  3. Digital mammography. Why hasn't it been approved for U.S. hospitals?

    Science.gov (United States)

    2000-01-01

    Mammography is the only major imaging technique still unavailable in the United States in digital form. This is because the Food and Drug Administration (FDA) has been unable to devise an effective method for manufacturers to demonstrate the safety and efficacy of digital mammography systems. As a result, the agency has been unable to approve any of those systems for marketing in the United States. In this Regulatory Update, we describe FDA's recent efforts to help manufacturers obtain approval and the reasons those efforts have so far proved ineffective.

  4. Impact on breast cancer diagnosis in a multidisciplinary unit after the incorporation of mammography digitalization and computer-aided detection systems.

    Science.gov (United States)

    Romero, Cristina; Varela, Celia; Muñoz, Enriqueta; Almenar, Asunción; Pinto, Jose María; Botella, Miguel

    2011-12-01

    The purpose of this article is to evaluate the impact on the diagnosis of breast cancer of implementing full-field digital mammography (FFDM) in a multidisciplinary breast pathology unit and, 1 year later, the addition of a computer-aided detection (CAD) system. A total of 13,453 mammograms performed between January and July of the years 2004, 2006, and 2007 were retrospectively reviewed using conventional mammography, digital mammography, and digital mammography plus CAD techniques. Mammograms were classified into two subsets: screening and diagnosis. Variables analyzed included cancer detection rate, rate of in situ carcinoma, tumor size at detection, biopsy rate, and positive predictive value of biopsy. FFDM increased the cancer detection rate, albeit not statistically significantly. The detection rate of in situ carcinoma increased significantly using FFDM plus CAD compared with conventional technique (36.8% vs 6.7%; p = 0.05 without Bonferroni statistical correction) for the screening dataset. Relative to conventional mammography, tumor size at detection decreased with digital mammography (T1, 61.5% vs 88%; p = 0.018) and with digital mammography plus CAD (T1, 79.7%; p = 0.03 without Bonferroni statistical correction). Biopsy rates in the general population increased significantly using CAD (10.6/1000 for conventional mammography, 14.7/1000 for digital mammography, and 17.9/1000 for digital mammography plus CAD; p = 0.02). The positive predictive value of biopsy decreased slightly, but not significantly, for both subsets. The incorporation of new techniques has improved the performance of the breast unit by increasing the overall detection rates and earlier detection (smaller tumors), both leading to an increase in interventionism.

  5. Quantitative breast density analysis using tomosynthesis and comparison with MRI and digital mammography.

    Science.gov (United States)

    Moon, Woo Kyung; Chang, Jie-Fan; Lo, Chung-Ming; Chang, Jung Min; Lee, Su Hyun; Shin, Sung Ui; Huang, Chiun-Sheng; Chang, Ruey-Feng

    2018-02-01

    Breast density at mammography has been used as markers of breast cancer risk. However, newly introduced tomosynthesis and computer-aided quantitative method could provide more reliable breast density evaluation. In the experiment, 98 tomosynthesis image volumes were obtained from 98 women. For each case, an automatic skin removal was used and followed by a fuzzy c-mean (FCM) classifier which separated the fibroglandular tissues from other tissues in breast area. Finally, percent of breast density and breast volume were calculated and the results were compared with MRI. In addition, the percent of breast density and breast area of digital mammography calculated using the software Cumulus (University of Toronto, Toronto, ON, Canada.) were also compared with 3-D modalities. Percent of breast density and breast volume, which were computed from tomosynthesis, MRI and digital mammography were 17.37% ± 4.39% and 607.12 cm 3  ± 323.01 cm 3 , 20.3% ± 8.6% and 537.59 cm 3  ± 287.74 cm 3 , and 12.03% ± 4.08%, respectively. There were significant correlations on breast density as well as volume between tomosynthesis and MRI (R = 0.482 and R = 0.805), tomosynthesis and breast density with breast area of digital mammography (R = 0.789 and R = 0.877), and MRI and breast density with breast area of digital mammography (R = 0.482 and R = 0.857) (all P values density and breast volume evaluated from tomosynthesis, MRI and breast density and breast area of digital mammographic images have significant correlations and indicate that tomosynthesis could provide useful 3-D information on breast density through proposed method. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Average glandular dose in digital mammography and digital breast tomosynthesis: comparison of phantom and patient data

    NARCIS (Netherlands)

    Bouwman, R. W.; van Engen, R. E.; Young, K. C.; den Heeten, G. J.; Broeders, M. J. M.; Schopphoven, S.; Jeukens, C. R. L. P. N.; Veldkamp, W. J. H.; Dance, D. R.

    2015-01-01

    For the evaluation of the average glandular dose (AGD) in digital mammography (DM) and digital breast tomosynthesis (DBT) phantoms simulating standard model breasts are used. These phantoms consist of slabs of polymethyl methacrylate (PMMA) or a combination of PMMA and polyethylene (PE). In the last

  7. 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

  8. Screen film vs full-field digital mammography: image quality, detectability and characterization of lesions

    International Nuclear Information System (INIS)

    Obenauer, S.; Luftner-Nagel, S.; Heyden, D. von; Baum, F.; Grabbe, E.; Munzel, U.

    2002-01-01

    The objective of this study was to compare screen-film mammography (SFM) to full-field digital mammography (FFDM) regarding image quality as well as detectability and characterization of lesions using equivalent images of the same patient acquired with both systems. Two mammography units were used, one with a screen-film system (Senographe DMR) and the other with a digital detector (Senographe 2000D, both GEMS). Screen-film and digital mammograms were performed on 55 patients with cytologically or histologically proven tumors on the same day. Together with these, 75 digital mammograms of patients without tumor and the corresponding previous screen-film mammograms not older than 1.5 years were reviewed by three observers in a random order. Contrast, exposure, and the presence of artifacts were evaluated. Different details, such as the skin, the retromamillary region, and the parenchymal structures, were judged according to a three-point ranking scale. Finally, the detectability of microcalcifications and lesions were compared and correlated to histology. Image contrast was judged to be good in 76%, satisfactory in 20%, and unsatisfactory in 4% of screen-film mammograms. Digital mammograms were judged to be good in 99% and unsatisfactory in 1% of cases. Improper exposure of screen-film system occurred in 18% (10% overexposed and 8% underexposed). Digital mammograms were improperly exposed in 4% of all cases but were of acceptable quality after post-processing. Artifacts, most of them of no significance, were found in 78% of screen-film and in none of the digital mammograms. Different anatomical regions, such as the skin, the retromamillary region, and dense parenchymal areas, were better visualized in digital than in screen-film mammography. All malignant tumors were seen by the three radiologists; however, digital mammograms allowed a better characterization of these lesions to the Breast Imaging Reporting and Data System (BI-RADSZZZ;) categories (FFDM better than

  9. 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).

  10. Magnification mammography: a comparison of full-field digital mammography and screen-film mammography for the detection of simulated small masses and microcalcifications

    International Nuclear Information System (INIS)

    Hermann, K.P.; Obenauer, S.; Funke, M.; Grabbe, E.H.

    2002-01-01

    The objective of this study was a comparison of a full-field digital mammography (FFDM) system and a conventional screen-film mammography (SFM) system with respect to the detectability of simulated small masses and microcalcifications in the magnification mode. All images were obtained using 1.8 times magnification. The FFDM images were obtained at radiation dose levels of 1.39, 1.0, 0.7, 0.49 and 0.24 times that of the SFM images. A contrast-detail phantom was used to compare the detection of simulated lesions using a four alternative forced-choice reader study with three readers. The correct observation ratio (COR) was calculated as the fraction of correctly identified lesions to the total number of simulated lesions. Soft-copy reading was performed for all digital images. Direct magnification images acquired with the digital system showed a lower object contrast threshold than those acquired with the conventional system. For equal radiation dose, the digital system provided a significantly increased COR (0.95) compared with the screen-film system (0.82). For simulated microcalcifications, the corresponding difference was 0.90 to 0.72. The digital system allowed equal detection to screen-film at 40% of the radiation dose used for screen film. Digital magnification images are superior to screen-film magnification images for the detection of simulated small masses and microcalcifications even at a lower radiation dose. (orig.)

  11. 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. 

  12. Effect of age on breast cancer screening using tomosynthesis in combination with digital mammography.

    Science.gov (United States)

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

    2017-08-01

    To determine the effect of tomosynthesis imaging as a function of age for breast cancer screening. Screening performance metrics from 13 institutions were examined for 12 months prior to introduction of tomosynthesis (period 1) and compared to those after introduction of tomosynthesis (period 2, range 3-22 months). Screening metrics for women ages 40-49, 50-59, 60-69, and 70+ , included rates per 1000 screens for recalls, biopsies, cancers, and invasive cancers detected. Performance parameters were compared for women screened with digital mammography alone (n = 278,908) and digital mammography + tomosynthesis (n = 173,414). Addition of tomosynthesis to digital mammography produced significant reductions in recall rates for all age groups and significant increases in cancer detection rates for women 40-69. Largest recall rate reduction with tomosynthesis was for women 40-49, decreasing from 137 (95% CI 117-156) to 115 (95% CI 95-135); difference, -22 (95% CI -26 to -18; P cancer detection rate for women 40-49 from 1.6 (95% CI 1.2-1.9) to 2.7 (95% CI 2.2-3.1) with tomosynthesis (difference, 1.1; 95% CI 0.6-1.6; P cancer detection rates for women 40-69 and decreased recall rates for all age groups with largest performance gains seen in women 40-49. The similar performance seen with tomosynthesis screening for women in their 40s compared to digital mammography for women in their 50s argues strongly for commencement of mammography screening at age 40 using tomosynthesis.

  13. Evaluation of average glandular dose in digital and conventional systems of the mammography

    International Nuclear Information System (INIS)

    Xavier, Aline C.S.; Barros, Vinicius S.M.; Khoury, Hellen J.

    2014-01-01

    Mammography is currently the most effective method of diagnosis and detection of breast pathologies. The main interest in this kid of exam comes from the high incidence rate of breast cancer and necessity of high quality images for accurate diagnosis. Digital mammography systems have several advantages compared to conventional systems, however the use of digital imaging systems is not always integrated to an image acquisition protocol. Therefore, it is questionable if digital systems truly reduce the dose received by the patient, because many times is introduced in the clinics without optimization of the image acquisition protocols. The aim of this study is to estimate the value of incident air Kerma and average glandular dose (AGD) in patients undergoing conventional and digital mammography systems in Recife. This study was conducted with 650 patients in three hospitals. The value of incident air Kerma was estimated from the measurement of the yield of equipment and irradiation parameters used for each patient. From these results and using the methodology proposed by Dance et al. the value of the average glandular dose was calculated. The results obtained show that the lowest value of AGD was found with conventional screen-film system, indicating that the parameters for image acquisition with digital systems are not optimized. It was also observed that the institutions with digital systems use lower breast compression values than the conventional. (author)

  14. 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

    In 2001 the ACPSEM published a position paper on quality assurance in screen film mammography which was subsequently adopted as a basis for the quality assurance programs of both the Royal Australian and New Zealand College of Radiologists (RANZCR) and of BreastScreen Australia. Since then the clinical implementation of digital mammography has been realised and it has become evident that existing screen-film protocols were not appropriate to assure the required image quality needed for reliable diagnosis or to address the new dose implications resulting from digital technology. In addition, the advantages and responsibilities inherent in teleradiology are most critical in mammography and also need to be addressed. The current document is the result of a review of current overseas practice and local experience in these areas. At this time the technology of digital imaging is undergoing significant development and there is still a lack of full international consensus about some of the detailed quality control (QC) tests that should be included in quality assurance (QA) programs. This document describes the current status in digital mammography QA and recommends test procedures that may be suitable in the Australasian environment. For completeness, this document also includes a review of the QA programs required for the various types of digital biopsy units used in mammography. In the future, international harmonisation of digital quality assurance in mammography and changes in the technology may require a review of this document. Version 2.0 represented the first of these updates and key changes related to image quality evaluation, ghost image evaluation and interpretation of signal to noise ratio measurements. In Version 3.0 some significant changes, made in light of further experience gained in testing digital mammography equipment were introduced. In Version 4.0, further changes have been made, most notably digital breast tomosynthesis (DBT) testing and QC have

  15. 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

  16. 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

  17. Stability of the CAE of a digital mammography machine; Estabilidad del CAE de un mamografo digital

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez Lara, A. A.; Ruiz Morales, C.; Buades Forner, M. J.; Tobarra, B. M.

    2013-07-01

    We analyzed the long-term reproducibility automatic exposure control (CAE) of a digital mammography machine for possible drifts and the factors that have led to changes in its baseline are discussed. (Author)

  18. Initial Image Quality and Clinical Experience with New CR Digital Mammography System: A Phantom and Clinical Study

    International Nuclear Information System (INIS)

    Gaona, Enrique; Enriquez, Jesus Gabriel Franco; Alfonso, Beatriz Y. Alvarez; Castellanos, Gustavo Casian

    2008-01-01

    The goal of the study was to evaluate the first CR digital mammography system ( registered Konica-Minolta) in Mexico in clinical routine for cancer detection in a screening population and to determine if high resolution CR digital imaging is equivalent to state-of-the-art screen-film imaging. The mammograms were evaluated by two observers with cytological or histological confirmation for BIRADS 3, 4 and 5. Contrast, exposure and artifacts of the images were evaluated. Different details like skin, retromamillary space and parenchymal structures were judged. The detectability of microcalcifications and lesions were compared and correlated to histology. The difference in sensitivity of CR Mammography (CRM) and Screen Film Mammography (SFM) was not statistically significant. However, CRM had a significantly lower recall rate, and the lesion detection was equal or superior to conventional images. There is no significant difference in the number of microcalcifications and highly suspicious calcifications were equally detected on both film-screen and digital images. Different anatomical regions were better detectable in digital than in conventional mammography

  19. Selective photon counter for digital x-ray mammography tomosynthesis

    Science.gov (United States)

    Goldan, Amir H.; Karim, Karim S.; Rowlands, J. A.

    2006-03-01

    Photon counting is an emerging detection technique that is promising for mammography tomosynthesis imagers. In photon counting systems, the value of each image pixel is equal to the number of photons that interact with the detector. In this research, we introduce the design and implementation of a low noise, novel selective photon counting pixel for digital mammography tomosynthesis in crystalline silicon CMOS (complementary metal oxide semiconductor) 0.18 micron technology. The design comprises of a low noise charge amplifier (CA), two low offset voltage comparators, a decision-making unit (DMU), a mode selector, and a pseudo-random counter. Theoretical calculations and simulation results of linearity, gain, and noise of the photon counting pixel are presented.

  20. A multiparametric automatic method to monitor long-term reproducibility in digital mammography: results from a regional screening programme.

    Science.gov (United States)

    Gennaro, G; Ballaminut, A; Contento, G

    2017-09-01

    This study aims to illustrate a multiparametric automatic method for monitoring long-term reproducibility of digital mammography systems, and its application on a large scale. Twenty-five digital mammography systems employed within a regional screening programme were controlled weekly using the same type of phantom, whose images were analysed by an automatic software tool. To assess system reproducibility levels, 15 image quality indices (IQIs) were extracted and compared with the corresponding indices previously determined by a baseline procedure. The coefficients of variation (COVs) of the IQIs were used to assess the overall variability. A total of 2553 phantom images were collected from the 25 digital mammography systems from March 2013 to December 2014. Most of the systems showed excellent image quality reproducibility over the surveillance interval, with mean variability below 5%. Variability of each IQI was 5%, with the exception of one index associated with the smallest phantom objects (0.25 mm), which was below 10%. The method applied for reproducibility tests-multi-detail phantoms, cloud automatic software tool to measure multiple image quality indices and statistical process control-was proven to be effective and applicable on a large scale and to any type of digital mammography system. • Reproducibility of mammography image quality should be monitored by appropriate quality controls. • Use of automatic software tools allows image quality evaluation by multiple indices. • System reproducibility can be assessed comparing current index value with baseline data. • Overall system reproducibility of modern digital mammography systems is excellent. • The method proposed and applied is cost-effective and easily scalable.

  1. Effect of area x-ray beam equalization on image quality and dose in digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jerry; Xu Tong; Husain, Adeel; Le, Huy; Molloi, Sabee [Department of Radiological Sciences, University of California, Irvine, CA 92697 (United States)

    2004-08-21

    In mammography, thick or dense breast regions persistently suffer from reduced contrast-to-noise ratio (CNR) because of degraded contrast from large scatter intensities and relatively high noise. Area x-ray beam equalization can improve image quality by increasing the x-ray exposure to under-penetrated regions without increasing the exposure to other breast regions. Optimal equalization parameters with respect to image quality and patient dose were determined through computer simulations and validated with experimental observations on a step phantom and an anthropomorphic breast phantom. Three parameters important in equalization digital mammography were considered: attenuator material (Z = 13-92), beam energy (22-34 kVp) and equalization level. A Mo/Mo digital mammography system was used for image acquisition. A prototype 16 x 16 piston driven equalization system was used for preparing patient-specific equalization masks. Simulation studies showed that a molybdenum attenuator and an equalization level of 20 were optimal for improving contrast, CNR and figure of merit (FOM = CNR{sup 2}/dose). Experimental measurements using these parameters showed significant improvements in contrast, CNR and FOM. Moreover, equalized images of a breast phantom showed improved image quality. These results indicate that area beam equalization can improve image quality in digital mammography.

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  3. 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.

  4. Mobile measurement setup according to IEC 62220-1-2 for DQE determination on digital mammography systems

    Science.gov (United States)

    Greiter, Matthias B.; Hoeschen, Christoph

    2010-04-01

    The international standard IEC 62220-1-2 defines the measurement procedure for determination of the detective quantum efficiency (DQE) of digital x-ray imaging devices used in mammography. A mobile setup complying to this standard and adaptable to most current systems was constructed in the Helmholtz Zentrum München to allow for an objective technical comparison of current full field digital mammography units employed in mammography screening in Germany. This article demonstrates the setup's capabilities with a focus on the measurement uncertainties of all quantities contributing to DQE measurements. Evaluation of uncertainties encompasses results from measurements on a Sectra Microdose Mammography in clinical use, as well as on a prototype of a Fujifilm Amulet system at various radiation qualities. Both systems have a high spatial resolution of 50 μm × 50 μm. The modulation transfer function (MTF), noise power spectrum (NPS) and DQE of the Sectra MDM are presented in comparison to results previously published by other authors.

  5. Can Breast Compression Be Reduced in Digital Mammography and Breast Tomosynthesis?

    NARCIS (Netherlands)

    Agasthya, G.A.; D'Orsi, E.; Kim, Y. J.; Handa, P.; Ho, C.P.; D'Orsi, C.J.; Sechopoulos, I.

    2017-01-01

    OBJECTIVE: The objective of this study was to investigate the impact of decreasing breast compression during digital mammography and breast tomosynthesis (DBT) on perceived pain and image quality. MATERIALS AND METHODS: In this two-part study, two groups of women with prior mammograms were

  6. Digital mammography in a screening programme and its implications for pathology: a comparative study.

    LENUS (Irish Health Repository)

    Feeley, Linda

    2011-03-01

    Most studies comparing full-field digital mammography (FFDM) with conventional screen-film mammography (SFM) have been radiology-based. The pathological implications of FFDM have received little attention in the literature, especially in the context of screening programmes. The primary objective of this retrospective study is to compare FFDM with SFM in a population-based screening programme with regard to a number of pathological parameters.

  7. Volumetric breast density affects performance of digital screening mammography

    OpenAIRE

    Wanders, JO; Holland, K; Veldhuis, WB; Mann, RM; Pijnappel, RM; Peeters, PH; Van Gils, CH; Karssemeijer, N

    2016-01-01

    PURPOSE: To determine to what extent automatically measured volumetric mammographic density influences screening performance when using digital mammography (DM). METHODS: We collected a consecutive series of 111,898 DM examinations (2003-2011) from one screening unit of the Dutch biennial screening program (age 50-75 years). Volumetric mammographic density was automatically assessed using Volpara. We determined screening performance measures for four density categories comparable to the Ameri...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  10. Dose and risk evaluation in digital mammography using computer modeling

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Samanda Cristine Arruda; Souza, Edmilson Monteiro de, E-mail: scorrea@nuclear.ufrj.b, E-mail: emonteiro@nuclear.ufrj.b [Centro Universitario Estadual da Zona Oeste (CCMAT/UEZO), Rio de Janeiro, RJ (Brazil); Silva, Humberto de Oliveira, E-mail: hbetorj@gmail.co [Universidade Federal do Rio de Janeiro IF/UFRJ, RJ (Brazil). Inst. de Fisica; Silva, Ademir Xavier da; Lopes, Ricardo Tadeu; Magalhaes, Sarah Braga, E-mail: ademir@nuclear.ufrj.b, E-mail: ricardo@lin.ufrj.b, E-mail: smagalhaes@nuclear.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Nuclear

    2010-07-01

    Digital mammography has been introduced in several countries in the last years. The new technology requires new optimising methods considering for instance the increased possibility of changing the absorbed dose, mainly in modern mammographic systems that allow the operator to choose the beam quality by varying the tube voltage, and filter and target materials. In this work, the Monte Carlo code MCNPX is used in order to investigate how the average glandular dose vary with tube voltage (23-32 kV) and anode-filter combination (Mo-Mo,Mo-Rh and Rh-Rh) in digital mammographic examinations. Furthermore, the risk of breast cancer incidence attributable to mammography exams was estimated using the Biological Effects of Ionizing Radiations (BEIR) VII Committee Report. The results show that the risk of breast cancer incidence in women younger than 30 years of age tends to decrease significantly using Rh-Rh anode-filter combination and higher tube voltage. For women older than 50 years of age the variation of tube voltage, and anode-filter combination did not influence the risk values considerably. (author)

  11. Dose and risk evaluation in digital mammography using computer modeling

    International Nuclear Information System (INIS)

    Correa, Samanda Cristine Arruda; Souza, Edmilson Monteiro de; Silva, Humberto de Oliveira; Silva, Ademir Xavier da; Lopes, Ricardo Tadeu; Magalhaes, Sarah Braga

    2010-01-01

    Digital mammography has been introduced in several countries in the last years. The new technology requires new optimising methods considering for instance the increased possibility of changing the absorbed dose, mainly in modern mammographic systems that allow the operator to choose the beam quality by varying the tube voltage, and filter and target materials. In this work, the Monte Carlo code MCNPX is used in order to investigate how the average glandular dose vary with tube voltage (23-32 kV) and anode-filter combination (Mo-Mo,Mo-Rh and Rh-Rh) in digital mammographic examinations. Furthermore, the risk of breast cancer incidence attributable to mammography exams was estimated using the Biological Effects of Ionizing Radiations (BEIR) VII Committee Report. The results show that the risk of breast cancer incidence in women younger than 30 years of age tends to decrease significantly using Rh-Rh anode-filter combination and higher tube voltage. For women older than 50 years of age the variation of tube voltage, and anode-filter combination did not influence the risk values considerably. (author)

  12. Breast Cancer Screening, Mammography, and Other Modalities.

    Science.gov (United States)

    Fiorica, James V

    2016-12-01

    This article is an overview of the modalities available for breast cancer screening. The modalities discussed include digital mammography, digital breast tomosynthesis, breast ultrasonography, magnetic resonance imaging, and clinical breast examination. There is a review of pertinent randomized controlled trials, studies and meta-analyses which contributed to the evolution of screening guidelines. Ultimately, 5 major medical organizations formulated the current screening guidelines in the United States. The lack of consensus in these guidelines represents an ongoing controversy about the optimal timing and method for breast cancer screening in women. For mammography screening, the Breast Imaging Reporting and Data System lexicon is explained which corresponds with recommended clinical management. The presentation and discussion of the data in this article are designed to help the clinician individualize breast cancer screening for each patient.

  13. 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.

  14. Lag and ghosting in a clinical flat-panel selenium digital mammography system

    International Nuclear Information System (INIS)

    Bloomquist, Aili K.; Yaffe, Martin J.; Mawdsley, Gordon E.; Hunter, David M.; Beideck, Daniel J.

    2006-01-01

    We present measurements of lag and ghosting in a FDA-approved digital mammography system that uses a dielectric/selenium based detector structure. Lag is the carryover of signal from a previous image, whereas ghosting is the reduction of sensitivity caused by previous exposure history of the detector. Data from six selenium units were acquired. For the type of selenium detector tested, and under typical clinical usage conditions, the lag was as high as 0.15% of source signal and the ghosting could be as high as 15%. The amount of lag and ghosting varied from unit to unit. Results were compared with data acquired on a phosphor-based full-field digital mammography system. Modifications in the technology of the selenium detectors appear to have resulted in a marked decrease in both lag and ghosting effects in more recent systems

  15. Control and monitoring of doses to patients in a team of digital mammography; Control y seguimiento de las dosis a pacientes en un equipo de mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Agulla Otero, M.; Torres Cabrera, R.; Hernando Gonzalez, I.

    2013-07-01

    In recent years is widespread use of imaging devices digital mammography. One of the advantages associated with this scanning is the ability to access a large amount of information contained in the headwaters of own digital images. The exploitation of this information allows the calculation of doses received by patients. This paper describes the methodology employed for this purpose and are presented the results of the control and monitoring of doses given in a digital mammography equipment. (Author)

  16. st Tomosynthesis Plus Full Field Digital Mammography or Full Field Digital Mammography Alone in the Screening Environment

    Directory of Open Access Journals (Sweden)

    Stamatia Destounis

    2014-01-01

    Full Text Available Objectives: Initial review of patients undergoing screening mammography imaged with a combination of digital breast tomosynthesis (DBT plus full field digital mammography (FFDM compared with FFDM alone. Materials and Methods: From June 2011 to December 2011, all patients presenting for routine screening mammography were offered a combination DBT plus FFDM exam. Under institutional review board approval, we reviewed 524 patients who opted for combination DBT plus FFDM and selected a sample group of 524 FFDM screening exams from the same time period for a comparative analysis. The χ2 (Chi-square test was used to compare recall rates, breast density, personal history of breast cancer, and family history of breast cancer between the two groups. Results: Recall rate for FFDM, 11.45%, was significantly higher (P < 0001 than in the combination DBT plus FFDM group (4.20%. The biopsy rate in the FFDM group was 2.29% (12/524, with a cancer detection rate of 0.38% (2/524, or 3.8 per 1000 and positive predictive value (PPV of 16.7% (2/12. The biopsy rate for the DBT plus FFDM group was 1.14% (n = 6/524, with a cancer detection rate 0.57% (n = 3/524, or 5.7 per 1000 and PPV of 50.0% (n = 3/6. Personal history of breast cancer in the FFDM group was significantly lower (P < 0.0001 than in the combination DBT plus FFDM group; 2.5% and 5.7%, respectively. A significant difference in family history of breast cancer (P < 0.0001 was found, with a higher rate in the combination DBT plus FFDM group (36.0% vs. 53.8%. There was a significant difference between the combination DBT plus FFDM group and FFDM alone group, when comparing breast density (P < 0.0147, 61.64% vs. 54.20% dense breasts, respectively with a higher rate of dense breasts in the DBT plus FFDM group. In follow-up, one cancer was detected within one year of normal screening mammogram in the combination DBT plus FFDM group. Conclusion: Our initial experience found the recall rate in the combination DBT

  17. Development of Automatic Cluster Algorithm for Microcalcification in Digital Mammography

    International Nuclear Information System (INIS)

    Choi, Seok Yoon; Kim, Chang Soo

    2009-01-01

    Digital Mammography is an efficient imaging technique for the detection and diagnosis of breast pathological disorders. Six mammographic criteria such as number of cluster, number, size, extent and morphologic shape of microcalcification, and presence of mass, were reviewed and correlation with pathologic diagnosis were evaluated. It is very important to find breast cancer early when treatment can reduce deaths from breast cancer and breast incision. In screening breast cancer, mammography is typically used to view the internal organization. Clusterig microcalcifications on mammography represent an important feature of breast mass, especially that of intraductal carcinoma. Because microcalcification has high correlation with breast cancer, a cluster of a microcalcification can be very helpful for the clinical doctor to predict breast cancer. For this study, three steps of quantitative evaluation are proposed : DoG filter, adaptive thresholding, Expectation maximization. Through the proposed algorithm, each cluster in the distribution of microcalcification was able to measure the number calcification and length of cluster also can be used to automatically diagnose breast cancer as indicators of the primary diagnosis.

  18. 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

  19. 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.

  20. CMOS cassette for digital upgrade of film-based mammography systems

    Science.gov (United States)

    Baysal, Mehmet A.; Toker, Emre

    2006-03-01

    While full-field digital mammography (FFDM) technology is gaining clinical acceptance, the overwhelming majority (96%) of the installed base of mammography systems are conventional film-screen (FSM) systems. A high performance, and economical digital cassette based product to conveniently upgrade FSM systems to FFDM would accelerate the adoption of FFDM, and make the clinical and technical advantages of FFDM available to a larger population of women. The planned FFDM cassette is based on our commercial Digital Radiography (DR) cassette for 10 cm x 10 cm field-of-view spot imaging and specimen radiography, utilizing a 150 micron columnar CsI(Tl) scintillator and 48 micron active-pixel CMOS sensor modules. Unlike a Computer Radiography (CR) cassette, which requires an external digitizer, our DR cassette transfers acquired images to a display workstation within approximately 5 seconds of exposure, greatly enhancing patient flow. We will present the physical performance of our prototype system against other FFDM systems in clinical use today, using established objective criteria such as the Modulation Transfer Function (MTF), Detective Quantum Efficiency (DQE), and subjective criteria, such as a contrast-detail (CD-MAM) observer performance study. Driven by the strong demand from the computer industry, CMOS technology is one of the lowest cost, and the most readily accessible technologies available for FFDM today. Recent popular use of CMOS imagers in high-end consumer cameras have also resulted in significant advances in the imaging performance of CMOS sensors against rivaling CCD sensors. This study promises to take advantage of these unique features to develop the first CMOS based FFDM upgrade cassette.

  1. Evaluation of patient dose saving in grid-less x-ray mammography acquisition compared with full field digital mammography (FFDMG) acquisition

    DEFF Research Database (Denmark)

    Abdi, Ahmed Jibril; Mussmann, Bo Redder

    2017-01-01

    to investigate the dose saving in grid-less acquisition compared with conventional full-field digital mammography (FFDMG) acquisitions. A Piranha 657 was used to measure the entrance exposure. The entrance exposure was directly measured on different PMMA thicknesses of 20-70mm in steps of 10mm. The PMMA block...

  2. 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.

  3. 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

  4. 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

  5. A feasibility study of projection-based energy weighting based on a photon-counting detector in contrast-enhanced digital subtraction mammography: a simulation study

    International Nuclear Information System (INIS)

    Choi, Sunghoon; Lee, Seungwan; Choi, Yuna; Kim, Heejoung

    2014-01-01

    Contrast media, such as iodine and gadolinium, are generally used in digital subtraction mammography to enhance the contrast between target and background materials. In digital subtraction mammography, where one image (with contrast medium) is subtracted from another (anatomical background) to facilitate visualization of the tumor structure, tumors can be more easily distinguished after the injection of a contrast medium. In order to have more an effective method to increase the contrast-to-noise ratio (CNR), we applied a projection-based energy-weighting method. The purpose of this study is to demonstrate the feasibility of using the projection-based energy-weighting method in digital subtraction mammography. Unlike some other previous studies, we applied the projection-based energy-weighting method to more practical mammography conditions by using the Monte Carlo method to simulate four different iodine solutions embedded in a breast phantom comprised of 50% adipose and 50% glandular tissues. We also considered an optimal tube voltage and anode/filter combination in digital iodine contrast media mammography in order to maximize the figure-of-merit (FOM). The simulated source energy was from 20 to 45 keV to prevent electronic noise and include the k-edge energy of iodine (33.2 keV). The results showed that the projection-based energy-weighting improved the CNR by factors of 1.05 - 1.86 compared to the conventionally integrated images. Consequently, the CNR of digital subtraction mammography images can be improved by using projection-based energy-weighting with photon-counting detectors.

  6. A feasibility study of projection-based energy weighting based on a photon-counting detector in contrast-enhanced digital subtraction mammography: a simulation study

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sunghoon; Lee, Seungwan; Choi, Yuna; Kim, Heejoung [Yonsei University, Wonju (Korea, Republic of)

    2014-06-15

    Contrast media, such as iodine and gadolinium, are generally used in digital subtraction mammography to enhance the contrast between target and background materials. In digital subtraction mammography, where one image (with contrast medium) is subtracted from another (anatomical background) to facilitate visualization of the tumor structure, tumors can be more easily distinguished after the injection of a contrast medium. In order to have more an effective method to increase the contrast-to-noise ratio (CNR), we applied a projection-based energy-weighting method. The purpose of this study is to demonstrate the feasibility of using the projection-based energy-weighting method in digital subtraction mammography. Unlike some other previous studies, we applied the projection-based energy-weighting method to more practical mammography conditions by using the Monte Carlo method to simulate four different iodine solutions embedded in a breast phantom comprised of 50% adipose and 50% glandular tissues. We also considered an optimal tube voltage and anode/filter combination in digital iodine contrast media mammography in order to maximize the figure-of-merit (FOM). The simulated source energy was from 20 to 45 keV to prevent electronic noise and include the k-edge energy of iodine (33.2 keV). The results showed that the projection-based energy-weighting improved the CNR by factors of 1.05 - 1.86 compared to the conventionally integrated images. Consequently, the CNR of digital subtraction mammography images can be improved by using projection-based energy-weighting with photon-counting detectors.

  7. Contrast enhanced digital mammography: Is it useful in detecting lesions in edematous breast?

    Directory of Open Access Journals (Sweden)

    Noha Abd ElShafy ElSaid

    2015-09-01

    Conclusion: Dual-energy contrast-enhanced digital mammography is a useful technique in identification of lesions in mammographically dense edematous breasts and proved to be a useful tool in the follow-up of cases presenting by edema after conservative breast surgery and chemotherapy.

  8. Hexagonal wavelet processing of digital mammography

    Science.gov (United States)

    Laine, Andrew F.; Schuler, Sergio; Huda, Walter; Honeyman-Buck, Janice C.; Steinbach, Barbara G.

    1993-09-01

    This paper introduces a novel approach for accomplishing mammographic feature analysis through overcomplete multiresolution representations. We show that efficient representations may be identified from digital mammograms and used to enhance features of importance to mammography within a continuum of scale-space. We present a method of contrast enhancement based on an overcomplete, non-separable multiscale representation: the hexagonal wavelet transform. Mammograms are reconstructed from transform coefficients modified at one or more levels by local and global non-linear operators. Multiscale edges identified within distinct levels of transform space provide local support for enhancement. We demonstrate that features extracted from multiresolution representations can provide an adaptive mechanism for accomplishing local contrast enhancement. We suggest that multiscale detection and local enhancement of singularities may be effectively employed for the visualization of breast pathology without excessive noise amplification.

  9. A comparison of the performance of modern screen-film and digital mammography systems

    Energy Technology Data Exchange (ETDEWEB)

    Monnin, P [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Gutierrez, D [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Bulling, S [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Lepori, D [Department of Radiology, University Hospital Center (CHUV), CH-1011 Lausanne (Switzerland); Valley, J-F [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Verdun, F R [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland)

    2005-06-07

    This work compares the detector performance and image quality of the new Kodak Min-R EV mammography screen-film system with the Fuji CR Profect detector and with other current mammography screen-film systems from Agfa, Fuji and Kodak. Basic image quality parameters (MTF, NPS, NEQ and DQE) were evaluated for a 28 kV Mo/Mo (HVL = 0.646 mm Al) beam using different mAs exposure settings. Compared with other screen-film systems, the new Kodak Min-R EV detector has the highest contrast and a low intrinsic noise level, giving better NEQ and DQE results, especially at high optical density. Thus, the properties of the new mammography film approach those of a fine mammography detector, especially at low frequency range. Screen-film systems provide the best resolution. The presampling MTF of the digital detector has a value of 15% at the Nyquist frequency and, due to the spread size of the laser beam, the use of a smaller pixel size would not permit a significant improvement of the detector resolution. The dual collection reading technology increases significantly the low frequency DQE of the Fuji CR system that can at present compete with the most efficient mammography screen-film systems.

  10. Modelling the imaging performance and low contrast detectability in digital mammography

    International Nuclear Information System (INIS)

    Spyropoulou, V; Kalyvas, N; Gaitanis, A; Michail, C; Panayiotakis, G; Kandarakis, I

    2009-01-01

    A digital x-ray mammography is a modern method for the early detection of breast cancer. The quality of a mammography image depends on various factors, the detector structure and performance being of primary importance. The aim of this work was to develop an analytical model simulating the imaging performance of a new commercially available digital mammography detector. This was achieved within the framework of the linear cascaded systems (LCS) theory. System analysis has allowed the estimation of important image quality metrics such as the Modulation Transfer Function (MTF), the Noise Power Spectrum (NPS) and the Detective Quantum Efficiency (DQE). The detector was an indirect detection system consisting of a large area, 100μm thick, CsI:TI scintillator coupled to an active matrix array of amorphous silicon (a-Si:H) photodiodes combined with thin film transistors (TFT). Pixel size was 100μm, while the active pixel dimension was 70μm. MTF and DQE data were calculated for air kerma conditions of 25, 53, 67 μGy using a 28 kVp Mo-Mo x-ray spectrum. The theoretical results were compared with published experimental data. The deviation between the theoretical and experimental MTF curves was less than 4%, while the DQE differences were found at an acceptable level. The model was also used to estimate system's capability to detect low contrast objects in the breast. It was estimated that, in the breast gland, low contrast structures larger than 1.4mm can be adequately identified by the above system.

  11. 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

  12. X-ray light valve (XLV): a novel detectors' technology for digital mammography

    Science.gov (United States)

    Marcovici, Sorin; Sukhovatkin, Vlad; Oakham, Peter

    2014-03-01

    A novel method, based on X-ray Light Valve (XLV) technology, is proposed for making good image quality yet inexpensive flat panel detectors for digital mammography. The digital mammography markets, particularly in the developing countries, demand quality machines at substantially lower prices than the ones available today. Continuous pressure is applied on x-ray detectors' manufacturers to reduce the flat panel detectors' prices. XLV presents a unique opportunity to achieve the needed price - performance characteristics for direct conversion, x-ray detectors. The XLV based detectors combine the proven, superior, spatial resolution of a-Se with the simplicity and low cost of liquid crystals and optical scanning. The x-ray quanta absorbed by a 200 μm a-Se produce electron - hole pairs that move under an electric field to the top and bottom of a-Se layer. This 2D charge distribution creates at the interface with the liquid crystals a continuous (analog) charge image corresponding to the impinging radiation's information. Under the influence of local electrical charges next to them, the liquid crystals twist proportionally to the charges and vary their light reflectivity. A scanning light source illuminates the liquid crystals while an associated, pixilated photo-detector, having a 42 μm pixel size, captures the light reflected by the liquid crystals and converts it in16 bit words that are transmitted to the machine for image processing and display. The paper will describe a novel XLV, 25 cm x 30 cm, flat panel detector structure and its underlying physics as well as its preliminary performance measured on several engineering prototypes. In particular, the paper will present the results of measuring XLV detectors' DQE, MTF, dynamic range, low contrast resolution and dynamic behavior. Finally, the paper will introduce the new, low cost, XLV detector based, digital mammography machine under development at XLV Diagnostics Inc.

  13. Automated analysis of phantom images for the evaluation of long-term reproducibility in digital mammography

    International Nuclear Information System (INIS)

    Gennaro, G; Ferro, F; Contento, G; Fornasin, F; Di Maggio, C

    2007-01-01

    The performance of an automatic software package was evaluated with phantom images acquired by a full-field digital mammography unit. After the validation, the software was used, together with a Leeds TORMAS test object, to model the image acquisition process. Process modelling results were used to evaluate the sensitivity of the method in detecting changes of exposure parameters from routine image quality measurements in digital mammography, which is the ultimate purpose of long-term reproducibility tests. Image quality indices measured by the software included the mean pixel value and standard deviation of circular details and surrounding background, contrast-to-noise ratio and relative contrast; detail counts were also collected. The validation procedure demonstrated that the software localizes the phantom details correctly and the difference between automatic and manual measurements was within few grey levels. Quantitative analysis showed sufficient sensitivity to relate fluctuations in exposure parameters (kV p or mAs) to variations in image quality indices. In comparison, detail counts were found less sensitive in detecting image quality changes, even when limitations due to observer subjectivity were overcome by automatic analysis. In conclusion, long-term reproducibility tests provided by the Leeds TORMAS phantom with quantitative analysis of multiple IQ indices have been demonstrated to be effective in predicting causes of deviation from standard operating conditions and can be used to monitor stability in full-field digital mammography

  14. Comparing the visualization of microcalcifications with direct magnification in digital full-field mammography vs. film-screen mammography

    International Nuclear Information System (INIS)

    Diekmann, F.; Diekmann, S.; Rogalla, P.; Hamm, B.; Bick, U.; Blohmer, J.U.; Winzer, K.J.

    2002-01-01

    Purpose: To evaluate the conspicuity of microcalcifications in magnified mammographic views of preparations obtained with full field digital mammography (FFDM), film-screen mammography (FSM), and the DIMA technique. Material and Methods: Twelve preparations were examined by FFDM and FSM using 1.8 x magnification and DIMA using 7 x magnification. Parameter settings were identical for all three techniques. The number of visible microcalcifications was then determined for each modality by three radiologists. As far as possible, all preparations were X-rayed at 22 kV and 10 mAS. Results: Altogether 9705 calcifications were counted (DIMA: 1609/1542/1534; FFDM: 1020/753/881; FSM: 901/643/822). The total number of microcalcifications identified with the DIMA technique was 4685 as compared to 2654 with FFDM and 2366 with FSM. The calcifications counted with FFDM and FSM thus corresponded to 56.6% and 50.5%, respectively, of those identified with DIMA. The differences between the groups were statistically significant (F-Test, p [de

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

    Directory of Open Access Journals (Sweden)

    Sahar Mansour

    2014-09-01

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

  16. Validation of a modified PENELOPE Monte Carlo code for applications in digital and dual-energy mammography

    Science.gov (United States)

    Del Lama, L. S.; Cunha, D. M.; Poletti, M. E.

    2017-08-01

    The presence and morphology of microcalcification clusters are the main point to provide early indications of breast carcinomas. However, the visualization of those structures may be jeopardized due to overlapping tissues even for digital mammography systems. Although digital mammography is the current standard for breast cancer diagnosis, further improvements should be achieved in order to address some of those physical limitations. One possible solution for such issues is the application of the dual-energy technique (DE), which is able to highlight specific lesions or cancel out the tissue background. In this sense, this work aimed to evaluate several quantities of interest in radiation applications and compare those values with works present in the literature to validate a modified PENELOPE code for digital mammography applications. For instance, the scatter-to-primary ratio (SPR), the scatter fraction (SF) and the normalized mean glandular dose (DgN) were evaluated by simulations and the resulting values were compared to those found in earlier studies. Our results present a good correlation for the evaluated quantities, showing agreement equal or better than 5% for the scatter and dosimetric-related quantities when compared to the literature. Finally, a DE imaging chain was simulated and the visualization of microcalcifications was investigated.

  17. 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

  18. 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

  19. Visualization of Breast Microcalcifications on Digital Breast Tomosynthesis and 2-Dimensional Digital Mammography Using Specimens

    Directory of Open Access Journals (Sweden)

    Jieun Byun

    2017-04-01

    Full Text Available Purpose: The purpose of this study is to compare the visibility of microcalcifications of digital breast tomosynthesis (DBT and full-field digital mammography (FFDM using breast specimens. Materials And Methods: Thirty-one specimens’ DBT and FFDM were retrospectively reviewed by four readers. Results: The image quality of microcalcifications of DBT was rated as superior or equivalent in 71.0% by reader 1, 67.8% by reader 2, 64.5% by reader 3, and 80.6% by reader 4. The Fleiss kappa statistic for agreement among readers was 0.31. Conclusions: We suggest that image quality of DBT appears to be comparable with or better than FFDM in terms of revealing microcalcifications.

  20. Are phantoms useful for predicting the potential of dose reduction in full-field digital mammography?

    International Nuclear Information System (INIS)

    Gennaro, Gisella; Katz, Luc; Souchay, Henri; Alberelli, Claudio; Maggio, Cosimo di

    2005-01-01

    A phantom study was performed in full-field digital mammography to investigate the opportunity and the magnitude of a possible dose reduction that would leave the image quality above the accepted thresholds associated with some classical phantoms. This preliminary work is intended to lay the groundwork for a future clinical study on the impact of dose reduction on clinical results. Three different mammography phantoms (ACR RMI 156, CIRS 11A and CDMAM 3.4) were imaged by a full-field digital mammography unit (GE Senographe 2000D) at different dose levels. Images were rated by three observers with softcopy reading and scoring methods specific to each phantom. Different types of data analysis were applied to the ACR (American College of Radiology) and the other two phantoms, respectively. With reference to the minimum acceptance score in screen/film accreditation programmes, the ACR phantom showed that about 45% dose reduction could be applied, while keeping the phantom scores above that threshold. A relative comparison was done for CIRS and CDMAM, for which no threshold is defined. CIRS scoring remained close to the reference level down to 40% dose reduction, the inter- and intra-observer variability being the main source of uncertainty. Contrast-detail curves provided by CDMAM overlapped down to 50% dose reduction, at least for object contrast values ranging between 30% and 3%. This multi-phantom study shows the potential of further reducing the dose in full-field digital mammography beyond the current values. A common dose reduction factor around 50% seems acceptable for all phantoms. However, caution is required before extrapolating the results for clinical use, given the limitations of these widely used phantoms, mainly related to their limited dynamic range and uniform background

  1. Image quality of digital mammography images produced using wet and dry laser imaging systems

    International Nuclear Information System (INIS)

    Al Khalifah, K.; Brindhaban, A.; AlArfaj, R.; Jassim, O.

    2006-01-01

    Introduction: A study was carried out to compare the quality of digital mammographic images printed or processed by a wet laser imaging system and a dedicated mammographic dry laser imaging system. Material and methods: Digital images of a tissue equivalent breast phantom were obtained using a GE Senographe 2000D digital mammography system and different target/filter combinations of the X-ray tube. These images were printed on films using the Fuji FL-IM D wet laser imaging system and the Kodak DryView 8600 dry laser imaging system. The quality of images was assessed in terms of detectability of microcalcifications and simulated tumour masses by five radiologists. In addition, the contrast index and speed index of the two systems were measured using the step wedge in the phantom. The unpaired, unequal variance t-test was used to test any statistically significant differences. Results: There were no significant (p < 0.05) differences between the images printed using the two systems in terms of microcalcification and tumour mass detectability. The wet system resulted in slightly higher contrast index while the dry system showed significantly higher speed index. Conclusion: Both wet and dry laser imaging systems can produce mammography images of good quality on which 0.2 mm microcalcifications and 2 mm tumour masses can be detected. Dry systems are preferable due to the absence of wet chemical processing and solid or liquid chemical waste. The wet laser imaging systems, however, still represent a useful alternative to dry laser imaging systems for mammography studies

  2. 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.

  3. Relation between breast cancer mortality and screening effectiveness: systematic review of the mammography trials

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C

    2011-01-01

    The mammography screening trials have shown varying results. This could be because screening was better in some trials than in others at advancing the time of diagnosis. If so, more cancers would be identified in such trials relative to the control group, and fewer of the cancers would have reach...

  4. 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)

  5. Dual-energy digital mammography for calcification imaging: Scatter and nonuniformity corrections

    International Nuclear Information System (INIS)

    Kappadath, S. Cheenu; Shaw, Chris C.

