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.

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)

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

Do cultural factors predict mammography behaviour among Korean immigrants in the USA?

Science.gov (United States)

Lee, Hanju; Kim, Jiyun; Han, Hae-Ra

2009-12-01

This paper is a report of a study of the correlates of mammogram use among Korean American women. Despite the increasing incidence of and mortality from breast cancer, Asian women in the United States of America report consistently low rates of mammography screening. A number of health beliefs and sociodemographic characteristics have been associated with mammogram participation among these women. However, studies systematically investigating cultural factors in relation to mammogram experience have been scarce. We measured screening-related health beliefs, modesty and use of Eastern medicine in 100 Korean American women in 2006. Hierarchical logistic regression was used to examine the unique contribution of the study variables, after accounting for sociodemographic characteristics. Only 51% reported past mammogram use. Korean American women who had previously had mammograms were statistically significantly older and had higher perceived benefit scores than those who had not. Perceived benefits (odds ratio = 6.3, 95% confidence interval = 2.12, 18.76) and breast cancer susceptibility (odds ratio = 3.18, 95% confidence interval = 1.06, 9.59) were statistically significant correlates of mammography experience, whereas cultural factors did not correlate. Post hoc analysis showed that for women with some or good English skills, cultural factors statistically significantly correlated with health beliefs and breast cancer knowledge (P culturally tailored interventions of more targeted outreach and healthcare system navigation assistance for promoting mammography screening in Korean American women. Further research is needed to unravel the interplay between acculturation, cultural factors and health beliefs related to cancer screening behaviours of Korean American women.

Mammography and Pap test screening among low-income foreign-born Hispanic women in the USA

Directory of Open Access Journals (Sweden)

Fernandez Maria E.

1998-01-01

Full Text Available Little is known about the factors influencing screening among low-income Hispanic women particularly among recent immigrants. A sample of 148 low-income, low-literate, foreign-born Hispanic women residing in the Washington DC metropolitan area participated in the study. The mean age of the sample was 46.2 (SD = 11.5, 84% reported annual household incomes<=$15,000. All women were Spanish speakers and had low acculturation levels. Ninety six percent had reported having a Pap smear, but 24% were not in compliance with recommended screening (Pap test within the last 3 years. Among women 40 and older, 62% had received a mammogram, but only 33% were compliant with age appropriate recommended mammography screening guidelines. Women in this study had more misconceptions about cancer than Hispanics in other studies. Multivariate logistic models for correlates of Pap test and mammography screening behavior indicate that factors such as fear of the screening test, embarrassment, and lack of knowledge influenced screening behavior. In conclusion, women in this study had lower rates of mammography screening than non-Hispanic women and lower rates of compliance with recommended Mammography and Pap test screening guidelines.

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

Validation of the English and Spanish Mammography Beliefs and Attitudes Questionnaire.

Science.gov (United States)

Lopez-McKee, Gloria; Bader, Julia

2011-03-21

Breast cancer is the leading cause of cancer deaths among Hispanic women in the United States. Unfortunately Hispanic women exhibit poor mammography screening participation, are diagnosed at later stages of the disease, and have lower survival rates than non-Hispanic white women. Several cultural and psycho-social factors have been found to influence mammography screening participation among Hispanic women. We will begin by presenting the theoretical framework that grounded this research program to develop an instrument to assess factors contributing to poor mammography participation among Hispanic women. We will also summarize the early stages in the development of the English and Spanish Mammography Beliefs and Attitudes Questionnaire (MBAQ and SMBAQ) for use with low-health-literacy Mexican-American women. Next we will describe the initial psychometric testing of the MBAQ/SMBAQ, after which we will present the psychometric testing of the SMBAQ with low-health-literacy women. This will be followed by a discussion of the modification of the MBAQ and SMBAQ subscales. We'll conclude with a discussion of the instruments and share our assessment regarding the limitations of this research program, where the program stands to date, and the implications for practice and future research.

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

Science.gov (United States)

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

2011-08-01

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

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

Science.gov (United States)

Sohail, Saba; Masroor, Imrana; Afzal, Shaista

2015-08-01

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

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…

Influence of the menstrual cycle on compression-induced pain during mammography: correlation with the thickness and volume of the mammary gland.

Science.gov (United States)

Kitaoka, Hitomi; Kawashima, Hiroko

2018-03-01

In mammography, breast compression is necessary and an important factor influencing image quality. The purpose of this study was to determine the influence of the menstrual cycle on compression-induced pain during mammography and to evaluate the association between the thickness and volume of the mammary gland and pain. We examined basal body temperature and categorized the menstrual cycle into five phases. We executed breast compression in the craniocaudal view using a customized compression plate, to which we introduced an opening. We measured the thickness of the mammary gland under compression using echography. Immediately after releasing the compression, we evaluated pain using the visual analogue scale. We performed magnetic resonance imaging (MRI) on the same day and measured the volume of the mammary gland. The thickness of the mammary gland, pain, and the volume of the mammary gland were minimal in the late follicular phase and maximal in the late luteal and early follicular phases. It was shown that the changes in the thickness and volume of the mammary gland during the menstrual cycle accounted for the changes in compression-induced pain. On MRI examination of each breast quadrant, the same changes were observed in areas A and C. In area A, it was shown that both the anatomical characteristics and the increase in volume of the mammary gland were associated with pain. We concluded that the late follicular phase constitutes the optimal timing for mammography.

Health-related lifestyle factors and mammography screening attendance in a Swedish cohort study.

Science.gov (United States)

Lagerlund, Magdalena; Drake, Isabel; Wirfält, Elisabet; Sontrop, Jessica M; Zackrisson, Sophia

2015-01-01

To determine whether health-related lifestyle factors are associated with attendance at a population-based invitational mammography screening program in southern Sweden, data on health-related lifestyle factors (smoking, alcohol use, physical activity, BMI, diet, self-rated health, and stress) were obtained from the Malmö Diet and Cancer Study and linked to the Malmö mammography register (Sweden, 1992-2009). Women (n=11 409) who were free from breast cancer at study entry were included in the cohort, and mammography attendance was followed from cohort entry to 31 December 2009. Generalized estimating equations were used to account for repeated measures within patients. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported. Nonattendance occurred in 8% of the 69 746 screening opportunities that were observed. Nonattendance was more common among women who were current or former smokers [OR=1.60 (1.45-1.76) and OR=1.15 (1.05-1.28)], had not used alcohol in the past year [OR=1.55 (1.32-1.83)], were less physically active outside of work [OR=1.10 (1.00-1.20)], had high physical activity at work (OR=1.13, 95% CI: 1.00-1.28), were vegetarians or vegans [OR=1.49 (1.11-1.99)], had not used dietary supplements [OR=1.11 (1.01-1.21)], had poor self-rated health [OR=1.24 (1.14-1.36)], and were experiencing greater stress [OR=1.25 (1.14-1.36)]. In this cohort, nonattendance was associated with smoking, alcohol abstinence, physical activity, poor self-rated health, stress, and following a vegetarian/vegan diet. These findings generally support the notion that women with less healthy lifestyles are less likely to engage in mammography screening.

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.

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.

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...

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

Mammography screening in Greece: An exploratory survey of women's views, experiences and behaviours

Directory of Open Access Journals (Sweden)

Athena Kalokerinou

2012-01-01

Full Text Available Background: Internationally, breast cancer comprises 29% of all cancer incidences. In Greece, 1,500-1,800women die annually from breast cancer out of the 4,000 who are affected. Only 5% are detected at an early diseasestage through mammography screening.Aim: This paper presents findings from a study exploring the factors that influence Greek women’smammography screening behaviour.Methodology: Data were collected in Athens-Greece, during the period March-July 2008, from individuals whowere members of six women’s associations. One hundred and eighty six questionnaires were completed and 33interviews were conducted from a sub-sample. This paper reports the findings from the questionnaire survey.Results: Participants had a variety of demographic characteristics with 85% of them having attendedmammography screening. Only 61% of them intended to continue in the future. Τhe majority of women agreedwith a number of factors which supported their decision to participate in regular mammography screening, such asdoctors’ encouragement and mammogram efficacy to detect breast cancer at an early stage, while anxiety wasidentified as a possible inhibitor to their participation.Conclusion: Women’s mammography screening behaviour and perceptions of mammography screening appearedto be positive in relation to their participation. However, the reasons as to why a large number of women indicatedthey were unlikely to go for mammography screening again is not known, and needs further investigation.

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)

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.)

Using Mammography Screening: Hmong Women’s Perceptions and Beliefs

Directory of Open Access Journals (Sweden)

Pang Vang

2010-01-01

Full Text Available Breast cancer is the second leading cause of cancer deaths among all women in the United States. Although mammography screening has been shown to be effective in detecting breast cancer, Hmong women, one of the Asian American/Pacific Islander subgroups, have a very low screening rate. The purpose of this study was to explore factors that influence Hmong women‘s willingness to be screened for breast cancer. Grounded Theory methodology guided the analysis of fifteen qualitative interviews with Midwestern Hmong women between the ages of40-64. Regardless of age, length of US residency, and language spoken, the results showed one core theme and three interrelated themes regarding the women‘s decision to seek mammographyscreening. The three interrelated themes of Breast Health Messages, Screening Barriers, and Screening Facilitators can have negative and/or positive influences on the core theme of mammography-screening decision-making processes. The first related theme of Breast HealthMessages included professional and lay breast health messages. The second related theme, Screening Facilitators, included breast health messages from professionals, abnormal findings, social support, risk for getting breast cancer, doctor‘s recommendations, and insurance. The third related theme, Screening Barriers, identified symptomatic health seeking behavior, instrumental barriers, fear, social influence (which included lay breast health messages, use of traditional Hmong healing practices, embarrassment, and perception of breast cancer risk. This study suggested that the healthcare professionals need to use a culturally sensitive and multidisciplinaryapproach to provide breast health education as well as to assess and provide instrumental support, while encouraging social support to influence Hmong women to attain mammography screening.