    2005-01-01

    Mammographic images of small calcifications, which are often the earliest signs of breast cancer, can be obscured by overlapping fibroglandular tissue. We have developed and implemented a dual-energy digital mammography (DEDM) technique for calcification imaging under full-field imaging conditions using a commercially available aSi:H/CsI:Tl flat-panel based digital mammography system. The low- and high-energy images were combined using a nonlinear mapping function to cancel the tissue structures and generate the dual-energy (DE) calcification images. The total entrance-skin exposure and mean-glandular dose from the low- and high-energy images were constrained so that they were similar to screening-examination levels. To evaluate the DE calcification image, we designed a phantom using calcium carbonate crystals to simulate calcifications of various sizes (212-425 μm) overlaid with breast-tissue-equivalent material 5 cm thick with a continuously varying glandular-tissue ratio from 0% to 100%. We report on the effects of scatter radiation and nonuniformity in x-ray intensity and detector response on the DE calcification images. The nonuniformity was corrected by normalizing the low- and high-energy images with full-field reference images. Correction of scatter in the low- and high-energy images significantly reduced the background signal in the DE calcification image. Under the current implementation of DEDM, utilizing the mammography system and dose level tested, calcifications in the 300-355 μm size range were clearly visible in DE calcification images. Calcification threshold sizes decreased to the 250-280 μm size range when the visibility criteria were lowered to barely visible. Calcifications smaller than ∼250 μm were usually not visible in most cases. The visibility of calcifications with our DEDM imaging technique was limited by quantum noise, not system noise

  6. The potential use of ultra-low radiation dose images in digital mammography-a clinical proof-of-concept study in craniocaudal views

    NARCIS (Netherlands)

    Bluekens, A. M. J.; Veldkamp, W. J. H.; Schuur, K. H.; Karssemeijer, N.; Broeders, M. J. M.; den Heeten, G. J.

    2015-01-01

    Objective: To estimate the potential of low-dose images in digital mammography by analysing the effect of substantial dose reduction in craniocaudal (CC) views on clinical performance. Methods: At routine mammography, additional CC views were obtained with about 10% of the standard dose. Five

  7. The potential use of ultra-low radiation dose images in digital mammography--a clinical proof-of-concept study in craniocaudal views

    NARCIS (Netherlands)

    Bluekens, A.M.; Veldkamp, W.J.H.; Schuur, K.H.; Karssemeijer, N.; Broeders, M.J.; Heeten, GJ. den

    2015-01-01

    OBJECTIVE: To estimate the potential of low-dose images in digital mammography by analysing the effect of substantial dose reduction in craniocaudal (CC) views on clinical performance. METHODS: At routine mammography, additional CC views were obtained with about 10% of the standard dose. Five

  8. Radiation dose with digital breast tomosynthesis compared to digital mammography. Per-view analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella [Veneto Institute of Oncology IOV- IRCCS, Radiology Unit, Padua (Italy); Bernardi, D. [Azienda Provinciale Servizi Sanitari (APSS), U.O. Senologia Clinica e Screening Mammografico, Department of Diagnostics, Trento (Italy); Houssami, N. [University of Sydney, Screening and Test Evaluation Program (STEP), School of Public Health, Sydney Medical School, Sydney (Australia)

    2018-02-15

    To compare radiation dose delivered by digital mammography (FFDM) and breast tomosynthesis (DBT) for a single view. 4,780 FFDM and 4,798 DBT images from 1,208 women enrolled in a screening trial were used to ground dose comparison. Raw images were processed by an automatic software to determine volumetric breast density (VBD) and were used together with exposure data to compute the mean glandular dose (MGD) according to Dance's model. DBT and FFDM were compared in terms of operation of the automatic exposure control (AEC) and MGD level. Statistically significant differences were found between FFDM and DBT MGDs for all views (CC: MGD{sub FFDM}=1.366 mGy, MGD{sub DBT}=1.858 mGy; p<0.0001; MLO: MGD{sub FFDM}=1.374 mGy, MGD{sub DBT}=1.877 mGy; p<0.0001). Considering the 4,768 paired views, Bland-Altman analysis showed that the average increase of DBT dose compared to FFDM is 38 %, and a range between 0 % and 75 %. Our findings show a modest increase of radiation dose to the breast by tomosynthesis compared to FFDM. Given the emerging role of DBT, its use in conjunction with synthetic 2D images should not be deterred by concerns regarding radiation burden, and should draw on evidence of potential clinical benefit. (orig.)

  9. Optimization of exposure parameters in full field digital mammography

    International Nuclear Information System (INIS)

    Williams, Mark B.; Raghunathan, Priya; More, Mitali J.; Seibert, J. Anthony; Kwan, Alexander; Lo, Joseph Y.; Samei, Ehsan; Ranger, Nicole T.; Fajardo, Laurie L.; McGruder, Allen; McGruder, Sandra M.; Maidment, Andrew D. A.; Yaffe, Martin J.; Bloomquist, Aili; Mawdsley, Gordon E.

    2008-01-01

    Optimization of exposure parameters (target, filter, and kVp) in digital mammography necessitates maximization of the image signal-to-noise ratio (SNR), while simultaneously minimizing patient dose. The goal of this study is to compare, for each of the major commercially available full field digital mammography (FFDM) systems, the impact of the selection of technique factors on image SNR and radiation dose for a range of breast thickness and tissue types. This phantom study is an update of a previous investigation and includes measurements on recent versions of two of the FFDM systems discussed in that article, as well as on three FFDM systems not available at that time. The five commercial FFDM systems tested, the Senographe 2000D from GE Healthcare, the Mammomat Novation DR from Siemens, the Selenia from Hologic, the Fischer Senoscan, and Fuji's 5000MA used with a Lorad M-IV mammography unit, are located at five different university test sites. Performance was assessed using all available x-ray target and filter combinations and nine different phantom types (three compressed thicknesses and three tissue composition types). Each phantom type was also imaged using the automatic exposure control (AEC) of each system to identify the exposure parameters used under automated image acquisition. The figure of merit (FOM) used to compare technique factors is the ratio of the square of the image SNR to the mean glandular dose. The results show that, for a given target/filter combination, in general FOM is a slowly changing function of kVp, with stronger dependence on the choice of target/filter combination. In all cases the FOM was a decreasing function of kVp at the top of the available range of kVp settings, indicating that higher tube voltages would produce no further performance improvement. For a given phantom type, the exposure parameter set resulting in the highest FOM value was system specific, depending on both the set of available target/filter combinations, and

  10. Evaluation of glandular dose in conventional and digital mammography systems

    International Nuclear Information System (INIS)

    Coutinho, Celia Maria Campos

    2009-01-01

    A survey was conducted to estimate the average glandular dose (D g ) for patients undergoing mammography and to report the distribution of incident air kerma (K i ), patient age, compressed breast thickness and glandular tissue content. From 1183 cranio caudal mammograms clinical data were collected and doses were measured. The survey data included mammograms from six mammography equipment: two screen/film units (SFM), two computed radiography units (CR) and two full-field digital (DR). Mean value for patient age and compressed breast thickness were 57 +-12 y and 5.4 +-1.4 cm, respectively. To investigate the importance of technical characteristics of three different mammography systems and breast glandularity, K i and D g were measured for individual breast of 392 patients from the original sample with compressed breast thickness in the range of 5.5 cm to 6.5 cm using tissue-equivalent phantoms of different glandularities manufactured in this study to mimic both the attenuation and the density of breast tissues. Mean K i value was 10.0 +-3.6 mGy for SFM systems, 12.0 +-3.6 mGy for CR systems and 4.9 +-1.3 mGy for DR systems. Mean D g value was 1.4 +-0.5 mGy for S/F systems, 1.7 +-0.5 mGy for CR systems and 0.9 +-0.2 mGy for D R systems. Statistical analysis for differences in mean values of K i and D g between mammography systems showed significant effect of their technical characteristics (p i and D g , it was observed statistically significant differences between the group of patients with 0 to 50% glandularity and the group of patients with 50 to 100% glandularity. (author)

  11. Dose to population as a metric in the design of optimised exposure control in digital mammography

    International Nuclear Information System (INIS)

    Klausz, R.; Shramchenko, N.

    2005-01-01

    This paper describes a methods for automatic optimisation of parameter (AOP) in digital mammography systems. Using a model of the image chain, contrast to noise ratio (CNR) and average glandular dose (AGD) are computed for possible X-ray parameters and breast types. The optimisation process consists of the determination of the operating points providing the lowest possible AGD for each CNR level and breast type. The proposed metric for the dose used in the design of an AOP mode is the resulting dose to the population, computed by averaging the AGD values over the distribution of breast types in the population. This method has been applied to the automatic exposure control of new digital mammography equipment. Breast thickness and composition are estimated from a low dose pre-exposure and used to index tables containing sets of optimised operating points. The resulting average dose to the population ranges from a level comparable to state-of-the-art screen/film mammography to a reduction by a factor of two. Using this method, both CNR and dose are kept under control for all breast types, taking into consideration both individual and collective risk. (authors)

  12. 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

  13. 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

  14. Evaluation of mean glandular dose in a full-field digital mammography unit in Tabriz (IR)

    International Nuclear Information System (INIS)

    Riabi, H. A.; Mehnati, P.; Mesbahi, A.

    2010-01-01

    This study was aimed at evaluating the mean glandular dose (MGD) and affecting factors during mammography examinations by a full-field digital mammography unit. An extensive quality control program was performed to assure that the unit is properly working. Required information including compressed breast thickness (CBT), breast parenchymal pattern and technical factors used for imaging were recorded. An entrance skin exposure measurement was also performed using slabs of polymethylmethacrylate with 2-8 cm thickness. On the basis of recorded information and measured data, the MGD was estimated for 1145 mammography examinations obtained from 298 patients. Mean CBTs of 4.9 and 5.8 cm and MGDs of 2 and 2.4 mGy were observed for cranio-caudal and medio-lateral oblique views, respectively. Significant correlation was seen between MGD and CBT, breast parenchymal pattern and applied kVp and mAs. (authors)

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  16. Benefits, harms, and costs for breast cancer screening after US implementation of digital mammography.

    Science.gov (United States)

    Stout, Natasha K; Lee, Sandra J; Schechter, Clyde B; Kerlikowske, Karla; Alagoz, Oguzhan; Berry, Donald; Buist, Diana S M; Cevik, Mucahit; Chisholm, Gary; de Koning, Harry J; Huang, Hui; Hubbard, Rebecca A; Miglioretti, Diana L; Munsell, Mark F; Trentham-Dietz, Amy; van Ravesteyn, Nicolien T; Tosteson, Anna N A; Mandelblatt, Jeanne S

    2014-06-01

    Compared with film, digital mammography has superior sensitivity but lower specificity for women aged 40 to 49 years and women with dense breasts. Digital has replaced film in virtually all US facilities, but overall population health and cost from use of this technology are unclear. Using five independent models, we compared digital screening strategies starting at age 40 or 50 years applied annually, biennially, or based on density with biennial film screening from ages 50 to 74 years and with no screening. Common data elements included cancer incidence and test performance, both modified by breast density. Lifetime outcomes included mortality, quality-adjusted life-years, and screening and treatment costs. For every 1000 women screened biennially from age 50 to 74 years, switching to digital from film yielded a median within-model improvement of 2 life-years, 0.27 additional deaths averted, 220 additional false-positive results, and $0.35 million more in costs. For an individual woman, this translates to a health gain of 0.73 days. Extending biennial digital screening to women ages 40 to 49 years was cost-effective, although results were sensitive to quality-of-life decrements related to screening and false positives. Targeting annual screening by density yielded similar outcomes to targeting by age. Annual screening approaches could increase costs to $5.26 million per 1000 women, in part because of higher numbers of screens and false positives, and were not efficient or cost-effective. The transition to digital breast cancer screening in the United States increased total costs for small added health benefits. The value of digital mammography screening among women aged 40 to 49 years depends on women's preferences regarding false positives. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. On the noise variance of a digital mammography system

    International Nuclear Information System (INIS)

    Burgess, Arthur

    2004-01-01

    A recent paper by Cooper et al. [Med. Phys. 30, 2614-2621 (2003)] contains some apparently anomalous results concerning the relationship between pixel variance and x-ray exposure for a digital mammography system. They found an unexpected peak in a display domain pixel variance plot as a function of 1/mAs (their Fig. 5) with a decrease in the range corresponding to high display data values, corresponding to low x-ray exposures. As they pointed out, if the detector response is linear in exposure and the transformation from raw to display data scales is logarithmic, then pixel variance should be a monotonically increasing function in the figure. They concluded that the total system transfer curve, between input exposure and display image data values, is not logarithmic over the full exposure range. They separated data analysis into two regions and plotted the logarithm of display image pixel variance as a function of the logarithm of the mAs used to produce the phantom images. They found a slope of minus one for high mAs values and concluded that the transfer function is logarithmic in this region. They found a slope of 0.6 for the low mAs region and concluded that the transfer curve was neither linear nor logarithmic for low exposure values. It is known that the digital mammography system investigated by Cooper et al. has a linear relationship between exposure and raw data values [Vedantham et al., Med. Phys. 27, 558-567 (2000)]. The purpose of this paper is to show that the variance effect found by Cooper et al. (their Fig. 5) arises because the transformation from the raw data scale (14 bits) to the display scale (12 bits), for the digital mammography system they investigated, is not logarithmic for raw data values less than about 300 (display data values greater than about 3300). At low raw data values the transformation is linear and prevents over-ranging of the display data scale. Parametric models for the two transformations will be presented. Results of pixel

  18. Optimization of x-ray spectra in digital mammography through Monte Carlo simulations.

    Science.gov (United States)

    Cunha, D M; Tomal, A; Poletti, M E

    2012-04-07

    In this work, a Monte Carlo code was used to investigate the performance of different x-ray spectra in digital mammography, through a figure of merit (FOM), defined as FOM = CNR²/(¯)D(g), with CNR being the contrast-to-noise ratio in image and [Formula: see text] being the average glandular dose. The FOM was studied for breasts with different thicknesses t (2 cm ≤ t ≤ 8 cm) and glandular contents (25%, 50% and 75% glandularity). The anode/filter combinations evaluated were those traditionally employed in mammography (Mo/Mo, Mo/Rh, Rh/Rh), and a W anode combined with Al or K-edge filters (Zr, Mo, Rh, Pd, Ag, Cd, Sn), for tube potentials between 22 and 34 kVp. Results show that the W anode combined with K-edge filters provides higher values of FOM for all breast thicknesses investigated. Nevertheless, the most suitable filter and tube potential depend on the breast thickness, and for t ≥ 6 cm, they also depend on breast glandularity. Particularly for thick and dense breasts, a W anode combined with K-edge filters can greatly improve the digital technique, with the values of FOM up to 200% greater than that obtained with the anode/filter combinations and tube potentials traditionally employed in mammography. For breasts with t < 4 cm, a general good performance was obtained with the W anode combined with 60 μm of the Mo filter at 24-25 kVp, while 60 μm of the Pd filter provided a general good performance at 24-26 kVp for t = 4 cm, and at 28-30 and 29-31 kVp for t = 6 and 8 cm, respectively.

  19. 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.

  20. Screening mammography-detected cancers: the sensitivity of the computer-aided detection system as applied to full-field digital mammography

    International Nuclear Information System (INIS)

    Yang, Sang Kyu; Cho, Nariya; Ko, Eun Sook; Kim, Do Yeon; Moon, Woo Kyung

    2006-01-01

    We wanted to evaluate the sensitivity of the computer-aided detection (CAD) system for performing full-field digital mammography (FFDM) on the breast cancers that were originally detected by screening mammography. The CAD system (Image Checker v3.1, R2 Technology, Los Altos, Calif.) together with a full-field digital mammography system (Senographe 2000D, GE Medical Systems, Buc, France) was prospectively applied to the mammograms of 70 mammographically detected breast cancer patients (age range, 37-69; median age, 51 years) who had negative findings on their clinical examinations. The sensitivity of the CAD system, according to histopathologic findings and radiologic primary features (i.e, mass, microcalcifications or mass with microcalcifications) and also the false-positive marking rate were then determined. The CAD system correctly depicted 67 of 70 breast cancer lesions (97.5%). The CAD system marked 29 of 30 breast cancers that presented with microcalcifications only (sensitivity 96.7%) and all 18 breast cancers the presented with mass together with microcalcifications (sensitivity 100%). Twenty of the 22 lesions that appeared as a mass only were marked correctly by the CAD system (sensitivity 90.9%). The CAD system correctly depicted all 22 lesions of ductal carcinoma in situ (sensitivity: 100%), all 13 lesions of invasive ductal carcinoma with ductal carcinoma in situ (sensitivity: 100%) and the 1 lesion of invasive lobular carcinoma (sensitivity: 100%). Thirty one of the 34 lesions of invasive ductal carcinoma were marked correctly by the CAD system (sensitivity: 91.8%). The rate of false-positive marks was 0.21 mass marks per image and 0.16 microcalcification marks per image. The overall rate of false-positive marks was 0.37 per image. The CAD system using FFDM is useful for the detection of asymptomatic breast cancers, and it has a high overall tumor detection rate. The false negative cases were found in relatively small invasive ductal carcinoma

  1. Screening mammography-detected cancers: the sensitivity of the computer-aided detection system as applied to full-field digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Sang Kyu; Cho, Nariya; Ko, Eun Sook; Kim, Do Yeon; Moon, Woo Kyung [College of Medicine Seoul National University and The Insititute of Radiation Medicine, Seoul National University Research Center, Seoul (Korea, Republic of)

    2006-04-15

    We wanted to evaluate the sensitivity of the computer-aided detection (CAD) system for performing full-field digital mammography (FFDM) on the breast cancers that were originally detected by screening mammography. The CAD system (Image Checker v3.1, R2 Technology, Los Altos, Calif.) together with a full-field digital mammography system (Senographe 2000D, GE Medical Systems, Buc, France) was prospectively applied to the mammograms of 70 mammographically detected breast cancer patients (age range, 37-69; median age, 51 years) who had negative findings on their clinical examinations. The sensitivity of the CAD system, according to histopathologic findings and radiologic primary features (i.e, mass, microcalcifications or mass with microcalcifications) and also the false-positive marking rate were then determined. The CAD system correctly depicted 67 of 70 breast cancer lesions (97.5%). The CAD system marked 29 of 30 breast cancers that presented with microcalcifications only (sensitivity 96.7%) and all 18 breast cancers the presented with mass together with microcalcifications (sensitivity 100%). Twenty of the 22 lesions that appeared as a mass only were marked correctly by the CAD system (sensitivity 90.9%). The CAD system correctly depicted all 22 lesions of ductal carcinoma in situ (sensitivity: 100%), all 13 lesions of invasive ductal carcinoma with ductal carcinoma in situ (sensitivity: 100%) and the 1 lesion of invasive lobular carcinoma (sensitivity: 100%). Thirty one of the 34 lesions of invasive ductal carcinoma were marked correctly by the CAD system (sensitivity: 91.8%). The rate of false-positive marks was 0.21 mass marks per image and 0.16 microcalcification marks per image. The overall rate of false-positive marks was 0.37 per image. The CAD system using FFDM is useful for the detection of asymptomatic breast cancers, and it has a high overall tumor detection rate. The false negative cases were found in relatively small invasive ductal carcinoma.

  2. FROST: an ASIC for digital mammography with synchrotron radiation

    International Nuclear Information System (INIS)

    Bergamaschi, A.; Prest, M.; Vallazza, E.; Arfelli, F.; Dreossi, D.; Longo, R.; Olivo, A.; Pani, S.; Castelli, E.

    2003-01-01

    The FRONTier RADiography (FRONTRAD) collaboration is developing a digital system for mammography at the Elettra Synchrotron Light Source in Trieste. The system is based on a silicon microstrip detector array. The ASIC FROST (FRONTRAD Read Out sySTem) was developed as a collaboration between INFN Trieste and Aurelia Microelettronica and is designed to operate in single photon counting mode. FROST provides low-noise and high-gain performances and is able to work at incident photon rates higher than 100 kHz with almost 100% efficiency. The ASIC has been tested and the first images of mammographic test objects will be shown. The acquisition time per breast image should be of about 10 s

  3. An alternative method for noise analysis using pixel variance as part of quality control procedures on digital mammography systems

    International Nuclear Information System (INIS)

    Bouwman, R; Broeders, M; Van Engen, R; Young, K; Lazzari, B; Ravaglia, V

    2009-01-01

    According to the European Guidelines for quality assured breast cancer screening and diagnosis, noise analysis is one of the measurements that needs to be performed as part of quality control procedures on digital mammography systems. However, the method recommended in the European Guidelines does not discriminate sufficiently between systems with and without additional noise besides quantum noise. This paper attempts to give an alternative and relatively simple method for noise analysis which can divide noise into electronic noise, structured noise and quantum noise. Quantum noise needs to be the dominant noise source in clinical images for optimal performance of a digital mammography system, and therefore the amount of electronic and structured noise should be minimal. For several digital mammography systems, the noise was separated into components based on the measured pixel value, standard deviation (SD) of the image and the detector entrance dose. The results showed that differences between systems exist. Our findings confirm that the proposed method is able to discriminate systems based on their noise performance and is able to detect possible quality problems. Therefore, we suggest to replace the current method for noise analysis as described in the European Guidelines by the alternative method described in this paper.

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

    Science.gov (United States)

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

    2017-12-01

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

  5. Low energy mammogram obtained in contrast-enhanced digital mammography (CEDM) is comparable to routine full-field digital mammography (FFDM)

    Energy Technology Data Exchange (ETDEWEB)

    Francescone, Mark A., E-mail: maf2184@columbia.edu [Columbia University Medical Center, ColumbiaDoctors Midtown, 51 West 51st Street, Suite 300, New York, NY 10019 (United States); Jochelson, Maxine S., E-mail: jochelsm@mskcc.org [Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Dershaw, D. David, E-mail: dershawd@mskcc.org [Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Sung, Janice S., E-mail: sungj@mskcc.org [Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Hughes, Mary C., E-mail: hughesm@mskcc.org [Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Zheng, Junting, E-mail: zhengj@mskcc.org [Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Moskowitz, Chaya, E-mail: moskowc1@mskcc.org [Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Morris, Elizabeth A., E-mail: morrise@mskcc.org [Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States)

    2014-08-15

    Purpose: Contrast enhanced digital mammography (CEDM) uses low energy and high energy exposures to produce a subtracted contrast image. It is currently performed with a standard full-field digital mammogram (FFDM). The purpose is to determine if the low energy image performed after intravenous iodine injection can replace the standard FFDM. Methods: And Materials: In an IRB approved HIPAA compatible study, low-energy CEDM images of 170 breasts in 88 women (ages 26–75; mean 50.3) undergoing evaluation for elevated risk or newly diagnosed breast cancer were compared to standard digital mammograms performed within 6 months. Technical parameters including posterior nipple line (PNL) distance, compression thickness, and compression force on the MLO projection were compared. Mammographic findings were compared qualitatively and quantitatively. Mixed linear regression using generalized estimating equation (GEE) method was performed. Intraclass correlation coefficients (ICC) with 95% confidence interval (95%CI) were estimated to assess agreement. Results: No statistical difference was found in the technical parameters compression thickness, PNL distance, compression force (p-values: 0.767, 0.947, 0.089). No difference was found in the measured size of mammographic findings (p-values 0.982–0.988). Grouped calcifications had a mean size/extent of 2.1 cm (SD 0.6) in the low-energy contrast images, and a mean size/extent of 2.2 cm (SD 0.6) in the standard digital mammogram images. Masses had a mean size of 1.8 cm (SD 0.2) in both groups. Calcifications were equally visible on both CEDM and FFDM. Conclusion: Low energy CEDM images are equivalent to standard FFDM despite the presence of intravenous iodinated contrast. Low energy CEDM images may be used for interpretation in place of the FFDM, thereby reducing patient dose.

  6. Low energy mammogram obtained in contrast-enhanced digital mammography (CEDM) is comparable to routine full-field digital mammography (FFDM)

    International Nuclear Information System (INIS)

    Francescone, Mark A.; Jochelson, Maxine S.; Dershaw, D. David; Sung, Janice S.; Hughes, Mary C.; Zheng, Junting; Moskowitz, Chaya; Morris, Elizabeth A.

    2014-01-01

    Purpose: Contrast enhanced digital mammography (CEDM) uses low energy and high energy exposures to produce a subtracted contrast image. It is currently performed with a standard full-field digital mammogram (FFDM). The purpose is to determine if the low energy image performed after intravenous iodine injection can replace the standard FFDM. Methods: And Materials: In an IRB approved HIPAA compatible study, low-energy CEDM images of 170 breasts in 88 women (ages 26–75; mean 50.3) undergoing evaluation for elevated risk or newly diagnosed breast cancer were compared to standard digital mammograms performed within 6 months. Technical parameters including posterior nipple line (PNL) distance, compression thickness, and compression force on the MLO projection were compared. Mammographic findings were compared qualitatively and quantitatively. Mixed linear regression using generalized estimating equation (GEE) method was performed. Intraclass correlation coefficients (ICC) with 95% confidence interval (95%CI) were estimated to assess agreement. Results: No statistical difference was found in the technical parameters compression thickness, PNL distance, compression force (p-values: 0.767, 0.947, 0.089). No difference was found in the measured size of mammographic findings (p-values 0.982–0.988). Grouped calcifications had a mean size/extent of 2.1 cm (SD 0.6) in the low-energy contrast images, and a mean size/extent of 2.2 cm (SD 0.6) in the standard digital mammogram images. Masses had a mean size of 1.8 cm (SD 0.2) in both groups. Calcifications were equally visible on both CEDM and FFDM. Conclusion: Low energy CEDM images are equivalent to standard FFDM despite the presence of intravenous iodinated contrast. Low energy CEDM images may be used for interpretation in place of the FFDM, thereby reducing patient dose

  7. A comparison of digital and screen-film mammography using quality control phantoms

    International Nuclear Information System (INIS)

    Undrill, Peter E.; O'Kane, Arlene D.; Gilbert, Fiona J.

    2000-01-01

    AIM: To compare the performance of a direct digital mammography system with normal-view and magnified-view conventional screen-film methods using quality control phantoms. MATERIALS AND METHODS: Using a Siemens Mammomat [reg] 3000 and an Opdima [reg] digital spot imaging and biopsy attachment, film and direct digital images of two phantoms [DuPont and TOR (MAM)] were obtained under normal operating conditions. These were assessed by three groups of observers with differing expertise -- radiologists, radiographers and medical physicists. Each observer was asked to compare the direct digital image with films taken in standard view and magnified view, providing scores for object visibility and confidence. For the digital images, observers were allowed to vary the image presentation parameters. RESULTS: Both phantoms showed that overall the direct digital view and the magnified view film performed significantly better (P < 0.05) than standard view film. For certain small or low contrast objects the differences became very highly significant (P < 0.001). CONCLUSION: Only the TOR (MAM) phantom showed any significant difference between digital and magnified modalities, with magnified views performing better for fine, faint filaments and digital acquisition better for low contrast objects. Almost no difference existed between the three observer groups. Undrill, P.E. (2000). Clinical Radiology 53, 782-790

  8. Breast Glandularity in Malaysian Women from a Full-Field Digital Mammography System

    International Nuclear Information System (INIS)

    Noriah Jamal; Humairah Samad Cheung; Siti Selina Abdul Hamid; Juliana Mahamad Napiah

    2014-01-01

    This study is undertaken to estimate breast glandularity in Malaysian women from a Full-Field Digital mammography System. This study involved 223 women (Malay=100;Chinese=101 and Indian=22) underwent voluntary screening mammography at Breast Centre, International Islamic University Malaysia (IIUM Breast Centre) for the first quarter of year 2009. Those are women aged between 31 to 69 years old (median age, 49 years). Data on miliampere-seconds, kilo voltage and compressed breast thickness for each cranio caudal view are used to estimate breast glandularity for an individual breast. Breast glandularity is calculated using the fitted equation reported earlier. The difference in breast glandularity among ethnic groups was tested for significance using the nonparametric Kruskal-Wallis test. The average breast glandularity estimated in our study, using FFDM system is 52.94±27.63 %. No significant difference was seen in breast glandularity among the ethnic groups (p>0.05, Kruskan Wallis test). Breast glandularity decrease as age increases, up to 60 years old. (author)

  9. National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium.

    Science.gov (United States)

    Lehman, Constance D; Arao, Robert F; Sprague, Brian L; Lee, Janie M; Buist, Diana S M; Kerlikowske, Karla; Henderson, Louise M; Onega, Tracy; Tosteson, Anna N A; Rauscher, Garth H; Miglioretti, Diana L

    2017-04-01

    Purpose To establish performance benchmarks for modern screening digital mammography and assess performance trends over time in U.S. community practice. Materials and Methods This HIPAA-compliant, institutional review board-approved study measured the performance of digital screening mammography interpreted by 359 radiologists across 95 facilities in six Breast Cancer Surveillance Consortium (BCSC) registries. The study included 1 682 504 digital screening mammograms performed between 2007 and 2013 in 792 808 women. Performance measures were calculated according to the American College of Radiology Breast Imaging Reporting and Data System, 5th edition, and were compared with published benchmarks by the BCSC, the National Mammography Database, and performance recommendations by expert opinion. Benchmarks were derived from the distribution of performance metrics across radiologists and were presented as 50th (median), 10th, 25th, 75th, and 90th percentiles, with graphic presentations using smoothed curves. Results Mean screening performance measures were as follows: abnormal interpretation rate (AIR), 11.6 (95% confidence interval [CI]: 11.5, 11.6); cancers detected per 1000 screens, or cancer detection rate (CDR), 5.1 (95% CI: 5.0, 5.2); sensitivity, 86.9% (95% CI: 86.3%, 87.6%); specificity, 88.9% (95% CI: 88.8%, 88.9%); false-negative rate per 1000 screens, 0.8 (95% CI: 0.7, 0.8); positive predictive value (PPV) 1, 4.4% (95% CI: 4.3%, 4.5%); PPV2, 25.6% (95% CI: 25.1%, 26.1%); PPV3, 28.6% (95% CI: 28.0%, 29.3%); cancers stage 0 or 1, 76.9%; minimal cancers, 57.7%; and node-negative invasive cancers, 79.4%. Recommended CDRs were achieved by 92.1% of radiologists in community practice, and 97.1% achieved recommended ranges for sensitivity. Only 59.0% of radiologists achieved recommended AIRs, and only 63.0% achieved recommended levels of specificity. Conclusion The majority of radiologists in the BCSC surpass cancer detection recommendations for screening

  10. Study of optimization in CR and DR digital mammography systems; Estudo da otimização em sistemas de mamografia digital CR e DR

    Energy Technology Data Exchange (ETDEWEB)

    Perez, Alessandra M.M.M.; Poletti, Martin E. [Universidade de Sao Paulo (USP), Ribeirão Preto, SP (Brazil). Departamento de Física; Tomal, Alessandra [Universidade de Campinas (UNICAMP), Campinas, SP (Brazil). Instituto de Física Gleb Wataghin; Correia, Paula D. [MP Radioproteção, Uberlândia, MG (Brazil); Paciência, Renato D. [BrasilRad, Florianópolis, SC (Brazil); Silva, Marcia C. [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

    2017-07-01

    The advance of digital mammography in Brazil require revisiting optimization conditions. This work aimed to determine optimized radiographic technique for two detection systems (Computerized Radiography and Digital Radiography) in use in three mammography units: Mammomat 3000 Nova (Siemens), Senographe DMR (GE) and Senographe 2000D (GE). Optimization was conducted for different technique factors and breast phantom configurations, such as tube voltage settings (26 to 32 kV), target and filter combinations (Mo/Mo, Mo/Rh and Rh/Rh) and breast equivalent material in various thicknesses (2 to 8 cm), using a figure of merit (FOM) as a parameter. The target and filter combinations that provided the highest FOM values were Mo/Rh for Siemens equipment and Rh/Rh for both GE equipment, corresponding to the higher energy spectra in each unity. It was also observed an increasing tendency of tube voltage which maximizes FOM with the increase of thickness. (author)

  11. Interval breast cancer characteristics before, during and after the transition from screen-film to full-field digital screening mammography.

    Science.gov (United States)

    van Bommel, Rob M G; Weber, Roy; Voogd, Adri C; Nederend, Joost; Louwman, Marieke W J; Venderink, Dick; Strobbe, Luc J A; Rutten, Matthieu J C; Plaisier, Menno L; Lohle, Paul N; Hooijen, Marianne J H; Tjan-Heijnen, Vivianne C G; Duijm, Lucien E M

    2017-05-05

    To determine the proportion of "true" interval cancers and tumor characteristics of interval breast cancers prior to, during and after the transition from screen-film mammography screening (SFM) to full-field digital mammography screening (FFDM). We included all women with interval cancers detected between January 2006 and January 2014. Breast imaging reports, biopsy results and breast surgery reports of all women recalled at screening mammography and of all women with interval breast cancers were collected. Two experienced screening radiologists reviewed the diagnostic mammograms, on which the interval cancers were diagnosed, as well as the prior screening mammograms and determined whether or not the interval cancer had been missed on the most recent screening mammogram. If not missed, the cancer was considered an occult ("true") interval cancer. A total of 442 interval cancers had been diagnosed, of which 144 at SFM with a prior SFM (SFM-SFM), 159 at FFDM with a prior SFM (FFDM-SFM) and 139 at FFDM with a prior FFDM (FFDM-FFDM). The transition from SFM to FFDM screening resulted in the diagnosis of more occult ("true") interval cancers at FFDM-SFM than at SFM-SFM (65.4% (104/159) versus 49.3% (71/144), P screened digitally for the second time (57.6% (80/139) at FFDM-FFDM versus 49.3% (71/144) at SFM-SFM). Tumor characteristics were comparable for the three interval cancer cohorts, except of a lower porportion (75.7 and 78.0% versus 67.2% af FFDM-FFDM, P cancers at FFDM with prior FFDM. An increase in the proportion of occult interval cancers is observed during the transition from SFM to FFDM screening mammography. However, this increase seems temporary and is no longer detectable after the second round of digital screening. Tumor characteristics and type of surgery are comparable for interval cancers detected prior to, during and after the transition from SFM to FFDM screening mammography, except of a lower proportion of invasive ductal cancers after the

  12. Budget Impact Analysis of Switching to Digital Mammography in a Population-Based Breast Cancer Screening Program: A Discrete Event Simulation Model

    Science.gov (United States)

    Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

    2014-01-01

    Objective To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. Methods A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Results Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Conclusions Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs. PMID:24832200

  13. 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...

  14. Comparison of digital mammography and digital breast tomosynthesis in the detection of architectural distortion.

    Science.gov (United States)

    Dibble, Elizabeth H; Lourenco, Ana P; Baird, Grayson L; Ward, Robert C; Maynard, A Stanley; Mainiero, Martha B

    2018-01-01

    To compare interobserver variability (IOV), reader confidence, and sensitivity/specificity in detecting architectural distortion (AD) on digital mammography (DM) versus digital breast tomosynthesis (DBT). This IRB-approved, HIPAA-compliant reader study used a counterbalanced experimental design. We searched radiology reports for AD on screening mammograms from 5 March 2012-27 November 2013. Cases were consensus-reviewed. Controls were selected from demographically matched non-AD examinations. Two radiologists and two fellows blinded to outcomes independently reviewed images from two patient groups in two sessions. Readers recorded presence/absence of AD and confidence level. Agreement and differences in confidence and sensitivity/specificity between DBT versus DM and attendings versus fellows were examined using weighted Kappa and generalised mixed modeling, respectively. There were 59 AD patients and 59 controls for 1,888 observations (59 × 2 (cases and controls) × 2 breasts × 2 imaging techniques × 4 readers). For all readers, agreement improved with DBT versus DM (0.61 vs. 0.37). Confidence was higher with DBT, p = .001. DBT achieved higher sensitivity (.59 vs. .32), p .90). DBT achieved higher positive likelihood ratio values, smaller negative likelihood ratio values, and larger ROC values. DBT decreases IOV, increases confidence, and improves sensitivity while maintaining high specificity in detecting AD. • Digital breast tomosynthesis decreases interobserver variability in the detection of architectural distortion. • Digital breast tomosynthesis increases reader confidence in the detection of architectural distortion. • Digital breast tomosynthesis improves sensitivity in the detection of architectural distortion.

  15. Teaching syllabus for radiological aspects of breast cancer screening with digital mammography

    International Nuclear Information System (INIS)

    Van Ongeval, C.; Van Steen, A.; Bosmans, H.

    2008-01-01

    The purpose of this study is to discuss the content of our new accreditation programme for radiologists' reading digital mammograms in a screening setting and to report our first experience with the new course. The course consisted of a theoretical part, given by the medical physicist, and a practical part given by the radiologist. The practical session is closely linked with the theoretical part and a reading session. The material is fully digital and can be presented on different platforms. In practice, the need for parallel soft-copy reading sessions on high-end workstations limits the number of participants. A high level of interactivity was noted between teacher and participant, with a thorough discussion of different digital mammography systems during a single teaching course. The main challenge for the teacher turned out to be the collection of representative material and the continuous updating of the material: new systems, processing techniques and artefacts need to be included regularly. (authors)

  16. Normalized Noise Power Spectrum of Full Field Digital Mammography System

    International Nuclear Information System (INIS)

    Isa, Norriza Mohd; Wan Hassan, Wan Muhamad Saridan

    2010-01-01

    A method to measure noise power spectrum of a full field digital mammography system is presented. The effect of X-ray radiation dose, size and configuration of region of interest on normalized noise power spectrum (NNPS) was investigated. Flat field images were acquired using RQA-M2 beam quality technique (Mo/Mo anode-filter, 28 kV, 2 mm Al) with different clinical radiation doses. The images were cropped at about 4 cm from the edge of the breast wall and then divided into different size of non-overlapping or overlapping segments. NNPS was determined through detrending, 2-D fast Fourier transformation and normalization. Our measurement shows that high radiation dose gave lower NNPS at a specific beam quality.

  17. X-ray imaging using amorphous selenium: a photoinduced discharge readout method for digital mammography.

    Science.gov (United States)

    Rowlands, J A; Hunter, D M; Araj, N

    1991-01-01

    A new digital image readout method for electrostatic charge images on photoconductive plates is described. The method can be used to read out images on selenium plates similar to those used in xeromammography. The readout method, called the air-gap photoinduced discharge method (PID), discharges the latent image pixel by pixel and measures the charge. The PID readout method, like electrometer methods, is linear. However, the PID method permits much better resolution than scanning electrometers while maintaining quantum limited performance at high radiation exposure levels. Thus the air-gap PID method appears to be uniquely superior for high-resolution digital imaging tasks such as mammography.

  18. Experimental test of a new technique of background suppression in digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Bisogni, M.G.; Bottari, S.; Ciocci, M.A.; Fantacci, M.E.; Maestro, P.; Malakhov, N.; Marrocchesi, P.S. E-mail: marrocchesi@pi.infn.it; Novelli, M.; Quattrocchi, M.; Pilo, F.; Rosso, V.; Turini, N.; Zucca, S

    2002-02-01

    A multiple-exposure technique in digital mammography has been developed to suppress the physical background in the image due to Compton scattering in the body. A pair of X-ray masks, shaped in a projective geometry and positioned upstream and downstream the patient, are coupled mechanically and moved in four steps along a square pattern in order to irradiate the full area in four consecutive short exposures. A proof-of-principle apparatus is under test with a breast phantom and a standard mammographic X-ray unit. Results are reported.

  19. Experimental test of a new technique of background suppression in digital mammography

    International Nuclear Information System (INIS)

    Bisogni, M.G.; Bottari, S.; Ciocci, M.A.; Fantacci, M.E.; Maestro, P.; Malakhov, N.; Marrocchesi, P.S.; Novelli, M.; Quattrocchi, M.; Pilo, F.; Rosso, V.; Turini, N.; Zucca, S.

    2002-01-01

    A multiple-exposure technique in digital mammography has been developed to suppress the physical background in the image due to Compton scattering in the body. A pair of X-ray masks, shaped in a projective geometry and positioned upstream and downstream the patient, are coupled mechanically and moved in four steps along a square pattern in order to irradiate the full area in four consecutive short exposures. A proof-of-principle apparatus is under test with a breast phantom and a standard mammographic X-ray unit. Results are reported

  20. 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)

  1. 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)

  2. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    Energy Technology Data Exchange (ETDEWEB)

    Bluekens, Adriana M.J. [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Karssemeijer, Nico [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Beijerinck, David; Deurenberg, Jan J.M. [Preventicon Screening Centre/Mid-West, Utrecht (Netherlands); Engen, Ruben E. van [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Broeders, Mireille J.M. [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Department of Epidemiology, Biostatistics and HTA, Nijmegen (Netherlands); Heeten, Gerard J. den [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Academic Medical Centre (AMC), Department of Radiology, Amsterdam (Netherlands)

    2010-09-15

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p <.001), with a significant increase in cancer detection (p =.010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection. (orig.)

  3. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates.

    Science.gov (United States)

    Bluekens, Adriana M J; Karssemeijer, Nico; Beijerinck, David; Deurenberg, Jan J M; van Engen, Ruben E; Broeders, Mireille J M; den Heeten, Gerard J

    2010-09-01

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p < .001), with a significant increase in cancer detection (p = .010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection.

  4. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    International Nuclear Information System (INIS)

    Bluekens, Adriana M.J.; Karssemeijer, Nico; Beijerinck, David; Deurenberg, Jan J.M.; Engen, Ruben E. van; Broeders, Mireille J.M.; Heeten, Gerard J. den

    2010-01-01

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p <.001), with a significant increase in cancer detection (p =.010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection. (orig.)

  5. The simulation of 3D microcalcification clusters in 2D digital mammography and breast tomosynthesis

    International Nuclear Information System (INIS)

    Shaheen, Eman; Van Ongeval, Chantal; Zanca, Federica; Cockmartin, Lesley; Marshall, Nicholas; Jacobs, Jurgen; Young, Kenneth C.; Dance, David R.; Bosmans, Hilde

    2011-01-01

    Purpose: This work proposes a new method of building 3D models of microcalcification clusters and describes the validation of their realistic appearance when simulated into 2D digital mammograms and into breast tomosynthesis images. Methods: A micro-CT unit was used to scan 23 breast biopsy specimens of microcalcification clusters with malignant and benign characteristics and their 3D reconstructed datasets were segmented to obtain 3D models of microcalcification clusters. These models were then adjusted for the x-ray spectrum used and for the system resolution and simulated into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. Six radiologists were asked to distinguish between 40 real and 40 simulated clusters of microcalcifications in two separate studies on 2D mammography and tomosynthesis datasets. Receiver operating characteristic (ROC) analysis was used to test the ability of each observer to distinguish between simulated and real microcalcification clusters. The kappa statistic was applied to assess how often the individual simulated and real microcalcification clusters had received similar scores (''agreement'') on their realistic appearance in both modalities. This analysis was performed for all readers and for the real and the simulated group of microcalcification clusters separately. ''Poor'' agreement would reflect radiologists' confusion between simulated and real clusters, i.e., lesions not systematically evaluated in both modalities as either simulated or real, and would therefore be interpreted as a success of the present models. Results: The area under the ROC curve, averaged over the observers, was 0.55 (95% confidence interval [0.44, 0.66]) for the 2D study, and 0.46 (95% confidence interval [0.29, 0.64]) for the tomosynthesis study, indicating no statistically significant difference between real and simulated

  6. A calibration approach to glandular tissue composition estimation in digital mammography

    International Nuclear Information System (INIS)

    Kaufhold, J.; Thomas, J.A.; Eberhard, J.W.; Galbo, C.E.; Trotter, D.E. Gonzalez

    2002-01-01

    The healthy breast is almost entirely composed of a mixture of fatty, epithelial, and stromal tissues which can be grouped into two distinctly attenuating tissue types: fatty and glandular. Further, the amount of glandular tissue is linked to breast cancer risk, so an objective quantitative analysis of glandular tissue can aid in risk estimation. Highnam and Brady have measured glandular tissue composition objectively. However, they argue that their work should only be used for 'relative' tissue measurements unless a careful calibration has been performed. In this work, we perform such a 'careful calibration' on a digital mammography system and use it to estimate breast tissue composition of patient breasts. We imaged 0%, 50%, and 100% glandular-equivalent phantoms of varying thicknesses for a number of clinically relevant x-ray techniques on a digital mammography system. From these images, we extracted mean signal and noise levels and computed calibration curves that can be used for quantitative tissue composition estimation. In this way, we calculate the percent glandular composition of a patient breast on a pixelwise basis. This tissue composition estimation method was applied to 23 digital mammograms. We estimated the quantitative impact of different error sources on the estimates of tissue composition. These error sources include compressed breast height estimation error, residual scattered radiation, quantum noise, and beam hardening. Errors in the compressed breast height estimate contribute the most error in tissue composition--on the order of ±7% for a 4 cm compressed breast height. The spatially varying scattered radiation will contribute quantitatively less error overall, but may be significant in regions near the skinline. It is calculated that for a 4 cm compressed breast height, a residual scatter signal error is mitigated by approximately sixfold in the composition estimate. The error in composition due to the quantum noise, which is the limiting

  7. Should processed or raw image data be used in mammographic image quality analyses? A comparative study of three full-field digital mammography systems

    International Nuclear Information System (INIS)

    Borg, Mark; Badr, Ishmail; Royle, Gary

    2015-01-01

    The purpose of this study is to compare a number of measured image quality parameters using processed and unprocessed or raw images in two full-field direct digital units and one computed radiography mammography system. This study shows that the difference between raw and processed image data is system specific. The results have shown that there are no significant differences between raw and processed data in the mean threshold contrast values using the contrast-detail mammography phantom in all the systems investigated; however, these results cannot be generalised to all available systems. Notable differences were noted in contrast-to-noise ratios and in other tests including: response function, modulation transfer function, noise equivalent quanta, normalised noise power spectra and detective quantum efficiency as specified in IEC 62220-1-2. Consequently, the authors strongly recommend the use of raw data for all image quality analyses in digital mammography. (authors)

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

    Science.gov (United States)

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

    2018-01-01

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

  9. Evaluation of average glandular dose in digital and conventional systems of the mammography; Avaliacao da dose glandular media em sistemas digitais e convencionais de mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Xavier, Aline C.S.; Barros, Vinicius S.M.; Khoury, Hellen J., E-mail: alinecx90@gmail.com, E-mail: vsmdbarros@gmail.com, E-mail: hjkhoury@gmail.com [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. de Energia Nuclear; Mello, Francisca A. de, E-mail: francissamello@yahoo.com.br [Hospital das Clinicas do Recife (HCR/UFPE), PE (Brazil)

    2014-07-01

    Mammography is currently the most effective method of diagnosis and detection of breast pathologies. The main interest in this kid of exam comes from the high incidence rate of breast cancer and necessity of high quality images for accurate diagnosis. Digital mammography systems have several advantages compared to conventional systems, however the use of digital imaging systems is not always integrated to an image acquisition protocol. Therefore, it is questionable if digital systems truly reduce the dose received by the patient, because many times is introduced in the clinics without optimization of the image acquisition protocols. The aim of this study is to estimate the value of incident air Kerma and average glandular dose (AGD) in patients undergoing conventional and digital mammography systems in Recife. This study was conducted with 650 patients in three hospitals. The value of incident air Kerma was estimated from the measurement of the yield of equipment and irradiation parameters used for each patient. From these results and using the methodology proposed by Dance et al. the value of the average glandular dose was calculated. The results obtained show that the lowest value of AGD was found with conventional screen-film system, indicating that the parameters for image acquisition with digital systems are not optimized. It was also observed that the institutions with digital systems use lower breast compression values than the conventional. (author)

  10. A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis, and cone-beam CT breast imaging

    International Nuclear Information System (INIS)

    Gong Xing; Glick, Stephen J.; Liu, Bob; Vedula, Aruna A.; Thacker, Samta

    2006-01-01

    Although conventional mammography is currently the best modality to detect early breast cancer, it is limited in that the recorded image represents the superposition of a three-dimensional (3D) object onto a 2D plane. Recently, two promising approaches for 3D volumetric breast imaging have been proposed, breast tomosynthesis (BT) and CT breast imaging (CTBI). To investigate possible improvements in lesion detection accuracy with either breast tomosynthesis or CT breast imaging as compared to digital mammography (DM), a computer simulation study was conducted using simulated lesions embedded into a structured 3D breast model. The computer simulation realistically modeled x-ray transport through a breast model, as well as the signal and noise propagation through a CsI based flat-panel imager. Polyenergetic x-ray spectra of Mo/Mo 28 kVp for digital mammography, Mo/Rh 28 kVp for BT, and W/Ce 50 kVp for CTBI were modeled. For the CTBI simulation, the intensity of the x-ray spectra for each projection view was determined so as to provide a total average glandular dose of 4 mGy, which is approximately equivalent to that given in conventional two-view screening mammography. The same total dose was modeled for both the DM and BT simulations. Irregular lesions were simulated by using a stochastic growth algorithm providing lesions with an effective diameter of 5 mm. Breast tissue was simulated by generating an ensemble of backgrounds with a power law spectrum, with the composition of 50% fibroglandular and 50% adipose tissue. To evaluate lesion detection accuracy, a receiver operating characteristic (ROC) study was performed with five observers reading an ensemble of images for each case. The average area under the ROC curves (A z ) was 0.76 for DM, 0.93 for BT, and 0.94 for CTBI. Results indicated that for the same dose, a 5 mm lesion embedded in a structured breast phantom was detected by the two volumetric breast imaging systems, BT and CTBI, with statistically

  11. Quantitative evaluation of dual-energy digital mammography for calcification imaging

    International Nuclear Information System (INIS)

    Kappadath, S Cheenu; Shaw, Chris C

    2004-01-01

    Dual-energy digital mammography (DEDM), where separate low- and high-energy images are acquired and synthesized to cancel the tissue structures, may improve the ability to detect and visualize microcalcifications. Under ideal imaging conditions, when the mammography image data are free of scatter and other biases, DEDM could be used to determine the thicknesses of the imaged calcifications. We present quantitative evaluation of a DEDM technique for calcification imaging. The phantoms used in the evaluation were constructed by placing aluminium strips of known thicknesses (to simulate calcifications) across breast-tissue-equivalent materials of different glandular-tissue compositions. The images were acquired under narrow-beam geometry and high exposures to suppress the detrimental effects of scatter and random noise. The measured aluminium thicknesses were found to be approximately linear with the true aluminium thicknesses and independent of the underlying glandular-tissue composition. However, the dual-energy images underestimated the true aluminium thickness due to the presence of scatter from adjacent regions. Regions in the DEDM image that contained no aluminium yielded very low aluminium thicknesses (<0.07 mm). The aluminium contrast-to-noise ratio in the dual-energy images increased with the aluminium thickness and decreased with the glandular-tissue composition. The changes to the aluminium contrast-to-noise ratio and the contrast of the tissue structures between the low-energy and DEDM images are also presented

  12. 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

  13. A novel approach to background subtraction in contrast-enhanced dual-energy digital mammography with commercially available mammography devices: Polychromaticity correction

    Energy Technology Data Exchange (ETDEWEB)

    Contillo, Adriano, E-mail: contillo@fe.infn.it; Di Domenico, Giovanni; Cardarelli, Paolo; Gambaccini, Mauro; Taibi, Angelo [Dipartimento di Fisica e Scienze della Terra, Università degli Studi di Ferrara, Via Saragat 1, Ferrara I-44122 (Italy)

    2015-11-15

    Purpose: Contrast-enhanced digital mammography is an image subtraction technique that is able to improve the detectability of lesions in dense breasts. One of the main sources of error, when the technique is performed by means of commercial mammography devices, is represented by the intrinsic polychromaticity of the x-ray beams. The aim of the work is to propose an iterative procedure, which only assumes the knowledge of a small set of universal quantities, to take into account the polychromaticity and correct the subtraction results accordingly. Methods: In order to verify the procedure, it has been applied to an analytical simulation of a target containing a contrast medium and to actual radiographs of a breast phantom containing cavities filled with a solution of the same medium. Results: The reconstructed densities of contrast medium were compared, showing very good agreement between the theoretical predictions and the experimental results already after the first iteration. Furthermore, the convergence of the iterative procedure was studied, showing that only a small number of iterations is necessary to reach limiting values. Conclusions: The proposed procedure represents an efficient solution to the polychromaticity issue, qualifying therefore as a viable alternative to inverse-map functions.

  14. Semiconductor pixel detectors for digital mammography

    International Nuclear Information System (INIS)

    Novelli, M.; Amendolia, S.R.; Bisogni, M.G.; Boscardin, M.; Dalla Betta, G.F.; Delogu, P.; Fantacci, M.E.; Quattrocchi, M.; Rosso, V.; Stefanini, A.; Venturelli, L.; Zucca, S.

    2003-01-01

    We present some results obtained with silicon and gallium arsenide pixel detectors to be applied in the field of digital mammography. Even though GaAs is suitable for medical imaging applications thanks to its atomic number, which allows a very good detection efficiency, it often contains an high concentrations of traps which decrease the charge collection efficiency (CCE). So we have analysed both electrical and spectroscopic performance of different SI GaAs diodes as a function of concentrations of dopants in the substrate, in order to find a material by which we can obtain a CCE allowing the detection of all the photons that interact in the detector. Nevertheless to be able to detect low contrast details, efficiency and CCE are not the only parameters to be optimized; also the stability of the detection system is fundamental. In the past we have worked with Si pixel detectors; even if its atomic number does not allow a good detection efficiency at standard thickness, it has a very high stability. So keeping in mind the need to increase the Silicon detection efficiency we performed simulations to study the behaviour of the electrical potential in order to find a geometry to avoid the risk of electrical breakdown

  15. Semiconductor pixel detectors for digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Novelli, M. E-mail: marzia.novelli@pi.infn.it; Amendolia, S.R.; Bisogni, M.G.; Boscardin, M.; Dalla Betta, G.F.; Delogu, P.; Fantacci, M.E.; Quattrocchi, M.; Rosso, V.; Stefanini, A.; Venturelli, L.; Zucca, S

    2003-08-21

    We present some results obtained with silicon and gallium arsenide pixel detectors to be applied in the field of digital mammography. Even though GaAs is suitable for medical imaging applications thanks to its atomic number, which allows a very good detection efficiency, it often contains an high concentrations of traps which decrease the charge collection efficiency (CCE). So we have analysed both electrical and spectroscopic performance of different SI GaAs diodes as a function of concentrations of dopants in the substrate, in order to find a material by which we can obtain a CCE allowing the detection of all the photons that interact in the detector. Nevertheless to be able to detect low contrast details, efficiency and CCE are not the only parameters to be optimized; also the stability of the detection system is fundamental. In the past we have worked with Si pixel detectors; even if its atomic number does not allow a good detection efficiency at standard thickness, it has a very high stability. So keeping in mind the need to increase the Silicon detection efficiency we performed simulations to study the behaviour of the electrical potential in order to find a geometry to avoid the risk of electrical breakdown.

  16. Breast screening with mammography: Overview of Swedish randomized trials

    International Nuclear Information System (INIS)

    Nystroem, L.; Wall, S.; Lindqvist, M.; Ryden, S.; Andersson, J.; Bjurstam, N.; Fagerberg, G.; Frisell, J.; Tabar, L.; Larson, L.G.

    1993-01-01

    Despite encouraging results from screening trials the efficacy of mammography in reducing mortality remains somewhat controversial. Five studies have been done in Sweden. This overview, reveals a 24% significant reduction of breast cancer mortality among those invited to mammography screening compared with those not invited. To avoid the potential risk of differential misclassification causes of death were assessed by an independent end-point committee after a blinded review of all fatal breast cancer cases. The mortality reduction was similar, irrespective of the end-point used for evaluation (breast cancer as underlying cause of death or breast cancer present at death). There was a consistent risk reduction associated with screening in all studies, although the point estimate of the relative risk for all ages varied non-significantly between 0.68 and 0.84. The cumulative breast cancer mortality by time since randomization was estimated at 1.3 per 1,000 within 6 years in the invited group compared with 1.6 in the control group. The corresponding figures after 9 years are 2.6 and 3.3 and after 12 years 3.9 and 5.1

  17. Normalized noise power spectrum of full field digital mammography system

    International Nuclear Information System (INIS)

    Norriza Mohd Isa; Wan Muhamad Saridan Wan Hassan

    2009-01-01

    A method to measure noise power spectrum of a full field digital mammography system is presented. The effect of X-ray radiation dose, size and configuration of region of interest on normalized noise power spectrum (NNPS) was investigated. Flat field images were acquired using RQA-M2 beam quality technique (Mo/Mo anode-filter, 28 kV, 2 mm Al) with different clinical radiation doses. The images were cropped at about 4 cm from the edge of the breast wall and then divided into different size of non-overlapping or overlapping segments. NNPS was determined through detrending, 2-D fast Fourier transformation and normalization. Our measurement shows that high radiation dose gave lower NNPS at a specific beam quality. (Author)

  18. Adaptive discrete cosine transform coding algorithm for digital mammography

    Science.gov (United States)

    Baskurt, Atilla M.; Magnin, Isabelle E.; Goutte, Robert

    1992-09-01

    The need for storage, transmission, and archiving of medical images has led researchers to develop adaptive and efficient data compression techniques. Among medical images, x-ray radiographs of the breast are especially difficult to process because of their particularly low contrast and very fine structures. A block adaptive coding algorithm based on the discrete cosine transform to compress digitized mammograms is described. A homogeneous repartition of the degradation in the decoded images is obtained using a spatially adaptive threshold. This threshold depends on the coding error associated with each block of the image. The proposed method is tested on a limited number of pathological mammograms including opacities and microcalcifications. A comparative visual analysis is performed between the original and the decoded images. Finally, it is shown that data compression with rather high compression rates (11 to 26) is possible in the mammography field.

  19. Use of prior mammograms in the transition to digital mammography: A performance and cost analysis

    International Nuclear Information System (INIS)

    Taylor-Phillips, S.; Wallis, M.G.; Duncan, A.; Gale, A.G.

    2012-01-01

    Breast screening in Europe is gradually changing from film to digital imaging and reporting of cases. In the transition period prior mammograms (from the preceding screening round) are films thereby potentially causing difficulties in comparison to current digital mammograms. To examine this breast screening performance was measured at a digital mammography workstation with prior mammograms displayed in different formats, and the associated costs calculated. 160 selected difficult cases (41% malignant) were read by eight UK qualified mammography readers in three conditions: with film prior mammograms; with digitised prior mammograms; or without prior mammograms. Lesion location and probability of malignancy were recorded, alongside a decision of whether to recall each case for further tests. JAFROC analysis showed a difference between conditions (p = .006); performance with prior mammograms in either film or digitised formats was superior to that without prior mammograms (p < .05). There was no difference in the performance when the prior mammograms were presented in film or digitised form. The number of benign or normal cases recalled was 26% higher without prior mammograms than with digitised or film prior mammograms (p < .05). This would correspond to an increase in recall rate at the study hospital from 4.3% to 5.5% with no associated increase in cancer detection rate. The cost of this increase was estimated to be £11,581 (€13,666) per 10,000 women screened, which is higher than the cost of digitised (£11,114/€13,115), or film display (£6451/€7612) of the prior mammograms. It is recommended that, where available, prior mammograms are used in the transition to digital breast screening.

  20. Breast cancer screening with digital breast tomosynthesis.

    Science.gov (United States)

    Skaane, Per

    2017-01-01

    To give an overview of studies comparing full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in breast cancer screening. The implementation of tomosynthesis in breast imaging is rapidly increasing world-wide. Experimental clinical studies of relevance for DBT screening have shown that tomosynthesis might have a great potential in breast cancer screening, although most of these retrospective reading studies are based on small populations, so that final conclusions are difficult to draw from individual reports. Several retrospective studies and three prospective trials on tomosynthesis in breast cancer screening have been published so far, confirming the great potential of DBT in mammography screening. The main results of these screening studies are presented. The retrospective screening studies from USA have all shown a significant decrease in the recall rate using DBT as adjunct to mammography. Most of these studies have also shown an increase in the cancer detection rate, and the non-significant results in some studies might be explained by a lack of statistical power. All the three prospective European trials have shown a significant increase in the cancer detection rate. The retrospective and the prospective screening studies comparing FFDM and DBT have all demonstrated that tomosynthesis has a great potential for improving breast cancer screening. DBT should be regarded as a better mammogram that could improve or overcome limitations of the conventional mammography, and tomosynthesis might be considered as the new technique in the next future of breast cancer screening.

  1. 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.

  2. Assessing tumor extent on contrast-enhanced spectral mammography versus full-field digital mammography and ultrasound.

    Science.gov (United States)

    Patel, Bhavika K; Garza, Sandra Alheli; Eversman, Sarah; Lopez-Alvarez, Yania; Kosiorek, Heidi; Pockaj, Barbara A

    To compare breast cancer size measurements on full-field digital mammography (FFDM), contrast-enhanced spectral mammography (CEDM), and ultrasound (US), with histologic tumor size used as the reference standard. Material and methods The HIPAA complaint, IRB approved study comprised 88 women with newly diagnosed breast cancer who underwent FFDM and CEDM;74 also had US. Breast density, histologic subtype, and maximum tumor measurements were recorded. Pearson correlation coefficients for FFDM, US, and CEDM vs histopathology were 0.598, 0.639, and 0.859, respectively (P<0.001). The following correlation coefficients were calculated for dense breasts (n=48): histopathology vs FFDM (0.555), US (0.633), and CEDM (0.843) (P<0.001); for nondense breasts (n=40), they were FFDM (0.618), US (0.512), and CEDM (0.885) (P<0.001). For size difference, the mean (SD) for histopathology vs FFDM, US, and CEDM was -1.3 (11.9) mm, -2.8 (11.1) mm, and 2.9 (9.5) mm, respectively. Limits of agreement were -24.8 to 22.0mm, -24.5 to 18.8mm, and -15.6 to 21.4mm, respectively. In patients with biopsy-proven malignancy, size measurements correlated well with histopathologic size, and were higher on CEDM than those for FFDM and US in patients with dense or nondense breasts. The added value of CEDM as a supplement to FFDM in determining tumor size, however, was greater in patients with dense breasts. CEDM may be a promising alternative preoperative measurement tool for breast cancer patients with dense breasts and/or limited access or contraindications to MRI. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Development of test objects for image quality evaluation of digital mammography

    International Nuclear Information System (INIS)

    Pinto, Vitor Nascimento de Carvalho

    2013-01-01

    Mammography is the image exam called 'gold standard' for early detection of breast cancer. 111 Brazil, more than eight million mammograms are carried out per year. With the advancement of technology, the digital systems CR and DR for this diagnostic modality have been increasingly implemented, replacing the conventional screen-film system, which brought environmental problems, like the disposal of chemical waste, and is also responsible for the rejection of radiographic films with processing artifacts. Digital systems, besides not experiencing the problem of environmental pollution, are still capable of image processing, allowing a much lower rejection rate when compared to the conventional system. Moreover, the determination of an accurate diagnosis is highly dependent on the image quality of the examination. To ensure the reliability of the images produced by these systems, it is necessary to evaluate them on a regular basis. Unfortunately, there is no regulation in Brazil about the Quality Assurance of these systems. The aim of this study was to develop a set of test objects that allow the evaluation of some parameters of image quality of these systems, such as field image uniformity, the linearity between the air Kerma incident on detector and the mean pixel value (MPV) of the image, the spatial resolution of the system through the modulation transfer function (MTF) and also to suggest an object to be applied in the evaluation of contrast-to-noise ratio (CNR) and signal-difference-to-noise ratio (SDNR). In order to test the objects. 10 mammography centers were evaluated, seven with CR systems and three with the DR systems. To evaluate the linearity, besides the test objects high sensitivity dosimeters were necessary to be used, namely LiF:Mg,Cu,P TL dosimeters. The use of these dosimeters was recommended in order to minimize the time required to perform the tests and to decrease the number of exposures needed. For evaluation of digital images in DICOM format

  4. An alternative method for noise analysis using pixel variance as part of quality control procedures on digital mammography systems.

    NARCIS (Netherlands)

    Bouwman, R.; Young, K.; Lazzari, B.; Ravaglia, V.; Broeders, M.J.M.; Engen, R. van

    2009-01-01

    According to the European Guidelines for quality assured breast cancer screening and diagnosis, noise analysis is one of the measurements that needs to be performed as part of quality control procedures on digital mammography systems. However, the method recommended in the European Guidelines does

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

    Science.gov (United States)

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

    2011-02-01

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

  6. Detection and optimization of image quality and dose in digital mammography systems

    International Nuclear Information System (INIS)

    Semturs, F.

    2015-01-01

    Background and purpose: During the last few years, mammography institutes have replaced their conventional mammography systems (FSM) with digital mammography systems (FFDM). This happened mainly in direction to digital computed radiography systems (FFDM-CR), where the mammography device could be kept in operation. Consequently also the AEC-parameters have not been changed and therefore the same dose as for FFM was used. Following the main theme of the thesis "Optimization of image quality and dose", also measurements with such CR-Systems have been performed in relation to image quality and dose behavior. Optimization in this context means - in following the ALARA principle - the reduction of dose while ensuring required clinical image quality. With other words - image quality is of higher value compared to dose. Considering this, it has been found out through measurements during this thesis, that FFDM-CR Systems need considerable more dose for achieving image quality comparable with FFM. On the other hand, it has been shown with measurements during this thesis, that the newest FFDM-CR technology (needle structure) supports dose reduction (optimization) to a certain degree without compromising image quality. Dose increase, as recommended in this thesis, could also increase the danger of more radiation induced carcinoma. There are several studies (which are also discussed in this thesis), which show that the benefit of not missing cancers because of higher dose dramatically overrides any health concerns. Such an optimization of image quality and dose is now described in more detail by comparing the new CR needle technology with the older power based CR technology. Material and Methods: The image quality and dose behavior for multiple breast thicknesses (simulated with PMMA slabs) of a CR needle crystal detector system is optimized by considering also different beam qualities. Technical image quality is determined with a low contrast phantom (CDMAM phantom) and from

  7. Does digital mammography suppose an advance in early diagnosis? Trends in performance indicators 6 years after digitalization.

    Science.gov (United States)

    Sala, Maria; Domingo, Laia; Macià, Francesc; Comas, Mercè; Burón, Andrea; Castells, Xavier

    2015-03-01

    To provide a complete evaluation of the long-term impact of full-field digital mammography (FFDM) on the improvement of early diagnosis in a population-based screening program. We included 82,961 screen-film mammograms (SFM) and 79,031 FFDM from women aged 50-69 screened biennially from 1995-2010 in Spain and followed-up to 2012. The first screening round of the program was excluded. Rates of cancer detection, interval cancer, tumoral characteristics and other quality indicators were compared between SFM and FFDM periods using the Chi-square test. Multivariate logistic regression models were fitted. Detection of ductal carcinoma in situ (DCIS) significantly increased with FFDM (0.05 % vs 0.09 %; p = 0.010), along with the proportion of small invasive cancers (Digitalization has supposed an improvement in early diagnosis because DCIS and small invasive cancers increased without a change in detection rate. Moreover, false-positive reduction without an increase in the interval cancer rate was confirmed.

  8. 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.

  9. Wavelet processing techniques for digital mammography

    Science.gov (United States)

    Laine, Andrew F.; Song, Shuwu

    1992-09-01

    This paper introduces a novel approach for accomplishing mammographic feature analysis through multiresolution representations. We show that efficient (nonredundant) representations may be identified from digital mammography and used to enhance specific mammographic features within a continuum of scale space. The multiresolution decomposition of wavelet transforms provides a natural hierarchy in which to embed an interactive paradigm for accomplishing scale space feature analysis. Similar to traditional coarse to fine matching strategies, the radiologist may first choose to look for coarse features (e.g., dominant mass) within low frequency levels of a wavelet transform and later examine finer features (e.g., microcalcifications) at higher frequency levels. In addition, features may be extracted by applying geometric constraints within each level of the transform. Choosing wavelets (or analyzing functions) that are simultaneously localized in both space and frequency, results in a powerful methodology for image analysis. Multiresolution and orientation selectivity, known biological mechanisms in primate vision, are ingrained in wavelet representations and inspire the techniques presented in this paper. Our approach includes local analysis of complete multiscale representations. Mammograms are reconstructed from wavelet representations, enhanced by linear, exponential and constant weight functions through scale space. By improving the visualization of breast pathology we can improve the chances of early detection of breast cancers (improve quality) while requiring less time to evaluate mammograms for most patients (lower costs).

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

    International Nuclear Information System (INIS)

    Perez-Ponce, H.

    2009-05-01

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

  11. Full-field digital mammography versus computed radiology mammography: comparison in image quality and radiation dose

    International Nuclear Information System (INIS)

    Zhao Yongxia; Song Shaojuan; Liu Chuanya; Qi Hengtao; Qin Weichang

    2008-01-01

    Objective: To investigate the differences in image quality and radiation dose between full- field digital mammography (FFDM) system and compute radiology mammography (CRM) system. Methods: The ALVIM mammographic phantom was exposed by FFDM system with automatic exposure control (AEC) and then exposed by CRM system with the unique imaging plank on the same condition. The FFDM system applied the same kV value and the different mAs values (14, 16, 18, 22 and 24 mAs), and the emission skin dose (ESD) and the average gland dose (AGD) were recorded for the above-mentioned exposure factors. All images were read by five experienced radiologists under the same condition and judged based on 5-point scales. And then receive operating characteristic (ROC) curve was drawn and the probability (P det ) values were calculated. The data were statistically processed with ANOVA. Results: The P det values of calcifications and lesion lump were higher with FFDM system than with CRM system at the same dose (1.36 mGy). Especially, for microcalcifications and lesion lump, the largest difference of the P det value was 0.215, and that of lesion lump was 0.245. In comparison with CRM system, the radiation dose of FFDM system could be reduced at the same P det value. The ESD value was reduced by 26%, and the ACD value was reduced by 41%. When the mAs value exceed AEC value, the P det value almost had no change, though the radiation dose was increased. Conclusions: The detection rates of microcalcifications and lesion lump with FFDM system are proven to be superior to CRM system at the same dose. The radiation dose of FFDM system was less than CRM system for the same image quality. (authors)

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

    Science.gov (United States)

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

    2018-01-01

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

  13. Evaluation of the weekly quality control of a digital mammography machine; Evaluacion del control de calidad semanal de un mamografo digital

    Energy Technology Data Exchange (ETDEWEB)

    Angulo Pain, E.; Ramos Caballero, L. J.; Urena Llinares, A.; Iborra Oquendo, M. A.; Quinones Rodriguez, L. A.; Castro Ramirez, I.; Gonzalez Aquino, P.; Aguirre Huelga, M. J.

    2013-07-01

    In the new edition of the PCCRD (2011) has been established as weekly quality control testing for digital mammography equipment the analysis of artifacts from the team and defective items in the DR, the constancy of the functioning of the CAE, the accuracy of the thickness determined by the compression system, constancy in the uniformity and quality of the image. The objective of the study is to evaluate data collected during the first year of operation of the equipment. (Author)

  14. Mammography image compression using Wavelet

    International Nuclear Information System (INIS)

    Azuhar Ripin; Md Saion Salikin; Wan Hazlinda Ismail; Asmaliza Hashim; Norriza Md Isa

    2004-01-01

    Image compression plays an important role in many applications like medical imaging, televideo conferencing, remote sensing, document and facsimile transmission, which depend on the efficient manipulation, storage, and transmission of binary, gray scale, or color images. In Medical imaging application such Picture Archiving and Communication System (PACs), the image size or image stream size is too large and requires a large amount of storage space or high bandwidth for communication. Image compression techniques are divided into two categories namely lossy and lossless data compression. Wavelet method used in this project is a lossless compression method. In this method, the exact original mammography image data can be recovered. In this project, mammography images are digitized by using Vider Sierra Plus digitizer. The digitized images are compressed by using this wavelet image compression technique. Interactive Data Language (IDLs) numerical and visualization software is used to perform all of the calculations, to generate and display all of the compressed images. Results of this project are presented in this paper. (Author)

  15. Normalized noise power spectrum of full field digital mammography detector system

    International Nuclear Information System (INIS)

    Norriza Mohd Isa; Wan Muhamad Saridan Wan Hassan

    2009-01-01

    Full text: A method to measure noise power spectrum of a full field digital mammography system is presented. The effect of X-ray radiation dose, size and configuration of region of interest on normalized noise power spectrum (NNPS) was investigated. Flat field images were acquired using RQA-M2 beam quality technique (Mo/Mo anode-filter, 28 kV, 2 mm Al) with different clinical radiation doses. The images were cropped at about 4 cm from the edge of the breast wall and then divided into different size of non-overlapping or overlapping segments. NNPS was determined through de trending, 2-D fast Fourier transformation and normalization. Our measurement shows that high radiation dose gave lower NNPS at a specific beam quality. (author)

  16. Pipeline for effective denoising of digital mammography and digital breast tomosynthesis

    Science.gov (United States)

    Borges, Lucas R.; Bakic, Predrag R.; Foi, Alessandro; Maidment, Andrew D. A.; Vieira, Marcelo A. C.

    2017-03-01

    Denoising can be used as a tool to enhance image quality and enforce low radiation doses in X-ray medical imaging. The effectiveness of denoising techniques relies on the validity of the underlying noise model. In full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT), calibration steps like the detector offset and flat-fielding can affect some assumptions made by most denoising techniques. Furthermore, quantum noise found in X-ray images is signal-dependent and can only be treated by specific filters. In this work we propose a pipeline for FFDM and DBT image denoising that considers the calibration steps and simplifies the modeling of the noise statistics through variance-stabilizing transformations (VST). The performance of a state-of-the-art denoising method was tested with and without the proposed pipeline. To evaluate the method, objective metrics such as the normalized root mean square error (N-RMSE), noise power spectrum, modulation transfer function (MTF) and the frequency signal-to-noise ratio (SNR) were analyzed. Preliminary tests show that the pipeline improves denoising. When the pipeline is not used, bright pixels of the denoised image are under-filtered and dark pixels are over-smoothed due to the assumption of a signal-independent Gaussian model. The pipeline improved denoising up to 20% in terms of spatial N-RMSE and up to 15% in terms of frequency SNR. Besides improving the denoising, the pipeline does not increase signal smoothing significantly, as shown by the MTF. Thus, the proposed pipeline can be used with state-of-the-art denoising techniques to improve the quality of DBT and FFDM images.

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

    Science.gov (United States)

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

    2013-11-01

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

  18. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  1. Monte Carlo derivation of filtered tungsten anode X-ray spectra for dose computation in digital mammography*

    Science.gov (United States)

    Paixão, Lucas; Oliveira, Bruno Beraldo; Viloria, Carolina; de Oliveira, Marcio Alves; Teixeira, Maria Helena Araújo; Nogueira, Maria do Socorro

    2015-01-01

    Objective Derive filtered tungsten X-ray spectra used in digital mammography systems by means of Monte Carlo simulations. Materials and Methods Filtered spectra for rhodium filter were obtained for tube potentials between 26 and 32 kV. The half-value layer (HVL) of simulated filtered spectra were compared with those obtained experimentally with a solid state detector Unfors model 8202031-H Xi R/F & MAM Detector Platinum and 8201023-C Xi Base unit Platinum Plus w mAs in a Hologic Selenia Dimensions system using a direct radiography mode. Results Calculated HVL values showed good agreement as compared with those obtained experimentally. The greatest relative difference between the Monte Carlo calculated HVL values and experimental HVL values was 4%. Conclusion The results show that the filtered tungsten anode X-ray spectra and the EGSnrc Monte Carlo code can be used for mean glandular dose determination in mammography. PMID:26811553

  2. Monte Carlo derivation of filtered tungsten anode X-ray spectra for dose computation in digital mammography

    Directory of Open Access Journals (Sweden)

    Lucas Paixão

    2015-12-01

    Full Text Available Abstract Objective: Derive filtered tungsten X-ray spectra used in digital mammography systems by means of Monte Carlo simulations. Materials and Methods: Filtered spectra for rhodium filter were obtained for tube potentials between 26 and 32 kV. The half-value layer (HVL of simulated filtered spectra were compared with those obtained experimentally with a solid state detector Unfors model 8202031-H Xi R/F & MAM Detector Platinum and 8201023-C Xi Base unit Platinum Plus w mAs in a Hologic Selenia Dimensions system using a direct radiography mode. Results: Calculated HVL values showed good agreement as compared with those obtained experimentally. The greatest relative difference between the Monte Carlo calculated HVL values and experimental HVL values was 4%. Conclusion: The results show that the filtered tungsten anode X-ray spectra and the EGSnrc Monte Carlo code can be used for mean glandular dose determination in mammography.

  3. Three-dimensional dose distribution in contrast-enhanced digital mammography using Gafchromic XR-QA2 films: Feasibility study

    International Nuclear Information System (INIS)

    Hwang, Yi-Shuan; Lin, Yu-Ying; Cheung, Yun-Chung; Tsai, Hui-Yu

    2014-01-01

    This study was aimed to establish three-dimensional dose distributions for contrast-enhanced digital mammography (CEDM) using self-developed Gafchromic XR-QA2 films. Dose calibration and distribution evaluations were performed on a full-field digital mammography unit with dual energy (DE) contrast-enhanced option. Strategy for dose calibration of films in the DE mode was based on the data obtained from common target/filter/kVp combinations used clinically and the dose response model modified from Rampado's model. Dose derived from films were also verified by measured data from an ionization chamber. The average difference of dose was 8.9% in the dose range for clinical uses. Three-dimensional dose distributions were estimated using triangular acrylic phantom equipped with the mammography system. Five pieces of film sheets were separately placed between the acrylic slabs to evaluate the dose distribution at different depths. After normalizing the dose in each pixel to the maximum dose at the top-center position of the acrylic, normalized dose distribution for transverse, coronal and sagittal planes, could thus be obtained. The depth dose distribution evaluated in this study may further serve as a reference for evaluating the patient glandular dose at different depths based on the entrance exposure information. - Highlights: • CEDM techniques can enhance contrast uptake areas and suppress background tissue. • Dose for the dual-energy acquisition is about 20% higher than standard mode. • A new method is proposed to estimate the 3D dose distribution in dual-energy CEDM. • Depth of normalized dose ratio of 0.5 is less than but near 1 cm in the DE mode

  4. Seamless lesion insertion in digital mammography: methodology and reader study

    Science.gov (United States)

    Pezeshk, Aria; Petrick, Nicholas; Sahiner, Berkman

    2016-03-01

    Collection of large repositories of clinical images containing verified cancer locations is costly and time consuming due to difficulties associated with both the accumulation of data and establishment of the ground truth. This problem poses a significant challenge to the development of machine learning algorithms that require large amounts of data to properly train and avoid overfitting. In this paper we expand the methods in our previous publications by making several modifications that significantly increase the speed of our insertion algorithms, thereby allowing them to be used for inserting lesions that are much larger in size. These algorithms have been incorporated into an image composition tool that we have made publicly available. This tool allows users to modify or supplement existing datasets by seamlessly inserting a real breast mass or micro-calcification cluster extracted from a source digital mammogram into a different location on another mammogram. We demonstrate examples of the performance of this tool on clinical cases taken from the University of South Florida Digital Database for Screening Mammography (DDSM). Finally, we report the results of a reader study evaluating the realism of inserted lesions compared to clinical lesions. Analysis of the radiologist scores in the study using receiver operating characteristic (ROC) methodology indicates that inserted lesions cannot be reliably distinguished from clinical lesions.

  5. Does digital mammography in a decentralized breast cancer screening program lead to screening performance parameters comparable with film-screen mammography?

    International Nuclear Information System (INIS)

    Ongeval, Chantal van; Steen, Andre van; Zanca, Federica; Bosmans, Hilde; Marchal, Guy; Putte, Gretel vande; Limbergen, Erik van

    2010-01-01

    To evaluate if the screening performance parameters of digital mammography (DM) in a decentralized screening organization were comparable with film-screen mammography (FSM). A nationwide screening program was launched in 2001, and since 2005 screening with DM has been allowed. Firstly, the parameters of the three regional screening units (RSUs) that first switched to DM (11,355 women) were compared with the FSM period of the same three RSUs (23,325 women). Secondly, they were compared with the results of the whole central breast unit (CBU). The recall rate (RR) of the DM group in the initial round was 2.64% [2.40% for FSM (p = 0.43)] and in the subsequent round 1.20% [1.58% for FSM (p = 0.03)]. The cancer detection rate (CDR) was 0.59% for DM and 0.64% for FSM (p = 0.56). The percentage of ductal carcinoma in situ was 0.07% for DM and 0.16% for FSM (p = 0.02). The positive predictive value was high in the subsequent rounds (DM 48.00%, FSM 45.93%) and lower in the initial round (DM 24.05%, FSM 24.86%). Compared with the results of the whole CBU, DM showed no significant difference. DM can be introduced in a decentralized screening organization with a high CDR without increasing the RR. (orig.)

  6. 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.

  7. Mammography screening: A major issue in medicine.

    Science.gov (United States)

    Autier, Philippe; Boniol, Mathieu

    2018-02-01

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

  8. Comparison between the implementation of quality criteria of radiographic image in conventional and digital mammography equipments

    International Nuclear Information System (INIS)

    Alcantara, M.C.; Sordi, G.M.A.A.; Caldas, L.V.E.; Furquim, T.A.C.

    2008-01-01

    The mammographic examination needs a strict quality control. A publication of the European Commission provides guidelines on quality criteria for the images of the breast, quantifying the quality obtained in the image. Following the recommendations of the European Commission, two kinds of mammographic equipments, at a same institution, were evaluated to compare the quality of the conventional and digital images. Besides of that, the Average Glandular Dose (AGD) and the Entrance Surface Dose (ESD) were measured by using an ionization chamber (Radcal, 6M) in the radiation beams of each equipment. The digital equipment fulfills more quality criteria than the conventional equipment, provided ESD values, AGD values and a rejection index lower than the conventional equipment. Therefore, the digital mammography can be considered more adequate than the conventional one, both for criteria analyses and for dose optimization. (author)

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  10. 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.

  11. Performance of breast cancer screening using digital breast tomosynthesis: results from the prospective population-based Oslo Tomosynthesis Screening Trial.

    Science.gov (United States)

    Skaane, Per; Sebuødegård, Sofie; Bandos, Andriy I; Gur, David; Østerås, Bjørn Helge; Gullien, Randi; Hofvind, Solveig

    2018-02-10

    Digital breast tomosynthesis (DBT) has the potential to overcome limitations of conventional mammography. This study investigated the effects of addition of DBT on interval and detected cancers in population-based screening. Oslo Tomosynthesis Screening Trial (OTST) was a prospective, independent double-reading trial inviting women 50-69 years biennially, comparing full-field digital mammography (FFDM) plus DBT with FFDM alone. Performance indicators and characteristics of screen-detected and interval cancers were compared with two previous FFDM rounds. 24,301 consenting women underwent FFDM + DBT screening over a 2-year period. Results were compared with 59,877 FFDM examinations during prior rounds. Addition of DBT resulted in a non-significant increase in sensitivity (76.2%, 378/496, vs. 80.8%, 227/281, p = 0.151) and a significant increase in specificity (96.4%, 57229/59381 vs. 97.5%, 23427/24020, p < .001). Number of recalls per screen-detected cancer decreased from 6.7 (2530/378) to 3.6 (820/227) with DBT (p < .001). Cancer detection per 1000 women screened increased (6.3, 378/59877, vs. 9.3, 227/24301, p < .001). Interval cancer rate per 1000 screens for FFDM + DBT remained similar to previous FFDM rounds (2.1, 51/24301 vs. 2.0, 118/59877, p = 0.734). Interval cancers post-DBT were comparable to prior rounds but significantly different in size, grade, and node status from cancers detected only using DBT. 39.6% (19/48) of interval cancers had positive nodes compared with only 3.9% (2/51) of additional DBT-only-detected cancers. DBT-supplemented screening resulted in significant increases in screen-detected cancers and specificity. However, no significant change was observed in the rate, size, node status, or grade of interval cancers. ClinicalTrials.gov: NCT01248546.

  12. Design and image-quality performance of high resolution CMOS-based X-ray imaging detectors for digital mammography

    Science.gov (United States)

    Cha, B. K.; Kim, J. Y.; Kim, Y. J.; Yun, S.; Cho, G.; Kim, H. K.; Seo, C.-W.; Jeon, S.; Huh, Y.

    2012-04-01

    In digital X-ray imaging systems, X-ray imaging detectors based on scintillating screens with electronic devices such as charge-coupled devices (CCDs), thin-film transistors (TFT), complementary metal oxide semiconductor (CMOS) flat panel imagers have been introduced for general radiography, dental, mammography and non-destructive testing (NDT) applications. Recently, a large-area CMOS active-pixel sensor (APS) in combination with scintillation films has been widely used in a variety of digital X-ray imaging applications. We employed a scintillator-based CMOS APS image sensor for high-resolution mammography. In this work, both powder-type Gd2O2S:Tb and a columnar structured CsI:Tl scintillation screens with various thicknesses were fabricated and used as materials to convert X-ray into visible light. These scintillating screens were directly coupled to a CMOS flat panel imager with a 25 × 50 mm2 active area and a 48 μm pixel pitch for high spatial resolution acquisition. We used a W/Al mammographic X-ray source with a 30 kVp energy condition. The imaging characterization of the X-ray detector was measured and analyzed in terms of linearity in incident X-ray dose, modulation transfer function (MTF), noise-power spectrum (NPS) and detective quantum efficiency (DQE).

  13. Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts: Interim Report of a Prospective Comparative Trial.

    Science.gov (United States)

    Tagliafico, Alberto S; Calabrese, Massimo; Mariscotti, Giovanna; Durando, Manuela; Tosto, Simona; Monetti, Francesco; Airaldi, Sonia; Bignotti, Bianca; Nori, Jacopo; Bagni, Antonella; Signori, Alessio; Sormani, Maria Pia; Houssami, Nehmat

    2016-03-09

    Debate on adjunct screening in women with dense breasts has followed legislation requiring that women be informed about their mammographic density and related adjunct imaging. Ultrasound or tomosynthesis can detect breast cancer (BC) in mammography-negative dense breasts, but these modalities have not been directly compared in prospective trials. We conducted a trial of adjunct screening to compare, within the same participants, incremental BC detection by tomosynthesis and ultrasound in mammography-negative dense breasts. Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts is a prospective multicenter study recruiting asymptomatic women with mammography-negative screens and dense breasts. Eligible women had tomosynthesis and physician-performed ultrasound with independent interpretation of adjunct imaging. Outcome measures included cancer detection rate (CDR), number of false-positive (FP) recalls, and incremental CDR for each modality; these were compared using McNemar's test for paired binary data in a preplanned interim analysis. Among 3,231 mammography-negative screening participants (median age, 51 years; interquartile range, 44 to 78 years) with dense breasts, 24 additional BCs were detected (23 invasive): 13 tomosynthesis-detected BCs (incremental CDR, 4.0 per 1,000 screens; 95% CI, 1.8 to 6.2) versus 23 ultrasound-detected BCs (incremental CDR, 7.1 per 1,000 screens; 95% CI, 4.2 to 10.0), P = .006. Incremental FP recall occurred in 107 participants (3.33%; 95% CI, 2.72% to 3.96%). FP recall (any testing) did not differ between tomosynthesis (FP = 53) and ultrasound (FP = 65), P = .26; FP recall (biopsy) also did not differ between tomosynthesis (FP = 22) and ultrasound (FP = 24), P = .86. The Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts' interim analysis shows that ultrasound has better incremental BC detection than tomosynthesis in mammography

  14. Estimation of breast percent density in raw and processed full field digital mammography images via adaptive fuzzy c-means clustering and support vector machine segmentation

    International Nuclear Information System (INIS)

    Keller, Brad M.; Nathan, Diane L.; Wang Yan; Zheng Yuanjie; Gee, James C.; Conant, Emily F.; Kontos, Despina

    2012-01-01

    Purpose: The amount of fibroglandular tissue content in the breast as estimated mammographically, commonly referred to as breast percent density (PD%), is one of the most significant risk factors for developing breast cancer. Approaches to quantify breast density commonly focus on either semiautomated methods or visual assessment, both of which are highly subjective. Furthermore, most studies published to date investigating computer-aided assessment of breast PD% have been performed using digitized screen-film mammograms, while digital mammography is increasingly replacing screen-film mammography in breast cancer screening protocols. Digital mammography imaging generates two types of images for analysis, raw (i.e., “FOR PROCESSING”) and vendor postprocessed (i.e., “FOR PRESENTATION”), of which postprocessed images are commonly used in clinical practice. Development of an algorithm which effectively estimates breast PD% in both raw and postprocessed digital mammography images would be beneficial in terms of direct clinical application and retrospective analysis. Methods: This work proposes a new algorithm for fully automated quantification of breast PD% based on adaptive multiclass fuzzy c-means (FCM) clustering and support vector machine (SVM) classification, optimized for the imaging characteristics of both raw and processed digital mammography images as well as for individual patient and image characteristics. Our algorithm first delineates the breast region within the mammogram via an automated thresholding scheme to identify background air followed by a straight line Hough transform to extract the pectoral muscle region. The algorithm then applies adaptive FCM clustering based on an optimal number of clusters derived from image properties of the specific mammogram to subdivide the breast into regions of similar gray-level intensity. Finally, a SVM classifier is trained to identify which clusters within the breast tissue are likely fibroglandular, which

  15. Optimization of tungsten x-ray spectra for digital mammography: a comparison of model to experiment

    Science.gov (United States)

    Andre, Michael P.; Spivey, Brett A.

    1997-05-01

    Tungsten (W) target x-rays tubes are being studied for use in digital mammography to improve x-ray flux, reduce noise and increase tube heat capacity. A parametric model was developed for digital mammography to evaluate optimization of x-ray spectra for a particular sensor. The model computes spectra and mean glandular doses (MGD) for combinations of W target, beam filters, kVp, breast type and thickness. Two figures of merit were defined: (signal/noise)2/MGD and spectral quantum efficiency; these were computed as a means to approach optimization of object contrast. The model is derived from a combination of classic equations, XCOM from NBS, and published data. X-ray spectra were calculated and measured for filters of Al, Sn, Rh, Mo and Ag on a Eureka tube. (Signal/noise)2/MGD was measured for a filtered W target tube and a digital camera employing CsI scintillator optically coupled to a CCD for which the detective quantum efficiency (DQE) was known. A 3-mm thick acrylic disk was imaged on thickness of 3-8 cm of acrylic and the results were compared to the predictions of the model. The relative error between predicted and measured spectra was +/- 2 percent from 24 to 34 kVp. Calculated MGD as a function of breast thickness, half-value layer and beam filter compares very well to published data. Best performance was found for the following combinations: Mo filter with 30 mm breast, Ag filter with 45 mm, Sn filter for 60 mm, and Al filter for 75 mm thick breast. The parametric model agrees well with measurement and provides a means to explore optimum combinations of kVp and beam filter. For a particular detector, this data may be used with the DQE to estimate total system signal-to-noise ratio for a particular imaging task.

  16. Effects of exposure equalization on image signal-to-noise ratios in digital mammography: A simulation study with an anthropomorphic breast phantom

    Energy Technology Data Exchange (ETDEWEB)

    Liu Xinming; Lai Chaojen; Whitman, Gary J.; Geiser, William R.; Shen Youtao; Yi Ying; Shaw, Chris C. [Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4009 (United States); Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4009 (United States); Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4009 (United States)

    2011-12-15

    Purpose: The scan equalization digital mammography (SEDM) technique combines slot scanning and exposure equalization to improve low-contrast performance of digital mammography in dense tissue areas. In this study, full-field digital mammography (FFDM) images of an anthropomorphic breast phantom acquired with an anti-scatter grid at various exposure levels were superimposed to simulate SEDM images and investigate the improvement of low-contrast performance as quantified by primary signal-to-noise ratios (PSNRs). Methods: We imaged an anthropomorphic breast phantom (Gammex 169 ''Rachel,'' Gammex RMI, Middleton, WI) at various exposure levels using a FFDM system (Senographe 2000D, GE Medical Systems, Milwaukee, WI). The exposure equalization factors were computed based on a standard FFDM image acquired in the automatic exposure control (AEC) mode. The equalized image was simulated and constructed by superimposing a selected set of FFDM images acquired at 2, 1, 1/2, 1/4, 1/8, 1/16, and 1/32 times of exposure levels to the standard AEC timed technique (125 mAs) using the equalization factors computed for each region. Finally, the equalized image was renormalized regionally with the exposure equalization factors to result in an appearance similar to that with standard digital mammography. Two sets of FFDM images were acquired to allow for two identically, but independently, formed equalized images to be subtracted from each other to estimate the noise levels. Similarly, two identically but independently acquired standard FFDM images were subtracted to estimate the noise levels. Corrections were applied to remove the excess system noise accumulated during image superimposition in forming the equalized image. PSNRs over the compressed area of breast phantom were computed and used to quantitatively study the effects of exposure equalization on low-contrast performance in digital mammography. Results: We found that the highest achievable PSNR improvement

  17. Effects of exposure equalization on image signal-to-noise ratios in digital mammography: A simulation study with an anthropomorphic breast phantom

    International Nuclear Information System (INIS)

    Liu Xinming; Lai Chaojen; Whitman, Gary J.; Geiser, William R.; Shen Youtao; Yi Ying; Shaw, Chris C.