Mammography screening among Arab American women in metropolitan Detroit.

Science.gov (United States)

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

2008-12-01

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

Radiology Residents' Performance in Screening Mammography Interpretation

International Nuclear Information System (INIS)

Lee, Eun Hye; Lyou, Chae Yeon

2013-01-01

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

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

[Hierarchy structuring for mammography technique by interpretive structural modeling method].

Science.gov (United States)

Kudo, Nozomi; Kurowarabi, Kunio; Terashita, Takayoshi; Nishimoto, Naoki; Ogasawara, Katsuhiko

2009-10-20

Participation in screening mammography is currently desired in Japan because of the increase in breast cancer morbidity. However, the pain and discomfort of mammography is recognized as a significant deterrent for women considering this examination. Thus quick procedures, sufficient experience, and advanced skills are required for radiologic technologists. The aim of this study was to make the point of imaging techniques explicit and to help understand the complicated procedure. We interviewed 3 technologists who were highly skilled in mammography, and 14 factors were retrieved by using brainstorming and the KJ method. We then applied Interpretive Structural Modeling (ISM) to the factors and developed a hierarchical concept structure. The result showed a six-layer hierarchy whose top node was explanation of the entire procedure on mammography. Male technologists were related to as a negative factor. Factors concerned with explanation were at the upper node. We gave attention to X-ray techniques and considerations. The findings will help beginners improve their skills.

The study of mean glandular dose in mammography in Yazd and the factors affecting it

International Nuclear Information System (INIS)

Bouzarjomehri, F.; Mostaar, A.; Ghasemi, A.; Ehramposh, M. H.; Khosravi, H.

2006-01-01

The objective of this study was to determine the mean glandular dose resulting from mammography examinations in Yazd, southeastern Iran and to identify the factors affecting it. Patients and Methods: This survey was conducted during May to December 2005 to estimate the mean glandular dose for women undergoing mammography and to report the distribution of dose. compressed breast thickness, glandular tissue content, and mammography technique used. The clinical data were collected from 946 mammograms taken from 246 women who were referred to four mammography centers. The mammography instruments in these centers were four modern units with a molybdenum anode and either molybdenum or rhodium filter. The exposure conditions of each mammogram were recorded. The breast glandular content of each mammogram was estimated by a radiologist. The mean glandular dose was calculated based on measuring the normalized entrance skin dose in air. half value layer, kVp, mAs, breast thickness and glandular content. Half value layer, kVp and entrance skin dose were measured by a solid-state detector. The analytical method of Sobol et al. was used for calculation of mean glandular dose . Results: The mean±SD mean glandular dose per film was.2±0.6 mGy for cranio caudal and 1.63±O.9 mGy for mediolateral oblique views. The mean±SD mean glandular dose per woman was 5.5 3.1.mGy. A positive correlation was found between the beam Half value layer with mean glandular dose (r=O.38) and the breast thickness with mean glandular dose (r=O.5). Conclusion: The mean±SD mean glandular dose per film of 1.42±0.8 mGy in present study was lower than most of similar reports. However, the mean mean glandular dose per woman was higher than that in other studies

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

A Survey on Physical Factors and Compressed Breast Thickness in Voluntary Mammography Screening Using FFDM System in Malaysia: Preliminary Results

International Nuclear Information System (INIS)

Noriah Jamal; Humairah Samad Cheung; Siti Kamariah Che Mohamad; Ellyda Muhamad Nordin

2013-01-01

This paper aims at presenting preliminary results of a survey on physical factors, namely tube potential (kV), tube current exposure time product (mAs) and compressed breast thickness (CBT) during voluntary mammography screening using Full-Field Digital Mammography (FFDM) System in Malaysia. Retrospective data were collected from 1128 FFDM images of 282 women from three major ethnic groups (Malay, Chinese and Indian) who underwent voluntary screening mammography at Breast Centre, International Islamic University Malaysia from January to March 2008. Results from the present study were then compared with results from the previous study on Screen-Film Mammography System (SFM) according to the ethnic group for both Cranio-caudal (CC) and Mediol-Lateral (MLO) views. We found that the mean kV for CC view for the three ethnic groups are Malay (28), Chinese (28) and Indian (28), and for MLO view are Malay (29), Chinese (28) and Indian (29). These values are higher than the kV for SFM which were Malay (26), Chinese (27) and Indian (26) for CC and Malay (26), Chinese (27) and Indian (26) for CC and MLO views respectively. The mean mAs for CC and MLO views for FFDM were lower compared to SFM systems. These values were Malay (104), Chinese (108) and Indian (91) for CC views and Malay (106), Chinese (105), and Indian (94) for MLO views for the FFDM system. The values for SFM system are for CC and MLO views were Malay (120), Chinese (106) and Indian (126), and Malay (166), Chinese (132), Indian (183) respectively. The median CBT for CC and MLO views increased by 27 % and 7 % respectively on the FFDM compared to the SFM system. In conclusion, the FFDM operates with higher kV, lower mAs, and higher CBT when compared with SFM system. Median CBT on CC and MLO view with FFDM system are 27 % and 7 % higher respectively compared to the SFM. We are currently collecting data on mean glandular dose with FFDM systems to assess how the change in local mammography practice influences this

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.

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.

An evaluation of musculoskeletal discomfort experience by radiographers performing mammography

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Gale, A.G.; May, J

1997-10-01

The aim of this study was to establish whether breast screening radiographers experience any problems of musculoskeletal discomfort, and if so the nature and extent of these problems. The study was then further extended to investigate and determine possible occupational, causal or contributory factors, and to suggest recommendations to help alleviate any discomfort. To investigate this problem five main approaches were undertaken. These consisted of; a national survey, an observational study, the comparison of the physical measurements of the mammography units with anthropometric data, a detailed task analysis, and a body mapping study. The national survey set out to determine if the nature and frequency of such problems were higher in mammography than in other areas of radiography or in the general population. Additionally, comparisons were made with non-radiographic staff working at the same breast screening centres. Video recordings of radiographers performing breast screening were also made and posture analysis performed on these data. A detailed task analysis was conducted to identify interaction points and possible problems between the radiographer and the equipment which she is required to use. Physical measurements of the mammography units were made and compared with anthropometric measurements and guidelines. The body mapping study measured the build up of discomfort throughout the working day on several different mammography units. The results from the survey questionnaire indicated that some breast screening radiographers do experience musculoskeletal problems, and that these are different in nature and prevalence from the musculoskeletal discomfort reported by the two control groups. The prevalence of back pain reported by radiographers undertaking mammography was higher than that present in the normal population. No comparison could be made with other body areas as data regarding other types of musculoskeletal discomfort in the general population are

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.)

Pain during mammography: Implications for breast screening programmes

International Nuclear Information System (INIS)

Andrews, F.J.

2001-01-01

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

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

Science.gov (United States)

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

2009-12-01

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

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

Science.gov (United States)

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

2009-01-01

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

An evaluation of musculoskeletal discomfort experience by radiographers performing mammography

International Nuclear Information System (INIS)

Gale, A.G.; May, J.

1997-01-01

The aim of this study was to establish whether breast screening radiographers experience any problems of musculoskeletal discomfort, and if so the nature and extent of these problems. The study was then further extended to investigate and determine possible occupational, causal or contributory factors, and to suggest recommendations to help alleviate any discomfort. To investigate this problem five main approaches were undertaken. These consisted of; a national survey, an observational study, the comparison of the physical measurements of the mammography units with anthropometric data, a detailed task analysis, and a body mapping study. The national survey set out to determine if the nature and frequency of such problems were higher in mammography than in other areas of radiography or in the general population. Additionally, comparisons were made with non-radiographic staff working at the same breast screening centres. Video recordings of radiographers performing breast screening were also made and posture analysis performed on these data. A detailed task analysis was conducted to identify interaction points and possible problems between the radiographer and the equipment which she is required to use. Physical measurements of the mammography units were made and compared with anthropometric measurements and guidelines. The body mapping study measured the build up of discomfort throughout the working day on several different mammography units. The results from the survey questionnaire indicated that some breast screening radiographers do experience musculoskeletal problems, and that these are different in nature and prevalence from the musculoskeletal discomfort reported by the two control groups. The prevalence of back pain reported by radiographers undertaking mammography was higher than that present in the normal population. No comparison could be made with other body areas as data regarding other types of musculoskeletal discomfort in the general population are

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.

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

Patterns and determinants of mammography screening in Lebanese women.

Science.gov (United States)

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

2017-03-01

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

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.)

Practical digital mammography

Energy Technology Data Exchange (ETDEWEB)

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

2008-07-01

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

Practical digital mammography

International Nuclear Information System (INIS)

Hashimoto, Beverly E.

2008-01-01

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

Mammography-oncogenecity at low doses

International Nuclear Information System (INIS)

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

2009-01-01

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

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.

Religious beliefs and mammography intention: findings from a qualitative study of a diverse group of American Muslim women.

Science.gov (United States)

Padela, Aasim I; Vu, Milkie; Muhammad, Hadiyah; Marfani, Farha; Mallick, Saleha; Peek, Monica; Quinn, Michael T

2016-10-01

Studies suggest that American Muslim women underutilize mammography. While religion has a strong influence upon Muslim health behaviors, scant research has examined how religion-related beliefs inform Muslim women's intention for mammography. Our study identifies and examines such beliefs. Muslim women aged 40 years and older sampled from mosques participated in focus groups and individual interviews. Drawing upon the theory of planned behavior, interviews elicited salient behavioral, normative, and control beliefs regarding mammography and the influence of Islam upon screening intention. Fifty women participated in 6 focus groups and 19 in semistructured interviews, with near-equal numbers of African American, South Asian, and Arab Muslims. Forty-two percent of participants had not had a mammogram within the past 2 years. Across differences in race/ethnicity and mammography status, women voiced four religion-related salient beliefs that inform mammography intention: (1) the perceived duty to care for one's health, (2) religious practices as methods of disease prevention, (3) fatalistic notions about health, and (4) comfort with gender concordant health care. Religious beliefs influence decisions to pursue mammography across the ethnic/racial diversity of Muslim women. Notions about duty to God and the stewardship of one's body appear to enhance mammography intention. Theocentric notions of cure and illness and varied views regarding personal agency also inform decisional frames that impact mammography intention. Given the salience of religion among our participants, religiously tailored messages in interventions have the potential to enhance cancer screening. Copyright © 2016 John Wiley & Sons, Ltd.

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

Directory of Open Access Journals (Sweden)

Mitra Moodi

2012-01-01

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

Reader practice in mammography screen reporting in Australia

International Nuclear Information System (INIS)

Reed, W.; Poulos, A.; Brennan, P.

2009-01-01

Full text: Reader variability is a problem in mammography image reporting and compromises the efficacy of screening programmes. The purpose of this exploratory study was to survey reader practice in reporting screening mammograms in Australia to identify aspects of practice that warrant further investigation. Mammography reporting practice and influences on concentration and attention were investigated by using an original questionnaire distributed to screen readers in Australia. A response rate of 71% (83 out of 117) was achieved. Demographic data indicated that the majority of readers were over 46 years of age (73%), have been reporting on screening mammograms for over 10 years (61%), take less than 1 min to report upon a screening mammogram examination (66%), report up to 200 examinations in a single session (83%) and take up to 2 h to report one session (61%). A majority report on more than 5000 examinations annually (66%); 93% of participants regard their search strategy as systematic, 87% agreed that their concentration can vary throughout a session, 64% agreed that the relatively low number of positives can lead to lapses in concentration and attention and almost all (94%) participants agreed that methods to maximise concentration should be explored. Participants identified a range of influences on concentration within their working environment including volume of images reported in one session, image types and aspects of the physical environment. This study has provided important evidence of the need to investigate adverse influences on concentration during mammography screen reporting

Factors associated with breast arterial calcification on mammography

International Nuclear Information System (INIS)

Zafar, A.N.; Khan, S.; Zafar, S.N.

2013-01-01

Objective: To determine the frequency of breast arterial calcifications (BAC) as seen on mammographic examination and to determine the association between BAC and hypertension, age, parity and weight of the person. Study Design: Cross-sectional analytic study. Place and Duration of Study: Department of Diagnostic Radiology, Military Hospital, Rawalpindi, from January 2006 to January 2007. Methodology: Two hundred patients undergoing mammography were studied to evaluate the association of BAC with raised blood pressure, age and parity. Previous history of lactation and the patients' weight were also recorded. Proportions of classes were compared using chi-square test. Results: 13.5% of the subjects (n = 200) were positive for BAC on mammograms. Mean age of the BAC positive subjects was higher than their counterparts found negative for BAC. Women bearing 5 - 6 children showed the highest frequency of BAC. Seventy seven (10.38%) of the BAC positive cases had previous history of lactation, whereas 15.44% (n = 123) had not breast fed their children and showed BAC. No significant association of presence of BAC was noted with the weight of the subjects. Conclusion: The frequency of presence of BAC on mammography was associated with systemic hypertension and higher age. It also increased with the reproductive parameters of a woman. (author)

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.

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

Science.gov (United States)

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

2013-04-01

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

The self-referred mammography patient

International Nuclear Information System (INIS)

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

1990-01-01

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

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.

Mammography dose in relation to body mass index, race, and menopausal status

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Schubauer-Berigan, M.K.; Frey, G.D.; Baron, L.; Hoel, D.G

2002-07-01

Mammography dose increases with compressed breast thickness (CBT), but few studies have examined other correlates of dose. The purpose of this study was to evaluate the relation between factors such as race, age, body mass index (BMI), CBT, and menopausal status and mammography screening dose, measured for 509 women in a US population. A multiple linear regression model was developed for dose, based on consideration of these factors as well as examination characteristics. BMI and number of films during examination were positively related to dose. After adjusting for these factors, high CBT also leads to higher dose. Whites receive lower doses than black women, but differences are slight after controlling for the effects of CBT and BMI, which were significantly higher among black women. Pre-menopausal women receive higher doses, after adjusting for all other factors, than post-menopausal women. Jointly, these factors account for approximately 75% to 80% of the variability in dose among this study population. Because rates of overweight are increasing in the US, average doses from mammography may be increasing as well. (author)

Mammography dose in relation to body mass index, race, and menopausal status

International Nuclear Information System (INIS)

Schubauer-Berigan, M.K.; Frey, G.D.; Baron, L.; Hoel, D.G.

2002-01-01

Mammography dose increases with compressed breast thickness (CBT), but few studies have examined other correlates of dose. The purpose of this study was to evaluate the relation between factors such as race, age, body mass index (BMI), CBT, and menopausal status and mammography screening dose, measured for 509 women in a US population. A multiple linear regression model was developed for dose, based on consideration of these factors as well as examination characteristics. BMI and number of films during examination were positively related to dose. After adjusting for these factors, high CBT also leads to higher dose. Whites receive lower doses than black women, but differences are slight after controlling for the effects of CBT and BMI, which were significantly higher among black women. Pre-menopausal women receive higher doses, after adjusting for all other factors, than post-menopausal women. Jointly, these factors account for approximately 75% to 80% of the variability in dose among this study population. Because rates of overweight are increasing in the US, average doses from mammography may be increasing as well. (author)

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

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.

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-10-15

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

Heterogeneity in mammography use across the nation: separating evidence of disparities from the disproportionate effects of geography

Directory of Open Access Journals (Sweden)

Clayton Laurel

2008-06-01

Full Text Available Abstract Background Mammography is essential for early detection of breast cancer and both reduced morbidity and increased survival among breast cancer victims. Utilization is lower than national guidelines, and evidence of a recent decline in mammography use has sparked concern. We demonstrate that regression models estimated over pooled samples of heterogeneous states may provide misleading information regarding predictors of health care utilization and that comprehensive cancer control efforts should focus on understanding these differences and underlying causal factors. Our study population includes all women over age 64 with breast cancer in the Surveillance Epidemiology and End Results (SEER cancer registries, linked to a nationally representative 5% reference sample of Medicare-eligible women located in 11 states that span all census regions and are heterogeneous in racial and ethnic mix. Combining women with and without cancer in the sample allows assessment of previous cancer diagnosis on propensity to use mammography. Our conceptual model recognizes the interplay between individual, social, cultural, and physical environments along the pathways to health care utilization, while delineating local and more distant levels of influence among contextual variables. In regression modeling, we assess individual-level effects, direct effects of contextual factors, and interaction effects between individual and contextual factors. Results Pooling all women across states leads to quite different conclusions than state-specific models. Commuter intensity, community acculturation, and community elderly impoverishment have significant direct impacts on mammography use which vary across states. Minorities living in isolated enclaves with others of the same race/ethnicity may be either advantaged or disadvantaged, depending upon the place studied. Conclusion Careful analysis of place-specific context is essential for understanding differences across

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.

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.

Prognostic value of contrast-enhanced MR mammography in patients with breast cancer.

Science.gov (United States)

Fischer, U; Kopka, L; Brinck, U; Korabiowska, M; Schauer, A; Grabbe, E

1997-01-01

The objective of this study was to evaluate the prognostic value of contrast-enhanced MR mammography in patients with breast cancer. A total of 190 patients with breast cancer (37 noninvasive carcinomas, 153 invasive carcinomas) underwent dynamic contrast-enhanced MR mammography preoperatively. Using 1.5-T unit, T1-weighted sequences (2D FLASH) were obtained repeatedly one time before and five times after IV administration of 0.1 mmol gadopentetate-dimeglumine per kilogram body weight. The findings on MR imaging were correlated with histopathologically defined prognostic factors (histological type, tumor size, tumor grading, metastasis in lymph nodes). In addition, immunohistochemically defined prognostic factors (c-erbB-1, c-erbB-2, p53, Ki-67) were correlated with the signal increase on MR mammogram in 40 patients. There was no significant correlation between the findings on MR mammography and the histopathological type of carcinoma, the grading, and the lymphonodular status. Noninvasive carcinomas showed a higher rate of moderate (38 %) or low (27 %) enhancement on MR imaging than invasive carcinomas (6 and 3 %). The results on MR mammography and the results of immunohistochemical stainings did not correlate significantly. Noninvasive carcinomas showed significantly lower enhancement than invasive carcinomas. However, the signal behavior of contrast-enhanced MR mammography is not related to established histopathological prognostic parameters as subtyping, grading, nodal status, and the expression of certain oncogenes/tumor suppressor genes.