    2011-01-01

    Purpose: The scan equalization digital mammography (SEDM) technique combines slot scanning and exposure equalization to improve low-contrast performance of digital mammography in dense tissue areas. In this study, full-field digital mammography (FFDM) images of an anthropomorphic breast phantom acquired with an anti-scatter grid at various exposure levels were superimposed to simulate SEDM images and investigate the improvement of low-contrast performance as quantified by primary signal-to-noise ratios (PSNRs). Methods: We imaged an anthropomorphic breast phantom (Gammex 169 ''Rachel,'' Gammex RMI, Middleton, WI) at various exposure levels using a FFDM system (Senographe 2000D, GE Medical Systems, Milwaukee, WI). The exposure equalization factors were computed based on a standard FFDM image acquired in the automatic exposure control (AEC) mode. The equalized image was simulated and constructed by superimposing a selected set of FFDM images acquired at 2, 1, 1/2, 1/4, 1/8, 1/16, and 1/32 times of exposure levels to the standard AEC timed technique (125 mAs) using the equalization factors computed for each region. Finally, the equalized image was renormalized regionally with the exposure equalization factors to result in an appearance similar to that with standard digital mammography. Two sets of FFDM images were acquired to allow for two identically, but independently, formed equalized images to be subtracted from each other to estimate the noise levels. Similarly, two identically but independently acquired standard FFDM images were subtracted to estimate the noise levels. Corrections were applied to remove the excess system noise accumulated during image superimposition in forming the equalized image. PSNRs over the compressed area of breast phantom were computed and used to quantitatively study the effects of exposure equalization on low-contrast performance in digital mammography. Results: We found that the highest achievable PSNR improvement factor was 1.89 for

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  19. Imaging performance of an amorphous selenium digital mammography detector in a breast tomosynthesis system

    International Nuclear Information System (INIS)

    Zhao Bo; Zhao Wei

    2008-01-01

    In breast tomosynthesis a rapid sequence of N images is acquired when the x-ray tube sweeps through different angular views with respect to the breast. Since the total dose to the breast is kept the same as that in regular mammography, the exposure used for each image of tomosynthesis is 1/N. The low dose and high frame rate pose a tremendous challenge to the imaging performance of digital mammography detectors. The purpose of the present work is to investigate the detector performance in different operational modes designed for tomosynthesis acquisition, e.g., binning or full resolution readout, the range of view angles, and the number of views N. A prototype breast tomosynthesis system with a nominal angular range of ±25 deg. was used in our investigation. The system was equipped with an amorphous selenium (a-Se) full field digital mammography detector with pixel size of 85 μm. The detector can be read out in full resolution or 2x1 binning (binning in the tube travel direction). The focal spot blur due to continuous tube travel was measured for different acquisition geometries, and it was found that pixel binning, instead of focal spot blur, dominates the detector modulation transfer function (MTF). The noise power spectrum (NPS) and detective quantum efficiency (DQE) of the detector were measured with the exposure range of 0.4-6 mR, which is relevant to the low dose used in tomosynthesis. It was found that DQE at 0.4 mR is only 20% less than that at highest exposure for both detector readout modes. The detector temporal performance was categorized as lag and ghosting, both of which were measured as a function of x-ray exposure. The first frame lags were 8% and 4%, respectively, for binning and full resolution mode. Ghosting is negligible and independent of the frame rate. The results showed that the detector performance is x-ray quantum noise limited at the low exposures used in each view of tomosynthesis, and the temporal performance at high frame rate (up to

  20. Development of a methodology for automated assessment of the quality of digitized images in mammography

    International Nuclear Information System (INIS)

    Santana, Priscila do Carmo

    2010-01-01

    The process of evaluating the quality of radiographic images in general, and mammography in particular, can be much more accurate, practical and fast with the help of computer analysis tools. The purpose of this study is to develop a computational methodology to automate the process of assessing the quality of mammography images through techniques of digital imaging processing (PDI), using an existing image processing environment (ImageJ). With the application of PDI techniques was possible to extract geometric and radiometric characteristics of the images evaluated. The evaluated parameters include spatial resolution, high-contrast detail, low contrast threshold, linear detail of low contrast, tumor masses, contrast ratio and background optical density. The results obtained by this method were compared with the results presented in the visual evaluations performed by the Health Surveillance of Minas Gerais. Through this comparison was possible to demonstrate that the automated methodology is presented as a promising alternative for the reduction or elimination of existing subjectivity in the visual assessment methodology currently in use. (author)

  1. Effective x-ray attenuation measurements with full field digital mammography

    International Nuclear Information System (INIS)

    Heine, John J.; Behera, Madhusmita

    2006-01-01

    This work shows that effective x-ray attenuation coefficients may be estimated by applying Beer's Law to phantom image data acquired with the General Electric Senographe 2000D full field digital mammography system. Theoretical developments are provided indicating that an approximate form of the Beer's relation holds for polychromatic x-ray beams. The theoretical values were compared with experimentally determined measured values, which were estimated at various detector locations. The measured effective attenuation coefficients are in agreement with those estimated with theoretical developments and numerical integration. The work shows that the measured quantities show little spatial variation. The main ideas are demonstrated with polymethylmethacrylate and breast tissue equivalent phantom imaging experiments. The work suggests that the effective attenuation coefficients may be used as known values for radiometric standardization applications that compensate for the image acquisition influences. The work indicates that it is possible to make quantitative attenuation coefficient measurements from a system designed for clinical purposes

  2. Blurred digital mammography images: an analysis of technical recall and observer detection performance.

    Science.gov (United States)

    Ma, Wang Kei; Borgen, Rita; Kelly, Judith; Millington, Sara; Hilton, Beverley; Aspin, Rob; Lança, Carla; Hogg, Peter

    2017-03-01

    Blurred images in full-field digital mammography are a problem in the UK Breast Screening Programme. Technical recalls may be due to blurring not being seen on lower resolution monitors used for review. This study assesses the visual detection of blurring on a 2.3-MP monitor and a 5-MP report grade monitor and proposes an observer standard for the visual detection of blurring on a 5-MP reporting grade monitor. 28 observers assessed 120 images for blurring; 20 images had no blurring present, whereas 100 images had blurring imposed through mathematical simulation at 0.2, 0.4, 0.6, 0.8 and 1.0 mm levels of motion. Technical recall rate for both monitors and angular size at each level of motion were calculated. χ 2 tests were used to test whether significant differences in blurring detection existed between 2.3- and 5-MP monitors. The technical recall rate for 2.3- and 5-MP monitors are 20.3% and 9.1%, respectively. The angular size for 0.2- to 1-mm motion varied from 55 to 275 arc s. The minimum amount of motion for visual detection of blurring in this study is 0.4 mm. For 0.2-mm simulated motion, there was no significant difference [χ 2 (1, N = 1095) = 1.61, p = 0.20] in blurring detection between the 2.3- and 5-MP monitors. According to this study, monitors ≤2.3 MP are not suitable for technical review of full-field digital mammography images for the detection of blur. Advances in knowledge: This research proposes the first observer standard for the visual detection of blurring.

  3. 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.

  4. X-ray induced formation of γ-H2AX foci after full-field digital mammography and digital breast-tomosynthesis.

    Directory of Open Access Journals (Sweden)

    Siegfried A Schwab

    Full Text Available PURPOSE: To determine in-vivo formation of x-ray induced γ-H2AX foci in systemic blood lymphocytes of patients undergoing full-field digital mammography (FFDM and to estimate foci after FFDM and digital breast-tomosynthesis (DBT using a biological phantom model. MATERIALS AND METHODS: The study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. For in-vivo tests, systemic blood lymphocytes were obtained from 20 patients before and after FFDM. In order to compare in-vivo post-exposure with pre-exposure foci levels, the Wilcoxon matched pairs test was used. For in-vitro experiments, isolated blood lymphocytes from healthy volunteers were irradiated at skin and glandular level of a porcine breast using FFDM and DBT. Cells were stained against the phosphorylated histone variant γ-H2AX, and foci representing distinct DNA damages were quantified. RESULTS: Median in-vivo foci level/cell was 0.086 (range 0.067-0.116 before and 0.094 (0.076-0.126 after FFDM (p = 0.0004. In the in-vitro model, the median x-ray induced foci level/cell after FFDM was 0.120 (range 0.086-0.140 at skin level and 0.035 (range 0.030-0.050 at glandular level. After DBT, the median x-ray induced foci level/cell was 0.061 (range 0.040-0.081 at skin level and 0.015 (range 0.006-0.020 at glandular level. CONCLUSION: In patients, mammography induces a slight but significant increase of γ-H2AX foci in systemic blood lymphocytes. The introduced biological phantom model is suitable for the estimation of x-ray induced DNA damages in breast tissue in different breast imaging techniques.

  5. 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.

  6. Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

    Science.gov (United States)

    Helge Østerås, Bjørn; Skaane, Per; Gullien, Randi; Catrine Trægde Martinsen, Anne

    2018-02-01

    The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra™). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra™. AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

  7. Method for simulating dose reduction in digital mammography using the Anscombe transformation

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Lucas R., E-mail: lucas.rodrigues.borges@usp.br; Oliveira, Helder C. R. de; Nunes, Polyana F.; Vieira, Marcelo A. C. [Department of Electrical and Computer Engineering, São Carlos School of Engineering, University of São Paulo, 400 Trabalhador São-Carlense Avenue, São Carlos 13566-590 (Brazil); Bakic, Predrag R.; Maidment, Andrew D. A. [Department of Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania, 3400 Spruce Street, Philadelphia, Pennsylvania 19104 (United States)

    2016-06-15

    Purpose: This work proposes an accurate method for simulating dose reduction in digital mammography starting from a clinical image acquired with a standard dose. Methods: The method developed in this work consists of scaling a mammogram acquired at the standard radiation dose and adding signal-dependent noise. The algorithm accounts for specific issues relevant in digital mammography images, such as anisotropic noise, spatial variations in pixel gain, and the effect of dose reduction on the detective quantum efficiency. The scaling process takes into account the linearity of the system and the offset of the detector elements. The inserted noise is obtained by acquiring images of a flat-field phantom at the standard radiation dose and at the simulated dose. Using the Anscombe transformation, a relationship is created between the calculated noise mask and the scaled image, resulting in a clinical mammogram with the same noise and gray level characteristics as an image acquired at the lower-radiation dose. Results: The performance of the proposed algorithm was validated using real images acquired with an anthropomorphic breast phantom at four different doses, with five exposures for each dose and 256 nonoverlapping ROIs extracted from each image and with uniform images. The authors simulated lower-dose images and compared these with the real images. The authors evaluated the similarity between the normalized noise power spectrum (NNPS) and power spectrum (PS) of simulated images and real images acquired with the same dose. The maximum relative error was less than 2.5% for every ROI. The added noise was also evaluated by measuring the local variance in the real and simulated images. The relative average error for the local variance was smaller than 1%. Conclusions: A new method is proposed for simulating dose reduction in clinical mammograms. In this method, the dependency between image noise and image signal is addressed using a novel application of the Anscombe

  8. Method for simulating dose reduction in digital mammography using the Anscombe transformation.

    Science.gov (United States)

    Borges, Lucas R; Oliveira, Helder C R de; Nunes, Polyana F; Bakic, Predrag R; Maidment, Andrew D A; Vieira, Marcelo A C

    2016-06-01

    This work proposes an accurate method for simulating dose reduction in digital mammography starting from a clinical image acquired with a standard dose. The method developed in this work consists of scaling a mammogram acquired at the standard radiation dose and adding signal-dependent noise. The algorithm accounts for specific issues relevant in digital mammography images, such as anisotropic noise, spatial variations in pixel gain, and the effect of dose reduction on the detective quantum efficiency. The scaling process takes into account the linearity of the system and the offset of the detector elements. The inserted noise is obtained by acquiring images of a flat-field phantom at the standard radiation dose and at the simulated dose. Using the Anscombe transformation, a relationship is created between the calculated noise mask and the scaled image, resulting in a clinical mammogram with the same noise and gray level characteristics as an image acquired at the lower-radiation dose. The performance of the proposed algorithm was validated using real images acquired with an anthropomorphic breast phantom at four different doses, with five exposures for each dose and 256 nonoverlapping ROIs extracted from each image and with uniform images. The authors simulated lower-dose images and compared these with the real images. The authors evaluated the similarity between the normalized noise power spectrum (NNPS) and power spectrum (PS) of simulated images and real images acquired with the same dose. The maximum relative error was less than 2.5% for every ROI. The added noise was also evaluated by measuring the local variance in the real and simulated images. The relative average error for the local variance was smaller than 1%. A new method is proposed for simulating dose reduction in clinical mammograms. In this method, the dependency between image noise and image signal is addressed using a novel application of the Anscombe transformation. NNPS, PS, and local noise

  9. Method for simulating dose reduction in digital mammography using the Anscombe transformation

    International Nuclear Information System (INIS)

    Borges, Lucas R.; Oliveira, Helder C. R. de; Nunes, Polyana F.; Vieira, Marcelo A. C.; Bakic, Predrag R.; Maidment, Andrew D. A.

    2016-01-01

    Purpose: This work proposes an accurate method for simulating dose reduction in digital mammography starting from a clinical image acquired with a standard dose. Methods: The method developed in this work consists of scaling a mammogram acquired at the standard radiation dose and adding signal-dependent noise. The algorithm accounts for specific issues relevant in digital mammography images, such as anisotropic noise, spatial variations in pixel gain, and the effect of dose reduction on the detective quantum efficiency. The scaling process takes into account the linearity of the system and the offset of the detector elements. The inserted noise is obtained by acquiring images of a flat-field phantom at the standard radiation dose and at the simulated dose. Using the Anscombe transformation, a relationship is created between the calculated noise mask and the scaled image, resulting in a clinical mammogram with the same noise and gray level characteristics as an image acquired at the lower-radiation dose. Results: The performance of the proposed algorithm was validated using real images acquired with an anthropomorphic breast phantom at four different doses, with five exposures for each dose and 256 nonoverlapping ROIs extracted from each image and with uniform images. The authors simulated lower-dose images and compared these with the real images. The authors evaluated the similarity between the normalized noise power spectrum (NNPS) and power spectrum (PS) of simulated images and real images acquired with the same dose. The maximum relative error was less than 2.5% for every ROI. The added noise was also evaluated by measuring the local variance in the real and simulated images. The relative average error for the local variance was smaller than 1%. Conclusions: A new method is proposed for simulating dose reduction in clinical mammograms. In this method, the dependency between image noise and image signal is addressed using a novel application of the Anscombe

  10. Correlation study of effect of additional filter on radiation dose and image quality in digital mammography

    International Nuclear Information System (INIS)

    Liu Jie; Liu Peifang; Wang Hongbin; Zhang Shuping; Liu Xueou

    2012-01-01

    Objective: To explore the effect of different additional filters on radiation dose and image quality in digital mammography. Methods: Hologic company's Selenia digital mammography machine and the post-processing workstations and 5 M high resolution medical monitor were used in this study. Mammography phantoms with the thickness from 1.6 cm to 8.6 cm were used to simulate human breast tissue. The same exposure conditions, pressure, compression thickness, the anode were employed with the additional filters of Mo and Rh under the automatic and manual exposure mode. The image kV, mAs, pressure, filter, average glandular dose (AGD), entrance surface dose (ESD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image score according to ACR criteria were recorded for the two additional filters. Paired sample t test was performed to compare the indices of Mo and Rh groups by using SPSS 17.0. Results: AGD and ESD of Rh and Mo group were both higher with the increase of the thickness of all the phantoms. AGD, ESD and their increased value of Rh filter(1.484 ± 1.041, 7.969 ± 7.633, 0.423 ± 0.190 and 3.057 ± 2.139) were lower than those of Mo filter (1.915 ± 1.301, 12.516 ± 11.632, 0.539 ±0.246 and 4.731 ± 3.294), in all the phantoms with different thickness (t values were 4.614, 3.209, 3.396 and 3.605, P<0.05). SNR, CNR, and image score of Rh and Mo group both decreased with the increase of the thickness of all the phantoms. There were no statistical difference (P>0.05). Conclusions: Compared with Mo filter, Rh filter could reduce the radiation dose, and this advantage is more obvious in the thicker phantom when the same image quality is required. (authors)

  11. Digital breast tomosynthesis

    International Nuclear Information System (INIS)

    Haegele, Julian; Barkhausen, Joerg; Pursche, Telja; Schaefer, Fritz K.W.

    2015-01-01

    In digital breast tomosynthesis a digital tomographic data set with a very high spatial resolution is reconstructed from low-dose projections collected over a limited rotation angle. This allows a very detailed assessment of e. g. masses and architectural distortions. The average glandular dose is comparable to 2 D mammography. First clinical studies demonstrated that tomosynthesis is able to supply important additional information in suspicious mammographic findings. In comparison to projection mammography, tomosynthesis shows an at least comparable diagnostic accuracy. In everyday practice, tomosynthesis is currently mostly used for further evaluation of suspicious findings in mammography.

  12. Comparison of anode/filter combinations in digital mammography with respect to the average glandular dose

    International Nuclear Information System (INIS)

    Uhlenbrock, D.F.; Mertelmeier, Thomas

    2009-01-01

    To investigate the average glandular dose (AGD) applied for clinical digital mammograms acquired with the anode/filter combinations molybdenum/molybdenum (Mo/Mo), molybdenum/rhodium (Mo/Rh), and tungsten/rhodium (W/Rh). Using the method of Dance, the AGD was evaluated from the exposure data of 4867 digital mammograms at two sites equipped with a full-field digital mammography (FFDM) system based on an amorphous selenium detector. 1793 images were acquired and analyzed with Mo/Mo, 643 with Mo/Rh, and 2431 with W/Rh. In the Mo/Mo cases the mean compressed breast thickness was 46 ± 10 mm with an average AGD of 2.29 ± 1.31 mGy. For the Mo/Rh cases with a mean compressed thickness of 64 ± 9 mm, we obtained 2.76 ± 1.31 mGy. The W/Rh cases with a mean compressed thickness of 52 ± 13 mm resulted in 1.26 ± 0.44 mGy. The image quality was assessed as normal and adequate for diagnostic purposes in all cases. (orig.)

  13. 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)

  14. The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Shaheen, Eman, E-mail: eman.shaheen@uzleuven.be; De Keyzer, Frederik; Bosmans, Hilde; Ongeval, Chantal Van [Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven (Belgium); Dance, David R.; Young, Kenneth C. [National Coordinating Centre for the Physics of Mammography, Royal Surrey County Hospital, Guildford GU2 7XX, United Kingdom and Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH (United Kingdom)

    2014-08-15

    suggestive for malignancy (BIRADS 5) indicating the required variety of shapes and margins of these models. The assessment of the BIRADS scores for all observers indicated good agreement based on Kendall's coefficient for both the 2D and the tomosynthesis evaluations. The paired analysis of the BIRADS scores between 2D and tomosynthesis for each observer revealed consistent behavior for the real and simulated masses. Conclusions: A database of 3D mass models, with variety of shapes and margins, was validated for the realism of their appearance for 2D digital mammography and for breast tomosynthesis. This database is suitable for use in future observer performance studies whether in virtual clinical trials or in patient images with simulated lesions.

  15. The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis

    International Nuclear Information System (INIS)

    Shaheen, Eman; De Keyzer, Frederik; Bosmans, Hilde; Ongeval, Chantal Van; Dance, David R.; Young, Kenneth C.

    2014-01-01

    suggestive for malignancy (BIRADS 5) indicating the required variety of shapes and margins of these models. The assessment of the BIRADS scores for all observers indicated good agreement based on Kendall's coefficient for both the 2D and the tomosynthesis evaluations. The paired analysis of the BIRADS scores between 2D and tomosynthesis for each observer revealed consistent behavior for the real and simulated masses. Conclusions: A database of 3D mass models, with variety of shapes and margins, was validated for the realism of their appearance for 2D digital mammography and for breast tomosynthesis. This database is suitable for use in future observer performance studies whether in virtual clinical trials or in patient images with simulated lesions

  16. The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis.

    Science.gov (United States)

    Shaheen, Eman; De Keyzer, Frederik; Bosmans, Hilde; Dance, David R; Young, Kenneth C; Van Ongeval, Chantal

    2014-08-01

    ) indicating the required variety of shapes and margins of these models. The assessment of the BIRADS scores for all observers indicated good agreement based on Kendall's coefficient for both the 2D and the tomosynthesis evaluations. The paired analysis of the BIRADS scores between 2D and tomosynthesis for each observer revealed consistent behavior for the real and simulated masses. A database of 3D mass models, with variety of shapes and margins, was validated for the realism of their appearance for 2D digital mammography and for breast tomosynthesis. This database is suitable for use in future observer performance studies whether in virtual clinical trials or in patient images with simulated lesions.

  17. Automatic Detection of Microcalcifications in a Digital Mammography Using Artificial Intelligence Techniques

    Directory of Open Access Journals (Sweden)

    Carlos A. Madrigal-González

    2013-11-01

    Full Text Available Breast cancer is one of the cancers that has a higher mortality rate among women and early detection increases the possibilities of cure, so its early detection is one of the best treatments for this serious disease. Microcalcifications are a type of lesion in the breast and its presence is highly correlated with the presence of cancer. In this paper we present a method for automatic detection of microcalcifications using digital image processing using a Gaussian filtering approach, which can enhance the contrast between microcalcifications and normal tissue present in a mammography, then apply a local thresholding algorithm witch allow the identification of suspicious microcalcifications. The classifier used to determine the degree of benign or malignant microcalcifications is the K-Nearest Neighbours (KNN and the validation of the results was done using ROC curves.

  18. TU-EF-207-02: Spectral Mammography Based on Photon Counting Detectors

    Energy Technology Data Exchange (ETDEWEB)

    Molloi, S. [University of California (United States)

    2015-06-15

    Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

  19. TU-EF-207-02: Spectral Mammography Based on Photon Counting Detectors

    International Nuclear Information System (INIS)

    Molloi, S.

    2015-01-01

    Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis

  20. Should previous mammograms be digitised in the transition to digital mammography?

    International Nuclear Information System (INIS)

    Taylor-Phillips, S.; Gale, A.G.; Wallis, M.G.

    2009-01-01

    Breast screening specificity is improved if previous mammograms are available, which presents a challenge when converting to digital mammography. Two display options were investigated: mounting previous film mammograms on a multiviewer adjacent to the workstation, or digitising them for soft copy display. Eight qualified screen readers were videotaped undertaking routine screen reading for two 45-min sessions in each scenario. Analysis of gross eye and head movements showed that when digitised, previous mammograms were examined a greater number of times per case (p=0.03), due to a combination of being used in 19% more cases (p=0.04) and where used, looked at a greater number of times (28% increase, p=0.04). Digitising previous mammograms reduced both the average time taken per case by 18% (p=0.04) and the participants' perceptions of workload (p < 0.05). Digitising previous analogue mammograms may be advantageous, in particular in increasing their level of use. (orig.)

  1. Direct conversion Si and CdZnTe detectors for digital mammography

    CERN Document Server

    Yin Shi Shi; Maeding, D; Mainprize, J; Mawdsley, G; Yaffe, M J; Gordon, E E; Hamilton, W J

    2000-01-01

    Hybrid pixel detector arrays that convert X-rays directly into charge signals are under development at NOVA for application to digital mammography. This technology also has wide application possibilities in other fields of radiology or in industrial imaging, nondestructive evaluation (NDE) and nondestructive inspection (NDI). These detectors have potentially superior properties compared to either emulsion-based film-screen systems which has nonlinear response to X-rays, or phosphor-based detectors in which there is an intermediate step of X-ray to light photon conversion (Feig and Yaffe, Radiol. Clinics North America 33 (1995) 1205-1230). Potential advantages of direct conversion detectors are high quantum efficiencies (QE) of 98% or higher (for 0.3 mm thick CdZnTe detector with 20 keV X-rays), improved contrast, high sensitivity and low intrinsic noise. These factors are expected to contribute to high detective quantum efficiency (DQE). The prototype hybrid pixel detector developed has 50x50 mu m pixel size,...

  2. Comparison of Breast Density Between Synthesized Versus Standard Digital Mammography.

    Science.gov (United States)

    Haider, Irfanullah; Morgan, Matthew; McGow, Anna; Stein, Matthew; Rezvani, Maryam; Freer, Phoebe; Hu, Nan; Fajardo, Laurie; Winkler, Nicole

    2018-06-12

    To evaluate perceptual difference in breast density classification using synthesized mammography (SM) compared with standard or full-field digital mammography (FFDM) for screening. This institutional review board-approved, retrospective, multireader study evaluated breast density on 200 patients who underwent baseline screening mammogram during which both SM and FFDM were obtained contemporaneously from June 1, 2016, through November 30, 2016. Qualitative breast density was independently assigned by seven readers initially evaluating FFDM alone. Then, in a separate session, these same readers assigned breast density using synthetic views alone on the same 200 patients. The readers were again blinded to each other's assignment. Qualitative density assessment was based on BI-RADS fifth edition. Interreader agreement was evaluated with κ statistic using 95% confidence intervals. Testing for homogeneity in paired proportions was performed using McNemar's test with a level of significance of .05. For patients across the SM and standard 2-D data set, diagnostic testing with McNemar's test with P = 0.32 demonstrates that the minimal density transitions across FFDM and SM are not statistically significant density shifts. Taking clinical significance into account, only 8 of 200 (4%) patients had clinically significant transition (dense versus not dense). There was substantial interreader agreement with overall κ in FFDM of 0.71 (minimum 0.53, maximum 0.81) and overall SM κ average of 0.63 (minimum 0.56, maximum 0.87). Overall subjective breast density assignment by radiologists on SM is similar to density assignment on standard 2-D mammogram. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  3. Estimation of breast percent density in raw and processed full field digital mammography images via adaptive fuzzy c-means clustering and support vector machine segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Brad M.; Nathan, Diane L.; Wang Yan; Zheng Yuanjie; Gee, James C.; Conant, Emily F.; Kontos, Despina [Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Applied Mathematics and Computational Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States)

    2012-08-15

    Purpose: The amount of fibroglandular tissue content in the breast as estimated mammographically, commonly referred to as breast percent density (PD%), is one of the most significant risk factors for developing breast cancer. Approaches to quantify breast density commonly focus on either semiautomated methods or visual assessment, both of which are highly subjective. Furthermore, most studies published to date investigating computer-aided assessment of breast PD% have been performed using digitized screen-film mammograms, while digital mammography is increasingly replacing screen-film mammography in breast cancer screening protocols. Digital mammography imaging generates two types of images for analysis, raw (i.e., 'FOR PROCESSING') and vendor postprocessed (i.e., 'FOR PRESENTATION'), of which postprocessed images are commonly used in clinical practice. Development of an algorithm which effectively estimates breast PD% in both raw and postprocessed digital mammography images would be beneficial in terms of direct clinical application and retrospective analysis. Methods: This work proposes a new algorithm for fully automated quantification of breast PD% based on adaptive multiclass fuzzy c-means (FCM) clustering and support vector machine (SVM) classification, optimized for the imaging characteristics of both raw and processed digital mammography images as well as for individual patient and image characteristics. Our algorithm first delineates the breast region within the mammogram via an automated thresholding scheme to identify background air followed by a straight line Hough transform to extract the pectoral muscle region. The algorithm then applies adaptive FCM clustering based on an optimal number of clusters derived from image properties of the specific mammogram to subdivide the breast into regions of similar gray-level intensity. Finally, a SVM classifier is trained to identify which clusters within the breast tissue are likely

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

    Science.gov (United States)

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

    2015-02-01

    To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. 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. 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, respectively. The proportion of false positive cases induced by the addition of breast tomosynthesis to mammography was 2.1% (2/94), 2.1% (2/94), 9.5% (9/94) and 12.7% (12/94) for Readers 1, 2, 3 and 4, respectively. Adding breast tomosynthesis to mammography improved sensitivity and negative predictive value for all readers except for the most experienced one, in whom only a tendency for improvement

  5. 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

  6. Breast density as indicator for the use of mammography or MRI to screen women with familial risk for breast cancer (FaMRIsc: a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Saadatmand Sepideh

    2012-10-01

    Full Text Available Abstract Background To reduce mortality, women with a family history of breast cancer often start mammography screening at a younger age than the general population. Breast density is high in over 50% of women younger than 50 years. With high breast density, breast cancer incidence increases, but sensitivity of mammography decreases. Therefore, mammography might not be the optimal method for breast cancer screening in young women. Adding MRI increases sensitivity, but also the risk of false-positive results. The limitation of all previous MRI screening studies is that they do not contain a comparison group; all participants received both MRI and mammography. Therefore, we cannot empirically assess in which stage tumours would have been detected by either test. The aim of the Familial MRI Screening Study (FaMRIsc is to compare the efficacy of MRI screening to mammography for women with a familial risk. Furthermore, we will assess the influence of breast density. Methods/Design This Dutch multicentre, randomized controlled trial, with balanced randomisation (1:1 has a parallel grouped design. Women with a cumulative lifetime risk for breast cancer due to their family history of ≥20%, aged 30–55 years are eligible. Identified BRCA1/2 mutation carriers or women with 50% risk of carrying a mutation are excluded. Group 1 receives yearly mammography and clinical breast examination (n = 1000, and group 2 yearly MRI and clinical breast examination, and mammography biennially (n = 1000. Primary endpoints are the number and stage of the detected breast cancers in each arm. Secondary endpoints are the number of false-positive results in both screening arms. Furthermore, sensitivity and positive predictive value of both screening strategies will be assessed. Cost-effectiveness of both strategies will be assessed. Analyses will also be performed with mammographic density as stratification factor. Discussion Personalized breast cancer screening

  7. Computer-aided detection of breast carcinoma in standard mammographic projections with digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Destounis, Stamatia [Elizabeth Wende Breast Care, LLC, Rochester, NY (United States); University of Rochester, School of Medicine and Dentistry, Rochester, NY (United States); Hanson, Sarah; Morgan, Renee; Murphy, Philip; Somerville, Patricia; Seifert, Posy; Andolina, Valerie; Arieno, Andrea; Skolny, Melissa; Logan-Young, Wende [Elizabeth Wende Breast Care, LLC, Rochester, NY (United States)

    2009-06-15

    A retrospective evaluation of the ability of computer-aided detection (CAD) ability to identify breast carcinoma in standard mammographic projections. Forty-five biopsy proven lesions in 44 patients imaged digitally with CAD applied at examination were reviewed. Forty-four screening BIRADS {sup registered} category 1 digital mammography examinations were randomly identified to serve as a comparative normal/control population. Data included patient age; BIRADS {sup registered} breast density; lesion type, size, and visibility; number, type, and location of CAD marks per image; CAD ability to mark lesions; needle core and surgical pathologic correlation. The CAD lesion/case sensitivity of 87% (n=39), image sensitivity of 69% (n=31) for mediolateral oblique view and 78% (n=35) for the craniocaudal view was found. The average false positive rate in 44 normal screening cases was 2.0 (range 1-8). The 2.0 figure is based on 88 reported false positive CAD marks in 44 normal screening exams: 98% (n=44) lesions proceeded to excision; initial pathology upgraded at surgical excision from in situ to invasive disease in 24% (n=9) lesions. CAD demonstrated potential to detect mammographically visible cancers in standard projections for all lesion types. (orig.)

  8. Development of a stationary digital breast tomosynthesis system for clinical applications

    Science.gov (United States)

    Tucker, Andrew Wallace

    Digital breast tomosynthesis (DBT) has been shown to be a very beneficial tool in the fight against breast cancer. However, current DBT systems have poor spatial resolution compared to full field digital mammography (FFDM), the current gold standard for screening mammography. The poor spatial resolution of DBT systems is a result of the single X-ray source design. In DBT systems a single X-ray source is rotated over an angular span in order to acquire the images needed for 3D reconstruction. The rotation of the X-ray source degrades the spatial resolution of the images. DBT systems which are approved for use in the United States for screening mammography are required to also take a full field digital mammogram with every DBT acquisition in order to compensate for the poor spatial resolution. This double exposure essentially doubles the radiation dose to patients. Over the past few years our research group has developed a carbon nanotube (CNT) based X-ray source technology. The unique nature of CNT X-ray sources allows for multiple X-ray focal spots in a single X-ray source. Using this technology we have recently developed a stationary DBT system (s-DBT) system which is capable of producing a full tomosynthesis image dataset with zero motion of the X-ray source. This system has been shown to have increased spatial resolution over other DBT systems in a laboratory setting. The goal of this thesis work was to optimize the s-DBT system, demonstrate its usefulness over other systems, and finally implement it into the clinic for a clinical trial. The s-DBT system was optimized using different image quality measurements. The optimized system was then used in a breast specimen imaging trial which compared s-DBT to magnified 2D mammography and a conventional single source DBT system. Readers preferred s-DBT to magnified 2D mammography for specimen margin delineation and mass detection, these results were not significant. Using physical measures for spatial resolution the s

  9. Comparison of screen-film and full-field digital mammography in Japanese population-based screening

    International Nuclear Information System (INIS)

    Yamada, Takayuki; Saito, Mioko; Ishibashi, Tadashi

    2004-01-01

    The purpose of this study was to investigate how the greater contrast of full-field digital mammography (FFDM) affects the detection of suspicious lesions in Japanese population-based screening. Screen-film mammography (SFM) and FFDM were performed in 480 women aged 50 years or more. A set of mediolateral oblique views was obtained with each modality. All mammograms were independently double-read. The five-scale category assessment and type of finding using the Breast Imaging Reporting and Data System (BIRADS) nomenclature were given. Intraobserver variance, recall rates, and positive predictive value were calculated. The findings between the two modalities were discordant. κ-values for each reader were 0.619 and 0.385, respectively. Almost half of the microcalcifications were called with both modalities. The detection of masses was less concordant between the readers (27%). The masses were detected more frequently with FFDM (73%). Other findings were only detected with one modality. The recall rate was not significantly different (2.9% with SFM vs. 4.2% with FFDM; p=0.253). The positive predictive value was not significantly different (14% with SFM vs. 10% with FFDM; p=0.69), either. Two patients with breast cancer were detected with both modalities. Recall rates and positive predictive value were not significantly different between SFM and FFDM. Cancers were detected with both modalities. (author)

  10. Dose surveys in two digital mammography units using DICOM headers

    International Nuclear Information System (INIS)

    Tsalafoutas, I.; Michalaki, C.; Papagiannopoulou, C.; Efstathopoulos, E.

    2012-01-01

    Background and objective: Digital mammography units store images in DICOM format. Thus, data regarding the acquisition parameters are available within DICOM headers, including among others, the anode/filter combination, tube potential and tube current exposure time product, compressed breast thickness, entrance surface air kerma (ESAK) and mean glandular dose (MGD). However, manual extraction of these data for the verification of the displayed values' accuracy and for dose survey purposes is time consuming. Our objective was to develop a method that enables the automation of such procedures. Materials and methods: Two hundred mammographic examinations (800 mammograms) performed in two digital units (GE, Essential) were recorded on CD-roms. Using appropriate software (DICOM Info Extractor) all dose related DICOM headers were extracted into a Microsoft Excel based spreadsheet, containing embedded algorithms for the calculation of ESAK and MGD according to Dance et al (Phys. Med. Biol. 45, 2000) methodology. Results: The ESAK and MGD values stored in the DICOM headers were compared with those calculated and in most cases were within ±10%. The basic difference among the two mammographic units is that, the older one calculates MGD assuming a breast composition 50% glandular-50% adipose tissue, while the newer one calculates the actual breast glandularity and stores this value in a DICOM header. The average MGD values were 1.21 mGy and 1.38 mGy, respectively. Conclusion: For the units studied, the ESAK and MGD values stored in DICOM headers are reliable. Utilizing tools for their automatic extraction provides an easy way to perform dose surveys. (authors)

  11. Spectral analysis of full field digital mammography data

    International Nuclear Information System (INIS)

    Heine, John J.; Velthuizen, Robert P.

    2002-01-01

    The spectral content of mammograms acquired from using a full field digital mammography (FFDM) system are analyzed. Fourier methods are used to show that the FFDM image power spectra obey an inverse power law; in an average sense, the images may be considered as 1/f fields. Two data representations are analyzed and compared (1) the raw data, and (2) the logarithm of the raw data. Two methods are employed to analyze the power spectra (1) a technique based on integrating the Fourier plane with octave ring sectioning developed previously, and (2) an approach based on integrating the Fourier plane using rings of constant width developed for this work. Both methods allow theoretical modeling. Numerical analysis indicates that the effects due to the transformation influence the power spectra measurements in a statistically significant manner in the high frequency range. However, this effect has little influence on the inverse power law estimation for a given image regardless of the data representation or the theoretical analysis approach. The analysis is presented from two points of view (1) each image is treated independently with the results presented as distributions, and (2) for a given representation, the entire image collection is treated as an ensemble with the results presented as expected values. In general, the constant ring width analysis forms the foundation for a spectral comparison method for finding spectral differences, from an image distribution sense, after applying a nonlinear transformation to the data. The work also shows that power law estimation may be influenced due to the presence of noise in the higher frequency range, which is consistent with the known attributes of the detector efficiency. The spectral modeling and inverse power law determinations obtained here are in agreement with that obtained from the analysis of digitized film-screen images presented previously. The form of the power spectrum for a given image is approximately 1/f 2

  12. 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.)

  13. 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.)

  14. Physical image quality of computed radiography in mammography system

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  15. 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

  16. Comparison Between Digital and Synthetic 2D Mammograms in Breast Density Interpretation.

    Science.gov (United States)

    Alshafeiy, Taghreed I; Wadih, Antoine; Nicholson, Brandi T; Rochman, Carrie M; Peppard, Heather R; Patrie, James T; Harvey, Jennifer A

    2017-07-01

    The purpose of this study was to compare assessments of breast density on synthetic 2D images as compared with digital 2D mammograms. This retrospective study included consecutive women undergoing screening with digital 2D mammography and tomosynthesis during May 2015 with a negative or benign outcome. In separate reading sessions, three radiologists with 5-25 years of clinical experience and 1 year of experience with synthetic 2D mammography read digital 2D and synthetic 2D images and assigned breast density categories according to the 5th edition of BI-RADS. Inter- and intrareader agreement was assessed for each BI-RADS density assessment and combined dense and nondense categories using percent agreement and Cohen kappa coefficient for consensus and all reads. A total of 309 patients met study inclusion criteria. Agreement between consensus BI-RADS density categories assigned for digital and synthetic 2D mammography was 80.3% (95% CI, 75.4-84.5%) with κ = 0.73 (95% CI, 0.66-0.79). For combined dense and nondense categories, agreement reached 91.9% (95% CI, 88.2-94.7%). For consensus readings, similar numbers of patients were shifted between nondense and dense categories (11 and 14, respectively) with the synthetic 2D compared with digital 2D mammography. Interreader differences were apparent; assignment to dense categories was greater with digital 2D mammography for reader 1 (odds ratio [OR], 1.26; p = 0.002), the same for reader 2 (OR, 0.91; p = 0.262), and greater with synthetic 2D mammography for reader 3 (OR, 0.86; p = 0.033). Overall, synthetic 2D mammography is comparable with digital 2D mammography in assessment of breast density, though there is some variability by reader. Practices can readily adopt synthetic 2D mammography without concern that it will affect density assessment and subsequent recommendations for supplemental screening.

  17. The implementation of CMOS sensors within a real time digital mammography intelligent imaging system: The I-ImaS System

    Science.gov (United States)

    Esbrand, C.; Royle, G.; Griffiths, J.; Speller, R.

    2009-07-01

    The integration of technology with healthcare has undoubtedly propelled the medical imaging sector well into the twenty first century. The concept of digital imaging introduced during the 1970s has since paved the way for established imaging techniques where digital mammography, phase contrast imaging and CT imaging are just a few examples. This paper presents a prototype intelligent digital mammography system designed and developed by a European consortium. The final system, the I-ImaS system, utilises CMOS monolithic active pixel sensor (MAPS) technology promoting on-chip data processing, enabling the acts of data processing and image acquisition to be achieved simultaneously; consequently, statistical analysis of tissue is achievable in real-time for the purpose of x-ray beam modulation via a feedback mechanism during the image acquisition procedure. The imager implements a dual array of twenty 520 pixel × 40 pixel CMOS MAPS sensing devices with a 32μm pixel size, each individually coupled to a 100μm thick thallium doped structured CsI scintillator. This paper presents the first intelligent images of real breast tissue obtained from the prototype system of real excised breast tissue where the x-ray exposure was modulated via the statistical information extracted from the breast tissue itself. Conventional images were experimentally acquired where the statistical analysis of the data was done off-line, resulting in the production of simulated real-time intelligently optimised images. The results obtained indicate real-time image optimisation using the statistical information extracted from the breast as a means of a feedback mechanisms is beneficial and foreseeable in the near future.

  18. Evaluation of the quality of CR mammography images in Chugoku Rosai Hospital. Visual evaluation and digital evaluation

    International Nuclear Information System (INIS)

    Makihata, Hiroshi; Fukuda, Tomoya; Aomori, Masaji; Hara, Shinji

    2005-01-01

    New mammography system (50-micrometer system) composed of Fuji computed tomography (FCR) both sides IP, 5000MA and dry imager was introduced in the Department of Physical Checkup of Chugoku Rosai Hospital in 2003. We performed visual evaluation and digital evaluation using 50-micrometer system in accordance with (the quality control guidance of) Non-Profit Organization the Central Committee on Quality Control of Mammographic Screening. In visual evaluation using RMI156 phantom the system cleared the quality control guidance about a fiber, calcification, and masses. On step phantom, it passed about 10 steps, masses, and calcifications. Since a success standard was not announced officially, the performance in digital evaluation cannot be judged and only the result is presented. In digital evaluation, signal-to-noise ratio (SNR) is 14.9, root of mean squares (RMS) is 32.9, SNRC is 16.4, SNRT is 3.65. This system image has high sharpness and is considered from the result in visual evaluation to have the ability of offering images with a high degree of information. (author)

  19. Analysis of the imaging performance in indirect digital mammography detectors by linear systems and signal detection models

    International Nuclear Information System (INIS)

    Liaparinos, P.; Kalyvas, N.; Kandarakis, I.; Cavouras, D.

    2013-01-01

    Purpose: The purpose of this study was to provide an analysis of imaging performance in digital mammography, using indirect detector instrumentation, by combining the Linear Cascaded Systems (LCS) theory and the Signal Detection Theory (SDT). Observer performance was assessed, by examining frequently employed detectors, consisting of phosphor-based X-ray converters (granular Gd 2 O 2 S:Tb and structural CsI:Tl), coupled with the recently introduced complementary metal-oxide-semiconductor (CMOS) sensor. By applying combinations of various irradiation conditions (filter-target and exposure levels at 28 kV) on imaging detectors, our study aimed to find the optimum system set-up for digital mammography. For this purpose, the signal to noise transfer properties of the medical imaging detectors were examined for breast carcinoma detectability. Methods: An analytical model was applied to calculate X-ray interactions within software breast phantoms and detective media. Modeling involved: (a) three X-ray spectra used in digital mammography: 28 kV Mo/Mo (Mo: 0.030 mm), 28 kV Rh/Rh (Rh: 0.025 mm) and 28 kV W/Rh (Rh: 0.060 mm) at different entrance surface air kerma (ESAK) of 3 mGy and 5 mGy, (b) a 5 cm thick Perspex software phantom incorporating a small Ca lesion of varying size (0.1–1 cm), and (c) two 200 μm thick phosphor-based X-ray converters (Gd2O2S:Tb, CsI:Tl), coupled to a CMOS based detector of 22.5 μm pixel size. Results: Best (lowest) contrast threshold (CT) values were obtained with the combination: (i) W/Rh target-filter, (ii) 5 mGy (ESAK), and (iii) CsI:Tl-CMOS detector. For lesion diameter 0.5 cm the CT was found improved, in comparison to other anode/filter combinations, approximately 42% than Rh/Rh and 55% than Mo/Mo, for small sized carcinoma (0.1 cm) and approximately 50% than Rh/Rh and 125% than Mo/Mo, for big sized carcinoma (1 cm), considering 5 mGy X-ray beam. By decreasing lesion diameter and thickness, a limiting CT (100%) was occurred for size

  20. Experience with the european quality assurance guidelines for digital mammography systems in a national screening programme

    International Nuclear Information System (INIS)

    McCullagh, J.; Keavey, E.; Egan, G.; Phelan, N.

    2013-01-01

    The transition to a fully digital breast screening programme, utilising three different full-field digital mammography (FFDM) systems has presented many challenges to the implementation of the European guidelines for physico-technical quality assurance (QA) testing. An analysis of the QA results collected from the FFDM systems in the screening programme over a 2-y period indicates that the three different systems have similar QA performances. Generally, the same tests were failed by all systems and failure rates were low. The findings provide some assurance that the QA guidelines are being correctly implemented. They also suggest that there is more scope for the development of the relevance of the guidelines with respect to modern FFDM systems. This study has also shown that a summary review of the QA data can be achieved by simple organisation of the QA data storage and by automation of data query and retrieval using commonly available software. (authors)

  1. Prospective trial comparing full-field digital mammography (FFDM) versus combined FFDM and tomosynthesis in a population-based screening programme using independent double reading with arbitration

    International Nuclear Information System (INIS)

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

    2013-01-01

    To compare double readings when interpreting full field digital mammography (2D) and tomosynthesis (3D) during mammographic screening. A prospective, Ethical Committee approved screening study is underway. During the first year 12,621 consenting women underwent both 2D and 3D imaging. Each examination was independently interpreted by four radiologists under four reading modes: Arm A - 2D; Arm B - 2D + CAD; Arm C - 2D + 3D; Arm D - synthesised 2D + 3D. Examinations with a positive score by at least one reader were discussed at an arbitration meeting before a final management decision. Paired double reading of 2D (Arm A + B) and 2D + 3D (Arm C + D) were analysed. Performance measures were compared using generalised linear mixed models, accounting for inter-reader performance heterogeneity (P < 0.05). Pre-arbitration false-positive scores were 10.3 % (1,286/12,501) and 8.5 % (1,057/12,501) for 2D and 2D + 3D, respectively (P < 0.001). Recall rates were 2.9 % (365/12,621) and 3.7 % (463/12,621), respectively (P = 0.005). Cancer detection was 7.1 (90/12,621) and 9.4 (119/12,621) per 1,000 examinations, respectively (30 % increase, P < 0.001); positive predictive values (detected cancer patients per 100 recalls) were 24.7 % and 25.5 %, respectively (P = 0.97). Using 2D + 3D, double-reading radiologists detected 27 additional invasive cancers (P < 0.001). Double reading of 2D + 3D significantly improves the cancer detection rate in mammography screening. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-11-15

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

  4. Measurement of effective detective quantum efficiency for a photon counting scanning mammography system and comparison with two flat panel full-field digital mammography systems

    Science.gov (United States)

    Wood, Tim J.; Moore, Craig S.; Saunderson, John R.; Beavis, Andrew W.

    2018-01-01

    Effective detective quantum efficiency (eDQE) describes the resolution and noise properties of an imaging system along with scatter and primary transmission, all measured under clinically appropriate conditions. Effective dose efficiency (eDE) is the eDQE normalised to mean glandular dose and has been proposed as a useful metric for the optimisation of clinical imaging systems. The aim of this study was to develop a methodology for measuring eDQE and eDE on a Philips microdose mammography (MDM) L30 photon counting scanning system, and to compare performance with two conventional flat panel systems. A custom made lead-blocker was manufactured to enable the accurate determination of dose measurements, and modulation transfer functions were determined free-in-air at heights of 2, 4 and 6 cm above the breast support platform. eDQE were calculated for a Philips MDM L30, Hologic Dimensions and Siemens Inspiration digital mammography system for 2, 4 and 6 cm thick poly(methyl methacrylate) (PMMA). The beam qualities (target/filter and kilovoltage) assessed were those selected by the automatic exposure control, and anti-scatter grids were used where available. Measurements of eDQE demonstrate significant differences in performance between the slit- and scan-directions for the photon counting imaging system. MTF has been shown to be the limiting factor in the scan-direction, which results in a rapid fall in eDQE at mid-to-high spatial frequencies. A comparison with two flat panel mammography systems demonstrates that this may limit image quality for small details, such as micro-calcifications, which correlates with a more conventional image quality assessment with the CDMAM phantom. eDE has shown the scanning photon counting system offers superior performance for low spatial frequencies, which will be important for the detection of large low contrast masses. Both eDQE and eDE are proposed as useful metrics that should enable optimisation of the Philips MDM L30.

  5. High Energy Resolution Hyperspectral X-Ray Imaging for Low-Dose Contrast-Enhanced Digital Mammography.

    Science.gov (United States)

    Pani, Silvia; Saifuddin, Sarene C; Ferreira, Filipa I M; Henthorn, Nicholas; Seller, Paul; Sellin, Paul J; Stratmann, Philipp; Veale, Matthew C; Wilson, Matthew D; Cernik, Robert J

    2017-09-01

    Contrast-enhanced digital mammography (CEDM) is an alternative to conventional X-ray mammography for imaging dense breasts. However, conventional approaches to CEDM require a double exposure of the patient, implying higher dose, and risk of incorrect image registration due to motion artifacts. A novel approach is presented, based on hyperspectral imaging, where a detector combining positional and high-resolution spectral information (in this case based on Cadmium Telluride) is used. This allows simultaneous acquisition of the two images required for CEDM. The approach was tested on a custom breast-equivalent phantom containing iodinated contrast agent (Niopam 150®). Two algorithms were used to obtain images of the contrast agent distribution: K-edge subtraction (KES), providing images of the distribution of the contrast agent with the background structures removed, and a dual-energy (DE) algorithm, providing an iodine-equivalent image and a water-equivalent image. The high energy resolution of the detector allowed the selection of two close-by energies, maximising the signal in KES images, and enhancing the visibility of details with the low surface concentration of contrast agent. DE performed consistently better than KES in terms of contrast-to-noise ratio of the details; moreover, it allowed a correct reconstruction of the surface concentration of the contrast agent in the iodine image. Comparison with CEDM with a conventional detector proved the superior performance of hyperspectral CEDM in terms of the image quality/dose tradeoff.