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

Science.gov (United States)

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

2015-07-01

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

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.

Mammography at reduced doses: present performance and future possibilities

International Nuclear Information System (INIS)

Muntz, E.P.; Wilkinson, E.; George, F.W.

1980-01-01

Reduced dose mammography is assessed with the aid of very recent work. It is concluded that there are technical and clinical reasons for believing that the reduced dose systems and their interpreters should perform more effectively than their predecessors. Review of known technologic achievements suggests a possible 6 to 7 reduction factor from present screen-film mammography dose levels without sacficifing image quality. Reasonable estimates of representative doses presently achieved by both xeroradiography and screen-film systems are given. The screen-film value is about 3 times higher than some previous

Review and analysis of mammographies of Servicio de Radiologia Hospital San Juan de Dios

International Nuclear Information System (INIS)

Araya Cerdas, Adrian; Mirambell Sanchez, Melania; Monge Vega, Mandred; Mora Vargas, Karla; Vega Aguilar, Laura

2013-01-01

The concept of mammography is defined. The mammography has been estimated as the best tool currently available for the detection of breast cancer in its early stages, in addition, have been detected clinically occult lesions. Mammographies of the Servicio de Radiologia Hospital San Juan de Dios were analyzed for a total of 1250. The findings were related as static between BIRADS categorization and inherited-family factors, geographical and personal pathological of patients treated in the period September 2012 to January 2013 [es

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

Science.gov (United States)

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

2016-10-01

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

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).

Effectiveness of a Mobile Mammography Program.

Science.gov (United States)

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

2017-12-01

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

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.

Prognostic value of contrast-enhanced MR mammography in patients with breast cancer

International Nuclear Information System (INIS)

Fischer, U.; Kopka, L.; Brinck, U.; Korabiowska, M.; Schauer, A.; Grabbe, E.

1997-01-01

The objective of this study was to evaluate the prognostic value of contrast-enhanced MR mammography in patients with breast cancer. A total of 190 patients with breast cancer (37 noninvasive carcinomas, 153 invasive carcinomas) underwent dynamic contrast-enhanced MR mammography preoperatively. Using 1.5-T unit, T1-weighted sequences (2D FLASH) were obtained repeatedly one time before and five times after IV administration of 0.1 mmol gadopentetate-dimeglumine per kilogram body weight. The findings on MR imaging were correlated with histopathologically defined prognostic factors (histological type, tumor size, tumor grading, metastasis in lymph nodes). In addition, immunohistochemically defined prognostic factors (c-erbB-1,c-erbB-2, p53, Ki-67) were correlated with the signal increase on MR mammogram in 40 patients. There was no significant correlation between the findings on MR mammography and the histopathological type of carcinoma, the grading, and the lymphonodular status. Noninvasive carcinomas showed a higher rate of moderate (38 %) or low (27 %) enhancement on MR imaging than invasive carcinomas (6 and 3 %). The results on MR mammography and the results of immunohistochemical stainings did not correlate significantly. Noninvasive carcinomas showed significantly lower enhancement than invasive carcinomas. However, the signal behavior of contrast-enhanced MR mammography is not related to established histopathological prognostic parameters as subtyping, grading, nodal status, and the expression of certain oncogenes/tumor suppressor genes. (orig.). With 5 tabs

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.

Screening mammography in women 65 years old and older

International Nuclear Information System (INIS)

Rubin, E.; Mulligan, S.A.; Han, S.Y.; Bernreuter, W.K.; Stanley, R.J.

1990-01-01

This paper compares the results of mammographic screening in women aged 65 years and older to those of women aged 50--64 years, to define risk factors and prior use of mammography in these women, and to determine whether mammographic abnormalities are managed differently in the two age groups. Historical data, mammographic findings, and biopsy results were analyzed for all women over 50 years of age screened during 1988 (2,862 patients) at a university hospital-based outpatient center and mobile van, excluding those referred by oncologists. The following factors were determined for patients screened at the outpatient center and the mobile van, with both groups divided according to patient age (50--64 vs ≥ 65 years): presence of risk factors, previous biopsy, exogenous hormones, percentage of black patients, previous mammography, biopsy rate, cancer detection rate, positive nodes, and presence of tumors smaller than 1 cm or ductal carcinoma in-situ

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 ...

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)

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 ...

Discount rates and the education gradient in mammography in the UK.

Science.gov (United States)

Bíró, Anikó

2013-09-01

I analyse intertemporal decisions on undertaking breast cancer screening by women aged 50-64  years in the UK and provide estimates of the rate of discounting potential future benefits of screening. I also analyse education differences in mammography decisions and examine the underlying mechanisms by which education influences breast cancer screening attendance. I estimate a structural model, which reveals that although there are differences in the disutility of breast cancer screening between education groups, there is no difference in the estimated discount factor. These results suggest that the observed education gradient is mainly due to differences in health behaviours and healthcare attitudes. Copyright © 2013 John Wiley & Sons, Ltd.

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.

The dose and image quality in mammography in Macedonia

International Nuclear Information System (INIS)

Gershan, V.

2007-01-01

Complete test of publication follows. Mean Glandular Dose (MGD), dose distribution, phantom and quality of the real mammogram were studied for the first time in Macedonia. The study was conducted to review the condition of mammography equipment, to access the dose and image quality in mammography practices in Macedonia.. The purpose was to find out the weak points in the mammography practices in order to suggest improvements in the practices and establish quality control procedures. Under evaluation were 12 monographic machines. MGD was estimated using Entrance Surface Air KERMA at the breast surface K f measured free in air and appropriate conversion factors. Dose survey was curried by measurement and calculated of the HVLs and radiation output for 25-32 kVp and keeping record of the clinical parameters (breast thickness, kVp, mAs). Image quality was evaluated using the Mammographic Accreditation Phantom Gammex 156, PMMA plates and test tool for film processing.

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

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

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.

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

Science.gov (United States)

Houssami, Nehmat

2017-09-28

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

Thermoluminescence dosimetry in quality imaging in CR mammography systems

Energy Technology Data Exchange (ETDEWEB)

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

2006-07-01

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

Thermoluminescence dosimetry in quality imaging in CR mammography systems

International Nuclear Information System (INIS)

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

2006-01-01

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

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.

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.

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.)

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

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...

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

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

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)

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.

Influence of breast compression pressure on the performance of population-based mammography screening

NARCIS (Netherlands)

Holland, Katharina; Sechopoulos, Ioannis; Mann, Ritse M.; Den Heeten, Gerard J.; van Gils, Carla H.; Karssemeijer, Nico

2017-01-01

Background: In mammography, breast compression is applied to reduce the thickness of the breast. While it is widely accepted that firm breast compression is needed to ensure acceptable image quality, guidelines remain vague about how much compression should be applied during mammogram acquisition. A

Postmortem validation of breast density using dual-energy mammography

Energy Technology Data Exchange (ETDEWEB)

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

2014-08-15

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

Postmortem validation of breast density using dual-energy mammography

International Nuclear Information System (INIS)

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

2014-01-01

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

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

The U.S. Online News Coverage of Mammography Based on a Google News Search.

Science.gov (United States)

Young Lin, Leng Leng; Rosenkrantz, Andrew B

2017-12-01

To characterize online news coverage relating to mammography, including articles' stance toward screening mammography. Google News was used to search U.S. news sites over a 9-year period (2006-2015) based on the search terms "mammography" and "mammogram." The top 100 search results were recorded. Identified articles were manually reviewed. The top 100 news articles were from the following sources: local news outlet (50%), national news outlet (24%), nonimaging medical source (13%), entertainment or culture news outlet (6%), business news outlet (4%), peer-reviewed journal (1%), and radiology news outlet (1%). Most common major themes were the screening mammography controversy (29%), description of a new breast imaging technology (23%), dense breasts (11%), and promotion of a public screening initiative (11%). For the most recent year, article stance toward screening mammography was 59%, favorable; 16%, unfavorable; and 25%, neutral. After 2010, there was an abrupt shift in articles' stances from neutral to both favorable and unfavorable. A wide range of online news sources addressed a range of issues related to mammography. National, rather than local, news sites were more likely to focus on the screening controversy and more likely to take an unfavorable view. The controversial United States Preventive Services Task Force guidelines may have influenced articles to take a stance on screening mammography. As such online news may impact public perception of the topic and thus potentially impact guideline adherence, radiologists are encouraged to maintain awareness of this online coverage and to support the online dissemination of reliable and accurate information. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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)

Thyroid absorbed dose using TLDs during mammography

International Nuclear Information System (INIS)

Gonzalez A, M.; Melendez L, M.; Davila M, P.

2015-10-01

Full text: In this study, the mean glandular dose (MGD) and the thyroid dose (D Thy) were measured in 200 women screened with mammography in Cranio caudal (Cc) and mediolateral oblique projections. All mammograms were performed with Giotto-Ims (6000-14-M2 Model) equipment, which was verified to meet the criteria of quality of NOM-229-Ssa-2002. During audits performance and HVL, for each anode filter combinations was measured with the camera Radcal mammography equipment 10 X 6-6M (HVL = 0.26 mm Al). D Thy measurements were performed with TLD dosimeters (LiF:Mn) , that were read with the Harshaw 3500 TLD reader. The MGD, was obtained according to the UK and European protocols for mammographic dosimetry using a plane parallel chamber (Standard Imaging, Model A-600) calibrated by a radiation beam UW-23-Mo (= 0.279 mm Al HVL). A comparative statistical analysis was carried out with the measured MGD and D thy. The thyroid mean dose was 0.063 mGy and 0.078 mGy for Cc and mediolateral oblique respectively. There is a linear correlation between the MGD and the D Thy slightly influenced by the anode-filter combination. Using a 95% for the confidence interval in MGD (1.07 mGy), the 90% of measurements are in agreement with the established uncertainty limits. The D Thy are lower than the MGD. There is no risk for cancer induction in thyroid in women due to mammography screening. (Author)

Predictors of Perceived Barriers to Mammography in Korean Women

Directory of Open Access Journals (Sweden)

Jung-Hee Kim, RN, PhD

2008-06-01

Conclusion: Nurses who work with Korean women for breast cancer screening need to assess these predictive factors, including health motivation and breast cancer fear. Further extensive research will be needed to demonstrate the relationship between breast cancer fatalism and perceived barriers to mammography.

Relationship between the arterial calcification detected in mammography and coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Topal, Ugur [Department of Radiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey)], E-mail: utopal@uludag.edu.tr; Kaderli, Aysel [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Topal, Naile Bolca [Department of Radiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Ozdemir, Buelent; Yesilbursa, Dilek; Cordan, Jale [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Ediz, Buelent [Department of Statistics, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Aydinlar, Ali [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey)

2007-09-15

Objective: Arterial calcification is frequently encountered in mammography. The frequency of breast arterial calcification (BAC) increases with increasing age. Studies have shown that BAC is seen more frequently among the people who are under the risk of coronary artery diseases (CAD) such as diabetes and hypertension. The objective of this study is to investigate the relationship between the arterial calcification detected in mammography and the CAD. Material and methods: Screening mammography was performed in 123 women above the age of 40 years who had been examined with coronary angiography for the evaluation of CAD. The presence of BAC, number of affected vessels, and the distribution of calcification in the vessel wall were evaluated in the mammography. Subjects were questioned in terms of the cardiovasculary risk factors. The severity of CAD was evaluated according to the Gensini scoring. In addition, the number of blood vessels with stenosis of more than 50% was used as the vascular score. The correlation between Gensini and the vascular scores, and BAC was statistically evaluated using Mann-Whitney U and Kruskal-Wallis tests. Results: Eighty (65%) of 123 patients had CAD. BAC was detected in the mammography of 49 (39.8%) subjects. The ages and duration of menopause of the cases with BAC were significantly higher than those without BAC (p < 0.001). There was an almost significant correlation between the BAC and Gensini scores (p = 0.059). There was a significant increase in the frequency of BAC among subjects with more than two vessels with stenosis (p = 0.033). Conclusion: Frequency of BAC increases with increasing age. BAC is also frequently seen in subjects having severe coronary artery disease. Although increasing age may be a factor increasing the frequency of BAC, BAC may also be an indicator of CAD. Therefore, the mentioning of arterial calcification in mammography reports may be important in warning the clinician in terms of CAD.

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

Mammography - recent technical developments and their clinical potential

Energy Technology Data Exchange (ETDEWEB)

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

2002-05-01

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

Mammography - recent technical developments and their clinical potential

International Nuclear Information System (INIS)

Hemdal, Bengt; Mattsson, Soeren; Bjurstam, Nils

2002-05-01

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

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.)

Mammography and breast sonography in transsexual women

International Nuclear Information System (INIS)

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

2010-01-01

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

Mammography and breast sonography in transsexual women

Energy Technology Data Exchange (ETDEWEB)

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

2010-06-15

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

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.

Mammography accreditation program

Energy Technology Data Exchange (ETDEWEB)

Wilcox, P.

1993-12-31

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

Mammography accreditation program

International Nuclear Information System (INIS)

Wilcox, P.

1993-01-01

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

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)

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)

Detection of breast abnormalities on enhanced chest CT: Correlation with breast composition on mammography

Energy Technology Data Exchange (ETDEWEB)

Cho, Eun Mi; Kang, Hee; Shin, Young Gyung; Yun, Jong Hyouk; Oh, Kyung Seung [Dept. of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of)

2017-02-15

To investigate the capability of enhanced chest computed tomography (CT) for detecting breast abnormalities and to assess the influence of breast composition on this detectability. From 2000 to 2013, 75 patients who underwent mammography, breast sonography, and enhanced chest CT within one month and had abnormalities on sonography were included. Detection rate of breast abnormality on enhanced chest CT was compared among 4 types of breast composition by the Breast Imaging Reporting and Data System. Contribution of breast composition, size and enhancement of target lesions to detectability of enhanced chest CT was assessed using logistic regression and chi-square test. Of the 75 target lesions, 34 (45.3%) were detected on enhanced chest CT, corresponding with those on breast sonography; there were no significantly different detection rates among the 4 types of breast composition (p = 0.078). Breast composition [odds ratio (OR) = 1.07, p = 0.206] and enhancement (OR = 21.49, p = 0.998) had no significant effect, but size (OR = 1.23, p = 0.004) was a significant contributing factor influencing the detectability of enhanced chest CT for breast lesions. About half of the cases (45.3%) demonstrated breast lesions on chest CT corresponding with target lesions on sonography. Breast composition defined on mammography did not affect the detectability of enhanced chest CT for breast lesions.

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.

Comparison of Background Parenchymal Enhancement at Contrast-enhanced Spectral Mammography and Breast MR Imaging.

Science.gov (United States)

Sogani, Julie; Morris, Elizabeth A; Kaplan, Jennifer B; D'Alessio, Donna; Goldman, Debra; Moskowitz, Chaya S; Jochelson, Maxine S

2017-01-01

Purpose To assess the extent of background parenchymal enhancement (BPE) at contrast material-enhanced (CE) spectral mammography and breast magnetic resonance (MR) imaging, to evaluate interreader agreement in BPE assessment, and to examine the relationships between clinical factors and BPE. Materials and Methods This was a retrospective, institutional review board-approved, HIPAA-compliant study. Two hundred seventy-eight women from 25 to 76 years of age with increased breast cancer risk who underwent CE spectral mammography and MR imaging for screening or staging from 2010 through 2014 were included. Three readers independently rated BPE on CE spectral mammographic and MR images with the ordinal scale: minimal, mild, moderate, or marked. To assess pairwise agreement between BPE levels on CE spectral mammographic and MR images and among readers, weighted κ coefficients with quadratic weights were calculated. For overall agreement, mean κ values and bootstrapped 95% confidence intervals were calculated. The univariate and multivariate associations between BPE and clinical factors were examined by using generalized estimating equations separately for CE spectral mammography and MR imaging. Results Most women had minimal or mild BPE at both CE spectral mammography (68%-76%) and MR imaging (69%-76%). Between CE spectral mammography and MR imaging, the intrareader agreement ranged from moderate to substantial (κ = 0.55-0.67). Overall agreement on BPE levels between CE spectral mammography and MR imaging and among readers was substantial (κ = 0.66; 95% confidence interval: 0.61, 0.70). With both modalities, BPE demonstrated significant association with menopausal status, prior breast radiation therapy, hormonal treatment, breast density on CE spectral mammographic images, and amount of fibroglandular tissue on MR images (P spectral mammographic and MR images. © RSNA, 2016.

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

Science.gov (United States)

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

2014-01-01

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

Teaching atlas of mammography

International Nuclear Information System (INIS)

Tabar, L.; Dean, P.B.

1985-01-01

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

Women's experiences of mammography: A thematic evaluation of the literature

International Nuclear Information System (INIS)

Clark, Sarah; Reeves, Pauline J.

2015-01-01

Aim: The aim of this study was to analyse relevant literature to understand women's experiences of mammography-both screening and symptomatic. Method: A structured literature search was performed to locate relevant research. Research articles published between 2002 and 2013 were identified in CINAHL, MEDLINE and Science Direct. The quality of the research was assessed using an appropriate critical appraisal tool to enable a systematic and consistent assessment. Results: Qualitative thematic analysis of the literature identified five themes: fear, pain and discomfort, waiting, the physical environment and staff interactions. Whilst it is accepted that women's experiences are unique and diverse, literature suggested that these themes do influence women's experiences. Conclusion: Women's experiences of mammography were not limited to the examinations alone but encompassed the entire encounter. The themes identified influenced women's experiences and their perception of care

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

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...

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

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.

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

Motivators and barriers to mammography screening uptake by female health-care workers in primary health-care centres: a cross-sectional study.