  6. Computer-aided detection of masses in full-field digital mammography using screen-film mammograms for training

    International Nuclear Information System (INIS)

    Kallenberg, Michiel; Karssemeijer, Nico

    2008-01-01

    It would be of great value when available databases of screen-film mammography (SFM) images can be used to train full-field digital mammography (FFDM) computer-aided detection (CAD) systems, as compilation of new databases is costly. In this paper, we investigate this possibility. Firstly, we develop a method that converts an FFDM image into an SFM-like representation. In this conversion method, we establish a relation between exposure and optical density by simulation of an automatic exposure control unit. Secondly, we investigate the effects of using the SFM images as training samples compared to training with FFDM images. Our FFDM database consisted of 266 cases, of which 102 were biopsy-proven malignant masses and 164 normals. The images were acquired with systems of two different manufacturers. We found that, when we trained our FFDM CAD system with a small number of images, training with FFDM images, using a five-fold crossvalidation procedure, outperformed training with SFM images. However, when the full SFM database, consisting of 348 abnormal cases (including 204 priors) and 810 normal cases, was used for training, SFM training outperformed FFDMA training. These results show that an existing CAD system for detection of masses in SFM can be used for FFDM images without retraining.

  7. Effectiveness and cost-effectiveness of double reading in digital mammography screening: A systematic review and meta-analysis.

    Science.gov (United States)

    Posso, Margarita; Puig, Teresa; Carles, Misericòrdia; Rué, Montserrat; Canelo-Aybar, Carlos; Bonfill, Xavier

    2017-11-01

    Double reading is the strategy of choice for mammogram interpretation in screening programmes. It remains, however, unknown whether double reading is still the strategy of choice in the context of digital mammography. Our aim was to determine the effectiveness and cost-effectiveness of double reading versus single reading of digital mammograms in screening programmes. We performed a systematic review by searching the PubMed, Embase, and Cochrane Library databases up to April 2017. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklist to assess the methodological quality of the diagnostic studies and economic evaluations, respectively. A proportion's meta-analysis approach, 95% Confidence Intervals (95% CI) and test of heterogeneity (P values) were used for pooled results. Costs are expressed US$ PPP (United States Dollar purchasing power parities). The PROSPERO ID of this Systematic Review's protocol is CRD42014013804. Of 1473 potentially relevant hits, four high-quality studies were included. The pooled cancer detection rate of double reading was 6.01 per 1000 screens (CI: 4.47‰-7.77‰), and it was 5.65 per 1000 screens (CI: 3.95‰-7.65‰) for single reading (P=0.76). The pooled proportion of false-positives of double reading was 47.03 per 1000 screens (CI: 39.13‰-55.62‰) and it was 40.60 per 1000 screens (CI: 38.58‰-42.67‰) for single reading (P=0.12). One study reported, for double reading, an ICER (Incremental Cost-Effectiveness Ratio) of 16,684 Euros (24,717 US$ PPP; 2015 value) per detected cancer. Single reading+CAD (computer-aided-detection) was cost-effective in Japan. The evidence of benefit for double reading compared to single reading for digital mammography interpretation is scarce. Double reading seems to increase operational costs, have a not significantly higher false-positive rate, and a similar cancer detection rate. Copyright

  8. Average glandular dose in digital mammography and digital breast tomosynthesis: comparison of phantom and patient data

    International Nuclear Information System (INIS)

    Bouwman, R W; Van Engen, R E; Den Heeten, G J; Broeders, M J M; Veldkamp, W J H; Young, K C; Dance, D R; Schopphoven, S; Jeukens, C R L P N

    2015-01-01

    For the evaluation of the average glandular dose (AGD) in digital mammography (DM) and digital breast tomosynthesis (DBT) phantoms simulating standard model breasts are used. These phantoms consist of slabs of polymethyl methacrylate (PMMA) or a combination of PMMA and polyethylene (PE). In the last decades the automatic exposure control (AEC) increased in complexity and became more sensitive to (local) differences in breast composition. The question is how well the AGD estimated using these simple dosimetry phantoms agrees with the average patient AGD. In this study the AGDs for both dosimetry phantoms and for patients have been evaluated for 5 different x-ray systems in DM and DBT modes. It was found that the ratios between patient and phantom AGD did not differ considerably using both dosimetry phantoms. These ratios averaged over all breast thicknesses were 1.14 and 1.15 for the PMMA and PMMA-PE dosimetry phantoms respectively in DM mode and 1.00 and 1.02 in the DBT mode. These ratios were deemed to be sufficiently close to unity to be suitable for dosimetry evaluation in quality control procedures. However care should be taken when comparing systems for DM and DBT since depending on the AEC operation, ratios for particular breast thicknesses may differ substantially (0.83–1.96). Although the predictions of both phantoms are similar we advise the use of PMMA  +  PE slabs for both DM and DBT to harmonize dosimetry protocols and avoid any potential issues with the use of spacers with the PMMA phantoms. (paper)

  9. 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.

  10. 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

  11. Average glandular dose in digital mammography and breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Olgar, T. [Ankara Univ. (Turkey). Dept. of Engineering Physics; Universitaetsklinikum Leipzig AoeR (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie; Kahn, T.; Gosch, D. [Universitaetsklinikum Leipzig AoeR (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

    2012-10-15

    Purpose: To determine the average glandular dose (AGD) in digital full-field mammography (2 D imaging mode) and in breast tomosynthesis (3 D imaging mode). Materials and Methods: Using the method described by Boone, the AGD was calculated from the exposure parameters of 2247 conventional 2 D mammograms and 984 mammograms in 3 D imaging mode of 641 patients examined with the digital mammographic system Hologic Selenia Dimensions. The breast glandular tissue content was estimated by the Hologic R2 Quantra automated volumetric breast density measurement tool for each patient from right craniocaudal (RCC) and left craniocaudal (LCC) images in 2 D imaging mode. Results: The mean compressed breast thickness (CBT) was 52.7 mm for craniocaudal (CC) and 56.0 mm for mediolateral oblique (MLO) views. The mean percentage of breast glandular tissue content was 18.0 % and 17.4 % for RCC and LCC projections, respectively. The mean AGD values in 2 D imaging mode per exposure for the standard breast were 1.57 mGy and 1.66 mGy, while the mean AGD values after correction for real breast composition were 1.82 mGy and 1.94 mGy for CC and MLO views, respectively. The mean AGD values in 3 D imaging mode per exposure for the standard breast were 2.19 mGy and 2.29 mGy, while the mean AGD values after correction for the real breast composition were 2.53 mGy and 2.63 mGy for CC and MLO views, respectively. No significant relationship was found between the AGD and CBT in 2 D imaging mode and a good correlation coefficient of 0.98 in 3 D imaging mode. Conclusion: In this study the mean calculated AGD per exposure in 3 D imaging mode was on average 34 % higher than for 2 D imaging mode for patients examined with the same CBT.

  12. Average glandular dose in digital mammography and breast tomosynthesis

    International Nuclear Information System (INIS)

    Olgar, T.; Universitaetsklinikum Leipzig AoeR; Kahn, T.; Gosch, D.

    2012-01-01

    Purpose: To determine the average glandular dose (AGD) in digital full-field mammography (2 D imaging mode) and in breast tomosynthesis (3 D imaging mode). Materials and Methods: Using the method described by Boone, the AGD was calculated from the exposure parameters of 2247 conventional 2 D mammograms and 984 mammograms in 3 D imaging mode of 641 patients examined with the digital mammographic system Hologic Selenia Dimensions. The breast glandular tissue content was estimated by the Hologic R2 Quantra automated volumetric breast density measurement tool for each patient from right craniocaudal (RCC) and left craniocaudal (LCC) images in 2 D imaging mode. Results: The mean compressed breast thickness (CBT) was 52.7 mm for craniocaudal (CC) and 56.0 mm for mediolateral oblique (MLO) views. The mean percentage of breast glandular tissue content was 18.0 % and 17.4 % for RCC and LCC projections, respectively. The mean AGD values in 2 D imaging mode per exposure for the standard breast were 1.57 mGy and 1.66 mGy, while the mean AGD values after correction for real breast composition were 1.82 mGy and 1.94 mGy for CC and MLO views, respectively. The mean AGD values in 3 D imaging mode per exposure for the standard breast were 2.19 mGy and 2.29 mGy, while the mean AGD values after correction for the real breast composition were 2.53 mGy and 2.63 mGy for CC and MLO views, respectively. No significant relationship was found between the AGD and CBT in 2 D imaging mode and a good correlation coefficient of 0.98 in 3 D imaging mode. Conclusion: In this study the mean calculated AGD per exposure in 3 D imaging mode was on average 34 % higher than for 2 D imaging mode for patients examined with the same CBT.

  13. Digital breast tomosynthesis; Digitale Tomosynthese der Brust

    Energy Technology Data Exchange (ETDEWEB)

    Haegele, Julian; Barkhausen, Joerg [Universtiaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin; Pursche, Telja [Universtiaetsklinikum Schleswig-Holstein, Luebeck (Germany). Brustzentrum; Schaefer, Fritz K.W. [Universtiaetsklinikum Schleswig-Holstein, Kiel (Germany). Bereich Mammadiagnostik und Intervention

    2015-09-15

    In digital breast tomosynthesis a digital tomographic data set with a very high spatial resolution is reconstructed from low-dose projections collected over a limited rotation angle. This allows a very detailed assessment of e. g. masses and architectural distortions. The average glandular dose is comparable to 2 D mammography. First clinical studies demonstrated that tomosynthesis is able to supply important additional information in suspicious mammographic findings. In comparison to projection mammography, tomosynthesis shows an at least comparable diagnostic accuracy. In everyday practice, tomosynthesis is currently mostly used for further evaluation of suspicious findings in mammography.

  14. Steerable dyadic wavelet transform and interval wavelets for enhancement of digital mammography

    Science.gov (United States)

    Laine, Andrew F.; Koren, Iztok; Yang, Wuhai; Taylor, Fred J.

    1995-04-01

    This paper describes two approaches for accomplishing interactive feature analysis by overcomplete multiresolution representations. We show quantitatively that transform coefficients, modified by an adaptive non-linear operator, can make more obvious unseen or barely seen features of mammography without requiring additional radiation. Our results are compared with traditional image enhancement techniques by measuring the local contrast of known mammographic features. We design a filter bank representing a steerable dyadic wavelet transform that can be used for multiresolution analysis along arbitrary orientations. Digital mammograms are enhanced by orientation analysis performed by a steerable dyadic wavelet transform. Arbitrary regions of interest (ROI) are enhanced by Deslauriers-Dubuc interpolation representations on an interval. We demonstrate that our methods can provide radiologists with an interactive capability to support localized processing of selected (suspicion) areas (lesions). Features extracted from multiscale representations can provide an adaptive mechanism for accomplishing local contrast enhancement. By improving the visualization of breast pathology can improve changes of early detection while requiring less time to evaluate mammograms for most patients.

  15. Evaluation of clinical image processing algorithms used in digital mammography.

    Science.gov (United States)

    Zanca, Federica; Jacobs, Jurgen; Van Ongeval, Chantal; Claus, Filip; Celis, Valerie; Geniets, Catherine; Provost, Veerle; Pauwels, Herman; Marchal, Guy; Bosmans, Hilde

    2009-03-01

    Screening is the only proven approach to reduce the mortality of breast cancer, but significant numbers of breast cancers remain undetected even when all quality assurance guidelines are implemented. With the increasing adoption of digital mammography systems, image processing may be a key factor in the imaging chain. Although to our knowledge statistically significant effects of manufacturer-recommended image processings have not been previously demonstrated, the subjective experience of our radiologists, that the apparent image quality can vary considerably between different algorithms, motivated this study. This article addresses the impact of five such algorithms on the detection of clusters of microcalcifications. A database of unprocessed (raw) images of 200 normal digital mammograms, acquired with the Siemens Novation DR, was collected retrospectively. Realistic simulated microcalcification clusters were inserted in half of the unprocessed images. All unprocessed images were subsequently processed with five manufacturer-recommended image processing algorithms (Agfa Musica 1, IMS Raffaello Mammo 1.2, Sectra Mamea AB Sigmoid, Siemens OPVIEW v2, and Siemens OPVIEW v1). Four breast imaging radiologists were asked to locate and score the clusters in each image on a five point rating scale. The free-response data were analyzed by the jackknife free-response receiver operating characteristic (JAFROC) method and, for comparison, also with the receiver operating characteristic (ROC) method. JAFROC analysis revealed highly significant differences between the image processings (F = 8.51, p < 0.0001), suggesting that image processing strongly impacts the detectability of clusters. Siemens OPVIEW2 and Siemens OPVIEW1 yielded the highest and lowest performances, respectively. ROC analysis of the data also revealed significant differences between the processing but at lower significance (F = 3.47, p = 0.0305) than JAFROC. Both statistical analysis methods revealed that the

  16. A novel method for contrast-to-noise ratio (CNR) evaluation of digital mammography detectors

    International Nuclear Information System (INIS)

    Baldelli, P.; Phelan, N.; Egan, G.

    2009-01-01

    The purpose of this study was to test a new, simple method of evaluating the contrast-to-noise ratio (CNR) over the entire image field of a digital detector and to compare different mammography systems. Images were taken under clinical exposure conditions for a range of simulated breast thicknesses using poly(methyl methacrylate) (PMMA). At each PMMA thickness, a second image which included an additional 0.2-mm Al sheet was also acquired. Image processing software was used to calculate the CNR in multiple regions of interest (ROI) covering the entire area of the detector in order to obtain a 'CNR image'. Five detector types were evaluated, two CsI-αSi (GE Healthcare) flat panel systems, one αSe (Hologic) flat panel system and a two generations of scanning photon counting digital detectors (Sectra). Flat panel detectors exhibit better CNR uniformity compared with the first-generation scanning photon counting detector in terms of mean pixel value variation. However, significant improvement in CNR uniformity was observed for the next-generation scanning detector. The method proposed produces a map of the CNR and a measurement of uniformity throughout the entire image field of the detector. The application of this method enables quality control measurement of individual detectors and a comparison of detectors using different technologies. (orig.)

  17. Evaluation of the 1Shot Phantom dedicated to the mammography system using FCR

    International Nuclear Information System (INIS)

    Nagashima, Chieko; Uchiyama, Nachiko; Moriyama, Noriyuki; Nagata, Mio; Kobayashi, Hiroyuki; Sankoda, Katsuhiro; Saotome, Shigeru; Tagi, Masahiro; Kusunoki, Tetsurou

    2009-01-01

    Currently daily quality control (QC) tests for mammography systems are generally evaluated by using visual analysis phantoms, which of course means subjective measurement. In our study, however, we evaluated a novel digital phantom, the 1Shot Phantom M plus (1Shot Phantom), together with automatic analysis software dedicated for mammography systems using Fuji computed radiography (FCR). The digital phantom enables objective evaluation by providing for actual physical measurement rather than subjective visual assessment. We measured contrast to noise ratio (CNR), image receptor homogeneity, missed tissue at chest wall side, modulation transfer function (MTF), and geometric distortion utilizing the 1Shot Phantom. We then compared the values obtained using the 1Shot Phantom with values obtained from the European guidelines and International Electrotechnical Commission (IEC) standards. In addition, we evaluated the convenience of using the digital phantom. The values utilizing the 1Shot Phantom and those from the European guidelines and IEC standards were consistent, but the QC tests for the European guidelines and IEC standards methods took about six hours while the same QC tests using the 1Shot Phantom took 10 minutes or less including exposure of the phantom image, measurement, and analysis. In conclusion, the digital phantom and dedicated software proved very useful and produced improved analysis for mammography systems using FCR in clinical daily QC testing because of their objectivity and substantial time-saving convenience. (author)

  18. Evaluation of average glandular dose in mammography services in 10 cities of Colombia

    International Nuclear Information System (INIS)

    Alejo-Martinez, H.; Salazar-Hurtado, E.; Puerto-Jimenez, D.

    2016-01-01

    The objective of this study was to conduct an assessment of dose in 60 mammography services that have screening programs for breast cancer in 10 cities of Colombia. The third quartile of the average glandular dose was 2,29 mGy, range between 1,0 and 5,6 mGy, for the phantom equivalent to a standard breast. This study included mammography units with conventional and digital technology. (author)

  19. 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)

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

    Science.gov (United States)

    Durand, Melissa A

    2018-04-04

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

  1. Development of test objects for image quality evaluation of digital mammography; Desenvolvimento de objetos de teste para avaliacao da qualidade da imagem em mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Vitor Nascimento de Carvalho

    2013-07-01

    Mammography is the image exam called 'gold standard' for early detection of breast cancer. 111 Brazil, more than eight million mammograms are carried out per year. With the advancement of technology, the digital systems CR and DR for this diagnostic modality have been increasingly implemented, replacing the conventional screen-film system, which brought environmental problems, like the disposal of chemical waste, and is also responsible for the rejection of radiographic films with processing artifacts. Digital systems, besides not experiencing the problem of environmental pollution, are still capable of image processing, allowing a much lower rejection rate when compared to the conventional system. Moreover, the determination of an accurate diagnosis is highly dependent on the image quality of the examination. To ensure the reliability of the images produced by these systems, it is necessary to evaluate them on a regular basis. Unfortunately, there is no regulation in Brazil about the Quality Assurance of these systems. The aim of this study was to develop a set of test objects that allow the evaluation of some parameters of image quality of these systems, such as field image uniformity, the linearity between the air Kerma incident on detector and the mean pixel value (MPV) of the image, the spatial resolution of the system through the modulation transfer function (MTF) and also to suggest an object to be applied in the evaluation of contrast-to-noise ratio (CNR) and signal-difference-to-noise ratio (SDNR). In order to test the objects. 10 mammography centers were evaluated, seven with CR systems and three with the DR systems. To evaluate the linearity, besides the test objects high sensitivity dosimeters were necessary to be used, namely LiF:Mg,Cu,P TL dosimeters. The use of these dosimeters was recommended in order to minimize the time required to perform the tests and to decrease the number of exposures needed. For evaluation of digital images in DICOM

  2. Do pre-trained deep learning models improve computer-aided classification of digital mammograms?

    Science.gov (United States)

    Aboutalib, Sarah S.; Mohamed, Aly A.; Zuley, Margarita L.; Berg, Wendie A.; Luo, Yahong; Wu, Shandong

    2018-02-01

    Digital mammography screening is an important exam for the early detection of breast cancer and reduction in mortality. False positives leading to high recall rates, however, results in unnecessary negative consequences to patients and health care systems. In order to better aid radiologists, computer-aided tools can be utilized to improve distinction between image classifications and thus potentially reduce false recalls. The emergence of deep learning has shown promising results in the area of biomedical imaging data analysis. This study aimed to investigate deep learning and transfer learning methods that can improve digital mammography classification performance. In particular, we evaluated the effect of pre-training deep learning models with other imaging datasets in order to boost classification performance on a digital mammography dataset. Two types of datasets were used for pre-training: (1) a digitized film mammography dataset, and (2) a very large non-medical imaging dataset. By using either of these datasets to pre-train the network initially, and then fine-tuning with the digital mammography dataset, we found an increase in overall classification performance in comparison to a model without pre-training, with the very large non-medical dataset performing the best in improving the classification accuracy.

  3. MO-E-217A-01: Contrast-Enhanced Spectral Mammography - Physical Aspects and QA.

    Science.gov (United States)

    Yaffe, M; Hill, M

    2012-06-01

    To describe the current state of dual energy contrast-enhanced digital mammography, to discuss those aspects of its operation that require evaluation or monitoring and to propose elements of a program for quality assurance of such systems. The principles of dual-energy contrast imaging will be discussed and tools and techniques for assessment of performance will be described. Many of the elements affecting image quality and dose performance in digital mammography (eg noise, system linearity, consistency of x-ray output and detector performance, artifacts) remain important. In addition, the ability to register images can influence the resultant image quality. The maintenance of breast compression thickness during the imaging procedure and calibration of the system to allow quantification of iodine in the breast represent new challenges to quality assurance. CESM provides a means of acquiring new information regarding tumor angiogenesis and may reveal some cancers that will not be detectable on digital mammography. It may also better demonstrate the extent of disease. The medical physicist must understand the dependence of image quality on physical factors. Implementation of a relevant QA program will be required if the promise of this new modality is to be delivered. © 2012 American Association of Physicists in Medicine.

  4. 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.

  5. Image Quality and Radiation Dose Assessment of a Digital Mammography System

    International Nuclear Information System (INIS)

    Isa, N. M.; Hassan, W. M. S. W.; Abdullah, W. A. K. W.; Othman, F.; Ramli, A. A. M.

    2010-01-01

    Image quality and radiation dose of a direct amorphous selenium digital mammography system were considered in terms of contrast to noise ratio (CNR) and average glandular dose (AGD). They were measured for various qualities and breast phantom thicknesses with different types of breast tissue composition to determine optimal radiation quality and dose. Three sets of breast tissue equivalent slabs (30%:70%, 50%:50% and 70%:30% glandular-adipose) with thickness of 2 cm to 7 cm and 0.2 mm aluminum foil were used to provide certain CNR. Two different combinations of anode/ilter material and a wide range of tube voltages were employed for each phantom thickness. Phantom images with grid were acquired using automatic exposure control (AEC) mode for each thickness. Phantom images without grid were also obtained in manual exposure mode by selecting the same anode/filter combination and kVp as the image obtained with grid at the same thickness, but varying mAs of 10 to 200 mAs. Optimization indicated that relatively high energy beam qualities should be used with a greater dose to compensate for lower energy x-rays. The results also indicate that current AEC setting for a fixed detector is not optimal.

  6. Patient exposure during plain radiography and mammography in Japan in 1974-2014

    International Nuclear Information System (INIS)

    Matsunaga, Yuta; Kawaguchi, Ai; Kobayashi, Kenichi; Kobayashi, Masanao; Asada, Yasuki; Minami, Kazuyuki; Suzuki, Shoichi; Chida, Koichi

    2017-01-01

    We investigated changes in the entrance skin dose (ESD) and the mean glandular dose (MGD) during plain radiography or mammography in Japan from 1974 to 2014. Surveys regarding the conditions used for plain radiography and mammography were performed throughout Japan in 1974, 1979, 1989, 1993, 1997, 2001, 2003, 2007, 2011 and 2014. The anatomical regions considered were categorised as follows: skull anteroposterior (AP), lumbar AP, lumbar lateral (LAT), pelvis (AP), ankle, chest posteroanterior (PA), Guthmann (lateral pelviography for pregnant women), infant hip joint and mammography. The doses for all anatomical regions decreased from 1974 to 1993. The MGD for mammography remained low from 1993 to 2014, and the ESDs for chest (PA) radiography trended upward. After the 2000's, the use of digital imaging increased in Japan. This is the first long-term study to examine changes in ESDs and MGDs in Japan. (authors)

  7. Image processing can cause some malignant soft-tissue lesions to be missed in digital mammography images.

    Science.gov (United States)

    Warren, L M; Halling-Brown, M D; Looney, P T; Dance, D R; Wallis, M G; Given-Wilson, R M; Wilkinson, L; McAvinchey, R; Young, K C

    2017-09-01

    To investigate the effect of image processing on cancer detection in mammography. An observer study was performed using 349 digital mammography images of women with normal breasts, calcification clusters, or soft-tissue lesions including 191 subtle cancers. Images underwent two types of processing: FlavourA (standard) and FlavourB (added enhancement). Six observers located features in the breast they suspected to be cancerous (4,188 observations). Data were analysed using jackknife alternative free-response receiver operating characteristic (JAFROC) analysis. Characteristics of the cancers detected with each image processing type were investigated. For calcifications, the JAFROC figure of merit (FOM) was equal to 0.86 for both types of image processing. For soft-tissue lesions, the JAFROC FOM were better for FlavourA (0.81) than FlavourB (0.78); this difference was significant (p=0.001). Using FlavourA a greater number of cancers of all grades and sizes were detected than with FlavourB. FlavourA improved soft-tissue lesion detection in denser breasts (p=0.04 when volumetric density was over 7.5%) CONCLUSIONS: The detection of malignant soft-tissue lesions (which were primarily invasive) was significantly better with FlavourA than FlavourB image processing. This is despite FlavourB having a higher contrast appearance often preferred by radiologists. It is important that clinical choice of image processing is based on objective measures. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Melissa A. Durand

    2018-04-01

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

  9. Design and application of a structured phantom for detection performance comparison between breast tomosynthesis and digital mammography

    Science.gov (United States)

    Cockmartin, L.; Marshall, N. W.; Zhang, G.; Lemmens, K.; Shaheen, E.; Van Ongeval, C.; Fredenberg, E.; Dance, D. R.; Salvagnini, E.; Michielsen, K.; Bosmans, H.

    2017-02-01

    This paper introduces and applies a structured phantom with inserted target objects for the comparison of detection performance of digital breast tomosynthesis (DBT) against 2D full field digital mammography (FFDM). The phantom consists of a 48 mm thick breast-shaped polymethyl methacrylate (PMMA) container filled with water and PMMA spheres of different diameters. Three-dimensionally (3D) printed spiculated masses (diameter range: 3.8-9.7 mm) and non-spiculated masses (1.6-6.2 mm) along with microcalcifications (90-250 µm) were inserted as targets. Reproducibility of the phantom application was studied on a single system using 30 acquisitions. Next, the phantom was evaluated on five different combined FFDM & DBT systems and target detection was compared for FFDM and DBT modes. Ten phantom images in both FFDM and DBT modes were acquired on these 5 systems using automatic exposure control. Five readers evaluated target detectability. Images were read with the four-alternative forced-choice (4-AFC) paradigm, with always one segment including a target and 3 normal background segments. The percentage of correct responses (PC) was assessed based on 10 trials of each reader for each object type, size and imaging modality. Additionally, detection threshold diameters at 62.5 PC were assessed via non-linear regression fitting of the psychometric curve. The reproducibility study showed no significant differences in PC values. Evaluation of target detection in FFDM showed that microcalcification detection thresholds ranged between 110 and 118 µm and were similar compared to the detection in DBT (range of 106-158 µm). In DBT, detection of both mass types increased significantly (p  =  0.0001 and p  =  0.0002 for non-spiculated and spiculated masses respectively) compared to FFDM, achieving almost 100% detection for all spiculated mass diameters. In conclusion, a structured phantom with inserted targets was able to show evidence for detectability

  10. Ultra-Fast Image Reconstruction of Tomosynthesis Mammography Using GPU.

    Science.gov (United States)

    Arefan, D; Talebpour, A; Ahmadinejhad, N; Kamali Asl, A

    2015-06-01

    Digital Breast Tomosynthesis (DBT) is a technology that creates three dimensional (3D) images of breast tissue. Tomosynthesis mammography detects lesions that are not detectable with other imaging systems. If image reconstruction time is in the order of seconds, we can use Tomosynthesis systems to perform Tomosynthesis-guided Interventional procedures. This research has been designed to study ultra-fast image reconstruction technique for Tomosynthesis Mammography systems using Graphics Processing Unit (GPU). At first, projections of Tomosynthesis mammography have been simulated. In order to produce Tomosynthesis projections, it has been designed a 3D breast phantom from empirical data. It is based on MRI data in its natural form. Then, projections have been created from 3D breast phantom. The image reconstruction algorithm based on FBP was programmed with C++ language in two methods using central processing unit (CPU) card and the Graphics Processing Unit (GPU). It calculated the time of image reconstruction in two kinds of programming (using CPU and GPU).

  11. Ultra-Fast Image Reconstruction of Tomosynthesis Mammography Using GPU

    Directory of Open Access Journals (Sweden)

    Arefan D

    2015-06-01

    Full Text Available Digital Breast Tomosynthesis (DBT is a technology that creates three dimensional (3D images of breast tissue. Tomosynthesis mammography detects lesions that are not detectable with other imaging systems. If image reconstruction time is in the order of seconds, we can use Tomosynthesis systems to perform Tomosynthesis-guided Interventional procedures. This research has been designed to study ultra-fast image reconstruction technique for Tomosynthesis Mammography systems using Graphics Processing Unit (GPU. At first, projections of Tomosynthesis mammography have been simulated. In order to produce Tomosynthesis projections, it has been designed a 3D breast phantom from empirical data. It is based on MRI data in its natural form. Then, projections have been created from 3D breast phantom. The image reconstruction algorithm based on FBP was programmed with C++ language in two methods using central processing unit (CPU card and the Graphics Processing Unit (GPU. It calculated the time of image reconstruction in two kinds of programming (using CPU and GPU.

  12. Visibility of microcalcification clusters and masses in breast tomosynthesis image volumes and digital mammography: A 4AFC human observer study

    International Nuclear Information System (INIS)

    Timberg, P.; Baath, M.; Andersson, I.; Mattsson, S.; Tingberg, A.; Ruschin, M.

    2012-01-01

    Purpose: To investigate the visibility of simulated lesions in digital breast tomosynthesis (BT) image volumes compared with 2D digital mammography (DM). Methods: Simulated lesions (masses and microcalcifications) were added to images of the same women acquired on a DM system (Mammomat Novation, Siemens) and a BT prototype. The same beam quality was used for the DM and BT acquisitions. The total absorbed dose resulting from a 25-projection BT acquisition and reconstruction (BT 25 ) was approximately twice that of a single DM view. By excluding every other projection image from the reconstruction (BT 13 ), approximately the same dose as in DM was effected. Simulated microcalcifications were digitally added with varying contrast to the DM and BT images. Simulated masses with 8 mm diameter were also added to BT images. A series of 4-alternative forced choice (4AFC) human observer experiments were conducted. Four medical physicists participated in all experiments, each consisting of 60 trials per experimental condition. The observers interpreted the BT image volumes in cine-mode at a fixed image sequence speed. The required threshold contrast (S t ) to achieve a detectability index (d') of 2.5 (i.e., 92.5% correct decisions) was determined. Results: The S t for mass detection in DM was approximately a factor of 2 higher than required in BT indicating that the detection of masses was improved under BT conditions compared to DM. S t for microcalcification detection was higher for BT than for DM at both BT dose levels (BT 25 and BT 13 ), with a statistically significant difference in S t between DM and BT 13 . These results indicate a dose-dependent decrease in detection performance in BT for detection of microcalcifications. Conclusions: In agreement with previous investigations, masses of size 8 mm can be detected with less contrast in BT than in DM indicating improved detection performance for BT. However, for the investigated microcalcifications, the results of this

  13. 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

  14. 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)

  15. Preliminary results for positron emission mammography: real-time functional breast imaging in a conventional mammography gantry

    International Nuclear Information System (INIS)

    Weinberg, I.; Majewski, S.; Weisenberger, A.; Markowitz, A.; Aloj, L.; Majewski, L,; Danforth, D.; Mulshine, J.; Cowan, K.; Zujewski, J.; Chow, C.; Jones, E.; Chang, V.; Berg, W.; Frank, J.

    1996-01-01

    In order to optimally integrate radiotracer breast imaging within the breast clinic, anatomy and pathology should be easily correlated with functional nuclear medicine breast images. As a first step in the development of a hybrid functional/anatomic breast imaging platform with biopsy capability, a conventional X-ray mammography gantry was modified to image the compressed brest with positron emitters. Phantom studies with the positron emission mammography (PEM) device showed that a 1-cc hot spot could be detected within 5 min. A preliminary clinical trial demonstrated in vivo visualization of primary breast cancer within 4 min. For sites where positron-emitting radionuclides are available, PEM promises to achieve low-cost directed functional examination of breast abnormalities, with potential for achieving X-ray correlation and image-guided biopsy. (orig.)

  16. Digital Breast Tomosynthesis with Synthesized Two-Dimensional Images versus Full-Field Digital Mammography for Population Screening: Outcomes from the Verona Screening Program.

    Science.gov (United States)

    Caumo, Francesca; Zorzi, Manuel; Brunelli, Silvia; Romanucci, Giovanna; Rella, Rossella; Cugola, Loredana; Bricolo, Paola; Fedato, Chiara; Montemezzi, Stefania; Houssami, Nehmat

    2018-04-01

    Purpose To examine the outcomes of a breast cancer screening program based on digital breast tomosynthesis (DBT) plus synthesized two-dimensional (2D) mammography compared with those after full-field digital mammography (FFDM). Materials and Methods This prospective study included 16 666 asymptomatic women aged 50-69 years who were recruited in April 2015 through March 2016 for DBT plus synthetic 2D screening in the Verona screening program. A comparison cohort of women screened with FFDM (n = 14 423) in the previous year was included. Screening detection measures for the two groups were compared by calculating the proportions associated with each outcome, and the relative rates (RRs) were estimated with multivariate logistic regression. Results Cancer detection rate (CDR) for DBT plus synthetic 2D imaging was 9.30 per 1000 screening examinations versus 5.41 per 1000 screening examinations with FFDM (RR, 1.72; 95% confidence interval [CI]: 1.30, 2.29). CDR was significantly higher in patients screened with DBT plus synthetic 2D imaging than in those screened with FFDM among women classified as having low breast density (RR, 1.53; 95% CI: 1.13, 2.10) or high breast density (RR, 2.86; 95% CI: 1.42, 6.25). The positive predictive value (PPV) for recall was almost doubled with DBT plus synthetic 2D imaging: 23.3% versus 12.9% of recalled patients who were screened with FFDM (RR, 1.81; 95% CI: 1.34, 2.47). The recall rate was similar between groups (RR, 0.95; 95% CI: 0.84, 1.06), whereas the recall rate with invasive assessment was higher for DBT plus synthetic 2D imaging than for FFDM (RR, 1.93; 95% CI: 1.31, 2.03). The mean number of screening studies interpreted per hour was significantly lower for screening examinations performed with DBT plus synthetic 2D imaging (38.5 screens per hour) than with FFDM (60 screens per hour) (P < .001). Conclusion DBT plus synthetic 2D imaging increases CDRs with recall rates comparable to those of FFDM. DBT plus synthetic 2D imaging

  17. High-Speed Data Acquisition and Digital Signal Processing System for PET Imaging Techniques Applied to Mammography

    Science.gov (United States)

    Martinez, J. D.; Benlloch, J. M.; Cerda, J.; Lerche, Ch. W.; Pavon, N.; Sebastia, A.

    2004-06-01

    This paper is framed into the Positron Emission Mammography (PEM) project, whose aim is to develop an innovative gamma ray sensor for early breast cancer diagnosis. Currently, breast cancer is detected using low-energy X-ray screening. However, functional imaging techniques such as PET/FDG could be employed to detect breast cancer and track disease changes with greater sensitivity. Furthermore, a small and less expensive PET camera can be utilized minimizing main problems of whole body PET. To accomplish these objectives, we are developing a new gamma ray sensor based on a newly released photodetector. However, a dedicated PEM detector requires an adequate data acquisition (DAQ) and processing system. The characterization of gamma events needs a free-running analog-to-digital converter (ADC) with sampling rates of more than 50 Ms/s and must achieve event count rates up to 10 MHz. Moreover, comprehensive data processing must be carried out to obtain event parameters necessary for performing the image reconstruction. A new generation digital signal processor (DSP) has been used to comply with these requirements. This device enables us to manage the DAQ system at up to 80 Ms/s and to execute intensive calculi over the detector signals. This paper describes our designed DAQ and processing architecture whose main features are: very high-speed data conversion, multichannel synchronized acquisition with zero dead time, a digital triggering scheme, and high throughput of data with an extensive optimization of the signal processing algorithms.

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

    International Nuclear Information System (INIS)

    Liu Jie; Liu Peifang; Zhang Lianlian; Ma Wenjuan

    2013-01-01

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

  19. Beyond the mammography debate: a moderate perspective.

    Science.gov (United States)

    Kaniklidis, C

    2015-06-01

    After some decades of contention, one can almost despair and conclude that (paraphrasing) "the mammography debate you will have with you always." Against that sentiment, in this review I argue, after reflecting on some of the major themes of this long-standing debate, that we must begin to move beyond the narrow borders of claim and counterclaim to seek consensus on what the balance of methodologically sound and critically appraised evidence demonstrates, and also to find overlooked underlying convergences; after acknowledging the reality of some residual and non-trivial harms from mammography, to promote effective strategies for harm mitigation; and to encourage deployment of new screening modalities that will render many of the issues and concerns in the debate obsolete. To these ends, I provide a sketch of what this looking forward and beyond the current debate might look like, leveraging advantages from abbreviated breast magnetic resonance imaging technologies (such as the ultrafast and twist protocols) and from digital breast tomosynthesis-also known as three-dimensional mammography. I also locate the debate within the broader context of mammography in the real world as it plays out not for the disputants, but for the stakeholders themselves: the screening-eligible patients and the physicians in the front lines who are charged with enabling both the acts of screening and the facts of screening at their maximally objective and patient-accessible levels to facilitate informed decisions.

  20. Sixty women a day examined with world-unique mammography system from Sectra. Breast disease centre in Sweden offers lowest radiation dose in the world

    CERN Multimedia

    2003-01-01

    "Sectra's digital mammography system, Sectra MicroDose Mammography(TM), has been used to examine more than 1,500 women in the Helsingborg Hospital mammography screening program. This was accomplished in the record time of two months in clinical operation. The system is now being used to examine more than sixty women every day" (1 page).

  1. 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

  2. [Follow-up of surgical biopsies in microcalcifications of the breast. Comparative analysis of patients submitted to mammography and digitalization of mammographic images].

    Science.gov (United States)

    Rulli, A; Cirocchi, R; Vento, A R; Naninato, P; Zanetti, A; Carli, L

    1997-01-01

    Improvements in the techniques of preoperative needle localization of nonpalpable breast lesions that have been detected at mammography, coupled with surgical biopsy of smaller volumes of breast tissue and the use of local anesthesia have produced a more aggressive attitude toward early biopsy of lesions that are suspected of malignancy. The authors report the follow-up in 92 cases, who underwent breast biopsy for microcalcifications with no palpable lesions. In 46 women the presence of microcalcifications was evaluated through a computerized instrument which allows digitalization of the image.

  3. Free software for performing physical analysis of systems for digital radiography and mammography

    Energy Technology Data Exchange (ETDEWEB)

    Donini, Bruno; Lanconelli, Nico, E-mail: nico.lanconelli@unibo.it [Alma Mater Studiorum, Department of Physics and Astronomy, University of Bologna, Bologna 40127 (Italy); Rivetti, Stefano [Fisica Medica, Ospedale di Sassuolo S.p.A., Sassuolo 41049 (Italy); Bertolini, Marco [Medical Physics Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia 42123 (Italy)

    2014-05-15

    Purpose: In this paper, the authors present a free software for assisting users in achieving the physical characterization of x-ray digital systems and image quality checks. Methods: The program was developed as a plugin of a well-known public-domain suite ImageJ. The software can assist users in calculating various physical parameters such as the response curve (also termed signal transfer property), modulation transfer function (MTF), noise power spectra (NPS), and detective quantum efficiency (DQE). It also includes the computation of some image quality checks: defective pixel analysis, uniformity, dark analysis, and lag. Results: The software was made available in 2009 and has been used during the last couple of years by many users who gave us valuable feedback for improving its usability. It was tested for achieving the physical characterization of several clinical systems for digital radiography and mammography. Various published papers made use of the outcomes of the plugin. Conclusions: This software is potentially beneficial to a variety of users: physicists working in hospitals, staff working in radiological departments, such as medical physicists, physicians, engineers. The plugin, together with a brief user manual, are freely available and can be found online ( http://www.medphys.it/downloads.htm ). With our plugin users can estimate all three most important parameters used for physical characterization (MTF, NPS, and also DQE). The plugin can run on any operating system equipped with ImageJ suite. The authors validated the software by comparing MTF and NPS curves on a common set of images with those obtained with other dedicated programs, achieving a very good agreement.

  4. Free software for performing physical analysis of systems for digital radiography and mammography.

    Science.gov (United States)

    Donini, Bruno; Rivetti, Stefano; Lanconelli, Nico; Bertolini, Marco

    2014-05-01

    In this paper, the authors present a free software for assisting users in achieving the physical characterization of x-ray digital systems and image quality checks. The program was developed as a plugin of a well-known public-domain suite ImageJ. The software can assist users in calculating various physical parameters such as the response curve (also termed signal transfer property), modulation transfer function (MTF), noise power spectra (NPS), and detective quantum efficiency (DQE). It also includes the computation of some image quality checks: defective pixel analysis, uniformity, dark analysis, and lag. The software was made available in 2009 and has been used during the last couple of years by many users who gave us valuable feedback for improving its usability. It was tested for achieving the physical characterization of several clinical systems for digital radiography and mammography. Various published papers made use of the outcomes of the plugin. This software is potentially beneficial to a variety of users: physicists working in hospitals, staff working in radiological departments, such as medical physicists, physicians, engineers. The plugin, together with a brief user manual, are freely available and can be found online (www.medphys.it/downloads.htm). With our plugin users can estimate all three most important parameters used for physical characterization (MTF, NPS, and also DQE). The plugin can run on any operating system equipped with ImageJ suite. The authors validated the software by comparing MTF and NPS curves on a common set of images with those obtained with other dedicated programs, achieving a very good agreement.

  5. State-wide provision of a digital mammography physics service : challenges and learning experiences

    International Nuclear Information System (INIS)

    Diffey, J.L.; Cartwright, L.E.; Collins, L.T.; Grewal, R.K.

    2010-01-01

    Full text: Breast Screen NSW is a fully digital screening programme with 70 mammographic units from eight vendors. We present the challenges and learning experiences associated with providing the physics service to this extensive screening programme. The EPA requires an annual check of Mean Glandular Dose and registration renewal every 2 years. Additionally, BreastScreen NSW requires annual compliance testing to RANZCR standards. To ensure that testing is carried out to a consistently high level, the contract specifies that only five physicists in the state are eligible to test the equipment. An equipment database has been developed to enable us to meet these deadlines. We have also created a radiog rapher QC manual. Two physicists take responsibility for the overall co-ordination of the service, reviewing reports and test methodology of other physics providers. The database has greatly improved the system for meeting deadlines; visits to all sites revealed that many were overdue. The radiographer QC manual has been accompanied by practical tutorials and has been successful in improving understanding of digital mam mography and ensuring consistency in testing. This has been a particular challenge because equipment has been supplied by a number of vendors, with a range of detector technology. The number of mammography units, combined with the range of vendor technology and frequency of testing has presented a challenge to both physicists and radiographers. It has been extremely beneficial to have two dedicated physicists in place to co-ordinate the service and ensure that the demands of the contract are met.

  6. Free software for performing physical analysis of systems for digital radiography and mammography

    International Nuclear Information System (INIS)

    Donini, Bruno; Lanconelli, Nico; Rivetti, Stefano; Bertolini, Marco

    2014-01-01

    Purpose: In this paper, the authors present a free software for assisting users in achieving the physical characterization of x-ray digital systems and image quality checks. Methods: The program was developed as a plugin of a well-known public-domain suite ImageJ. The software can assist users in calculating various physical parameters such as the response curve (also termed signal transfer property), modulation transfer function (MTF), noise power spectra (NPS), and detective quantum efficiency (DQE). It also includes the computation of some image quality checks: defective pixel analysis, uniformity, dark analysis, and lag. Results: The software was made available in 2009 and has been used during the last couple of years by many users who gave us valuable feedback for improving its usability. It was tested for achieving the physical characterization of several clinical systems for digital radiography and mammography. Various published papers made use of the outcomes of the plugin. Conclusions: This software is potentially beneficial to a variety of users: physicists working in hospitals, staff working in radiological departments, such as medical physicists, physicians, engineers. The plugin, together with a brief user manual, are freely available and can be found online ( http://www.medphys.it/downloads.htm ). With our plugin users can estimate all three most important parameters used for physical characterization (MTF, NPS, and also DQE). The plugin can run on any operating system equipped with ImageJ suite. The authors validated the software by comparing MTF and NPS curves on a common set of images with those obtained with other dedicated programs, achieving a very good agreement

  7. Monte Carlo derivation of filtered tungsten anode X-ray spectra for dose computation in digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Paixao, L.; Oliveira, B. B.; Nogueira, M. do S. [Centro de Desenvolvimento da Tecnologia Nuclear, Post-graduation in Science and Technology of Radiations, Minerals and Materials, Pte. Antonio Carlos 6.627, Pampulha, 31270-901 Belo Horizonte (Brazil); Viloria, C. [UFMG, Departamento de Engenharia Nuclear, Post-graduation in Nuclear Sciences and Techniques, Pte. Antonio Carlos 6.627, Pampulha, 31270-901 Belo Horizonte (Brazil); Alves de O, M. [UFMG, Department of Anatomy and Imaging, Prof. Alfredo Balena 190, 30130-100 Belo Horizonte (Brazil); Araujo T, M. H., E-mail: lpr@cdtn.br [Dr Maria Helena Araujo Teixeira Clinic, Guajajaras 40, 30180-100 Belo Horizonte (Brazil)

    2014-08-15

    It is widely accepted that the mean glandular dose (D{sub G}) for the glandular tissue is the more useful magnitude for characterizing the breast cancer risk. The procedure to estimate the D{sub G}, for being difficult to measure it directly in the breast, it is to make the use of conversion factors that relate incident air kerma (K{sub i}) at this dose. Generally, the conversion factors vary with the x-ray spectrum half-value layer and the breast composition and thickness. Several authors through computer simulations have calculated such factors by the Monte Carlo (Mc) method. Many spectral models for D{sub G} computer simulations purposes are available in the diagnostic range. One of the models available generates unfiltered spectra. In this work, the Monte Carlo EGSnrc code package with the C++ class library (eg spp) was employed to derive filtered tungsten x-ray spectra used in digital mammography systems. Filtered spectra for rhodium and aluminium filters were obtained for tube potentials between 26 and 32 kV. The half-value layer of simulated filtered spectra were compared with those obtained experimentally with a solid state detector Unfors model 8202031-H Xi R/F and Mam Detector Platinum and 8201023-C Xi Base unit Platinum Plus w m As in a Hologic Selenia Dimensions system using a Direct Radiography mode. Calculated half-value layer values showed good agreement compared to those obtained experimentally. These results show that the filtered tungsten anode x-ray spectra and the EGSnrc Mc code can be used for D{sub G} determination in mammography. (Author)

  8. Monte Carlo derivation of filtered tungsten anode X-ray spectra for dose computation in digital mammography

    International Nuclear Information System (INIS)

    Paixao, L.; Oliveira, B. B.; Nogueira, M. do S.; Viloria, C.; Alves de O, M.; Araujo T, M. H.

    2014-08-01

    It is widely accepted that the mean glandular dose (D G ) for the glandular tissue is the more useful magnitude for characterizing the breast cancer risk. The procedure to estimate the D G , for being difficult to measure it directly in the breast, it is to make the use of conversion factors that relate incident air kerma (K i ) at this dose. Generally, the conversion factors vary with the x-ray spectrum half-value layer and the breast composition and thickness. Several authors through computer simulations have calculated such factors by the Monte Carlo (Mc) method. Many spectral models for D G computer simulations purposes are available in the diagnostic range. One of the models available generates unfiltered spectra. In this work, the Monte Carlo EGSnrc code package with the C++ class library (eg spp) was employed to derive filtered tungsten x-ray spectra used in digital mammography systems. Filtered spectra for rhodium and aluminium filters were obtained for tube potentials between 26 and 32 kV. The half-value layer of simulated filtered spectra were compared with those obtained experimentally with a solid state detector Unfors model 8202031-H Xi R/F and Mam Detector Platinum and 8201023-C Xi Base unit Platinum Plus w m As in a Hologic Selenia Dimensions system using a Direct Radiography mode. Calculated half-value layer values showed good agreement compared to those obtained experimentally. These results show that the filtered tungsten anode x-ray spectra and the EGSnrc Mc code can be used for D G determination in mammography. (Author)

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

    Science.gov (United States)

    Liang, Zhigang; Du, Xiangying; Guo, Xiaojuan; Rong, Dongdong; Kang, Ruiying; Mao, Guangyun; Liu, Jiabin; Li, Kuncheng

    2010-04-01

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

  10. Digital pathology in nephrology clinical trials, research, and pathology practice.

    Science.gov (United States)

    Barisoni, Laura; Hodgin, Jeffrey B

    2017-11-01

    In this review, we will discuss (i) how the recent advancements in digital technology and computational engineering are currently applied to nephropathology in the setting of clinical research, trials, and practice; (ii) the benefits of the new digital environment; (iii) how recognizing its challenges provides opportunities for transformation; and (iv) nephropathology in the upcoming era of kidney precision and predictive medicine. Recent studies highlighted how new standardized protocols facilitate the harmonization of digital pathology database infrastructure and morphologic, morphometric, and computer-aided quantitative analyses. Digital pathology enables robust protocols for clinical trials and research, with the potential to identify previously underused or unrecognized clinically useful parameters. The integration of digital pathology with molecular signatures is leading the way to establishing clinically relevant morpho-omic taxonomies of renal diseases. The introduction of digital pathology in clinical research and trials, and the progressive implementation of the modern software ecosystem, opens opportunities for the development of new predictive diagnostic paradigms and computer-aided algorithms, transforming the practice of renal disease into a modern computational science.

  11. Development of techniques and methods for evaluation of quality of scanned image in mammography

    International Nuclear Information System (INIS)

    Carmo Santana, P. do; Nogueira, M.S.

    2008-01-01

    Cancer is the second cause of death in the Brazilian female population and breast cancer is the most frequent neoplasm amongst women. Mammography is an essential tool for diagnosis and early detection of this disease. In order to be effective, the mammography must be of good quality. The Brazilian College of Radiology (CBR), the National Agency for Health Surveillance (ANVISA) and international bodies recommend standards of practice for mammography. Due to the risk of ionizing radiation, techniques that minimize dose and optimize image quality are essential to ensure that all women are submitted to mammography procedures of high quality for the detection of breast cancer. In this research were analyzed components of the image treatment via digital and developed methods and techniques of analysis aiming the detection of structures for medical diagnosis, decreasing variations due to subjectivity. It used free software Image J, to make the evaluations of the information contained in the scanned images. We use the scanned images of calibration of a simulated breast to calibrate the program Image J. Thus, it was able to correctly convert the values of the scale of shades of gray in optical density values of presenting the standard deviation for each measure held. Applying the test t-student noticed that the values obtained with the digital system to the level of contrast and spatial resolution are consistent with the results obtained so subjective, since there was no significant difference (p <0.05) for all comparisons evaluated. Since then, this methodology is recommended in routine evaluations of services of mammography. (author)

  12. Statistical methods for determining the effect of mammography screening

    DEFF Research Database (Denmark)

    Lophaven, Søren

    2016-01-01

    In an overview of five randomised controlled trials from Sweden, a reduction of 29% was found in breast cancer mortality in women aged 50-69 at randomisation after a follow up of 5-13 years. Organised, population based, mammography service screening was introduced on the basis of these resultsin...... in 2007-2008. Women aged 50-69 were invited to screening every second year. Taking advantage of the registers of population and health, we present statistical methods for evaluating the effect of mammography screening on breast cancer mortality (Olsen et al. 2005, Njor et al. 2015 and Weedon-Fekjær etal...

  13. Description and dosimetry estimation of spectral mammography with enhancement of contrast-Hospital Universitario Virgen de Valme; Descripcion y estimacion dosimetrica de la mamografia espectral con realce de contraste-Hospital Universitario Virge de Valme

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Castillo, M.; Almansa Lopez, J.; Roman Collado, J. R.; Rubio Rubio, F.; Escobar Casas, P.; Aznar Mendez, R.

    2013-07-01

    It has been implanted a complementary technique to conventional detection of breast cancer (digital mammography, ultrasound, magnetic resonance) with only an increase of 1.2 times the dose given in a standard digital mammography and with undeniable advantages: -Immediate implementation, without added time a standard digital mammography (in less than 10 minutes are made standard mammographic projections ). -With the ability to discover hidden injuries (by heterogeneities, density,...) in a conventional mammogram. -Being possible in those cases where the RM in unfeasible (in addition to more face time and money). (Author)

  14. Valorization procedure of x-ray equipment in the mammography equipment

    International Nuclear Information System (INIS)

    Ruiz, M. A.; Ordonez, J.; Antolin, E.; Andres, J. C. de; Gonzalez, I.; Arranz, L.; Sastre, J. M.; Ferrer, N.

    2006-01-01

    The Ramon y Cajal Hospital mammography service has three X-rays units, two of them with high resolution computed radiography (CR) system and one with flat-panel (FP)-based full-field digital mammography system. Periodic control dose tests in patients have shown lower glandular dose levels (DGM) than references provided by European Protocol for de Quality Control of de Physical and Technical Aspects of Mammography Screening. In this work, we have tried to establish an easy method for DGM calculation which is representative of the three equipment results. For this aim, we have defined an index which is measured along the time like a reference point. This index is defined as the relation between the blind test punctuations of a standard phantom image given by at least three radiologists in the Unit, and the average DGM values obtained in 20 patients in each Unit (using random thickness and random mama composition). (Author)

  15. 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.

  16. Patient dose in digital mammography

    International Nuclear Information System (INIS)

    Chevalier, Margarita; Moran, Pilar; Ten, Jose I.; Fernandez Soto, Jose M.; Cepeda, T.; Vano, Eliseo

    2004-01-01

    In the present investigation, we analyze the dose of 5034 patients (20 137 images) who underwent mammographic examinations with a full-field digital mammography system. Also, we evaluate the system calibration by analyzing the exposure factors as a function of breast thickness. The information relevant to this study has been extracted from the image DICOM header and stored in a database during a 3-year period (March 2001-October 2003). Patient data included age, breast thickness, kVp, mAs, target/filter combination, and nominal dose values. Entrance surface air kerma (ESAK) without backscatter was calculated from the tube output as measured for each voltage used under clinical conditions and from the tube loading (mAs) included in the DICOM header. Mean values for the patient age and compressed breast thickness were 56 years (SD: 11) and 52 mm (SD: 13), respectively. The majority of the images was acquired using the STD (for standard) automatic mode (98%). The most frequent target/filter combination automatically selected for breast smaller than 35 mm was Mo/Mo (75%); for intermediate thicknesses between 35 and 65 mm, the combinations were Mo/Rh (54%) and Rh/Rh (38.5%); Rh/Rh was the combination selected for 91% of the cases for breasts thicker than 65 mm. A wide kVp range was observed for each target/filter combination. The most frequent values were 28 kVp for Mo/Mo, 29 kVp for Mo/Rh, and 29 and 30 kV for Rh/Rh. Exposure times ranged from 0.2 to 4.2 s with a mean value of 1.1 s. Average glandular doses (AGD) per exposure were calculated by multiplying the ESAK values by the conversion factors tabulated by Dance for women in the age groups 50 to 64 and 40 to 49. This approach is based on the dependence of breast glandularity on breast thickness and age. The total mean average glandular dose (AGD T ) was calculated by summing the values associated with the pre-exposure and with the main exposure. Mean AGD T per exposure was 1.88 mGy (CI 0.01) and the mean AGD T per

  17. Solid-state dosimeters: A new approach for mammography measurements

    International Nuclear Information System (INIS)

    Brateman, Libby F.; Heintz, Philip H.

    2015-01-01

    Purpose: To compare responses of modern commercially available solid-state dosimeters (SStDs) used in mammography medical physics surveys for two major vendors of current digital mammography units. To compare differences in dose estimates among SStD responses with ionization chamber (IC) measurements for several target/filter (TF) combinations and report their characteristics. To review scientific bases for measurements of quantities required for mammography for traditional measurement procedures and SStDs. Methods: SStDs designed for use with modern digital mammography units were acquired for evaluation from four manufacturers. Each instrument was evaluated under similar conditions with the available mammography beams provided by two modern full-field digital mammography units in clinical use: a GE Healthcare Senographe Essential (Essential) and a Hologic Selenia Dimensions 5000 (Dimensions), with TFs of Mo/Mo, Mo/Rh; and Rh/Rh and W/Rh, W/Ag, and W/Al, respectively. Measurements were compared among the instruments for the TFs over their respective clinical ranges of peak tube potentials for kVp and half-value layer (HVL) measurements. Comparisons for air kerma (AK) and their associated relative calculated average glandular doses (AGDs), i.e., using fixed mAs, were evaluated over the limited range of 28–30 kVp. Measurements were compared with reference IC measurements for AK, reference HVLs and calculated AGD, for two compression paddle heights for AK, to evaluate scatter effects from compression paddles. SStDs may require different positioning from current mammography measurement protocols. Results: Measurements of kVp were accurate in general for the SStDs (within −1.2 and +1.1 kVp) for all instruments over a wide range of set kVp’s and TFs and most accurate for Mo/Mo and W/Rh. Discrepancies between measurements and reference values were greater for HVL and AK. Measured HVL values differed from reference values by −6.5% to +3.5% depending on the SStD and

  18. Preliminary evaluation of a prototype stereoscopic a-Si:H-based X-ray imaging system for full-field digital mammography

    International Nuclear Information System (INIS)

    Darambara, D.G.; Speller, R.D.; Horrocks, J.A.; Godber, S.; Wilson, R.; Hanby, A.

    2001-01-01

    In a pre-clinical study, we have been investigating the potential of a-Si:H active matrix, flat panel imagers for X-ray full-field digital mammography through the development of an advanced 3D X-ray imaging system and have measured a number of their important imaging characteristics. To enhance the information embodied into the digital images produced by the a-Si array, stereoscopic images, created by viewing the object under examination from two angles and recombining the images, were obtained. This method provided us with a full 3D X-ray image of the test object as well as left and right perspective 2D images all at the same time. Within this scope, images of fresh, small human breast tissue specimens--normal and diseased--were obtained at ±2 deg., processed and stereoscopically displayed for a pre-clinical evaluation by radiologists. It was demonstrated that the stereoscopic presentation of the images provides important additional information and has potential benefits over the more traditional 2D data

  19. Digital Breast Tomosynthesis: State of the Art

    Science.gov (United States)

    Vedantham, Srinivasan; Vijayaraghavan, Gopal R.; Kopans, Daniel B.

    2015-01-01

    This topical review on digital breast tomosynthesis (DBT) is provided with the intent of describing the state of the art in terms of technology, results from recent clinical studies, advanced applications, and ongoing efforts to develop multimodality imaging systems that include DBT. Particular emphasis is placed on clinical studies. The observations of increase in cancer detection rates, particularly for invasive cancers, and the reduction in false-positive rates with DBT in prospective trials indicate its benefit for breast cancer screening. Retrospective multireader multicase studies show either noninferiority or superiority of DBT compared with mammography. Methods to curtail radiation dose are of importance. © RSNA, 2015 PMID:26599926

  20. WE-DE-207B-08: Towards Standardization of X-Ray Filters in Digital Mammography-Enabled Breast Tomosynthesis Systems

    International Nuclear Information System (INIS)

    Shrestha, S; Vedantham, S; Karellas, A

    2016-01-01

    Purpose: In digital breast tomosynthesis (DBT) systems capable of digital mammography (DM), Al filters are used during DBT and K-edge filters during DM. The potential for standardizing the x-ray filters with Al, instead of K-edge filters, was investigated with intent to reduce exposure duration and to promote a simpler system design. Methods: Analytical computations of the half-value thickness (HVT) and the photon fluence per mAs (photons/mm2/mAs) for K-edge filters (50µm Rh; 50µm Ag) were compared with Al filters of varying thickness. Two strategies for matching the HVT from K-edge and Al filtered spectra were investigated: varying the kVp for fixed Al thickness, or varying the Al thickness at matched kVp. For both strategies, Al filters were an order of magnitude thicker than K-edge filters. Hence, Monte Carlo simulations were conducted with the GEANT4 toolkit to determine if the scatter-to-primary ratio (SPR) and the point spread function of scatter (scatter PSF) differed between Al and K-edge filters. Results: Results show the potential for replacing currently used Kedge filters with Al. For fixed Al thickness (700µm), ±1 kVp and +(1–3) kVp change, matched HVT of Rh and Ag filtered spectra. At matched kVp, Al thickness range (650,750)µm and (750,860)µm matched the HVT from Rh and Ag filtered spectra. Photon fluence/mAs with Al filters were 1.5–2.5 times higher, depending on kVp and Al thickness, compared to K-edge filters. Although Al thickness was an order higher than K-edge filters, neither the SPR nor the scatter PSF differed from K-edge filters. Conclusion: The use of Al filters for digital mammography is potentially feasible. The increased fluence/mAs with Al could decrease exposure duration for the combined DBT+DM exam and simplify system design. Effect of x-ray spectrum change due to Al filtration on radiation dose, signal, noise, contrast and related metrics are being investigated. Funding support: Supported in part by NIH R21CA176470 and R01

  1. WE-DE-207B-08: Towards Standardization of X-Ray Filters in Digital Mammography-Enabled Breast Tomosynthesis Systems

    Energy Technology Data Exchange (ETDEWEB)

    Shrestha, S; Vedantham, S; Karellas, A [University of Massachusetts Medical School, Worcester, MA (United States)

    2016-06-15

    Purpose: In digital breast tomosynthesis (DBT) systems capable of digital mammography (DM), Al filters are used during DBT and K-edge filters during DM. The potential for standardizing the x-ray filters with Al, instead of K-edge filters, was investigated with intent to reduce exposure duration and to promote a simpler system design. Methods: Analytical computations of the half-value thickness (HVT) and the photon fluence per mAs (photons/mm2/mAs) for K-edge filters (50µm Rh; 50µm Ag) were compared with Al filters of varying thickness. Two strategies for matching the HVT from K-edge and Al filtered spectra were investigated: varying the kVp for fixed Al thickness, or varying the Al thickness at matched kVp. For both strategies, Al filters were an order of magnitude thicker than K-edge filters. Hence, Monte Carlo simulations were conducted with the GEANT4 toolkit to determine if the scatter-to-primary ratio (SPR) and the point spread function of scatter (scatter PSF) differed between Al and K-edge filters. Results: Results show the potential for replacing currently used Kedge filters with Al. For fixed Al thickness (700µm), ±1 kVp and +(1–3) kVp change, matched HVT of Rh and Ag filtered spectra. At matched kVp, Al thickness range (650,750)µm and (750,860)µm matched the HVT from Rh and Ag filtered spectra. Photon fluence/mAs with Al filters were 1.5–2.5 times higher, depending on kVp and Al thickness, compared to K-edge filters. Although Al thickness was an order higher than K-edge filters, neither the SPR nor the scatter PSF differed from K-edge filters. Conclusion: The use of Al filters for digital mammography is potentially feasible. The increased fluence/mAs with Al could decrease exposure duration for the combined DBT+DM exam and simplify system design. Effect of x-ray spectrum change due to Al filtration on radiation dose, signal, noise, contrast and related metrics are being investigated. Funding support: Supported in part by NIH R21CA176470 and R01

  2. Mechanistic modeling for mammography screening risks

    International Nuclear Information System (INIS)

    Bijwaard, Harmen

    2008-01-01

    Full text: Western populations show a very high incidence of breast cancer and in many countries mammography screening programs have been set up for the early detection of these cancers. Through these programs large numbers of women (in the Netherlands, 700.000 per year) are exposed to low but not insignificant X-ray doses. ICRP based risk estimates indicate that the number of breast cancer casualties due to mammography screening can be as high as 50 in the Netherlands per year. The number of lives saved is estimated to be much higher, but for an accurate calculation of the benefits of screening a better estimate of these risks is indispensable. Here it is attempted to better quantify the radiological risks of mammography screening through the application of a biologically based model for breast tumor induction by X-rays. The model is applied to data obtained from the National Institutes of Health in the U.S. These concern epidemiological data of female TB patients who received high X-ray breast doses in the period 1930-1950 through frequent fluoroscopy of their lungs. The mechanistic model that is used to describe the increased breast cancer incidence is based on an earlier study by Moolgavkar et al. (1980), in which the natural background incidence of breast cancer was modeled. The model allows for a more sophisticated extrapolation of risks to the low dose X-ray exposures that are common in mammography screening and to the higher ages that are usually involved. Furthermore, it allows for risk transfer to other (non-western) populations. The results have implications for decisions on the frequency of screening, the number of mammograms taken at each screening, minimum and maximum ages for screening and the transfer to digital equipment. (author)

  3. A Survey On Mean Glandular Dose From Full-Field Digital Mammography Systems, Operate Using Mo/ Mo And W/Rh Target/ Filter Combinations

    International Nuclear Information System (INIS)

    Noriah Jamal; Siti Selina Abdul Hamid; Humairah Samad Cheung; Siti Kamariah Che Mohamed; Ellyda Muhammed Nordin; Radhiana Hassan; Rehir Dahalan

    2013-01-01

    We had conducted a survey on Mean Glandular Dose (MGD) from Full-Field Digital Mammography systems (FFDM) operate using Molybdenum/ Molybdenum (Mo/ Mo) and Tungsten/ Rhodium (W/ Rh) target/ filter combinations. A survey was carried out at two randomly selected mammography centres in Malaysia, namely National Cancer Society and International Islamic University of Malaysia. The first centre operates using a W/ Rh, while the second centre operates using an Mo/ Mo target/ filter combinations. On the basis of recorded information, data on mammographic views, MGD, age and Compressed Breast Thickness (CBT) were recorded for 100 patients, for each mammographic centre respectively. The MGD data were analyzed for variation with age group, with 5 years increment. The MGD data were also analyzed for variation with CBT, with 5 mm increment. We found that for both CC and MLO views, FFDM systems operated using Mo/ Mo and W/ Rh target/ filter combinations present the same trend on MGD. The average MGD decreases as age increases. While average MGD increases with the increasing of CBT. However, FFDM system operates using Mo/ Mo gives higher MGD as compared with FFDM system operates using W/ Rh. (author)

  4. 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

  5. Clinical evaluation of a mobile digital specimen radiography system for intraoperative specimen verification.

    Science.gov (United States)

    Wang, Yingbing; Ebuoma, Lilian; Saksena, Mansi; Liu, Bob; Specht, Michelle; Rafferty, Elizabeth

    2014-08-01

    Use of mobile digital specimen radiography systems expedites intraoperative verification of excised breast specimens. The purpose of this study was to evaluate the performance of a such a system for verifying targets. A retrospective review included 100 consecutive pairs of breast specimen radiographs. Specimens were imaged in the operating room with a mobile digital specimen radiography system and then with a conventional digital mammography system in the radiology department. Two expert reviewers independently scored each image for image quality on a 3-point scale and confidence in target visualization on a 5-point scale. A target was considered confidently verified only if both reviewers declared the target to be confidently detected. The 100 specimens contained a total of 174 targets, including 85 clips (49%), 53 calcifications (30%), 35 masses (20%), and one architectural distortion (1%). Although a significantly higher percentage of mobile digital specimen radiographs were considered poor quality by at least one reviewer (25%) compared with conventional digital mammograms (1%), 169 targets (97%), were confidently verified with mobile specimen radiography; 172 targets (98%) were verified with conventional digital mammography. Three faint masses were not confidently verified with mobile specimen radiography, and conventional digital mammography was needed for confirmation. One faint mass and one architectural distortion were not confidently verified with either method. Mobile digital specimen radiography allows high diagnostic confidence for verification of target excision in breast specimens across target types, despite lower image quality. Substituting this modality for conventional digital mammography can eliminate delays associated with specimen transport, potentially decreasing surgical duration and increasing operating room throughput.

  6. Evaluation of the image quality criteria and study of doses in a mammography department

    International Nuclear Information System (INIS)

    Alcantara, Marcela Costa

    2009-01-01

    The mammographic image quality criteria published by European Commission were implemented in three mammography equipment of a same radiology department in a hospital of Sao Paulo city. Among the mammography equipment, two use the screen-film system and one of them uses the indirect digital system. During the data collection, it was noted the need to conduct a study about image rejection in each mammography equipment. Therefore, this study was realized and, after that, the results in each mammography equipment of image rejection and image percentage that present each quality criterion it were compared. At the same time of this studies, it was realized other study about surface entrance dose and average glandular dose. These doses it was estimated based on different methods published by different groups of researcher, for all combinations anode filter available in the equipment. To estimate the surface entrance dose following the methodology published in Avenue's' guide and the average glandular dose following the Wu' methodology, it was developed a phantom, in different thicknesses of acrylic, to simulate a breast. Finally, the image quality it was associated with the dose received by patient. The digital equipment shows better results in the evaluation of quality criteria, lower rate of image rejection and lower values of average glandular dose and surface entrance dose in all methods studied. But it is not sufficient, because is not adequate for patients with great breast. (author)

  7. High-speed large angle mammography tomosynthesis system

    Science.gov (United States)

    Eberhard, Jeffrey W.; Staudinger, Paul; Smolenski, Joe; Ding, Jason; Schmitz, Andrea; McCoy, Julie; Rumsey, Michael; Al-Khalidy, Abdulrahman; Ross, William; Landberg, Cynthia E.; Claus, Bernhard E. H.; Carson, Paul; Goodsitt, Mitchell; Chan, Heang-Ping; Roubidoux, Marilyn; Thomas, Jerry A.; Osland, Jacqueline

    2006-03-01

    A new mammography tomosynthesis prototype system that acquires 21 projection images over a 60 degree angular range in approximately 8 seconds has been developed and characterized. Fast imaging sequences are facilitated by a high power tube and generator for faster delivery of the x-ray exposure and a high speed detector read-out. An enhanced a-Si/CsI flat panel digital detector provides greater DQE at low exposure, enabling tomo image sequence acquisitions at total patient dose levels between 150% and 200% of the dose of a standard mammographic view. For clinical scenarios where a single MLO tomographic acquisition per breast may replace the standard CC and MLO views, total tomosynthesis breast dose is comparable to or below the dose in standard mammography. The system supports co-registered acquisition of x-ray tomosynthesis and 3-D ultrasound data sets by incorporating an ultrasound transducer scanning system that flips into position above the compression paddle for the ultrasound exam. Initial images acquired with the system are presented.

  8. 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

  9. Acceptance testing in digital systens of mammography. Protocols applicability; Pruebas de aceptacion en equipos digitales de mamografia. Aplicabilidad de protocolos

    Energy Technology Data Exchange (ETDEWEB)

    Bermudez, R.; Espana, M.L.; Garcia Castanon, P.; Gomez Barrado, A.; Rodriguez Martin, G.; Fernandez Bedoya, B.

    2011-07-01

    Acceptance testing of mammographic imaging systems technical is the first approach in order to guarantee that mammograms will be achieved with the minimun radiation dose compatible with an image quality sutiable for diagnose purposes. The aim of this study is to assess the practical applicability of different protocols in acceptance test of digital mammographyc systems. This study has been carried out on the results of ltyhe acceptance tests of five flat panel digital mammographic systems. Parameters established in the systems technical specifications and those evaluated in the consulted protocols were tested. Due to the fact that the legislation oin our country does not demand to consider a specific protocol, the results obtained were also compared considering different existing protocols. Results show discrepancies between manufacturers limiting values and those established in the protocols. Some parameters, such as the authomatic exposure control compensation and the detector noise, were found out to meet or not the limiting value, depending on the selected protocol. From our results we could suggest, that protocols from manufacturers should be adapted to acknowledged documents on acceptance testing in digital mammography. They buyer representative could even specify the protocol to be followed during the acceptance tests. (Author). 25 refs.

  10. Acceptance testing in digital systems of mammography. Protocols applicability; Pruebas de aceptacion en equipos digitales de mamografia. Aplicabilidad de protocolos

    Energy Technology Data Exchange (ETDEWEB)

    Bermudez, R.; Espana, M.L.; Garcia Castanon, P.; Gomez Barrado, A.; Rodriguez Martin, G.; Fernandez Bedoya, B.

    2011-07-01

    Acceptance testing of mammographic imaging systems technical is the first approach in order to guarantee that mammograms will be achieved with the minimum radiation dose compatible with an image quality suitable for diagnose purposes. The aim of this study is to assess the practical applicability of different protocols in acceptance test of digital mammographic systems. This study has been carried out on the results of the acceptance tests of five flat panel digital mammographic systems. Parameters established in the systems technical specifications and those evaluated in the consulted protocols were tested. Due to the fact that the legislation in our country does not demand to consider a specific protocol, the results obtained were also compared considering different existing protocols. Results show discrepancies between manufacturers limiting values and those established in the protocols. Some parameters, such as the automatic exposure control compensation and the detector noise, were found out to meet or not the limiting value, depending on the selected protocol. From our results we could suggest, that protocols from manufacturers should be adapted to acknowledged documents on acceptance testing in digital mammography. They buyer representative could even specify the protocol to be followed during the acceptance tests. (Author). 25 refs.

  11. 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)

  12. A PET imaging system dedicated to mammography

    CERN Document Server

    Varela, J

    2007-01-01

    The imaging system Clear-PEM for positron emission mammography, under development within the framework of the Crystal Clear Collaboration at CERN, is presented. The detector is based on pixelized LYSO crystals optically coupled to avalanche photodiodes (APD) and readout by a fast low-noise electronic system. A dedicated digital trigger and data acquisition system is used for on-line selection of coincidence events with high efficiency, large bandwidth and negligible dead-time. The detector module performance was characterized in detail.

  13. Segmentation of the Breast Region in Digital Mammograms and Detection of Masses

    OpenAIRE

    Armen Sahakyan; Hakop Sarukhanyan

    2012-01-01

    The mammography is the most effective procedure for an early diagnosis of the breast cancer. Finding an accurate and efficient breast region segmentation technique still remains a challenging problem in digital mammography. In this paper we explore an automated technique for mammogram segmentation. The proposed algorithm uses morphological preprocessing algorithm in order to: remove digitization noises and separate background region from the breast profile region for further edge detection an...

  14. Measurement of the radiation dose and assessment of the risk in mammography screening for early detection of cancer of the breast, in Israel

    International Nuclear Information System (INIS)

    Broisman, A.; Schlesinger, T.; Alfassi, Z. B.

    2011-01-01

    The mean glandular doses to samples of women attending for mammographic screening are measured routinely at screening centres in Israel. As at present, no detailed and systematic data have been collected regarding the average glandular dose in mammography screening procedures carried out in Israel for the last 20 y. Especially data are lacking related to the glandular dose (GD) involved in mammography with the new digital mammography systems. In this work, partial results of the measurements are presented to asses the radiation dose to the breast and to the glandular tissue within the Israeli national mammography programme updated to year 2009. (authors)

  15. SU-E-I-45: Feasibility for Using Iodine Quantification to Assist Diagnosis in Dual Energy Contrast-Enhanced Digital Mammography

    International Nuclear Information System (INIS)

    Hwang, Y; Lin, Y; Tsai, C; Cheung, Y

    2015-01-01

    Purpose: The objective of this study is to develop quantitative calibration between image quality indexes and iodine concentration with dual-energy (DE) contrast-enhanced digital mammography (CEDM) techniques and further serve as the assistance for diagnosis. Methods: Custom-made acrylic phantom with dimensions of 24×30 cm 2 simulated breast thickness from 2 to 6 cm was used in the calibration. The phantom contained matrix of four times four holes of 3 mm deep with a diameter of 15 mm for filling contrast agent with area density ranged from 0.1 to 10 mg/cm 2 . All the image acquisitions were performed on a full-field digital mammography system (Senographe Essential, GE) with dual energy acquisitions. Mean pixel value (MPV), and contrast-to-noise ratio (CNR) were used for evaluating the relationship between image quality indexes and iodine concentration. Iodine map and CNR map could further be constructed with these calibration curves applied pixel by pixel utilized MATLAB software. Minimum iodine concentration could also be calculated with the visibility threshold of CNR=5 according the Rose model. Results: When evaluating the DE subtraction images, MPV increased linearly as the iodine concentration increased with all the phantom thickness surveyed (R 2 between 0.989 and 0.992). Lesions with increased iodine uptake could thus be enhanced in the color-encoded iodine maps, and the mean iodine concentration could be obtained through the ROI measurements. As for investigating CNR performance, linear relationships were also shown between the iodine concentration and CNR (R 2 between 0.983 and 0.990). Minimum iodine area density of 1.45, 1.73, 1.80, 1.73 and 1.72 mg/cm 2 for phantom thickness of 2, 3, 4, 5, 6 cm were calculated based on Rose’s visualization criteria. Conclusion: Quantitative calibration between image quality indexes and iodine concentrations may further serving as the assistance for analyzing contrast enhancement for patient participating the dual

  16. Micro calcification evaluation using CR plates in computerized mammography

    International Nuclear Information System (INIS)

    Bustos F, M.; Prata M, A.

    2017-10-01

    Cancer is one of the leading causes of mortality in the world. In 2012, about 14 million new cases were registered, of which 1.6 million are breast cancer, according to the World Health Organization. The National Cancer Institute of Brazil estimated 57 thousand new cases of breast cancer by 2016. Mammography is the imaging technique most used worldwide for the early diagnosis of breast cancer. Computed radiography (CR) plates are used for digital radiography, and are widely used to obtain digital mammograms. This work aims to evaluate te response of CR plates to the variation of exposure in mammography equipment. Three CR plates for mammography of different models were used for the study. X-ray beams were selected to perform successive exposures of CR plates by varying the exposure time. These exposures were performed to obtain raw images that were subsequently analyzed using ImageJ software, from which the value of intensity recorded in the central region of each image was obtained, correlating it with the exposure time. From these data the necessary correlations were made to determine the exposure time for which the CR plate begins to saturate, observing that the saturation occurs first for the highest value of the applied voltage. Finally, successive exposures of the CR plate were made using the compressed breast simulator made of acrylic plates and containing microcalcifications of different sizes to determine the qualitative resolution of CR plates, observing that only microcalcifications above 177 μm are visible in the image. The knowledge of saturation characteristics and resolution of the CR plate allows the selection of more adequate parameters to work without approaching the saturation region. (Author)

  17. Micro calcification evaluation using CR plates in computerized mammography

    Energy Technology Data Exchange (ETDEWEB)

    Bustos F, M.; Prata M, A., E-mail: mabelita.bfm@gmail.com [Federal University of Minas Gerais, School of Engineering, Department of Nuclear Engineering, Av. Antonio Carlos CEP 131270-901 Belo Horizonte, Minas Gerais (Brazil)

    2017-10-15

    Cancer is one of the leading causes of mortality in the world. In 2012, about 14 million new cases were registered, of which 1.6 million are breast cancer, according to the World Health Organization. The National Cancer Institute of Brazil estimated 57 thousand new cases of breast cancer by 2016. Mammography is the imaging technique most used worldwide for the early diagnosis of breast cancer. Computed radiography (CR) plates are used for digital radiography, and are widely used to obtain digital mammograms. This work aims to evaluate te response of CR plates to the variation of exposure in mammography equipment. Three CR plates for mammography of different models were used for the study. X-ray beams were selected to perform successive exposures of CR plates by varying the exposure time. These exposures were performed to obtain raw images that were subsequently analyzed using ImageJ software, from which the value of intensity recorded in the central region of each image was obtained, correlating it with the exposure time. From these data the necessary correlations were made to determine the exposure time for which the CR plate begins to saturate, observing that the saturation occurs first for the highest value of the applied voltage. Finally, successive exposures of the CR plate were made using the compressed breast simulator made of acrylic plates and containing microcalcifications of different sizes to determine the qualitative resolution of CR plates, observing that only microcalcifications above 177 μm are visible in the image. The knowledge of saturation characteristics and resolution of the CR plate allows the selection of more adequate parameters to work without approaching the saturation region. (Author)

  18. Analog and digital image quality:

    OpenAIRE

    Sardo, Alberto

    2004-01-01

    Background. Lastly the X ray facilities are moving to a slow, but continuous process of digitalization. The dry laser printers allow hardcopy images with optimum resolution and contrast for all the modalities. In breast imaging, thedelay of digitalization depends to the high cost of digital systems and, attimes, to the doubts of the diagnostic accuracy of reading the breast digital images. Conclusions. The Screen film mammography (SFM) is the most efficient diagnostic modality to detect the b...

  19. Automated Breast Density Computation in Digital Mammography and Digital Breast Tomosynthesis: Influence on Mean Glandular Dose and BIRADS Density Categorization.

    Science.gov (United States)

    Castillo-García, Maria; Chevalier, Margarita; Garayoa, Julia; Rodriguez-Ruiz, Alejandro; García-Pinto, Diego; Valverde, Julio

    2017-07-01

    The study aimed to compare the breast density estimates from two algorithms on full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and to analyze the clinical implications. We selected 561 FFDM and DBT examinations from patients without breast pathologies. Two versions of a commercial software (Quantra 2D and Quantra 3D) calculated the volumetric breast density automatically in FFDM and DBT, respectively. Other parameters such as area breast density and total breast volume were evaluated. We compared the results from both algorithms using the Mann-Whitney U non-parametric test and the Spearman's rank coefficient for data correlation analysis. Mean glandular dose (MGD) was calculated following the methodology proposed by Dance et al. Measurements with both algorithms are well correlated (r ≥ 0.77). However, there are statistically significant differences between the medians (P density median values from FFDM are, respectively, 8% and 77% higher than DBT estimations. Both algorithms classify 35% and 55% of breasts into BIRADS (Breast Imaging-Reporting and Data System) b and c categories, respectively. There are no significant differences between the MGD calculated using the breast density from each algorithm. DBT delivers higher MGD than FFDM, with a lower difference (5%) for breasts in the BIRADS d category. MGD is, on average, 6% higher than values obtained with the breast glandularity proposed by Dance et al. Breast density measurements from both algorithms lead to equivalent BIRADS classification and MGD values, hence showing no difference in clinical outcomes. The median MGD values of FFDM and DBT examinations are similar for dense breasts (BIRADS d category). Published by Elsevier Inc.

  20. The effect of information about the benefits and harms of mammography on women's decision-making: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Carles, Misericòrdia; Martínez-Alonso, Montserrat; Pons, Anna; Pérez-Lacasta, Maria José; Perestelo-Pérez, Lilisbeth; Sala, Maria; Vidal, Carmen; Garcia, Montse; Toledo-Chávarri, Ana; Codern, Núria; Feijoo-Cid, Maria; Romero, Anabel; Pla, Roger; Soler-González, Jorge; Castells, Xavier; Rué, Montserrat

    2017-09-12

    The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening. A two-stage, randomized controlled trial (RCT). In the first stage, 40 Basic Health Areas (BHAs) will be selected and randomized to intervention or control. In the second stage, women within each BHA will be randomly selected (n = 400). Four breast cancer screening programs (BCSPs) of the Spanish public health system, three in Catalonia and one in the Canary Islands will participate in the study. Women in the intervention arm will receive a leaflet with detailed information on the benefits and harms of screening using mammography. Women in the control arm will receive a standard leaflet that does not mention harms and recommends accepting the invitation to participate in the biennial examinations of the BCSP. The primary outcome is informed choice, a dichotomous variable that combines knowledge, attitudes, and intentions. Secondary outcomes include decisional conflict; confidence in the decision made; anxiety about screening participation; worry about breast cancer; anticipated regret; time perspective; perceived importance of benefits/harms of screening; perceived risk of breast cancer; and leaflet acceptability. Primary and secondary outcomes are assessed 2-3 weeks after the intervention. This is the first RCT that assesses the effect of informing about the benefits and harms of breast cancer screening in Spain in women facing the decision to be screened using mammography. It aims to assess the

  1. 3D computer-aided detection for digital breast tomosynthesis: Comparison with 2D computer-aided detection for digital mammography in the detection of calcifications

    Energy Technology Data Exchange (ETDEWEB)

    Chu, A Jung; Cho, Nariya; Chang, Jung Min; Kim, Won Hwa; Lee, Su Hyun; Song, Sung Eun; Shin, Sung Ui; Moon, Woo Kyung [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2017-08-15

    To retrospectively evaluate the performance of 3D computer-aided detection (CAD) for digital breast tomosynthesis (DBT) in the detection of calcifications in comparison with 2D CAD for digital mammography (DM). Between 2012 and 2013, both 3D CAD and 2D CAD systems were retrospectively applied to the calcification data set including 69 calcifications (31 malignant calcifications and 38 benign calcifications) and the normal data set including 20 bilateral normal mammograms. Each data set consisted of paired DBT and DM images. Sensitivities for the detection of malignant calcifications were calculated from the calcification data set. False-positive mark rates were calculated from the normal data set. They were compared between the two systems. Sensitivities of 3D CAD [100% (31/31) at levels 2, 1, and 0] were same as those of the 2D CAD system [100% (31/31) at levels 2 and 1] (p = 1.0, respectively). The mean value of false-positive marks per view with 3D CAD was higher than that with 2D CAD at level 2 (0.52 marks ± 0.91 vs. 0.07 marks ± 0.26, p = 0.009). 3D CAD for DBT showed equivalent sensitivity, albeit with a higher false-positive mark rate, than 2D CAD for DM in the detection of calcifications.

  2. Breast mass detection in mammography and tomosynthesis via fully convolutional network-based heatmap regression

    Science.gov (United States)

    Zhang, Jun; Cain, Elizabeth Hope; Saha, Ashirbani; Zhu, Zhe; Mazurowski, Maciej A.

    2018-02-01

    Breast mass detection in mammography and digital breast tomosynthesis (DBT) is an essential step in computerized breast cancer analysis. Deep learning-based methods incorporate feature extraction and model learning into a unified framework and have achieved impressive performance in various medical applications (e.g., disease diagnosis, tumor detection, and landmark detection). However, these methods require large-scale accurately annotated data. Unfortunately, it is challenging to get precise annotations of breast masses. To address this issue, we propose a fully convolutional network (FCN) based heatmap regression method for breast mass detection, using only weakly annotated mass regions in mammography images. Specifically, we first generate heat maps of masses based on human-annotated rough regions for breast masses. We then develop an FCN model for end-to-end heatmap regression with an F-score loss function, where the mammography images are regarded as the input and heatmaps for breast masses are used as the output. Finally, the probability map of mass locations can be estimated with the trained model. Experimental results on a mammography dataset with 439 subjects demonstrate the effectiveness of our method. Furthermore, we evaluate whether we can use mammography data to improve detection models for DBT, since mammography shares similar structure with tomosynthesis. We propose a transfer learning strategy by fine-tuning the learned FCN model from mammography images. We test this approach on a small tomosynthesis dataset with only 40 subjects, and we show an improvement in the detection performance as compared to training the model from scratch.

  3. A method for calculating effective lifetime risk of radiation-induced cancer from screening mammography

    International Nuclear Information System (INIS)

    Ali, R.M.; England, A.; McEntee, M.F.; Hogg, P.

    2015-01-01

    Purpose: To propose a method for evaluating the effective lifetime risk of radiation-induced cancer from screening mammography and to present initial data for the UK National Breast Screening Programme. Material and methods: The imaging was undertaken using a Hologic Selenia full field digital mammographic unit. The proposed method utilises an ATOM phantom containing thermoluminescent dosimeters and a perspex-polyethylene breast phantom to measure organ doses during a standard four view screening mammogram. Effective dose was calculated and effective risk was modelled for a range of client ages. The total lifetime effective risk was then calculated for the UK national screening programme. Calculation of effective risk includes the radiation dose to examined and contralateral breasts in addition to other body organs; this is an advantage over the mean glandular dose. Results: The contralateral breast, thyroid, thymus, brain, lung, salivary glands, and bone marrow all receive more than 1 μGy radiation dose during screening mammography. A major difference exists for total effective lifetime risk of radiation-induced cancer between clients with average and high breast cancer risk. Differences are attributed to the commencement age of screening and time interval between screens. Conclusion: This study proposes a method to evaluate effective lifetime risk of radiation-induced cancer from screening mammography in order to compare different mammography screening programmes. - Highlights: • We proposed a method for the calculation of radiation-induced cancer from screening mammography. • We measured the radiation absorbed dose of different organs during screening mammography. • There are major differences between mammography screening programme categories with regard to radiation effective risk.

  4. First epidemiological analysis of breast cancer incidence and tumor characteristics after implementation of population-based digital mammography screening

    International Nuclear Information System (INIS)

    Weigel, Stefanie; Heindel, Walter; Batzler, W.U.; Decker, T.; Hense, H.W.

    2009-01-01

    Purpose: to epidemiologically evaluate the impact of digital mammography screening on incidence rates and tumor characteristics for breast cancer. Materials and methods: the first German digital screening units in the clinical routine were evaluated during the implementation period by using data from the cancer registry to compare the incidence rate of breast cancers and prognostic characteristics. 74% of women aged 50-69 within the region of Muenster/Coesfeld/Warendorf were invited between 10/2005 and 12/2007 for initial screening; 55% participated (n = 35961). Results: in 2002-2004 the average breast cancer incidence rate (per 100000) was 297.9. During the implementation of screening, the rate rose to 532.9 in 2007. Of the 349 cancers detected with screening, 76% (265/349) were invasive compared to 90% (546/608) of cases not detected with screening during the same period. 37% (97/265) of cancers detected in the screening program had a diameter of ≤ 10 mm and 75% (198/265) were node-negative compared to 15% (79/546) and 64% (322/503), respectively, in cancers detected outside the screening program. The distribution of invasive tumor size (pT categories) and the nodal status differed with statistical significance between cancers detected in and outside the program (p = 0.005 and p = 0.004, respectively). (orig.)

  5. Comparison of tissue equalization, and premium view post-processing methods in full field digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Chen Baoying, E-mail: chenby128@yahoo.co [Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xinsi Road 1, 710038 Xi' an, Shaanxi (China); Wang Wei; Huang Jin; Zhao Ming; Cui Guangbin [Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xinsi Road 1, 710038 Xi' an, Shaanxi (China); Xu Jing [Cell Engineering Research Centre and Department of Cell Biology, State Key Laboratory of Cancer Biology, Fourth Military Medical University, Changle West Road 169, 710032 Xi' an, Shaanxi (China); Guo Wei; Du Pang; Li Pei [Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xinsi Road 1, 710038 Xi' an, Shaanxi (China); Yu Jun, E-mail: pclamper@163.co [Department of Preclinical Experiment Center, Fourth Military Medical University, Changle West Road 169, 710032 Xi' an, Shaanxi (China)

    2010-10-15

    Objective: To retrospectively evaluate the diagnostic abilities of 2 post-processing methods provided by GE Senographe DS system, tissue equalization (TE) and premium view (PV) in full field digital mammography (FFDM). Materials and methods: In accordance with the ethical standards of the World Medical Association, this study was approved by regional ethics committee and signed informed patient consents were obtained. We retrospectively reviewed digital mammograms from 101 women (mean age, 47 years; range, 23-81 years) in the modes of TE and PV, respectively. Three radiologists, fully blinded to the post-processing methods, all patient clinical information and histologic results, read images by using objective image interpretation criteria for diagnostic information end points such as lesion border delineation, definition of disease extent, visualization of internal and surrounding morphologic features of the lesions. Also, overall diagnostic impression in terms of lesion conspicuity, detectability and diagnostic confidence was assessed. Between-group comparisons were performed with Wilcoxon signed rank test. Results: Readers 1, 2, and 3 demonstrated significant overall better impression of PV in 29, 27, and 24 patients, compared with that for TE in 12, 13, and 11 patients, respectively (p < 0.05). Significant (p < 0.05) better impression of PV was also demonstrated for diagnostic information end points. Importantly, PV proved to be more sensitive than TE while detecting malignant lesions in dense breast rather than benign lesions and malignancy in non-dense breast (p < 0.01). Conclusion: PV compared with TE provides marked better diagnostic information in FFDM, particularly for patients with malignancy in dense breast.

  6. Comparison of tissue equalization, and premium view post-processing methods in full field digital mammography

    International Nuclear Information System (INIS)

    Chen Baoying; Wang Wei; Huang Jin; Zhao Ming; Cui Guangbin; Xu Jing; Guo Wei; Du Pang; Li Pei; Yu Jun

    2010-01-01

    Objective: To retrospectively evaluate the diagnostic abilities of 2 post-processing methods provided by GE Senographe DS system, tissue equalization (TE) and premium view (PV) in full field digital mammography (FFDM). Materials and methods: In accordance with the ethical standards of the World Medical Association, this study was approved by regional ethics committee and signed informed patient consents were obtained. We retrospectively reviewed digital mammograms from 101 women (mean age, 47 years; range, 23-81 years) in the modes of TE and PV, respectively. Three radiologists, fully blinded to the post-processing methods, all patient clinical information and histologic results, read images by using objective image interpretation criteria for diagnostic information end points such as lesion border delineation, definition of disease extent, visualization of internal and surrounding morphologic features of the lesions. Also, overall diagnostic impression in terms of lesion conspicuity, detectability and diagnostic confidence was assessed. Between-group comparisons were performed with Wilcoxon signed rank test. Results: Readers 1, 2, and 3 demonstrated significant overall better impression of PV in 29, 27, and 24 patients, compared with that for TE in 12, 13, and 11 patients, respectively (p < 0.05). Significant (p < 0.05) better impression of PV was also demonstrated for diagnostic information end points. Importantly, PV proved to be more sensitive than TE while detecting malignant lesions in dense breast rather than benign lesions and malignancy in non-dense breast (p < 0.01). Conclusion: PV compared with TE provides marked better diagnostic information in FFDM, particularly for patients with malignancy in dense breast.

  7. A CdZnTe slot-scanned detector for digital mammography

    International Nuclear Information System (INIS)

    Mainprize, James G.; Ford, Nancy L.; Yin Shi; Gordon, Eli E.; Hamilton, William J.; Tuemer, Tuemay O.; Yaffe, Martin J.

    2002-01-01

    A new high-resolution detector has been developed for use in a slot-scanned digital mammography system. The detector is a hybrid device that consists of a CCD operating in time-delay integration mode that is bonded to a 150-μm-thick CdZnTe photoconductor array. The CCD was designed with a detector element pitch of 50 μm. Two devices were evaluated with differing crystalline quality. Incomplete charge collection was a source of reduction in DQE. This occurs in both devices due to characteristically low mobility-lifetime products for CdZnTe, with the greatest losses demonstrated by the multicrystalline sample. The mobility-lifetime products for the multicrystalline device were found to be 2.4x10 -4 and 4.0x10 -7 cm 2 /V for electrons and holes, respectively. The device constructed with higher quality single crystal CdZnTe demonstrated mobility-lifetime products of 1.0x10 -4 and 4.4x10 -6 cm 2 /V for electrons and holes. The MTF and DQE for the device were measured at several exposures and results were compared to predictions from a linear systems model of signal and noise propagation. The MTF at a spatial frequency of 10 mm -1 exceeded 0.18 and 0.56 along the scan and slot directions, respectively. Scanning motion and CCD design limited the resolution along the scan direction. For an x-ray beam from a tungsten target tube with 40 μm molybdenum filtration operated at 26 kV, the single crystal device demonstrated a DQE(0) of 0.70±0.02 at 7.1x10 -6 C/kg (27 mR) exposure to the detector, despite its relatively poor charge collection efficiency

  8. Digitized mammograms

    International Nuclear Information System (INIS)

    Bruneton, J.N.; Balu-Maestro, C.; Rogopoulos, A.; Chauvel, C.; Geoffray, A.

    1988-01-01

    Two observers conducted a blind evaluation of 100 mammography files, including 47 malignant cases. Films were read both before and after image digitization at 50 μm and 100 μm with the FilmDRSII. Digitization permitted better analysis of the normal anatomic structures and moderately improved diagnostic sensitivity. Searches for microcalcifications before and after digitization at 100 μm and 50 μm showed better analysis of anatomic structures after digitization (especially for solitary microcalcifications). The diagnostic benefit, with discovery of clustered microcalcifications, was more limited (one case at 100 μm, nine cases at 50 μm). Recognition of microcalcifications was clearly improved in dense breasts, which can benefit from reinterpretation after digitization at 50 μm rather 100μm

  9. Minimal invasive biopsy results of 'uncertain malignant potential' in digital mammography screening. High prevalence but also high predictive value for malignancy

    International Nuclear Information System (INIS)

    Weigel, S.; Heindel, W.; Universitaetsklinikum Muenster; Decker, T.; Universitaetsklinikum Muenster; Korsching, E.; Biesheuvel, C.; Woestmann, A.; Boecker, W.; Hungermann, D.; Roterberg, K.; Tio, J.