Science.gov (United States)

Nazzal, Zaher; Sholi, Hisham; Sholi, Suha B; Sholi, Mohammad B; Lahaseh, Rawya

2018-02-21

Mammography screening is an effective tool for early detection and management of breast cancer. Female health-care workers' awareness of breast cancer screening is important because their beliefs and behaviours could influence other women. The aim of this study was to assess mammography screening uptake by female health-care workers at primary health-care centres and to identify the primary motivators and barriers that affect uptake. This cross-sectional study included all governmental primary health-care centres in the West Bank. Governorates were grouped into three regions as follows: north West Bank (Nablus, Jenin, Tulkarm, Tubas, Qalqiliya, and Salfit), middle West Bank (Jerusalem, Jericho, and Ramallah), and south West Bank (Hebron, and Bethlehem). The study population included all female health-care workers older than 40 years. Those who performed mammography for a suspected mass or other breast abnormalities were excluded. A self-administered questionnaire was used to collect data on demographic characteristics, knowledge about mammography screening, the extent and regularity of mammography screening, and motivators and barriers influencing their mammography screening uptake. The rate of mammography screening uptake was calculated. χ 2 test and t tests were used to assess screening motivators and barriers. The study was approved by the Institutional Review Board of the An-Najah National University. Participation was voluntary, and written consent was obtained from each participant. 299 female health-care workers completed a self-administered questionnaire. The mean age of the participants was 46 years (SD 4·7). 284 (95%) women had adequate knowledge about breast cancer and mammography screening, and 149 (50%) women reported having had at least one mammogram. 62 (21%) women had had regular scheduled mammograms. The most frequent reported motivators were the perceived benefit that early detection of breast cancer is important for its management (269 [90

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)

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

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)

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...

TL dosimetry for quality control of CR mammography imaging systems

Science.gov (United States)

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

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

Radiogenic breast cancer risk and mammography

International Nuclear Information System (INIS)

Jayaprakash, Shobha; Nair, C.P.R.; Rao, B.S.; Sawant, S.G.

2001-01-01

There is a general concern that the risks from mammography screening in inducting radiogenic breast cancer may outweigh the possible benefits to be derived from it. A review of epidemiological, case-control and cohort studies of radiogenic breast cancer, age-specific incidence and dose and dose-rate relationship reveals that such a fear is unfounded. The dose to the breast tissues in a quality assured mammography screening programme falls far below the levels that were observed to produce increased relative risk. The age-specific incidence rates also indicate that the need for mammography is for the women of age at which the relative risk is minimum

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

Directory of Open Access Journals (Sweden)

Joseph Gibbons

2016-11-01

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

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.

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

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

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

International Nuclear Information System (INIS)

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

2005-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-07-01

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

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

International Nuclear Information System (INIS)

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

2014-01-01

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

Mammography screening credit card and compliance.

Science.gov (United States)

Schapira, D V; Kumar, N B; Clark, R A; Yag, C

1992-07-15

Screening for breast cancer using mammography has been shown to be effective in reducing mortality from breast cancer. The authors attempted to determine if use of a wallet-size plastic screening "credit" card would increase participants' compliance for subsequent mammograms when compared with traditional methods of increasing compliance. Two hundred and twenty consecutive women, ages 40-70 years, undergoing their first screening mammography were recruited and assigned randomly to four groups receiving (1) a reminder plastic credit card (2) reminder credit card with written reminder; (3) appointment card; and (4) verbal recommendation. Return rates of the four groups were determined after 15 months. The return rate for subsequent mammograms was significantly higher for participants (72.4%) using the credit card than for participants (39.8%) exposed to traditional encouragement/reminders (P less than 0.0001). The credit card was designed to show the participant's screening anniversary, and the durability of the card may have been a factor in increasing the return rate. The use of reminder credit cards may increase compliance for periodic screening examinations for other cancers and other chronic diseases.

Social processes used by African American women in making decisions about mammography screening.

Science.gov (United States)

Fowler, Barbara Ann

2006-01-01

To describe the social processes used by African American (AA) women ages > or = 50 years in making decisions about mammography screening. Grounded theory methodology. Tape-recorded interviews with a researcher-designed, semi-structured interview guide with an initial and theoretical sample of 30 AA women ages 52 to 71 of diverse socioeconomic status. Interviews occurred in various settings such as the church rectory, women's homes, and work settings. Extensive written field notes and tapes were transcribed verbatim immediately after the interviews by an experienced transcriptionist. The women's decisions about mammography screening were associated with five social processes: (a) acknowledging prior experiences with healthcare providers and systems; (b) reporting fears and fatalistic beliefs of breast cancer and related treatment; (c) valuing the opinions of significant others; (d) relying on religious beliefs and supports; and (e) caregiving responsibilities of significant others. The processes were further differentiated by three distinct decision-making styles: taking charge, enduring, and protesting. Each of the social processes was reported equally and emphasized by the diverse sample of AA women in decisions related to mammography screening. Mammography screening decisions were heavily influenced by caregiving responsibilities. Further research is needed to explain and understand this social process on the health and well-being of AA women over time.

Quality control in digital mammography: the noise components

Energy Technology Data Exchange (ETDEWEB)

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

2011-07-01

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

Quality control in digital mammography: the noise components

International Nuclear Information System (INIS)

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

2011-01-01

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

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)

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)

Mammography calibration qualities establishment in a Mo-Mo clinical system

International Nuclear Information System (INIS)

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

2015-01-01

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

Mammography calibration qualities establishment in a Mo-Mo clinical system

Energy Technology Data Exchange (ETDEWEB)

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

2015-07-01

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

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

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

International Nuclear Information System (INIS)

Arboleda, Walter; Murillo Raul; Pinero, Marion

2009-01-01

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

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.

Evaluation of the influence of the TH-GEM detector components in dosimetric measurements of standard mammography beams

Energy Technology Data Exchange (ETDEWEB)

Silva, Natália F.; Castro, Maysa C.; Caldas, Linda V.E., E-mail: nsilva@ipen.br, E-mail: maysadecastro@gmail.com, E-mail: fbelonsi@gmail.com, E-mail: lcaldas@ipen.br [Instituto de Pesquisas Energéticas e Nucleares (IPEN/CNEN-SP), São Paulo, SP (Brazil); Silva, Tiago F.; Cintra, Felipe B.; Luz, Hugo N. da, E-mail: tfsilva@if.usp.br, E-mail: hugonluz@if.usp.br [Universidade de São Paulo (IF/USP), São Paulo, SP (Brazil). Instituto de Física

2017-07-01

GEM detectors have found applications in many areas due to their simplicity of construction, low cost, ruggedness and diversity of shape. A dosimeter with these qualities presents utility in several applications, as for example in diagnostic and therapeutic medicine, industrial radiography and nuclear meters. Furthermore, the high sensitivity provided by GEM detectors may extend their applications in low dose dosimetry. Based on these facts, it may be interesting to produce a prototype of a portable TH-GEM type detector with characteristics suitable for dosimetric use in X-rays with low and medium energies. The precise determination of the dosimeter characteristics is very important for laboratories of instrument calibration, as well as to determine how the various components of the detector may influence on the energy deposited in the sensitive volume. In this work, the results obtained about the influence of each one of the components present in this type of detector in standard mammography beams is presented. The code MCNP5 was used. The results allowed the adaptation of the detector to the desired conditions. (author)

Supposed cancer risk from mammography. Reply to previous statements

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

1976-12-01

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

Quality control tests for conventional mammography

International Nuclear Information System (INIS)

Dawod, Alnazer Ahmed Ibrahim

2014-12-01

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

Reproducibility of Mammography Units, Film Processing and Quality Imaging

International Nuclear Information System (INIS)

Gaona, Enrique

2003-01-01

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

Prevalence and Determinants of Repeat Mammography Among Women from a Developing Country.

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Salinas-Martínez, Ana María; Gaspar-Rivera, Jimena Estefanía; Juárez-Pérez, Oscar; Montañez-Sauceda, José Roberto; Núñez-Rocha, Georgina Mayela; Guzmán-de-la-Garza, Francisco Javier; Mathiew-Quirós, Álvaro

2017-04-01

Failures in repeat mammography decrease the potential benefits of screening; however, it is notable that the recent use of mammography is more frequently studied than repeat use. We estimated the prevalence and analyzed determinants for repeat mammography among women from Mexico, a developing country of Latin America. It was a two-stage study with an initial cross-sectional design (n = 1045) and a final case-control design that involved women of at least 45 years of age with no history of breast, ovarian, or uterine cancer. Case subjects were those with three or more mammograms in the last 5 years, with the last one carried out within the last two years (n = 444); control subjects included those who underwent ≥3 mammograms throughout their life with the most recent carried out >2 years ago (n = 444). Through interviews, we evaluated context-dependency, fulfillment of expected outcomes, self-efficacy, and risk perception, among other factors. We estimated the prevalence with 95 % confidence intervals (CI), and odds ratios (OR) using multivariate binary logistic regression. The prevalence of repeat mammography was 40.4 % (95 % CI 37.4-43.4). Self-efficacy demonstrated the highest effect on repeat use (OR 7.7, 95 % CI 4.7-12.6), followed by awareness context-dependency (OR 4.9, 95 % CI 3.3-7.2), the use of Papanicolaou testing (OR 3.5, 95 % CI 2.3-5.2), the fulfillment of expected waiting time outcome (OR 2.4, 95 % CI 1.2-4.7), and context-dependency related to self-referral/health provider referral (OR 2.4, 95 % CI 1.7-3.4), independent of risk perception, age, education, and positive emotional state of mind. The study showed a need for increasing the prevalence of promoting awareness of the determining factors of repeat mammography, which is a necessary component in the early detection of breast cancer.

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

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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.

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.

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

Science.gov (United States)

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

2018-06-04

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

Mammography practices for radiation protection in Kenya

International Nuclear Information System (INIS)

Shadrack, Anthony K.