    2011-01-01

    Purpose: To evaluate the rate, the histological spectrum and the positive predictive value (PPV) for malignancy of minimally invasive biopsies with 'uncertain malignant potential (B3)' in digital mammography screening. Methods and Materials: Consecutive data of 37 178 participants of one digital unit of the German screening program were included. Results: The B 3 rate was 15.1 % (148/979). The frequencies of lesion subtypes were as follows: atypical epithelial proliferation of ductal type (AEPDT) 35.1 % (52/148), radial scar (RS) 28.4 % (42/148), papillary lesions (PAP) 20.3 % (30/148), lobular carcinoma in situ 8.8 % (13/148), flat epithelial atypia 5.4 % (8/148), and mucocele-like lesions 2.0 % (3/148). The PPV for malignancy in surgical excisions was overall 0.28 (25/91); in detail 0.40 (19/47) for AEPDT, 0.20 (5/25) for RS, 0.08 (1/12) for PAP. Conclusion: Despite a higher B 3 rate of minimally invasive biopsies with 'uncertain malignant potential' in digital screening, the benign surgical biopsy rate is not disproportionally increased compared with analog screening programs. Together with defined management protocols, this results in an increased cancer detection rate per screening participant with surgical excision. (orig.)

  10. Quality control for the mammography screening program in Serbia: Physical and technical aspects

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, O.; Bozovic, P.; Lazarevic, D.; Arandjic, D.; Kosutic, D.

    2012-01-01

    Breast cancer is the major cause of mortality among female population in Serbia. It is presumed that the introduction of screening programme will reduce mortality and therefore, 47 new mammography units were installed for the purpose of population-based screening program in 2011. In parallel, Quality assurance and Quality control (QC) in mammography has received increasing attention as an essential element of the successful breast cancer campaign that is for the first time initialed in Serbia. The purpose of this study is to investigate the need for and the possible implementation of the comprehensive QC programme for the mammography screening in Serbia, with special focus on physical and technical aspect. In the first phase, a QC protocols containing list of parameters, methodology, frequency of tests and reference values for screen-film, computed radiography and full-filed digital mammography) units, were developed. The second phase is focused on the initial implementation of these protocols. The paper presents results of tests of the selected parameters in 35 mammography units, with special emphasis on patient dose and image quality descriptors. After initial implementation at the beginning of the population based breast cancer screening campaign, it is essential to establish system of regular and periodic QC equipment monitoring and to ensure high quality mammograms with minimal possible radiation dose to population included in the screening. (authors)

  11. Procedure for the standardized measure of the detective quantum efficiency in digital mammography

    International Nuclear Information System (INIS)

    Rodriguez Martin, G.; Garcia Castano, P.; Bermudez Luna, R.; Fernandez Bedoya, V.; Espana Lopez, M. L.; Miquelez Alonso, S.

    2011-01-01

    The objective of this work is to develop a simple guide for determining the DQE, according to the CEI, in those having mammography flat panel detectors, and highlight the main difficulties that may be in the process of the standardized measurement.

  12. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Nielsen, Margrethe

    2009-01-01

    BACKGROUND: A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary. OBJECTIVES: To assess the effect of screening for breast cancer with mammography on mortality and morbidity. SEARCH STRATEGY: We searched Pub...... excluded a biased trial and included 600,000 women in the analyses. Three trials with adequate randomisation did not show a significant reduction in breast cancer mortality at 13 years (relative risk (RR) 0.90, 95% confidence interval (CI) 0.79 to 1.02); four trials with suboptimal randomisation showed...... a significant reduction in breast cancer mortality with an RR of 0.75 (95% CI 0.67 to 0.83). The RR for all seven trials combined was 0.81 (95% CI 0.74 to 0.87). We found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential...

  13. Performance of computer-aided detection applied to full-field digital mammography in detection of breast cancers

    International Nuclear Information System (INIS)

    Sadaf, Arifa; Crystal, Pavel; Scaranelo, Anabel; Helbich, Thomas

    2011-01-01

    Objective: The aim of this retrospective study was to evaluate performance of computer-aided detection (CAD) with full-field digital mammography (FFDM) in detection of breast cancers. Materials and Methods: CAD was retrospectively applied to standard mammographic views of 127 cases with biopsy proven breast cancers detected with FFDM (Senographe 2000, GE Medical Systems). CAD sensitivity was assessed in total group of 127 cases and for subgroups based on breast density, mammographic lesion type, mammographic lesion size, histopathology and mode of presentation. Results: Overall CAD sensitivity was 91% (115 of 127 cases). There were no statistical differences (p > 0.1) in CAD detection of cancers in dense breasts 90% (53/59) versus non-dense breasts 91% (62/68). There was statistical difference (p 20 mm 97% (22/23). Conclusion: CAD applied to FFDM showed 100% sensitivity in identifying cancers manifesting as microcalcifications only and high sensitivity 86% (71/83) for other mammographic appearances of cancer. Sensitivity is influenced by lesion size. CAD in FFDM is an adjunct helping radiologist in early detection of breast cancers.

  14. Task-based strategy for optimized contrast enhanced breast imaging: Analysis of six imaging techniques for mammography and tomosynthesis

    Science.gov (United States)

    Ikejimba, Lynda C.; Kiarashi, Nooshin; Ghate, Sujata V.; Samei, Ehsan; Lo, Joseph Y.

    2014-01-01

    Purpose: The use of contrast agents in breast imaging has the capability of enhancing nodule detectability and providing physiological information. Accordingly, there has been a growing trend toward using iodine as a contrast medium in digital mammography (DM) and digital breast tomosynthesis (DBT). Widespread use raises concerns about the best way to use iodine in DM and DBT, and thus a comparison is necessary to evaluate typical iodine-enhanced imaging methods. This study used a task-based observer model to determine the optimal imaging approach by analyzing six imaging paradigms in terms of their ability to resolve iodine at a given dose: unsubtracted mammography and tomosynthesis, temporal subtraction mammography and tomosynthesis, and dual energy subtraction mammography and tomosynthesis. Methods: Imaging performance was characterized using a detectability index d′, derived from the system task transfer function (TTF), an imaging task, iodine signal difference, and the noise power spectrum (NPS). The task modeled a 10 mm diameter lesion containing iodine concentrations between 2.1 mg/cc and 8.6 mg/cc. TTF was obtained using an edge phantom, and the NPS was measured over several exposure levels, energies, and target-filter combinations. Using a structured CIRS phantom, d′ was generated as a function of dose and iodine concentration. Results: For all iodine concentrations and dose, temporal subtraction techniques for mammography and tomosynthesis yielded the highest d′, while dual energy techniques for both modalities demonstrated the next best performance. Unsubtracted imaging resulted in the lowest d′ values for both modalities, with unsubtracted mammography performing the worst out of all six paradigms. Conclusions: At any dose, temporal subtraction imaging provides the greatest detectability, with temporally subtracted DBT performing the highest. The authors attribute the successful performance to excellent cancellation of inplane structures and

  15. The impact of digital mammography on screening a young cohort of women for breast cancer in an urban specialist breast unit

    International Nuclear Information System (INIS)

    Perry, Nicholas M.; Milner, S.E.; Mokbel, K.; Patani, N.; Pinker, K.; Allgood, P.C.; Duffy, S.W.

    2011-01-01

    To compare the diagnostic performance of full-field digital mammography (FFDM) with screen-film mammography (SFM) in a corporate screening programme including younger women. Data were available on 14,946 screening episodes, 5010 FFDM and 9936 SFM. Formal analysis was by logistic regression, adjusting for age and calendar year. FFDM is compared with SFM with reference to cancer detection rates, cancers presenting as clustering microcalcifications, recall rates and PPV of recall. Overall detection rates were 6.4 cancers per thousand screens for FFDM and 2.8 per thousand for SFM (p < 0.001). In women aged 50+ cancer detection was significantly higher for FFDM at 8.6 per thousand vs. 4.0 per thousand, (p = 0.002). In women <50, cancer detection was also significantly higher for FFDM at 4.3 per thousand vs. 1.4 per thousand, (p = 0.02). Cancers detected as clustering microcalcifications increased from 0.4 per thousand with SFM to 2.0 per thousand with FFDM. Rates of assessment recall were higher for FFDM (7.3% vs. 5.0%, p < 0.001). FFDM provided a higher PPV for assessment recall, (32 cancers/364 recalls, 8.8%) than SFM, (28 cancers/493 recalls, 5.7%). Cancer detection rates were significantly higher for FFDM than for SFM, especially for women <50, and cancers detected as clustering microcalcifications. (orig.)

  16. The impact of digital mammography on screening a young cohort of women for breast cancer in an urban specialist breast unit

    Energy Technology Data Exchange (ETDEWEB)

    Perry, Nicholas M.; Milner, S.E.; Mokbel, K. [The Princess Grace Hospital, The London Breast Institute, London (United Kingdom); Patani, N. [St. George' s University of London, Department of Breast Surgery, London (United Kingdom); Pinker, K. [Medical University Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Vienna (Austria); Allgood, P.C.; Duffy, S.W. [Queen Mary University of London, Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, London (United Kingdom)

    2011-04-15

    To compare the diagnostic performance of full-field digital mammography (FFDM) with screen-film mammography (SFM) in a corporate screening programme including younger women. Data were available on 14,946 screening episodes, 5010 FFDM and 9936 SFM. Formal analysis was by logistic regression, adjusting for age and calendar year. FFDM is compared with SFM with reference to cancer detection rates, cancers presenting as clustering microcalcifications, recall rates and PPV of recall. Overall detection rates were 6.4 cancers per thousand screens for FFDM and 2.8 per thousand for SFM (p < 0.001). In women aged 50+ cancer detection was significantly higher for FFDM at 8.6 per thousand vs. 4.0 per thousand, (p = 0.002). In women <50, cancer detection was also significantly higher for FFDM at 4.3 per thousand vs. 1.4 per thousand, (p = 0.02). Cancers detected as clustering microcalcifications increased from 0.4 per thousand with SFM to 2.0 per thousand with FFDM. Rates of assessment recall were higher for FFDM (7.3% vs. 5.0%, p < 0.001). FFDM provided a higher PPV for assessment recall, (32 cancers/364 recalls, 8.8%) than SFM, (28 cancers/493 recalls, 5.7%). Cancer detection rates were significantly higher for FFDM than for SFM, especially for women <50, and cancers detected as clustering microcalcifications. (orig.)

  17. The impact of digital mammography on screening a young cohort of women for breast cancer in an urban specialist breast unit.

    Science.gov (United States)

    Perry, Nicholas M; Patani, N; Milner, S E; Pinker, K; Mokbel, K; Allgood, P C; Duffy, S W

    2011-04-01

    To compare the diagnostic performance of full-field digital mammography (FFDM) with screen-film mammography (SFM) in a corporate screening programme including younger women. Data were available on 14,946 screening episodes, 5010 FFDM and 9936 SFM. Formal analysis was by logistic regression, adjusting for age and calendar year. FFDM is compared with SFM with reference to cancer detection rates, cancers presenting as clustering microcalcifications, recall rates and PPV of recall. Overall detection rates were 6.4 cancers per thousand screens for FFDM and 2.8 per thousand for SFM (p < 0.001). In women aged 50+ cancer detection was significantly higher for FFDM at 8.6 per thousand vs. 4.0 per thousand, (p = 0.002). In women <50, cancer detection was also significantly higher for FFDM at 4.3 per thousand vs. 1.4 per thousand, (p = 0.02). Cancers detected as clustering microcalcifications increased from 0.4 per thousand with SFM to 2.0 per thousand with FFDM. Rates of assessment recall were higher for FFDM (7.3% vs. 5.0%, p < 0.001). FFDM provided a higher PPV for assessment recall, (32 cancers/364 recalls, 8.8%) than SFM, (28 cancers/493 recalls, 5.7%). Cancer detection rates were significantly higher for FFDM than for SFM, especially for women <50, and cancers detected as clustering microcalcifications.

  18. Mass detection in digital breast tomosynthesis: Deep convolutional neural network with transfer learning from mammography.

    Science.gov (United States)

    Samala, Ravi K; Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A; Wei, Jun; Cha, Kenny

    2016-12-01

    Develop a computer-aided detection (CAD) system for masses in digital breast tomosynthesis (DBT) volume using a deep convolutional neural network (DCNN) with transfer learning from mammograms. A data set containing 2282 digitized film and digital mammograms and 324 DBT volumes were collected with IRB approval. The mass of interest on the images was marked by an experienced breast radiologist as reference standard. The data set was partitioned into a training set (2282 mammograms with 2461 masses and 230 DBT views with 228 masses) and an independent test set (94 DBT views with 89 masses). For DCNN training, the region of interest (ROI) containing the mass (true positive) was extracted from each image. False positive (FP) ROIs were identified at prescreening by their previously developed CAD systems. After data augmentation, a total of 45 072 mammographic ROIs and 37 450 DBT ROIs were obtained. Data normalization and reduction of non-uniformity in the ROIs across heterogeneous data was achieved using a background correction method applied to each ROI. A DCNN with four convolutional layers and three fully connected (FC) layers was first trained on the mammography data. Jittering and dropout techniques were used to reduce overfitting. After training with the mammographic ROIs, all weights in the first three convolutional layers were frozen, and only the last convolution layer and the FC layers were randomly initialized again and trained using the DBT training ROIs. The authors compared the performances of two CAD systems for mass detection in DBT: one used the DCNN-based approach and the other used their previously developed feature-based approach for FP reduction. The prescreening stage was identical in both systems, passing the same set of mass candidates to the FP reduction stage. For the feature-based CAD system, 3D clustering and active contour method was used for segmentation; morphological, gray level, and texture features were extracted and merged with a

  19. 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.

  20. Feasibility of generating quantitative composition images in dual energy mammography: a simulation study

    Science.gov (United States)

    Lee, Donghoon; Kim, Ye-seul; Choi, Sunghoon; Lee, Haenghwa; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Breast cancer is one of the most common malignancies in women. For years, mammography has been used as the gold standard for localizing breast cancer, despite its limitation in determining cancer composition. Therefore, the purpose of this simulation study is to confirm the feasibility of obtaining tumor composition using dual energy digital mammography. To generate X-ray sources for dual energy mammography, 26 kVp and 39 kVp voltages were generated for low and high energy beams, respectively. Additionally, the energy subtraction and inverse mapping functions were applied to provide compositional images. The resultant images showed that the breast composition obtained by the inverse mapping function with cubic fitting achieved the highest accuracy and least noise. Furthermore, breast density analysis with cubic fitting showed less than 10% error compare to true values. In conclusion, this study demonstrated the feasibility of creating individual compositional images and capability of analyzing breast density effectively.

  1. Evaluation of the mammography screening studies conducted in Europe and North America

    International Nuclear Information System (INIS)

    Schreer, I.

    2001-01-01

    The ancient randomized-controlled trials of breast cancer screening have offered clear evidence that invitation to participate in mammography screening with/without clinical examination is effective in breast cancer mortality reduction and underline the detection sensitivity of mammography. Recently published criticism of both the effect and fundamental data handling could be shown to be untenable. Randomized studies underestimate the effect while well-designed observational studies do not systematically overestimate the magnitude of the effect. To transform high-quality study results in all-day's practice is a huge challenge, but affordable as has been demonstrated in Great Britain, the Netherlands and Sweden. (orig.) [de

  2. Visibility of microcalcifications in computed and screen-film mammography

    International Nuclear Information System (INIS)

    Cowen, Arnold R.; Launders, Jason H.; Jadav, Mark; Brettle, David S.

    1997-01-01

    Due to the clinically and technically demanding nature of breast x-ray imaging, mammography still remains one of the few essentially film-based radiological imaging techniques in modern medical imaging. There are a range of possible benefits available if a practical and economical direct digital imaging technique can be introduced to routine clinical practice. There has been much debate regarding the minimum specification required for direct digital acquisition. One such direct digital system available is computed radiography (CR), which has a modest specification when compared with modern screen-film mammography (SFM) systems. This paper details two psychophysical studies in which the detection of simulated microcalcifications with CR has been directly compared to that with SFM. The first study found that under scatter-free conditions the minimum detectable size of micro calcification was approximately 130 μm for both SFM and CR. The second study found that SFM had a 4.6% higher probability of observers being able to correctly identify the shape of 350 μm diameter test details; there was no significant difference for either larger or smaller test details. From the results of these studies it has been demonstrated that the modest specification of CR, in terms of limiting resolution, does not translate into a dramatic difference in the perception of details at the limit of detectability. When judging the imaging performance of a system it is more important to compare the signal-to-noise ratio transfer spectrum characteristics, rather than simply the modulation transfer function. (author)

  3. Radiologists' preferences for digital mammographic display. The International Digital Mammography Development Group.

    Science.gov (United States)

    Pisano, E D; Cole, E B; Major, S; Zong, S; Hemminger, B M; Muller, K E; Johnston, R E; Walsh, R; Conant, E; Fajardo, L L; Feig, S A; Nishikawa, R M; Yaffe, M J; Williams, M B; Aylward, S R

    2000-09-01

    To determine the preferences of radiologists among eight different image processing algorithms applied to digital mammograms obtained for screening and diagnostic imaging tasks. Twenty-eight images representing histologically proved masses or calcifications were obtained by using three clinically available digital mammographic units. Images were processed and printed on film by using manual intensity windowing, histogram-based intensity windowing, mixture model intensity windowing, peripheral equalization, multiscale image contrast amplification (MUSICA), contrast-limited adaptive histogram equalization, Trex processing, and unsharp masking. Twelve radiologists compared the processed digital images with screen-film mammograms obtained in the same patient for breast cancer screening and breast lesion diagnosis. For the screening task, screen-film mammograms were preferred to all digital presentations, but the acceptability of images processed with Trex and MUSICA algorithms were not significantly different. All printed digital images were preferred to screen-film radiographs in the diagnosis of masses; mammograms processed with unsharp masking were significantly preferred. For the diagnosis of calcifications, no processed digital mammogram was preferred to screen-film mammograms. When digital mammograms were preferred to screen-film mammograms, radiologists selected different digital processing algorithms for each of three mammographic reading tasks and for different lesion types. Soft-copy display will eventually allow radiologists to select among these options more easily.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-09-01

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

  5. Suspicious amorphous microcalcifications detected on full-field digital mammography: correlation with histopathology

    Directory of Open Access Journals (Sweden)

    Vera Christina Camargo de Siqueira Ferreira

    2018-03-01

    Full Text Available Abstract Objective: To evaluate suspicious amorphous calcifications diagnosed on full-field digital mammography (FFDM and establish correlations with histopathology findings. Materials and Methods: This was a retrospective study of 78 suspicious amorphous calcifications (all classified as BI-RADS® 4 detected on FFDM. Vacuum-assisted breast biopsy (VABB was performed. The histopathological classification of VABB core samples was as follows: pB2 (benign; pB3 (uncertain malignant potential; pB4 (suspicion of malignancy; and pB5 (malignant. Treatment was recommended for pB5 lesions. To rule out malignancy, surgical excision was recommended for pB3 and pB4 lesions. Patients not submitted to surgery were followed for at least 6 months. Results: Among the 78 amorphous calcifications evaluated, the histopathological analysis indicated that 8 (10.3% were malignant/suspicious (6 classified as pB5 and 2 classified as pB4 and 36 (46.2% were benign (classified as pB2. The remaining 34 lesions (43.6% were classified as pB3: 33.3% were precursor lesions (atypical ductal hyperplasia, lobular neoplasia, or flat epithelial atypia and 10.3% were high-risk lesions. For the pB3 lesions, the underestimation rate was zero. Conclusion: The diagnosis of precursor lesions (excluding atypical ductal hyperplasia, which can be pB4 depending on the severity and extent of the lesion should not necessarily be considered indicative of underestimation of malignancy. Suspicious amorphous calcifications correlated more often with precursor lesions than with malignant lesions, at a ratio of 3:1.

  6. Evaluation of the mammography screening studies conducted in Europe and North America; Auswertung der bisherigen Mammographie-Screening-Studien in Europa und in Nordamerika

    Energy Technology Data Exchange (ETDEWEB)

    Schreer, I. [Mammazentrum des Universitaetsklinikums Kiel (Germany)

    2001-04-01

    The ancient randomized-controlled trials of breast cancer screening have offered clear evidence that invitation to participate in mammography screening with/without clinical examination is effective in breast cancer mortality reduction and underline the detection sensitivity of mammography. Recently published criticism of both the effect and fundamental data handling could be shown to be untenable. Randomized studies underestimate the effect while well-designed observational studies do not systematically overestimate the magnitude of the effect. To transform high-quality study results in all-day's practice is a huge challenge, but affordable as has been demonstrated in Great Britain, the Netherlands and Sweden. (orig.) [German] Die alten randomisiert-kontrollierten Studien erbrachten den Nachweis, dass durch Einladung zur Teilnahme an einem Mammmographiescreening mit/ohne klinische Untersuchung der Effekt der Mortalitaetsreduktion erreicht wird und unterstreichen die Sensitivitaet der Mammographie als Detektionstest. Juengste Kritik hat sich in der wissenschaftlichen Auseinandersetzung als unbegruendet herausgestellt. Randomisierte Studien unterschaetzen den Effekt, Beobachtungsstudien spiegeln besser das Ausmass des individuellen Nutzens. Die Uebertragung von Studienergebnissen in den Versorgungsalltag ist aeusserst schwierig, stellt hoechste Anforderungen an ein umfassendes Qualitaetsmanagement, ist jedoch machbar, wie Laender wie Grossbritannien, die Niederlande und Schweden zeigen. (orig.)

  7. 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.

  8. 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.

  9. 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

  10. Physical characteristics of GE Senographe Essential and DS digital mammography detectors

    International Nuclear Information System (INIS)

    Ghetti, Caterina; Borrini, Adriano; Ortenzia, Ornella; Rossi, Raffaella; Ordonez, Pedro L.

    2008-01-01

    The purpose of this study was to investigate physical characteristics of two full field digital mammography (FFDM) systems (GE Senographe Essential and DS). Both are indirect conversion (x ray to light) a-Si flat panels coupled with a CsI(Tl) scintillator. The examined systems have the same pixel size (100 μm) but a different field of view: a conventional size 23x19.2 cm 2 and a large field 24x30.7 cm 2 , specifically designed to image large breasts. In the GE Senographe Essential model relevant improvements in flat panel design were implemented and new deposition tools for metal, a-Si, and CsI(Tl) were introduced by GE. These changes in detector design are expected to be beneficial for advanced applications such as breast tomosynthesis. The presampling modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) were measured for a wide range of exposure (25-240 μGy) with a RQA-M2 technique (28 kVp with a Mo/Mo target/filter combination and 2 mm of additional aluminum filtration). At 1, 2, and at 4 lp/mm MTF is equal to 0.9, 0.76, and 0.46 for the conventional field detector and to 0.85, 0.59, and 0.24 for the large field detector. The latter detector exhibits an improved NNPS due to a lower electronic noise and a better DQE that reaches 60%. In addition a contrast-detail analysis was performed with CDMAM 3.4 phantom and CDCOM software: GE Senographe DS showed statistically significant poorer detection ability in comparison with the GE Senographe Essential. These results could have been expected, at least qualitatively, considering the relative DQE of the two systems

  11. Comparative power law analysis of structured breast phantom and patient images in digital mammography and breast tomosynthesis.

    Science.gov (United States)

    Cockmartin, L; Bosmans, H; Marshall, N W

    2013-08-01

    This work characterizes three candidate mammography phantoms with structured background in terms of power law analysis in the low frequency region of the power spectrum for 2D (planar) mammography and digital breast tomosynthesis (DBT). The study was performed using three phantoms (spheres in water, Voxmam, and BR3D CIRS phantoms) on two DBT systems from two different vendors (Siemens Inspiration and Hologic Selenia Dimensions). Power spectra (PS) were calculated for planar projection, DBT projection, and reconstructed images and curve fitted in the low frequency region from 0.2 to 0.7 mm(-1) with a power law function characterized by an exponent β and magnitude κ. The influence of acquisition dose and tube voltage on the power law parameters was first explored. Then power law parameters were calculated from images acquired with the same anode∕filter combination and tube voltage for the three test objects, and compared with each other. Finally, PS curves for automatic exposure controlled acquisitions (anode∕filter combination and tube voltages selected by the systems based on the breast equivalent thickness of the test objects) were compared against PS analysis performed on patient data (for Siemens 80 and for Hologic 48 mammograms and DBT series). Dosimetric aspects of the three test objects were also examined. The power law exponent (β) was found to be independent of acquisition dose for planar mammography but varied more for DBT projections of the sphere-phantom. Systematic increase of tube voltage did not affect β but decreased κ, both in planar and DBT projection phantom images. Power spectra of the BR3D phantom were closer to those of the patients than these of the Voxmam phantom; the Voxmam phantom gave high values of κ compared to the other phantoms and the patient series. The magnitude of the PS curves of the BR3D phantom was within the patient range but β was lower than the average patient value. Finally, PS magnitude for the sphere

  12. Contribution to digital radiography. Study of a 2D X-ray sensor for mammography using the electrically-stimulated-luminescence effect

    International Nuclear Information System (INIS)

    Ayral, Jean-Luc

    1990-01-01

    Radiography is in a fast change period. This work describes the study and demonstration of a new type of 2D flat X-Ray sensor for mammography and delivering a digital signal. X-ray transmission study of breast tissues leads to: a-definition of X-Ray photons properties for optimized signal-to-noise ratio, and b-specifications of a 2D X-Ray sensor such as mean exposure, dynamic range and pixel size. Then the X-Ray detection processes using a direct or a delayed luminescence mechanism are reviewed. The detailed analysis of the different ways for detecting visible photons is combined with the system specifications (pixel size, image reading time) in order to characterize (from a signal-to-noise ratio aspect) an X-Ray imaging system integrating a delayed luminescence property. The imaging plate and associated luminescent material are specified by their minimum X-Ray absorption and conversion gain. The Gudden-Pohl effect, or Electrically Stimulated Luminescence (ESL) is experimentally studied and quantified under X-Ray excitation in ZnCdS: Cu, Al materials. An original UV sensitization technique opens us the way to highly reproducible results and large sensitivity. The obtained information storage time in the material is compatible with a delayed image reading. These results allow the achievement of an X-Ray imaging demonstrator integrating the ESL imaging plate, an intensified CCD sensor and the sensitization technique. First images are obtained. Further conception of real dimension X-Ray imaging system for mammography is described. (author) [fr

  13. Comparison of the automated evaluation of phantom mama in digital and digitalized images

    International Nuclear Information System (INIS)

    Santana, Priscila do Carmo

    2011-01-01

    Mammography is an essential tool for diagnosis and early detection of breast cancer if it is provided as a very good quality service. The process of evaluating the quality of radiographic images in general, and mammography in particular, can be much more accurate, practical and fast with the help of computer analysis tools. This work compare the automated methodology for the evaluation of scanned digital images the phantom mama. By applied the DIP method techniques was possible determine geometrical and radiometric images evaluated. The evaluated parameters include circular details of low contrast, contrast ratio, spatial resolution, tumor masses, optical density and background in Phantom Mama scanned and digitized images. The both results of images were evaluated. Through this comparison was possible to demonstrate that this automated methodology is presented as a promising alternative for the reduction or elimination of subjectivity in both types of images, but the Phantom Mama present insufficient parameters for spatial resolution evaluation. (author)

  14. Minimal invasive biopsy results of 'uncertain malignant potential' in digital mammography screening. High prevalence but also high predictive value for malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Weigel, S.; Heindel, W. [Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie; Universitaetsklinikum Muenster (Germany). Referenzzentrum Mammographie; Decker, T. [Dietrich Bonhoeffer Klinikum, Neubrandenburg (Germany). Inst. fuer Pathologie; Universitaetsklinikum Muenster (Germany). Referenzzentrum Mammographie; Korsching, E. [Universitaetsklinikum Muenster (Germany). Inst. fuer Bioinformatik; Biesheuvel, C.; Woestmann, A.; Boecker, W. [Universitaetsklinikum Muenster (Germany). Referenzzentrum Mammographie; Hungermann, D. [Universitaetsklinikum Muenster (Germany). Gerhard-Domagk-Inst. fuer Pathologie; Roterberg, K.; Tio, J. [Universitaetsklinikum Muenster (Germany). Klinik und Poliklinik fuer Frauenheilkunde und Geburtshilfe, Bereich Senologie

    2011-08-15

    Purpose: To evaluate the rate, the histological spectrum and the positive predictive value (PPV) for malignancy of minimally invasive biopsies with 'uncertain malignant potential (B3)' in digital mammography screening. Methods and Materials: Consecutive data of 37 178 participants of one digital unit of the German screening program were included. Results: The B 3 rate was 15.1 % (148/979). The frequencies of lesion subtypes were as follows: atypical epithelial proliferation of ductal type (AEPDT) 35.1 % (52/148), radial scar (RS) 28.4 % (42/148), papillary lesions (PAP) 20.3 % (30/148), lobular carcinoma in situ 8.8 % (13/148), flat epithelial atypia 5.4 % (8/148), and mucocele-like lesions 2.0 % (3/148). The PPV for malignancy in surgical excisions was overall 0.28 (25/91); in detail 0.40 (19/47) for AEPDT, 0.20 (5/25) for RS, 0.08 (1/12) for PAP. Conclusion: Despite a higher B 3 rate of minimally invasive biopsies with 'uncertain malignant potential' in digital screening, the benign surgical biopsy rate is not disproportionally increased compared with analog screening programs. Together with defined management protocols, this results in an increased cancer detection rate per screening participant with surgical excision. (orig.)

  15. Investigating the effect of independent, blinded digital image assessment on the STOP GAP trial.

    Science.gov (United States)

    Patsko, Emily; Godolphin, Peter J; Thomas, Kim S; Hepburn, Trish; Mitchell, Eleanor J; Craig, Fiona E; Bath, Philip M; Montgomery, Alan A

    2017-02-02

    Blinding is the process of keeping treatment assignment hidden and is used to minimise the possibility of bias. Trials at high risk of bias have been shown to report larger treatment effects than low-risk studies. In dermatology, one popular method of blinding is to have independent outcome assessors who are unaware of treatment allocation assessing the endpoint using digital photographs. However, this can be complex, expensive and time-consuming. The objective of this study was to compare the effect of blinded and unblinded outcome assessment on the results of the STOP GAP trial. The STOP GAP trial compared prednisolone to ciclosporin in treating pyoderma gangrenosum. Participants' lesions were measured at baseline and at 6 weeks to calculate the primary outcome, speed of healing. Independent blinded assessors obtained measurements from digital photographs using specialist software. In addition, unblinded treating clinicians estimated lesion area by measuring length and width. The primary outcome was determined using blinded measurements where available, otherwise unblinded measurements were used (method referred to as trial measurements). In this study, agreement between the trial and unblinded measurements was determined using the intraclass correlation coefficient (ICC). The STOP GAP trial's primary analysis was repeated using unblinded measurements only. We introduced differential and nondifferential error in unblinded measurements and investigated the effect on the STOP GAP trial's primary analysis. Eighty-six (80%) of the 108 patients were assessed using digital images. Agreement between trial and unblinded measurements was excellent (ICC = 0.92 at baseline; 0.83 at 6 weeks). There was no evidence that the results of the trial primary analysis differed according to how the primary outcome was assessed (p value for homogeneity = 1.00). Blinded digital image assessment in the STOP GAP trial did not meaningfully alter trial conclusions compared with

  16. 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.)

  17. The quality of digital mammograms. Development and use of a phantom for optimal certainty

    International Nuclear Information System (INIS)

    Schoefer, H.; Kotsianos, D.; Wirth, S.; Britsch, S.; Reiser, M.

    2005-01-01

    Digital imaging in mammography is becoming more and more accepted using both computed (CR) and direct radiography (DR). These techniques will soon be used in screening programs. Therefore, quality assurance for this technique is indispensable. The relevance of the current regulations, such as EPOC and the German QS-RL was investigated. For the investigation, a breast phantom and appropriate software were developed. Both were tested using digital mammography systems from six manufactures. Quality assurance parameters (such as contrast to noise ratio and contrast resolution) were calculated from these data sets. The results should be considered in future standards for mammography (IEC respectively DIN). In addition, this type of test procedure is time saving and enables a reduction in test devices, i. e. in costs. (orig.) [de

  18. Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening.

    Science.gov (United States)

    Strech, Daniel

    2014-03-01

    Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the "European guideline for quality assurance in breast cancer screening and diagnosis" specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Quality assurance and quality control in mammography: a review of available guidance worldwide.

    Science.gov (United States)

    Reis, Cláudia; Pascoal, Ana; Sakellaris, Taxiarchis; Koutalonis, Manthos

    2013-10-01

    Review available guidance for quality assurance (QA) in mammography and discuss its contribution to harmonise practices worldwide. Literature search was performed on different sources to identify guidance documents for QA in mammography available worldwide in international bodies, healthcare providers, professional/scientific associations. The guidance documents identified were reviewed and a selection was compared for type of guidance (clinical/technical), technology and proposed QA methodologies focusing on dose and image quality (IQ) performance assessment. Fourteen protocols (targeted at conventional and digital mammography) were reviewed. All included recommendations for testing acquisition, processing and display systems associated with mammographic equipment. All guidance reviewed highlighted the importance of dose assessment and testing the Automatic Exposure Control (AEC) system. Recommended tests for assessment of IQ showed variations in the proposed methodologies. Recommended testing focused on assessment of low-contrast detection, spatial resolution and noise. QC of image display is recommended following the American Association of Physicists in Medicine guidelines. The existing QA guidance for mammography is derived from key documents (American College of Radiology and European Union guidelines) and proposes similar tests despite the variations in detail and methodologies. Studies reported on QA data should provide detail on experimental technique to allow robust data comparison. Countries aiming to implement a mammography/QA program may select/prioritise the tests depending on available technology and resources. •An effective QA program should be practical to implement in a clinical setting. •QA should address the various stages of the imaging chain: acquisition, processing and display. •AEC system QC testing is simple to implement and provides information on equipment performance.

  20. 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.

  1. 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.)

  2. Sensitivity and specificity of a digit symbol recognition trial in the identification of response bias.

    Science.gov (United States)

    Kim, Nancy; Boone, Kyle B; Victor, Tara; Lu, Po; Keatinge, Carolyn; Mitchell, Cary

    2010-08-01

    Recently published practice standards recommend that multiple effort indicators be interspersed throughout neuropsychological evaluations to assess for response bias, which is most efficiently accomplished through use of effort indicators from standard cognitive tests already included in test batteries. The present study examined the utility of a timed recognition trial added to standard administration of the WAIS-III Digit Symbol subtest in a large sample of "real world" noncredible patients (n=82) as compared with credible neuropsychology clinic patients (n=89). Scores from the recognition trial were more sensitive in identifying poor effort than were standard Digit Symbol scores, and use of an equation incorporating Digit Symbol Age-Corrected Scaled Scores plus accuracy and time scores from the recognition trial was associated with nearly 80% sensitivity at 88.7% specificity. Thus, inclusion of a brief recognition trial to Digit Symbol administration has the potential to provide accurate assessment of response bias.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Science.gov (United States)

    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

    2015-10-01

    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). A total of 147 cases with both FFDM and LE images were independently scored by two experienced radiologists using these (20) EUREF criteria. Contrast detail measurements were performed using a dedicated phantom. Differences in image quality scores, average glandular dose, and contrast detail measurements between LE and FFDM were tested for statistical significance. No significant differences in image quality scores were observed between LE and FFDM images for 17 out of 20 criteria. LE scored significantly lower on one criterion regarding the sharpness of the pectoral muscle (p < 0.001), and significantly better on two criteria on the visualization of micro-calcifications (p = 0.02 and p = 0.034). Dose and contrast detail measurements did not reveal any physical explanation for these observed differences. Low-energy CESM images are non-inferior to FFDM images. From this perspective FFDM can be omitted in patients with an indication for CESM. • Low-energy CESM images are non-inferior to FFDM images. • Micro-calcifications are significantly more visible on LE CESM than on FFDM. • There is no physical explanation for this improved visibility of micro-calcifications. • There is no need for an extra FFDM when CESM is indicated.

  5. Computer-aided detection of breast carcinoma in standard mammographic projections with digital mammography

    International Nuclear Information System (INIS)

    Destounis, S.; Hanson, S.

    2007-01-01

    This study was conducted to retrospectively evaluate a computer-aided detection system's ability to detect breast carcinoma in multiple standard mammographic projections. Forty-five lesions in 44 patients imaged with digital mammography (Selenia registered , Hologic, Bedford, MA; Senographe registered , GE, Milwaukee, WI) and had computer-aided detection (CAD, Image-checker registered V 8.3.15, Hologic/R2, Santa Clara, CA) applied at the time of examination were identified for review; all were subsequently recommended to biopsy where cancer was revealed. These lesions were determined by the study Radiologist to be visible in both standard mammographic images (mediolateral oblique, MLO; craniocaudal, CC). For each patient, case data included patient age, tissue density, lesion type, BIRADS registered assessment, lesion size, lesion visibility-visible on MLO and/or CC view, ability of CAD to correctly mark the cancerous lesion, number of CAD marks per image, needle core biopsy results and surgical pathologic correlation. For this study cohort. CAD lesion/case sensitivity of 87% (n = 39) was found and image sensitivity was found to be 69% (n = 31) for MLO view and 78% (n = 35) for the CC view. For the study cohort, cases presented with a median of four marks per cases (range 0-13). Eighty-four percent (n = 38) of lesions proceeded to excision; initial needle biopsy pathology was upgraded at surgical excision from in situ disease to invasive for 24% (n = 9) lesions. CAD has demonstrated the potential to detect mammographically visible cancers in multiple standard mammographic projections in all categories of lesions in this study cohort. (orig.)

  6. 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.)

  7. Studies of dose optimization and image quality in technological transition in mammography; Estudos de otimizacao de dose e qualidade de imagem em processos de transicao tecnologica em mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Furquim, Tania C.; Nersissian, Denise Y., E-mail: tfurquim@iee.usp.b [Universidade de Sao Paulo (IEE/USP), SP (Brazil). Inst. de Eletrotecnica e Energia

    2011-07-01

    The introduction of new technologies in mammography may improve image quality; however, it may unnecessarily increase doses if optimization processes are not studied. In this work, radiation doses of the moment of transition of conventional to digital mammography have been analyzed. The presented data have been acquired from 2005 to 2009, in hospitals and clinics of Sao Paulo city, to 4 conventional and 5 digital equipment. The results show that even after optimization processes, new technologies still impart higher doses. Thus, individualized studies are needed when technological transitions occur, in order to maintain image quality without significant dose increase. (author)

  8. 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.

  9. 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.

  10. Preliminary Clinical Experience with Digital Breast Tomosynthesis in the Visualization of Breast Microcalcifications

    Directory of Open Access Journals (Sweden)

    Stamatia V Destounis

    2013-01-01

    Full Text Available Objectives: To compare the visualization and image quality of microcalcifications imaged with digital breast tomosynthesis (DBT versus conventional digital mammography. Materials and Methods: Patients with microcalcifications detected on full field digital mammography (FFDM recommended for needle core biopsy were enrolled in the study after obtaining patient′s consent and institutional review board approval (n = 177 patients, 179 lesions. All had a bilateral combination DBT exam, after undergoing routine digital mammography, prior to biopsy. The study radiologist reviewed the FFDM and DBT images in a non-blinded comparison and assessed the visibility of the microcalcifications with both methods, including image quality and clarity with which the calcifications were seen. Data recorded included patient demographics, lesion size on FFDM, DBT, and surgical excision (when applicable, biopsy, and surgical pathology, if any. Results: Average lesion size on DBT was 1.5 cm; average lesion size on FFDM was 1.4 cm. The image quality of DBT was assessed as equivalent or superior in 92.2% of cases. In 7.8% of the cases, the FFDM image quality was assessed as equivalent or superior. Conclusion: In our review, DBT image quality appears to be comparable to or better than conventional FFDM in terms of demonstrating microcalcifications, as shown in 92.2% of cases.

  11. 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.

  12. 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.

  13. Introduction of organised mammography screening in tyrol: results of a one-year pilot phase

    Directory of Open Access Journals (Sweden)

    Daniaux Martin

    2011-02-01

    Full Text Available Abstract Background Efficiency and efficacy of organised mammography screening programs have been proven in large randomised trials. But every local implementation of mammography screening has to check whether the well established quality standards are met. Therefore it was the aim of this study to analyse the most common quality indices after introducing organised mammography screening in Tyrol, Austria, in a smooth transition from the existing system of opportunistic screening. Methods In June 2007, the system of opportunistic mammography screening in Tyrol was changed to an organised system by introducing a personal invitation system, a training program, a quality assurance program and by setting up a screening database. All procedures are noted in a written protocol. Most EU recommendations for organised mammography screening were followed, except double reading. All women living in Tyrol and covered by social insurance are now invited for a mammography, in age group 40-59 annually and in age group 60-69 biannually. Screening mammography is offered mainly by radiologists in private practice. We report on the results of the first year of piloting organised mammography screening in two counties in Tyrol. Results 56,432 women were invited. Estimated participation rate was 34.5% at one year of follow-up (and 55.5% at the second year of follow-up; 3.4% of screened women were recalled for further assessment or intermediate screening within six months. Per 1000 mammograms nine biopsies were performed and four breast cancer cases detected (N = 68. Of invasive breast cancer cases 34.4% were ≤ 10 mm in size and 65.6% were node-negative. In total, six interval cancer cases were detected during one year of follow-up; this is 19% of the background incidence rate. Conclusions In the Tyrolean breast cancer screening program, a smooth transition from a spontaneous to an organised mammography screening system was achieved in a short time and with minimal

  14. Noise equalization for detection of microcalcification clusters in direct digital mammogram images.

    NARCIS (Netherlands)

    McLoughlin, K.J.; Bones, P.J.; Karssemeijer, N.

    2004-01-01

    Equalizing image noise is shown to be an important step in the automatic detection of microcalcifications in digital mammography. This study extends a well established film-screen noise equalization scheme developed by Veldkamp et al. for application to full-field digital mammogram (FFDM) images. A

  15. 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 ...

  16. 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)

  17. 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 ...

  18. Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density

    International Nuclear Information System (INIS)

    Shin, Sung Ui; Chang, Jung Min; Bae, Min Sun; Lee, Su Hyun; Cho, Nariya; Seo, Mirinae; Kim, Won Hwa; Moon, Woo Kyung

    2015-01-01

    To compare the average glandular dose (AGD) and diagnostic performance of mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus cranio-caudal (CC) digital mammography (DM) with two-view DM, and to evaluate the correlation of AGD with breast thickness and density. MLO and CC DM and DBT images of both breasts were obtained in 149 subjects. AGDs of DBT and DM per exposure were recorded, and their correlation with breast thickness and density were evaluated. Paired data of MLO DBT plus CC DM and two-view DM were reviewed for presence of malignancy in a jack-knife alternative free-response ROC (JAFROC) method. The AGDs of both DBT and DM, and differences in AGD between DBT and DM (ΔAGD), were correlated with breast thickness and density. The average JAFROC figure of merit (FOM) was significantly higher on the combined technique than two-view DM (P = 0.005). In dense breasts, the FOM and sensitivity of the combined technique was higher than that of two-view DM (P = 0.003) with small ΔAGD. MLO DBT plus CC DM provided higher diagnostic performance than two-view DM in dense breasts with a small increase in AGD. (orig.)

  19. Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sung Ui; Chang, Jung Min; Bae, Min Sun; Lee, Su Hyun; Cho, Nariya; Seo, Mirinae; Kim, Won Hwa; Moon, Woo Kyung [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of)

    2015-01-15

    To compare the average glandular dose (AGD) and diagnostic performance of mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus cranio-caudal (CC) digital mammography (DM) with two-view DM, and to evaluate the correlation of AGD with breast thickness and density. MLO and CC DM and DBT images of both breasts were obtained in 149 subjects. AGDs of DBT and DM per exposure were recorded, and their correlation with breast thickness and density were evaluated. Paired data of MLO DBT plus CC DM and two-view DM were reviewed for presence of malignancy in a jack-knife alternative free-response ROC (JAFROC) method. The AGDs of both DBT and DM, and differences in AGD between DBT and DM (ΔAGD), were correlated with breast thickness and density. The average JAFROC figure of merit (FOM) was significantly higher on the combined technique than two-view DM (P = 0.005). In dense breasts, the FOM and sensitivity of the combined technique was higher than that of two-view DM (P = 0.003) with small ΔAGD. MLO DBT plus CC DM provided higher diagnostic performance than two-view DM in dense breasts with a small increase in AGD. (orig.)

  20. 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)

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  2. 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.

  3. Finding the minimal intervention needed for sustained mammography adherence.

    Science.gov (United States)

    Gierisch, Jennifer M; DeFrank, Jessica T; Bowling, J Michael; Rimer, Barbara K; Matuszewski, Jeanine M; Farrell, David; Skinner, Celette Sugg

    2010-10-01

    Regular adherence to mammography screening saves lives, yet few women receive regular mammograms. RCT. Participants were recruited through a state employee health plan. All were women aged 40-75 years and had recent mammograms prior to enrollment (n=3547). Data were collected from 2004 to 2009. Trial tested efficacy of a two-step adaptively-designed intervention to increase mammography adherence over 4 years. The first intervention step consisted of three reminder types: enhanced usual care reminders (EUCR); enhanced letter reminders (ELR); both delivered by mail, and automated telephone reminders (ATR). After delivery of reminders, women who became off-schedule in any of the 4 years received a second step of supplemental interventions. Three supplemental intervention arms contained priming letters and telephone counseling: barriers only (BarriCall); barriers plus positive consequences of getting mammograms (BarriConCall+); and barriers plus negative consequences of not getting mammograms (BarriConCall-). Average cumulative number of days non-adherent to mammography over 4 years based on annual screening guidelines (analyses conducted in 2009). All reminders performed equally well in reducing number of days of non-adherence. Women randomized to receive supplemental interventions had significantly fewer days of non-adherence compared to women who received EUCR (p=0.0003). BarrConCall+ and BarrConCall- conditions did not significantly differ in days non-adherent compared to women in the barriers-only condition (BarriCon). The minimal intervention needed for sustained mammography use is a combination of a reminder followed by a priming letter and barrier-specific telephone counseling for women who become off-schedule. Additional costs associated with supplemental interventions should be considered by organizations deciding which interventions to use. NCT01148875. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Model-based estimation of breast percent density in raw and processed full-field digital mammography images from image-acquisition physics and patient-image characteristics

    Science.gov (United States)

    Keller, Brad M.; Nathan, Diane L.; Conant, Emily F.; Kontos, Despina

    2012-03-01

    Breast percent density (PD%), as measured mammographically, is one of the strongest known risk factors for breast cancer. While the majority of studies to date have focused on PD% assessment from digitized film mammograms, digital mammography (DM) is becoming increasingly common, and allows for direct PD% assessment at the time of imaging. This work investigates the accuracy of a generalized linear model-based (GLM) estimation of PD% from raw and postprocessed digital mammograms, utilizing image acquisition physics, patient characteristics and gray-level intensity features of the specific image. The model is trained in a leave-one-woman-out fashion on a series of 81 cases for which bilateral, mediolateral-oblique DM images were available in both raw and post-processed format. Baseline continuous and categorical density estimates were provided by a trained breast-imaging radiologist. Regression analysis is performed and Pearson's correlation, r, and Cohen's kappa, κ, are computed. The GLM PD% estimation model performed well on both processed (r=0.89, p<0.001) and raw (r=0.75, p<0.001) images. Model agreement with radiologist assigned density categories was also high for processed (κ=0.79, p<0.001) and raw (κ=0.76, p<0.001) images. Model-based prediction of breast PD% could allow for a reproducible estimation of breast density, providing a rapid risk assessment tool for clinical practice.

  5. 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…

  6. Evaluation of average glandular dose in mammography services in 10 cities of Colombia; Avaliacao de dose glandular media em servicos de mamografia de 10 cidades de Colombia

    Energy Technology Data Exchange (ETDEWEB)

    Alejo-Martinez, H.; Salazar-Hurtado, E.; Puerto-Jimenez, D. [Grupo de Prevencion Temprana Del Cancer, Instituto Nacional de Cancerologia, Bogota D.C. (Colombia)

    2016-07-01

    The objective of this study was to conduct an assessment of dose in 60 mammography services that have screening programs for breast cancer in 10 cities of Colombia. The third quartile of the average glandular dose was 2,29 mGy, range between 1,0 and 5,6 mGy, for the phantom equivalent to a standard breast. This study included mammography units with conventional and digital technology. (author)

  7. 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

  8. Clinical Trials

    Medline Plus

    Full Text Available ... sponsor clinical trials. Examples include Government Agencies, such as the U.S. Departments of Defense and Veterans Affairs; ... age and frequency for doing screening tests, such as mammography; and compare two or more screening tests ...