2008-01-01

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

Risks, radiation dose and image quality of mammography

International Nuclear Information System (INIS)

Menges, V.

1979-01-01

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

Computer-aided diagnosis in routine mammography

International Nuclear Information System (INIS)

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

1998-01-01

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

Influence of lifestyle factors on mammographic density in postmenopausal women.

Directory of Open Access Journals (Sweden)

Judith S Brand

Full Text Available BACKGROUND: Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT, little is known about lifestyle factors that influence breast density. METHODS: We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI and HRT was studied. RESULTS: Overall, alcohol intake was positively associated with percent mammographic density (P trend  = 0.07. This association was modified by HRT use (P interaction  = 0.06: increasing alcohol intake was associated with increasing percent density in current HRT users (P trend  = 0.01 but not in non-current users (P trend  = 0.82. A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction  = 0.04. No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use. CONCLUSIONS: Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk.

Mammography

International Nuclear Information System (INIS)

1975-01-01

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

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

International Nuclear Information System (INIS)

Poulos, Ann; Llewellyn, Gwynnyth

2005-01-01

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

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

International Nuclear Information System (INIS)

Anon.

1994-01-01

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

Analysis of mammography on breast fibroadenoma

International Nuclear Information System (INIS)

Fu Xiaomin; Han Benyi; Zhao Yae

2009-01-01

Objective: To study the imaging characteristics of breast fibroadenoma on mammograms. Methods: Mammography of 70 patients with breast fibroadenoma confirmed by pathology were analyzed retrospectively. All patients took breast X-ray of mediolateral oblique projection and craniocaudal projection before operation. Results: In 70 cases with fibroadenoma, mammography revealed 74 foci (36 left breast, 38 right breast) of 62 cases, and failed to reveal lesions in 8 cases. The shape of the lesions was round or round-like lesion in 60(31%). The border was well-defined in 46 masses, partly well-outlined in 14 and ill-defined in 4. 'Membranoid sign' can be seen in 40 cases. Conclusion: Typical X-ray findings of breast fibroadenoma is very important, mammography is a good method of choice in diagnosis of fibroadenoma. (authors)

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

Science.gov (United States)

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

2013-01-01

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

Barriers to Mammography among Inadequately Screened Women

Science.gov (United States)

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

2015-01-01

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

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

International Nuclear Information System (INIS)

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

2000-01-01

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

Traceability and quality control in mammography: measurements and models

International Nuclear Information System (INIS)

Peixoto, Jose Guilherme Pereira

2002-10-01

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

Mammography use among women aged 18-39 years in the United States.

Science.gov (United States)

Qin, Jin; White, Mary C; Sabatino, Susan A; Febo-Vázquez, Isaedmarie

2018-04-01

Recommendations for breast cancer screening using mammography target asymptomatic women aged ≥ 40 years who are not at increased risk for breast cancer. Evidence is not available to demonstrate benefits of screening with mammography at younger ages, and little is known about mammography use among younger women. This study described mammography use among women aged 18-39 years. We analyzed data from the 2011-2015 National Survey of Family Growth, an in-person survey of a nationally representative sample of the U.S. household population. We estimated the prevalence of ever receiving a mammogram and examined reasons for the first mammograms among women aged 18-39 years without personal cancer history (n = 8324). We classified the first mammogram as a screening examination if it was performed either as part of a routine exam or because of family history of cancer. Among women aged 18-39 years, 14.3% (95% CI 13.2-15.4) reported ever having a mammogram. Prevalence of mammography use was highest among women aged 35-39 years (31.0%, 95% CI 27.8-34.5), and was higher among non-Hispanic black women than in other race/ethnicity groups. Women with a family history of breast cancer reported a higher prevalence of mammography use than women without this family history. For both women with and without a family history of breast cancer, about half of all first mammograms were performed for screening reasons. Among U.S. women aged 18-39 years with no personal cancer history, one in seven reported having received a mammogram. Women with no family history of breast cancer were as likely as those with a family history to initiate breast cancer screening with mammography before age 40. Our findings provide evidence that supports further research to examine factors that prompt young women to receive screening mammograms.

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.)

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

Science.gov (United States)

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

2014-10-01

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

Mammography and ultrasound in the evaluation of male breast disease

Energy Technology Data Exchange (ETDEWEB)

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

2010-12-15

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

Organization and standards of screening and diagnostic mammography

International Nuclear Information System (INIS)

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

1999-01-01

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

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

International Nuclear Information System (INIS)

Schnejder-Wilk, A.

2010-01-01

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

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

OpenAIRE

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

2016-01-01

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

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.

Control of quality in mammography

International Nuclear Information System (INIS)

2006-10-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Simon, N

1977-10-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1976-01-01

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

Quality assurance programme at Slovak mammography departments

International Nuclear Information System (INIS)

Horvathova, M.; Nikodemova, D.

2004-01-01

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

Control of image quality in mammography. Influence of assessing subjective image of a test object; Control de calidad de imagen en mamografia. Influencia de la valoracion subjetiva de la imagen de un objeto de prueba

Energy Technology Data Exchange (ETDEWEB)

Hernandez Concepcion, E.; Garrido Breton, C.; Batista Arce, A.; Gonzalez Lopez, S.; Catalan Acosta, A.; Hernandez Armas, J.

2013-07-01

. The object of this work is to assess the influence of the observer in the control of image quality to the digital mammography machine of our hospital, establishing reference values and tolerances that take into account the variability between observers. (Author)

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.

Mammography: Technique and diagnostic accuracy

International Nuclear Information System (INIS)

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

1974-01-01

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

Dual-energy mammography: simulation studies

International Nuclear Information System (INIS)

Bliznakova, K; Kolitsi, Z; Pallikarakis, N

2006-01-01

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

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

Quality assurance in mammography

International Nuclear Information System (INIS)

Fosmark, H.; Olerud, H.M.

1992-01-01

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

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.)

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.

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.)

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.

Influence of breast compression pressure on the performance of population-based mammography screening.

Science.gov (United States)

Holland, Katharina; Sechopoulos, Ioannis; Mann, Ritse M; den Heeten, Gerard J; van Gils, Carla H; Karssemeijer, Nico

2017-11-28

In mammography, breast compression is applied to reduce the thickness of the breast. While it is widely accepted that firm breast compression is needed to ensure acceptable image quality, guidelines remain vague about how much compression should be applied during mammogram acquisition. A quantitative parameter indicating the desirable amount of compression is not available. Consequently, little is known about the relationship between the amount of breast compression and breast cancer detectability. The purpose of this study is to determine the effect of breast compression pressure in mammography on breast cancer screening outcomes. We used digital image analysis methods to determine breast volume, percent dense volume, and pressure from 132,776 examinations of 57,179 women participating in the Dutch population-based biennial breast cancer screening program. Pressure was estimated by dividing the compression force by the area of the contact surface between breast and compression paddle. The data was subdivided into quintiles of pressure and the number of screen-detected cancers, interval cancers, false positives, and true negatives were determined for each group. Generalized estimating equations were used to account for correlation between examinations of the same woman and for the effect of breast density and volume when estimating sensitivity, specificity, and other performance measures. Sensitivity was computed using interval cancers occurring between two screening rounds and using interval cancers within 12 months after screening. Pair-wise testing for significant differences was performed. Percent dense volume increased with increasing pressure, while breast volume decreased. Sensitivity in quintiles with increasing pressure was 82.0%, 77.1%, 79.8%, 71.1%, and 70.8%. Sensitivity based on interval cancers within 12 months was significantly lower in the highest pressure quintile compared to the third (84.3% vs 93.9%, p = 0.034). Specificity was lower in the

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.)

Current perspectives on indications and limitations of mammography

International Nuclear Information System (INIS)

Pope, T.L. Jr.

1983-01-01

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

Current status of mammography

International Nuclear Information System (INIS)

Crymes, J.E.

1979-01-01

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

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

International Nuclear Information System (INIS)

Mora Rodriguez, Patricia

2011-01-01

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

Evaluation of the performance characteristic for mammography by using edge device

Energy Technology Data Exchange (ETDEWEB)

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

2016-09-15

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

Predictors of Participation in Mammography Screening among non-Hispanic Black, non-Hispanic White, and Hispanic Women

Directory of Open Access Journals (Sweden)

Cathy Melvin

2016-09-01

Full Text Available Introduction: Many factors influence women’s decisions to participate in guideline recommended screening mammography. We evaluated the influence of women’s socioeconomic characteristics, healthcare access, and cultural and psychological healthcare preferences on timely mammography screening participation.Materials and methods: A random digit dial survey of United States non-Hispanic Black, non-Hispanic White, and Hispanic women ages 40-75, from January-August 2009 determined self- reported time of most recent mammogram. Screening rates were assessed based on receipt of a screening mammogram within the prior 12 months, the interval recommended at the time by the American Cancer Society.Results: Thirty-nine percent of women reported not having a mammogram within the last 12 months. The odds of not having had a screening mammography was higher for non-Hispanic White women than for non-Hispanic Black (OR=2.16, 95% CI=0.26, 0.82, p=0.009 or Hispanic (OR=4.17, 95% CI=0.12, 0.48, p=0.01 women. Lack of health insurance (OR=3.22, 95% CI=1.54, 6.73, p=0.002 and lack of usual source of medical care (OR=3.37, 95% CI=1.43, 7.94, p=0.01 were associated with not being screened as were lower self-efficacy to obtain screening (OR=2.43, 95% CI=1.26, 4.73, p=0.01 and greater levels of religiosity and spirituality (OR=1.42, 95% CI=1.00, 2.00, p=0.05. Neither perceived risk nor present temporal orientation was significant.Discussion: Odds of not having a mammogram increased if women were uninsured, without medical care, non-Hispanic white, older in age, not confident in their ability to obtain screening, or held passive or external religious/spiritual values. Results are encouraging given racial disparities in healthcare participation and suggest that efforts to increase screening among minority women may be working.