  9. Neural networks for the classification of microcalcifications in digital mammography; Uso di reti neurali per classificazione di microcalcificazioni in mammografia digitale

    Energy Technology Data Exchange (ETDEWEB)

    Galli, M. [ENEA, Centro Ricerche Ezio Clementel, Bologna (Italy). Dipt. Innovazione; Capaldo, R.

    1999-07-01

    This report deals with the use of neural networks for the classification of microcalcifications in digital mammography. An automated system for the detection of microcalcifications introduces a number of false signals (false positive). Here a neural network system has been implemented to recognize these false signals. After an introduction to the micro calcification detection problems, the used neural network is described, with its advantages and drawbacks. The obtained results are described and discussed. [Italian] Questo lavoro tratta dell'uso delle reti neurali per la classificazione di microcalcificazioni nella mammografia digitale. Un sistema automatico per il riconoscimento delle microcalcificazioni introduce un certo numero di falsi. Segnali (falsi positivi). Qui e' stata messa a punto una rete neurale per riconoscere questi falsi segnali. Dopo un'introduzione ai problemi connessi con l'individuazione delle microcalcificazioni, viene descritto l'uso della rete neurale implementata, con i suoi vantaggi e svantaggi. Vengono poi descritti e discussi i risultati raggiunti.

  10. Staging of breast cancer and the advanced applications of digital mammogram: what the physician needs to know?

    Science.gov (United States)

    Helal, Maha H; Mansour, Sahar M; Zaglol, Mai; Salaleldin, Lamia A; Nada, Omniya M; Haggag, Marwa A

    2017-03-01

    To study the role of advanced applications of digital mammogram, whether contrast-enhanced spectral mammography (CESM) or digital breast tomosynthesis (DBT), in the "T" staging of histologically proven breast cancer before planning for treatment management. In this prospective analysis, we evaluated 98 proved malignant breast masses regarding their size, multiplicity and the presence of associated clusters of microcalcifications. Evaluation methods included digital mammography (DM), 3D tomosynthesis and CESM. Traditional DM was first performed then in a period of 10-14-day interval; breast tomosynthesis and contrast-based mammography were performed for the involved breast only. Views at tomosynthesis were acquired in a "step-and-shoot" tube motion mode to produce multiple (11-15), low-dose images and in contrast-enhanced study, low-energy (22-33 kVp) and high-energy (44-49 kVp) exposures were taken after the i.v. injection of the contrast agent. Operative data were the gold standard reference. Breast tomosynthesis showed the highest accuracy in size assessment (n = 69, 70.4%) than contrast-enhanced (n = 49, 50%) and regular mammography (n = 59, 60.2%). Contrast-enhanced mammography presented the least performance in assessing calcifications, yet it was most sensitive in the detection of multiplicity (92.3%), followed by tomosynthesis (77%) and regular mammography (53.8%). The combined analysis of the three modalities provided an accuracy of 74% in the "T" staging of breast cancer. The combined application of tomosynthesis and contrast-enhanced digital mammogram enhanced the performance of the traditional DM and presented an informative method in the staging of breast cancer. Advances in knowledge: Staging and management planning of breast cancer can divert according to tumour size, multiplicity and the presence of microcalcifications. DBT shows sharp outlines of the tumour with no overlap tissue and spots microcalcifications. Contrast

  11. 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

  12. 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

  13. Digital mammography: Signal-extraction strategies for computer-aided detection of microcalcifications

    International Nuclear Information System (INIS)

    Chan, H.P.; Doi, K.; Metz, C.E.; Vyborny, C.J.; Lam, K.L.; Schmidt, R.A.

    1987-01-01

    The authors found that the structured background of a mammogram can be removed effectively by either a difference-image technique (using a matched filter in combination with a median filter, a contrast-reversal filter, or a box-rim filter) or a visual response filter alone. Locally adaptive gray-level thresholding and region-growing techniques can then be employed to extract microcalcifications from the processed image. Signals are further distinguished from noise or artifacts by their size, contrast, and clustering properties. The authors studied the dependence of the detectability of microcalcifications on the various signal-extraction strategies. Potential application of the computer-aided system to mammography is assessed by its performance on clinical mammograms

  14. Evaluation of breast cancer through mammographies and image digital processing; Avaliacao do cancer de mama atraves de mamografias e processamento digital de imagens

    Energy Technology Data Exchange (ETDEWEB)

    Crestana, Rita H.S.

    1996-12-31

    The state of art of image processing has provided important advances to many scientific investigation areas particularly to medical own. This work exploits the potentiality of using image processing techniques for analyzing breast phantoms and mammographies. 36 refs., 62 figs.

  15. Experimental study of the X-ray spectra optimization for computed radiography mammography systems; Investigacao experimental da otimizacao do espectro de raios X em sistemas de mamografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Tomal, Alessandra, E-mail: atomal@ifi.unicamp.br [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil). Instituto de Fisica Gleb Wataghin; Cunha, Diego M. [Universidade Federal de Uberlandia (UFU), Uberlandia, MG (Brazil). Instituto de Fisica; Nogueira, Maria S. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Gaspar, Fabio [Vigilancia Sanitaria, Campinas, SP (Brazil); Poletti, Martin E. [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras. Departamento de Fisica

    2013-12-15

    Digital mammography is replacing screen-film mammography due to several advantages of digital receptors. The use of Computed Radiography (CR) mammography systems has been considered an alternative to achieve digital images with a low cost. Besides, the optimization of the X-ray spectrum, characterized by the anode/filter combination and tube potential, is an important step in order to improve the image quality with the lower dose to the breast. In this work, we investigated the optimal X-ray spectra using a figure of merit for two mammography equipment: Senographe DMR (General Electric Medical Systems) and Mammomat 3000 Nova (Siemens), both using an image plate Kodak EHR-M2 (Kodak DirectView). A PMMA phantom, simulating breast with thicknesses of 5 cm, was used. The anode/filter combinations evaluated were: Mo/Mo, Mo/Rh, Rh/Rh and Rh/Al for the Senographe system, and Mo/Mo, Mo/Rh, W/Rh for the Mammomat system, for all the intervals of tube potential range from 24 to 35 kVp. Results demonstrate that the higher values of FOM were achieved with the Rh/Rh at 29 kVp and Rh/Al at 26 kVp for the Senographe system, and for the W/Rh at 28 kVp in the Mammomat one. The reduction in the dose associated with the optimum spectra was 13 and 26% for the Senographe and Mammomat systems, respectively. Finally, our results suggest that anode/filter combinations of more energetic spectra than the standard Mo/Mo combination are recommended for thicker breast, in order to reduce the breast dose levels. (author)

  16. 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.

  17. 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.

  18. Temporal Subtraction of Digital Breast Tomosynthesis Images for Improved Mass Detection

    National Research Council Canada - National Science Library

    Li, Christina M

    2007-01-01

    Digital breast tomosynthesis (DBT) strives to overcome the obstacles presented in conventional 2D mammography by taking multiple projections over a fixed angle and reconstructing volumetric data isolates overlying anatomy...

  19. Performance of OSL dosimeters in clinical beams from mammography; Desempenho de dosimetros OSL em feixes clinicos empregados na mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Caio V.; Cabete, Henrique V.; Alves, Fatima F.R.; Pires, Silvio R.; Medeiros, Regina B.; Freitas, Marcelo B. [Universidade Federal de Sao Paulo (HSP/EPM/UNIFESP), SP (Brazil). Escola Paulista de Medicina; Malthez, Anna Luiza M.C. [Universidade Estadual de Campinas (CPG/FEEC/UNICAMP), Campinas, SP (Brazil). Faculdade de Engenharia Eletrica e de Computacao. Programa de Pos-Graduacao

    2015-08-15

    The search for the relationship between dose and mammography image is critical to the quality of clinical practice. In this sense, dosimetry using optically stimulated luminescent detectors (OSLD) is configured as alternative to traditional methods and allows on-site dose checks received by patients. This study aimed to verify the performance of OSL dosimeters in clinical beams typically used in mammography. For this, aluminum oxide detectors, especially designed to reduce interference on the image quality, were exposed to radiation beam combining targets and filters of a mammography equipment with digital imaging system. In addition were also employed lithium fluoride detectors irradiated under the same conditions, together with a ionization chamber for determination of dose values. A homogeneous acrylic phantom was designed and used for simulating different breast and also determine internal dose values under the irradiation conditions. The results allowed the determination of calibration factors (OSL signal x dose) of the exposed detectors to the radiation beams typically used in clinical practice. The phantom images and the comparison between TL and OSL responses suggest the possibility of routine use of the OSL dosimetry system in mammography. (author)

  20. Surveillance of Women with the BRCA1 or BRCA2 Mutation by Using Biannual Automated Breast US, MR Imaging, and Mammography

    NARCIS (Netherlands)

    Zelst, J.C.M. van; Mus, R.D.M.; Woldringh, G.H.; Rutten, M.; Bult, P.; Vreemann, S.; Jong, M de; Karssemeijer, N.; Hoogerbrugge, N.; Mann, R.M.

    2017-01-01

    Purpose To evaluate a multimodal surveillance regimen including yearly full-field digital (FFD) mammography, dynamic contrast agent-enhanced (DCE) magnetic resonance (MR) imaging, and biannual automated breast (AB) ultrasonography (US) in women with BRCA1 and BRCA2 mutations. Materials and Methods

  1. 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.)

  2. Validation of image quality in full-field digital mammography: Is the replacement of wet by dry laser printers justified?

    International Nuclear Information System (INIS)

    Schueller, Gerd; Kaindl, Elisabeth; Langenberger, Herbert; Stadler, Alfred; Schueller-Weidekamm, Claudia; Semturs, Friedrich; Helbich, Thomas H.

    2007-01-01

    Objective: Dry laser printers have replaced wet laser printers to produce hard copies of high-resolution digital images, primarily because of environmental concerns. However, no scientific research data have been published that compare the image quality of dry and wet laser printers in full-field digital mammography (FFDM). This study questions the image quality of these printers. Materials and methods: Objective image quality parameters of both printers were evaluated using a standardized printer test image, i.e., optical density and detectability of specific image elements (lines, curves, and shapes). Furthermore, mammograms of 129 patients with different breast tissue composition patterns were imaged with both printers. A total of 1806 subjective image quality parameters (brightness, contrast, and detail detection of anatomic structures), the detectability of breast lesions, as well as diagnostic performance according to the BI-RADS classification were evaluated. In addition, the presence of film artifacts was investigated. Results: Optical density values were equal for the dry and the wet laser printer. Detection of specific image elements on the printer test image was not different. Ratings of subjective image quality parameters were equal, as were the detectability of breast lesions and the diagnostic performance. Dry laser printer images showed more artifacts (164 versus 27). However, these artifacts did not influence image quality. Conclusion: Based on the evidence of objective and subjective parameters, a dry laser printer equals the image quality of a wet laser printer in FFDM. Therefore, not only for reasons of environmental preference, the replacement of wet laser printers by dry laser printers in FFDM is justified

  3. 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

  4. Mammography Facilities

    Data.gov (United States)

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

  5. Dose optimization for dual-energy contrast-enhanced digital mammography based on an energy-resolved photon-counting detector: A Monte Carlo simulation study

    International Nuclear Information System (INIS)

    Lee, Youngjin; Lee, Seungwan; Kang, Sooncheol; Eom, Jisoo

    2017-01-01

    Dual-energy contrast-enhanced digital mammography (CEDM) has been used to decompose breast images and improve diagnostic accuracy for tumor detection. However, this technique causes an increase of radiation dose and an inaccuracy in material decomposition due to the limitations of conventional X-ray detectors. In this study, we simulated the dual-energy CEDM with an energy-resolved photon-counting detector (ERPCD) for reducing radiation dose and improving the quantitative accuracy of material decomposition images. The ERPCD-based dual-energy CEDM was compared to the conventional dual-energy CEDM in terms of radiation dose and quantitative accuracy. The correlation between radiation dose and image quality was also evaluated for optimizing the ERPCD-based dual-energy CEDM technique. The results showed that the material decomposition errors of the ERPCD-based dual-energy CEDM were 0.56–0.67 times lower than those of the conventional dual-energy CEDM. The imaging performance of the proposed technique was optimized at the radiation dose of 1.09 mGy, which is a half of the MGD for a single view mammogram. It can be concluded that the ERPCD-based dual-energy CEDM with an optimal exposure level is able to improve the quality of material decomposition images as well as reduce radiation dose. - Highlights: • Dual-energy mammography based on a photon-counting detector was simulated. • Radiation dose and image quality were evaluated for optimizing the proposed technique. • The proposed technique reduced radiation dose as well as improved image quality. • The proposed technique was optimized at the radiation dose of 1.09 mGy.

  6. 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.

  7. Task-based strategy for optimized contrast enhanced breast imaging: analysis of six imaging techniques for mammography and tomosynthesis

    Science.gov (United States)

    Ikejimba, Lynda; Kiarashi, Nooshin; Lin, Yuan; Chen, Baiyu; Ghate, Sujata V.; Zerhouni, Moustafa; Samei, Ehsan; Lo, Joseph Y.

    2012-03-01

    Digital breast tomosynthesis (DBT) is a novel x-ray imaging technique that provides 3D structural information of the breast. In contrast to 2D mammography, DBT minimizes tissue overlap potentially improving cancer detection and reducing number of unnecessary recalls. The addition of a contrast agent to DBT and mammography for lesion enhancement has the benefit of providing functional information of a lesion, as lesion contrast uptake and washout patterns may help differentiate between benign and malignant tumors. This study used a task-based method to determine the optimal imaging approach by analyzing six imaging paradigms in terms of their ability to resolve iodine at a given dose: contrast enhanced mammography and tomosynthesis, temporal subtraction mammography and tomosynthesis, and dual energy subtraction mammography and tomosynthesis. Imaging performance was characterized using a detectability index d', derived from the system task transfer function (TTF), an imaging task, iodine contrast, and the noise power spectrum (NPS). The task modeled a 5 mm lesion containing iodine concentrations between 2.1 mg/cc and 8.6 mg/cc. TTF was obtained using an edge phantom, and the NPS was measured over several exposure levels, energies, and target-filter combinations. Using a structured CIRS phantom, d' was generated as a function of dose and iodine concentration. In general, higher dose gave higher d', but for the lowest iodine concentration and lowest dose, dual energy subtraction tomosynthesis and temporal subtraction tomosynthesis demonstrated the highest performance.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. In-plane visibility of lesions using breast tomosynthesis and digital mammography

    International Nuclear Information System (INIS)

    Timberg, P.; Baath, M.; Andersson, I.; Mattsson, S.; Tingberg, A.; Ruschin, M.

    2010-01-01

    Purpose: The purpose of this work was to evaluate the visibility of simulated lesions in 2D digital mammography (DM) and breast tomosynthesis (BT) images of patients. Methods: Images of the same women were acquired on both a DM system (Mammomat Novation, Siemens Healthcare, Erlangen, Germany) and a BT prototype system adapted from the same type of DM system. Using the geometrical properties of the two systems, simulated lesions were projected and added to each DM image as well as to each BT projection image prior to 3D reconstruction. The same beam quality and approximately the same total absorbed dose to the glandular tissue were used for each breast image acquisition on the two systems. A series of four-alternative forced choice human observer experiments was conducted for each of five simulated lesion diameters: 0.2, 1, 3, 8, and 25 mm. An additional experiment was conducted for the 0.2 mm lesion in BT only at twice the dose level (BT 2x ). Threshold signal was defined as the lesion signal intensity required for a detectability index (d ' ) of 2.5. Four medical physicists participated in all experiments. One experiment, consisting of 60 cases, was conducted per test condition (i.e., lesion size and signal combination). Results: For the smallest lesions (0.2 mm), the threshold signal for DM was 21% lower than for BT at equivalent dose levels, and BT 2x was 26% lower than DM. For the lesions larger than 1 mm, the threshold signal increased linearly (in log space) with the lesion diameter for both DM and BT, with DM requiring around twice the signal as BT. The difference in the threshold signal between BT and DM at each lesion size was statistically significant, except for the 0.2 mm lesion between BT 2x and DM. Conclusions: The results of this study indicate that low-signal lesions larger than 1.0 mm may be more visible in BT compared to DM, whereas 0.2 mm lesions may be better visualized with DM compared to BT, when compared at equal dose.

  13. 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.

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

    International Nuclear Information System (INIS)

    Liu Jie; Wang Xia; Li Xiaokang; Liu Peifang

    2013-01-01

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

  15. 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.

  16. 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

  17. An adaptive algorithm for the detection of microcalcifications in simulated low-dose mammography

    Science.gov (United States)

    Treiber, O.; Wanninger, F.; Führ, H.; Panzer, W.; Regulla, D.; Winkler, G.

    2003-02-01

    This paper uses the task of microcalcification detection as a benchmark problem to assess the potential for dose reduction in x-ray mammography. We present the results of a newly developed algorithm for detection of microcalcifications as a case study for a typical commercial film-screen system (Kodak Min-R 2000/2190). The first part of the paper deals with the simulation of dose reduction for film-screen mammography based on a physical model of the imaging process. Use of a more sensitive film-screen system is expected to result in additional smoothing of the image. We introduce two different models of that behaviour, called moderate and strong smoothing. We then present an adaptive, model-based microcalcification detection algorithm. Comparing detection results with ground-truth images obtained under the supervision of an expert radiologist allows us to establish the soundness of the detection algorithm. We measure the performance on the dose-reduced images in order to assess the loss of information due to dose reduction. It turns out that the smoothing behaviour has a strong influence on detection rates. For moderate smoothing, a dose reduction by 25% has no serious influence on the detection results, whereas a dose reduction by 50% already entails a marked deterioration of the performance. Strong smoothing generally leads to an unacceptable loss of image quality. The test results emphasize the impact of the more sensitive film-screen system and its characteristics on the problem of assessing the potential for dose reduction in film-screen mammography. The general approach presented in the paper can be adapted to fully digital mammography.

  18. An adaptive algorithm for the detection of microcalcifications in simulated low-dose mammography

    International Nuclear Information System (INIS)

    Treiber, O; Wanninger, F; Fuehr, H; Panzer, W; Regulla, D; Winkler, G

    2003-01-01

    This paper uses the task of microcalcification detection as a benchmark problem to assess the potential for dose reduction in x-ray mammography. We present the results of a newly developed algorithm for detection of microcalcifications as a case study for a typical commercial film-screen system (Kodak Min-R 2000/2190). The first part of the paper deals with the simulation of dose reduction for film-screen mammography based on a physical model of the imaging process. Use of a more sensitive film-screen system is expected to result in additional smoothing of the image. We introduce two different models of that behaviour, called moderate and strong smoothing. We then present an adaptive, model-based microcalcification detection algorithm. Comparing detection results with ground-truth images obtained under the supervision of an expert radiologist allows us to establish the soundness of the detection algorithm. We measure the performance on the dose-reduced images in order to assess the loss of information due to dose reduction. It turns out that the smoothing behaviour has a strong influence on detection rates. For moderate smoothing, a dose reduction by 25% has no serious influence on the detection results, whereas a dose reduction by 50% already entails a marked deterioration of the performance. Strong smoothing generally leads to an unacceptable loss of image quality. The test results emphasize the impact of the more sensitive film-screen system and its characteristics on the problem of assessing the potential for dose reduction in film-screen mammography. The general approach presented in the paper can be adapted to fully digital mammography

  19. 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.

  20. Latin American dose survey results in mammography studies under IAEA programme: radiological protection of patients in medical exposures (TSA3).

    Science.gov (United States)

    Mora, Patricia; Blanco, Susana; Khoury, Helen; Leyton, Fernando; Cárdenas, Juan; Defaz, María Yolanda; Garay, Fernando; Telón, Flaviano; Aguilar, Juan Garcia; Roas, Norma; Gamarra, Mirtha; Blanco, Daniel; Quintero, Ana Rosa; Nader, Alejandro

    2015-03-01

    Latin American countries (Argentina, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Paraguay, Uruguay and Venezuela) working under the International Atomic Energy Agency (IAEA) Technical Cooperation Programme: TSA3 Radiological Protection of Patients in Medical Exposures have joined efforts in the optimisation of radiation protection in mammography practice. Through surveys of patient doses, the region has a unique database of diagnostic reference levels for analogue and digital equipment that will direct future optimisation activities towards the early detection of breast cancer among asymptomatic women. During RLA9/057 (2007-09) 24 institutions participated with analogue equipment in a dose survey. Regional training on methodology and measurement equipment was addressed in May 2007. The mean glandular dose (DG) was estimated using the incident kerma in air and relevant conversion coefficients for both projections craneo caudal and mediolateral oblique (CC and MLO). For Phase 2, RLA9/067 (2010-11), it was decided to include also digital systems in order to see their impact in future dose optimisation activities. Any new country that joined the project received training in the activities through IAEA expert missions. Twenty-nine new institutions participated (9 analogue and 20 digital equipment). A total of 2262 patient doses were collected during this study and from them D(G) (mGy) for both projections were estimated for each institution and country. Regional results (75 percentile in mGy) show for CC and MLO views, respectively: RLA9/057 (analogue) 2.63 and 3.17; RLA/067: 2.57 and 3.15 (analogue) and 2.69 and 2.90 (digital). Regarding only digital equipment for CC and MLO, respectively, computed radiography systems showed 2.59 and 2.78 and direct digital radiography (DDR) systems 2.78 and 3.04. Based on the IAEA Basic Safety Standard (BSS) reference dose (3 mGy), it can be observed that there is enough room to start

  1. Latin American dose survey results in mammography studies under IAEA programme: radiological protection of patients in medical exposures (TSA3)

    International Nuclear Information System (INIS)

    Mora, Patricia; Blanco, Susana; Khoury, Helen; Leyton, Fernando; Cardenas, Juan; Defaz, Maria Yolanda; Garay, Fernando; Telon, Flaviano; Garcia Aguilar, Juan; Roas, Norma; Gamarra, Mirtha; Blanco, Daniel; Quintero, Ana Rosa; Nader, Alejandro

    2015-01-01

    Latin American countries (Argentina, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Paraguay, Uruguay and Venezuela) working under the International Atomic Energy Agency (IAEA) Technical Cooperation Programme: TSA3 Radiological Protection of Patients in Medical Exposures have joined efforts in the optimisation of radiation protection in mammography practice. Through surveys of patient doses, the region has a unique database of diagnostic reference levels for analogue and digital equipment that will direct future optimisation activities towards the early detection of breast cancer among asymptomatic women. During RLA9/057 (2007-09) 24 institutions participated with analogue equipment in a dose survey. Regional training on methodology and measurement equipment was addressed in May 2007. The mean glandular dose (DG) was estimated using the incident kerma in air and relevant conversion coefficients for both projections craneo caudal and mediolateral oblique (CC and MLO). For Phase 2, RLA9/067 (2010-11), it was decided to include also digital systems in order to see their impact in future dose optimisation activities. Any new country that joined the project received training in the activities through IAEA expert missions. Twenty-nine new institutions participated (9 analogue and 20 digital equipment). A total of 2262 patient doses were collected during this study and from them D G (mGy) for both projections were estimated for each institution and country. Regional results (75 percentile in mGy) show for CC and MLO views, respectively: RLA9/057 (analogue) 2.63 and 3.17; RLA/067: 2.57 and 3.15 (analogue) and 2.69 and 2.90 (digital). Regarding only digital equipment for CC and MLO, respectively, computed radiography systems showed 2.59 and 2.78 and direct digital radiography (DDR) systems 2.78 and 3.04. Based on the IAEA Basic Safety Standard (BSS) reference dose (3 mGy), it can be observed that there is enough room to start

  2. 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.

  3. 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

  4. 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.

  5. Meta-analysis of breast cancer mortality benefit and overdiagnosis adjusted for adherence: improving information on the effects of attending screening mammography

    Science.gov (United States)

    Jacklyn, Gemma; Glasziou, Paul; Macaskill, Petra; Barratt, Alexandra

    2016-01-01

    Background: Women require information about the impact of regularly attending screening mammography on breast cancer mortality and overdiagnosis to make informed decisions. To provide this information we aimed to meta-analyse randomised controlled trials adjusted for adherence to the trial protocol. Methods: Nine screening mammography trials used in the Independent UK Breast Screening Report were selected. Extending an existing approach to adjust intention-to-treat (ITT) estimates for less than 100% adherence rates, we conducted a random-effects meta-analysis. This produced a combined deattenuated prevented fraction and a combined deattenuated percentage risk of overdiagnosis. Results: In women aged 39–75 years invited to screen, the prevented fraction of breast cancer mortality at 13-year follow-up was 0.22 (95% CI 0.15–0.28) and it increased to 0.30 (95% CI 0.18–0.42) with deattenuation. In women aged 40–69 years invited to screen, the ITT percentage risk of overdiagnosis during the screening period was 19.0% (95% CI 15.2–22.7%), deattenuation increased this to 29.7% (95% CI 17.8–41.5%). Conclusions: Adjustment for nonadherence increased the size of the mortality benefit and risk of overdiagnosis by up to 50%. These estimates are more appropriate when developing quantitative information to support individual decisions about attending screening mammography. PMID:27124337

  6. Applying Data-driven Imaging Biomarker in Mammography for Breast Cancer Screening: Preliminary Study

    OpenAIRE

    Kim, Eun-Kyung; Kim, Hyo-Eun; Han, Kyunghwa; Kang, Bong Joo; Sohn, Yu-Mee; Woo, Ok Hee; Lee, Chan Wha

    2018-01-01

    We assessed the feasibility of a data-driven imaging biomarker based on weakly supervised learning (DIB; an imaging biomarker derived from large-scale medical image data with deep learning technology) in mammography (DIB-MG). A total of 29,107 digital mammograms from five institutions (4,339 cancer cases and 24,768 normal cases) were included. After matching patients’ age, breast density, and equipment, 1,238 and 1,238 cases were chosen as validation and test sets, respectively, and the remai...

  7. 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

  8. 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...

  9. Intraoperative digital specimen radiography in the treatment of nonpalpable breast lesions

    Directory of Open Access Journals (Sweden)

    Vicko Ferenc

    2017-01-01

    Full Text Available Introduction/Objective. About a third of the breast lesions on mammography are clinically occult. The goals of surgical treatment are to locate, remove, and verify their presence in the removed breast tissue. Standard specimen mammography (SSM has been an official procedure for the latter, while intraoperative digital specimen radiography (IDSR was introduced recently. The aim of this study was to evaluate the use of IDSR versus SSM and possible benefits regarding the duration of the procedures (operating room occupancy, availability of digital mammography for additional number of patients, surgeon productivity, and the quality of performed services. Methods. A retrospective chart review of 109 patients who underwent IDSR for nonpalpable breast lesions was performed between January 2014 and June 2016. We compared the difference in the duration of IDSR versus SSM procedure. We also observed the number of re-excisions and evaluated time-saving in the operating room workflow. Results. The average duration of surgery in the IDSR group of patients was 51 minutes, compared to 64 minutes in the SSM group. Every IDSR procedure saved 13 minutes over the standard SSM. That would allow another 28 procedures in the same time frame, with the same quality of service compared with SSM. In that way we increased productivity by 27.5%. Additional operation/surgery was needed for histologically involved surgical margins in three cases (2.75%. Conclusion. The use of new technology resulted in the rationalization of the operative room workflow and gave better productivity. More savings were obtained through the increase of digital mammography capacity for diagnostics, decrease of anesthesia duration, and better management of human resources. The number of “true” re-excisions, involving additional surgery, remained similar after introducing IDSR.

  10. Effect of the Availability of Prior Full-Field Digital Mammography and Digital Breast Tomosynthesis Images on the Interpretation of Mammograms

    Science.gov (United States)

    Catullo, Victor J.; Chough, Denise M.; Ganott, Marie A.; Kelly, Amy E.; Shinde, Dilip D.; Sumkin, Jules H.; Wallace, Luisa P.; Bandos, Andriy I.; Gur, David

    2015-01-01

    Purpose To assess the effect of and interaction between the availability of prior images and digital breast tomosynthesis (DBT) images in decisions to recall women during mammogram interpretation. Materials and Methods Verbal informed consent was obtained for this HIPAA-compliant institutional review board–approved protocol. Eight radiologists independently interpreted twice deidentified mammograms obtained in 153 women (age range, 37–83 years; mean age, 53.7 years ± 9.3 [standard deviation]) in a mode by reader by case-balanced fully crossed study. Each study consisted of current and prior full-field digital mammography (FFDM) images and DBT images that were acquired in our facility between June 2009 and January 2013. For one reading, sequential ratings were provided by using (a) current FFDM images only, (b) current FFDM and DBT images, and (c) current FFDM, DBT, and prior FFDM images. The other reading consisted of (a) current FFDM images only, (b) current and prior FFDM images, and (c) current FFDM, prior FFDM, and DBT images. Fifty verified cancer cases, 60 negative and benign cases (clinically not recalled), and 43 benign cases (clinically recalled) were included. Recall recommendations and interaction between the effect of prior FFDM and DBT images were assessed by using a generalized linear model accounting for case and reader variability. Results Average recall rates in noncancer cases were significantly reduced with the addition of prior FFDM images by 34% (145 of 421) and 32% (106 of 333) without and with DBT images, respectively (P < .001). However, this recall reduction was achieved at the cost of a corresponding 7% (23 of 345) and 4% (14 of 353) reduction in sensitivity (P = .006). In contrast, availability of DBT images resulted in a smaller reduction in recall rates (false-positive interpretations) of 19% (76 of 409) and 26% (71 of 276) without and with prior FFDM images, respectively (P = .001). Availability of DBT images resulted in 4% (15 of

  11. Retrospective analysis of a Computer-Aided Detection (CAD) system in full-field digital mammography in correlation to tumor histology

    International Nuclear Information System (INIS)

    Obenauer, S.; Sohns, C.; Grabbe, E.; Werner, C.

    2005-01-01

    Purpose: to evaluate the usefulness of a computer-aided detection (CAD) system in full-field digital mammography in correlation to tumor histology. Material and methods: a total of 476 patients (226 patients with histologically proven malignant tumors, 250 healthy women) took part in this study. The mammograms were studied retrospectively, using the CAD system Image Checker. For 226 patients digital mammograms in MLO-projection were available. For 186 of these patients the CC-projection was also available. CAD markers that correlated with histologically proven carcinomas were considered to be true-positive markers. All other CAD markers were considered to be false-positive. Histologically proven carcinomas without markers were false-negative results. The dependence of the CAD markers placement upon the different carcinoma histologies was studied using the Chi-square test. Results: no significant difference could be proven for the detectability of malignant breast lesions of different histologic types. For the detectability of ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), lobular carcinoma in situ (LCIS), tubular carcinoma and ductulo-lobular carcinoma, the true positives were 71.1%, 75%, 70.7%, 70%, 60% and 80%, respectively, in the MLO projection and 83.9%, 75.9%, 81.8%, 77.8%, 87.5% and 33.3%, respectively, in the CC projection. There was an average of 0.5 false-positive markers per mammographic image. Conclusion: The histologic type of carcinoma seems to have no influence on detectability when using the CAD system. The high rate of false-positive markers shows, however, the limited specificity of the CAD system and that improvements are necessary. (orig.)

  12. 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).

  13. 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...

  14. 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)

  15. 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

  16. Optimization of technique factors for a silicon diode array full-field digital mammography system and comparison to screen-film mammography with matched average glandular dose

    International Nuclear Information System (INIS)

    Berns, Eric A.; Hendrick, R. Edward; Cutter, Gary R.

    2003-01-01

    Contrast-detail experiments were performed to optimize technique factors for the detection of low-contrast lesions using a silicon diode array full-field digital mammography (FFDM) system under the conditions of a matched average glandular dose (AGD) for different techniques. Optimization was performed for compressed breast thickness from 2 to 8 cm. FFDM results were compared to screen-film mammography (SFM) at each breast thickness. Four contrast-detail (CD) images were acquired on a SFM unit with optimal techniques at 2, 4, 6, and 8 cm breast thicknesses. The AGD for each breast thickness was calculated based on half-value layer (HVL) and entrance exposure measurements on the SFM unit. A computer algorithm was developed and used to determine FFDM beam current (mAs) that matched AGD between FFDM and SFM at each thickness, while varying target, filter, and peak kilovoltage (kVp) across the full range available for the FFDM unit. CD images were then acquired on FFDM for kVp values from 23-35 for a molybdenum-molybdenum (Mo-Mo), 23-40 for a molybdenum-rhodium (Mo-Rh), and 25-49 for a rhodium-rhodium (Rh-Rh) target-filter under the constraint of matching the AGD from screen-film for each breast thickness (2, 4, 6, and 8 cm). CD images were scored independently for SFM and each FFDM technique by six readers. CD scores were analyzed to assess trends as a function of target-filter and kVp and were compared to SFM at each breast thickness. For 2 cm thick breasts, optimal FFDM CD scores occurred at the lowest possible kVp setting for each target-filter, with significant decreases in FFDM CD scores as kVp was increased under the constraint of matched AGD. For 2 cm breasts, optimal FFDM CD scores were not significantly different from SFM CD scores. For 4-8 cm breasts, optimum FFDM CD scores were superior to SFM CD scores. For 4 cm breasts, FFDM CD scores decreased as kVp increased for each target-filter combination. For 6 cm breasts, CD scores decreased slightly as k

  17. Contrast-enhanced Spectral Mammography: Modality-Specific Artifacts and Other Factors Which May Interfere with Image Quality.

    Science.gov (United States)

    Bhimani, Chandni; Li, Luna; Liao, Lydia; Roth, Robyn G; Tinney, Elizabeth; Germaine, Pauline

    2017-01-01

    Contrast-enhanced spectral mammography (CESM) uses full field digital mammography with the added benefit of intravenous contrast administration to significantly reduce false-positive and false-negative results and improve specificity while maintaining high sensitivity. For CESM to fulfill its purpose, one should be aware of possible artifacts and other factors which may interfere with image quality, and attention should be taken to minimize these factors. This pictorial demonstration will depict types of artifacts detected and other factors that interfere with image acquisition in our practice since CESM implementation. Many of the artifacts and other factors we have encountered while using CESM have simple solutions to resolve them. The illustrated artifacts and other factors interfering with image quality will serve as a useful reference to anyone using CESM. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  18. 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

  19. 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)

  20. 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.

  1. 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

  2. Digital mammography--DQE versus optimized image quality in clinical environment: an on site study

    Science.gov (United States)

    Oberhofer, Nadia; Fracchetti, Alessandro; Springeth, Margareth; Moroder, Ehrenfried

    2010-04-01

    The intrinsic quality of the detection system of 7 different digital mammography units (5 direct radiography DR; 2 computed radiography CR), expressed by DQE, has been compared with their image quality/dose performances in clinical use. DQE measurements followed IEC 62220-1-2 using a tungsten test object for MTF determination. For image quality assessment two different methods have been applied: 1) measurement of contrast to noise ratio (CNR) according to the European guidelines and 2) contrast-detail (CD) evaluation. The latter was carried out with the phantom CDMAM ver. 3.4 and the commercial software CDMAM Analyser ver. 1.1 (both Artinis) for automated image analysis. The overall image quality index IQFinv proposed by the software has been validated. Correspondence between the two methods has been shown figuring out a linear correlation between CNR and IQFinv. All systems were optimized with respect to image quality and average glandular dose (AGD) within the constraints of automatic exposure control (AEC). For each equipment, a good image quality level was defined by means of CD analysis, and the corresponding CNR value considered as target value. The goal was to achieve for different PMMA-phantom thicknesses constant image quality, that means the CNR target value, at minimum dose. All DR systems exhibited higher DQE and significantly better image quality compared to CR systems. Generally switching, where available, to a target/filter combination with an x-ray spectrum of higher mean energy permitted dose savings at equal image quality. However, several systems did not allow to modify the AEC in order to apply optimal radiographic technique in clinical use. The best ratio image quality/dose was achieved by a unit with a-Se detector and W anode only recently available on the market.

  3. Clinical Trials

    Medline Plus

    Full Text Available ... treatments produce better results for certain illnesses or groups of people; look at the best age and frequency for doing screening tests, such as mammography; and compare two or more screening tests to see which test ... Some companies and groups sponsor clinical trials that test the safety of ...

  4. 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)

  5. 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)

  6. 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.

  7. 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.

  8. 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)

  9. 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)

  10. 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

  11. 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...

  12. Performance evaluation of a retrofit digital detector-based mammography system.

    Science.gov (United States)

    Marshall, Nicholas W; van Ongeval, Chantal; Bosmans, Hilde

    2016-02-01

    A retrofit flat panel detector was integrated with a GE DMR+ analog mammography system and characterized using detective quantum efficiency (DQE). Technical system performance was evaluated using the European Guidelines protocol, followed by a limited evaluation of clinical image quality for 20 cases using image quality criteria in the European Guidelines. Optimal anode/filter selections were established using signal difference-to-noise ratio measurements. Only small differences in peak DQE were seen between the three anode/filter settings, with an average value of 0.53. For poly(methyl methacrylate) (PMMA) thicknesses above 60 mm, the Rh/Rh setting was the optimal anode/filter setting. The system required a mean glandular dose of 0.54 mGy at 30 kV Rh/Rh to reach the Acceptable gold thickness limit for 0.1 mm details. Imaging performance of the retrofit unit with the GE DMR+ is notably better than of powder based computed radiography systems and is comparable to current flat panel FFDM systems. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. The efficacy of using computer-aided detection (CAD) for detection of breast cancer in mammography screening: a systematic review.

    Science.gov (United States)

    Henriksen, Emilie L; Carlsen, Jonathan F; Vejborg, Ilse Mm; Nielsen, Michael B; Lauridsen, Carsten A

    2018-01-01

    Background Early detection of breast cancer (BC) is crucial in lowering the mortality. Purpose To present an overview of studies concerning computer-aided detection (CAD) in screening mammography for early detection of BC and compare diagnostic accuracy and recall rates (RR) of single reading (SR) with SR + CAD and double reading (DR) with SR + CAD. Material and Methods PRISMA guidelines were used as a review protocol. Articles on clinical trials concerning CAD for detection of BC in a screening population were included. The literature search resulted in 1522 records. A total of 1491 records were excluded by abstract and 18 were excluded by full text reading. A total of 13 articles were included. Results All but two studies from the SR vs. SR + CAD group showed an increased sensitivity and/or cancer detection rate (CDR) when adding CAD. The DR vs. SR + CAD group showed no significant differences in sensitivity and CDR. Adding CAD to SR increased the RR and decreased the specificity in all but one study. For the DR vs. SR + CAD group only one study reported a significant difference in RR. Conclusion All but two studies showed an increase in RR, sensitivity and CDR when adding CAD to SR. Compared to DR no statistically significant differences in sensitivity or CDR were reported. Additional studies based on organized population-based screening programs, with longer follow-up time, high-volume readers, and digital mammography are needed to evaluate the efficacy of CAD.

  14. The Influence of Spiritual Framing on African American Women's Mammography Intentions: A Randomized Trial.

    Science.gov (United States)

    Best, Alicia L; Spencer, S Melinda; Friedman, Daniela B; Hall, Ingrid J; Billings, Deborah

    2016-06-01

    Spiritual framing of breast cancer communication may provide a useful strategy for addressing disparate rates of breast cancer mortality among African American women. The efficacy of a spiritually framed breast cancer screening (BCS) message was compared with that of a traditional BCS message. Specifically, 200 African American women were randomly assigned to review either a spiritually framed or traditional BCS message and complete a self-administered survey, including a thought-listing form. Message efficacy was measured by number of thoughts generated (elaboration), ratio of positive to negative thoughts (polarity), and intention to obtain and/or recommend a mammogram. Multiple linear regression and structural equation modeling were used to assess direct and indirect (mediated) associations among variables. Spiritual framing was positively associated with greater elaboration (β = .265, SE = .36, p framing also had a significant indirect effect on mammography intentions through polarity (standardized indirect effect = .057, 95% confidence interval [.024, .106], p framing may improve the efficacy of BCS messages among African American women by eliciting more positive thoughts about screening. Interventions targeting African American women might consider the role of spirituality when tailoring messages to encourage regular mammography use.

  15. Detector evaluation of a prototype amorphous selenium-based full field digital mammography system

    Science.gov (United States)

    Jesneck, Jonathan L.; Saunders, Robert S.; Samei, Ehsan; Xia, Jessie Q.; Lo, Joseph Y.

    2005-04-01

    This study evaluated the physical performance of a selenium-based direct full-field digital mammography prototype detector (Siemens Mammomat NovationDR), including the pixel value vs. exposure linearity, the modulation transfer function (MTF), the normalized noise power spectrum (NNPS), and the detective quantum efficiency (DQE). The current detector is the same model which received an approvable letter from FDA for release to the US market. The results of the current prototype are compared to those of an earlier prototype. Two IEC standard beam qualities (RQA-M2: Mo/Mo, 28 kVp, 2 mm Al; RQA-M4: Mo/Mo, 35 kVp, 2 mm Al) and two additional beam qualities (MW2: W/Rh, 28 kVp, 2 mm Al; MW4: W/Rh, 35 kVp, 2 mm Al) were investigated. To calculate the modulation transfer function (MTF), a 0.1 mm Pt-Ir edge was imaged at each beam quality. Detector pixel values responded linearly against exposure values (R2 0.999). As before, above 6 cycles/mm Mo/Mo MTF was slightly higher along the chest-nipple axis compared to the left-right axis. MTF was comparable to the previously reported prototype, with slightly reduced resolution. The DQE peaks ranged from 0.71 for 3.31 μC/kg (12.83 mR) to 0.4 for 0.48 μC/kg (1.86 mR) at 1.75 cycles/mm for Mo/Mo at 28 kVp. The DQE range for W/Rh at 28 kVP was 0.81 at 2.03 μC/kg (7.87 mR) to 0.50 at 0.50 μC/kg (1.94 mR) at 1 cycle/mm. NNPS tended to increase with greater exposures, while all exposures had a significant low-frequency component. Bloom and detector edge artifacts observed previously were no longer present in this prototype. The new detector shows marked noise improvement, with slightly reduced resolution. There remain artifacts due to imperfect gain calibration, but at a reduced magnitude compared to a prototype detector.

  16. Analytical optimization of digital subtraction mammography with contrast medium using a commercial unit.

    Science.gov (United States)

    Rosado-Méndez, I; Palma, B A; Brandan, M E

    2008-12-01

    Contrast-medium-enhanced digital mammography (CEDM) is an image subtraction technique which might help unmasking lesions embedded in very dense breasts. Previous works have stated the feasibility of CEDM and the imperative need of radiological optimization. This work presents an extension of a former analytical formalism to predict contrast-to-noise ratio (CNR) in subtracted mammograms. The goal is to optimize radiological parameters available in a clinical mammographic unit (x-ray tube anode/filter combination, voltage, and loading) by maximizing CNR and minimizing total mean glandular dose (D(gT)), simulating the experimental application of an iodine-based contrast medium and the image subtraction under dual-energy nontemporal, and single- or dual-energy temporal modalities. Total breast-entrance air kerma is limited to a fixed 8.76 mGy (1 R, similar to screening studies). Mathematical expressions obtained from the formalism are evaluated using computed mammographic x-ray spectra attenuated by an adipose/glandular breast containing an elongated structure filled with an iodinated solution in various concentrations. A systematic study of contrast, its associated variance, and CNR for different spectral combinations is performed, concluding in the proposal of optimum x-ray spectra. The linearity between contrast in subtracted images and iodine mass thickness is proven, including the determination of iodine visualization limits based on Rose's detection criterion. Finally, total breast-entrance air kerma is distributed between both images in various proportions in order to maximize the figure of merit CNR2/D(gT). Predicted results indicate the advantage of temporal subtraction (either single- or dual-energy modalities) with optimum parameters corresponding to high-voltage, strongly hardened Rh/Rh spectra. For temporal techniques, CNR was found to depend mostly on the energy of the iodinated image, and thus reduction in D(gT) could be achieved if the spectral energy

  17. 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.

  18. Volumetric breast density estimation from full-field digital mammograms.

    NARCIS (Netherlands)

    Engeland, S. van; Snoeren, P.R.; Huisman, H.J.; Boetes, C.; Karssemeijer, N.

    2006-01-01

    A method is presented for estimation of dense breast tissue volume from mammograms obtained with full-field digital mammography (FFDM). The thickness of dense tissue mapping to a pixel is determined by using a physical model of image acquisition. This model is based on the assumption that the breast

  19. Mammography image quality and evidence based practice: Analysis of the demonstration of the inframammary angle in the digital setting.

    Science.gov (United States)

    Spuur, Kelly; Webb, Jodi; Poulos, Ann; Nielsen, Sharon; Robinson, Wayne

    2018-03-01

    The aim of this study is to determine the clinical rates of the demonstration of the inframammary angle (IMA) on the mediolateral oblique (MLO) view of the breast on digital mammograms and to compare the outcomes with current accreditation standards for compliance. Relationships between the IMA, age, the posterior nipple line (PNL) and compressed breast thickness will be identified and the study outcomes validated using appropriate analyses of inter-reader and inter-rater reliability and variability. Differences in left versus right data were also investigated. A quantitative retrospective study of 2270 randomly selected paired digital mammograms performed by BreastScreen NSW was undertaken. Data was collected by direct measurement and visual analysis. Intra-class correlation analyses were used to evaluate inter- and intra-rater reliability. The IMA was demonstrated on 52.4% of individual and 42.6% of paired mammograms. A linear relationship was found between the posterior nipple line (PNL) and age (p-value PNL was predicted to increase by 0.48 mm for every one year increment in age. The odds of demonstrating the IMA reduced by 2% for every one year increase in age (p-value = 0.001); are 0.4% higher for every 1 mm increase in PNL (p-value = 0.001) and 1.6% lower for every 1 mm increase in compressed breast thickness, (p-valuePNL while there was 100% agreement for the demonstration of the IMA. Analysis of the demonstration of the IMA indicates clinically achievable rates (42.6%) well below that required for compliance (50%-75%) to known worldwide accreditation standards for screening mammography. These standards should be aligned to the reported evidence base. Visualisation of the IMA is impacted negatively by increasing age and compressed breast thickness but positively by breast size (PNL). Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Clinical evaluation of JPEG2000 compression for digital mammography

    Science.gov (United States)

    Sung, Min-Mo; Kim, Hee-Joung; Kim, Eun-Kyung; Kwak, Jin-Young; Yoo, Jae-Kyung; Yoo, Hyung-Sik

    2002-06-01

    Medical images, such as computed radiography (CR), and digital mammographic images will require large storage facilities and long transmission times for picture archiving and communications system (PACS) implementation. American College of Radiology and National Equipment Manufacturers Association (ACR/NEMA) group is planning to adopt a JPEG2000 compression algorithm in digital imaging and communications in medicine (DICOM) standard to better utilize medical images. The purpose of the study was to evaluate the compression ratios of JPEG2000 for digital mammographic images using peak signal-to-noise ratio (PSNR), receiver operating characteristic (ROC) analysis, and the t-test. The traditional statistical quality measures such as PSNR, which is a commonly used measure for the evaluation of reconstructed images, measures how the reconstructed image differs from the original by making pixel-by-pixel comparisons. The ability to accurately discriminate diseased cases from normal cases is evaluated using ROC curve analysis. ROC curves can be used to compare the diagnostic performance of two or more reconstructed images. The t test can be also used to evaluate the subjective image quality of reconstructed images. The results of the t test suggested that the possible compression ratios using JPEG2000 for digital mammographic images may be as much as 15:1 without visual loss or with preserving significant medical information at a confidence level of 99%, although both PSNR and ROC analyses suggest as much as 80:1 compression ratio can be achieved without affecting clinical diagnostic performance.