Calibration procedures for mammography dosemeters in Poland

International Nuclear Information System (INIS)

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

2002-01-01

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

Tests with films and film-screens using grid-mammography

International Nuclear Information System (INIS)

Wolf, G.; Kallinger, G.

1982-01-01

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

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

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

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

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

1996-01-01

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

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

International Nuclear Information System (INIS)

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

1987-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

Study of mammography in mass screening for breast cancer

International Nuclear Information System (INIS)

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

1995-01-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

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

Science.gov (United States)

Yeo, Younsook

2016-01-01

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

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

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

International Nuclear Information System (INIS)

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

2011-01-01

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

Cost-effectiveness of breast cancer screening using mammography in Vietnamese women

Science.gov (United States)

2018-01-01

Background The incidence rate of breast cancer is increasing and has become the most common cancer in Vietnamese women while the survival rate is lower than that of developed countries. Early detection to improve breast cancer survival as well as reducing risk factors remains the cornerstone of breast cancer control according to the World Health Organization (WHO). This study aims to evaluate the costs and outcomes of introducing a mammography screening program for Vietnamese women aged 45–64 years, compared to the current situation of no screening. Methods Decision analytical modeling using Markov chain analysis was used to estimate costs and health outcomes over a lifetime horizon. Model inputs were derived from published literature and the results were reported as incremental cost-effectiveness ratios (ICERs) and/or incremental net monetary benefits (INMBs). One-way sensitivity analyses and probabilistic sensitivity analyses were performed to assess parameter uncertainty. Results The ICER per life year gained of the first round of mammography screening was US$3647.06 and US$4405.44 for women aged 50–54 years and 55–59 years, respectively. In probabilistic sensitivity analyses, mammography screening in the 50–54 age group and the 55–59 age group were cost-effective in 100% of cases at a threshold of three times the Vietnamese Gross Domestic Product (GDP) i.e., US$6332.70. However, less than 50% of the cases in the 60–64 age group and 0% of the cases in the 45–49 age group were cost effective at the WHO threshold. The ICERs were sensitive to the discount rate, mammography sensitivity, and transition probability from remission to distant recurrence in stage II for all age groups. Conclusion From the healthcare payer viewpoint, offering the first round of mammography screening to Vietnamese women aged 50–59 years should be considered, with the given threshold of three times the Vietnamese GDP per capita. PMID:29579131

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

Science.gov (United States)

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

2017-06-01

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

Effectiveness of mammography boot camp for radiology residents

International Nuclear Information System (INIS)

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

2017-01-01

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

Effectiveness of mammography boot camp for radiology residents

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

2017-01-15

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

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

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

2017-05-15

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

Dose and risk evaluation in digital mammography using computer modeling

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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)

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)

Investigation of breast dose in five screening mammography centres in Greece

International Nuclear Information System (INIS)

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

2008-01-01

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

Investigation of breast dose in five screening mammography centres in Greece

Energy Technology Data Exchange (ETDEWEB)

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

2008-09-01

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

THE VALUE OF ULTRASOUND MAMMOGRAPHY IN PALPABLE BREAST MASSES

NARCIS (Netherlands)

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

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

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

Science.gov (United States)

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

2011-08-01

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

Perspectives of Mobile Versus Fixed Mammography in Santa Clara County, California: A Focus Group Study.

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Chen, Yi-Ren; Chang-Halpenny, Christine; Kumarasamy, Narmadan A; Venegas, Angela; Braddock Iii, Clarence H

2016-02-12

Our aim was to examine underserved women's perceptions on mobile versus fixed mammography in Santa Clara, California through a focus group study.  Research has shown that medically underserved women have higher breast cancer mortality rates correlated with under-screening and a disproportional rate of late-stage diagnosis. The Community Health Partnership in Santa Clara County, California runs the Community Mammography Access Project (CMAP) that targets nearly 20,000 medically underserved women over the age of 40 in the county through the collaborative effort of an existing safety net of healthcare providers. However, little data exists on the advantages or disadvantages of mobile mammography units from the patient perspective.   We assessed underserved women's perspectives on mammography services in Santa Clara County through two focus groups from women screened at mobile or fixed site programs. Patients were recruited from both CMAP clinics and a county hospital, and focus group data were analyzed using content analysis.  We found that women from both the mobile and fixed sites shared similar motivating factors for getting a mammogram. Both groups recognized that screening was uncomfortable but necessary for good health and had positive feedback about their personal physicians. However, mobile participants, in particular, appreciated the atmosphere of mobile screening, reported shorter wait times, and remarked on the good communication from the clinic staff and empathetic treatment they received. However, mobile participants also expressed concern about the quality of films at mobile sites due to delayed initial reading of the films.   Mobile mammography offers a unique opportunity for women of underserved populations to access high satisfaction screenings, and it encourages a model similar to CMAP in other underserved areas. However, emphasis should be placed on providing a warm and welcoming environment for patients and ensuring the quality of

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

International Nuclear Information System (INIS)

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

2011-01-01

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

Characterization of a free-air ionization chamber in direct X-ray beams as used in mammography

International Nuclear Information System (INIS)

Lima, Mateus Hilario de

2014-01-01

At this work stability and characterization tests were undertaken on a Victoreen free-air ionization chamber, model 481. The tests were realized using direct X-ray beams as a contribution for its establishment as a primary standard system of the quantity air kerma. The characterization tests were: saturation curve, ion collection efficiency, polarity effect, response linearity with the air kerma rate and response linearity with the chamber volume variation. The ion collection efficiency allowed the determination of the ion recombination factor. Most of the test results showed agreement with the limits established by international standards. Furthermore, the air attenuation factors for the mammography beams with aluminum and molybdenum filters were obtained. The factors for photon transmission and scattering at the diaphragm edges were also determined for mammography beams with aluminum filter and for the standard beam with molybdenum filter. (author)

The Role of Effective Communication to Enhance Participation in Screening Mammography: A New Zealand Case

Directory of Open Access Journals (Sweden)

Margaret A. Brunton

2009-02-01

Full Text Available Changes in the organisation of health care have dominated policy initiatives over the past two decades in many countries. An increasing reliance on public health initiatives to prevent or detect disease early has resulted in an increase in programs that screen for cancer in the community. In turn, this accentuates the need to persuasively communicate the value of such initiatives to encourage continued participation. Merely placing screening programs into a community setting is not sufficient to ensure that adequate numbers will voluntarily participate regularly to achieve anticipated cost and mortality savings in the population. In this research the influence of managing communication in a public screening mammography program was investigated. The results revealed that significant opportunities were overlooked for reassurance and information during the physical mammography process. In turn, this highlights the influence of constraints imposed by the structure of the screening program and the resources allocated to the process. This research suggests that it is important to address multiple influences, including ethnic differences, when asking questions about the effectiveness of public health policy, particularly when considering the choices women make about ongoing participation in breast screening programs.

Patterns and determinants of mammography screening in Lebanese women

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Nadia Elias

2017-03-01

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

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

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

2015-10-24

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

Rayleigh imaging in spectral mammography

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Berggren, Karl; Danielsson, Mats; Fredenberg, Erik

2016-03-01

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

A socioecological approach to improving mammography rates in a tribal community.

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English, Kevin C; Fairbanks, Jo; Finster, Carolyn E; Rafelito, Alvin; Luna, Jolene; Kennedy, Marianna

2008-06-01

This article highlights the processes and intermediate outcomes of a pilot project to increase mammography rates of women in an American Indian tribe in New Mexico. Using a socioecological framework and principles of community-based participatory research, a community coalition was able to (a) bolster local infrastructure to increase access to mammography services; (b) build public health knowledge and skills among tribal health providers; (c) identify community-specific knowledge, attitudes, and beliefs related to breast cancer; (d) establish interdependent partnerships among community health programs and between the tribe and outside organizations; and (e) adopt local policy initiatives to bolster tribal cancer control. These findings demonstrate the value of targeting a combination of individual, community, and environmental factors, which affect community breast cancer screening rates and incorporating cultural strengths and resources into all facets of a tribal health promotion intervention.

Potential Cost Savings of Contrast-Enhanced Digital Mammography.

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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.

Mammography in Norway: Image quality and total performance

International Nuclear Information System (INIS)

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

1997-04-01

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

Object characterization simulator for estimating compressed breast during mammography

International Nuclear Information System (INIS)

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

2011-01-01

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

Estimation of patient dose in mammography screening examinations

International Nuclear Information System (INIS)

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

1996-01-01

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

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

Science.gov (United States)

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

2015-10-01

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

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

Science.gov (United States)

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

2014-07-01

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

Bi-directional x-ray phase-contrast mammography.

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Kai Scherer

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

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

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

2014-07-15

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

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

International Nuclear Information System (INIS)

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

2005-01-01

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

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

International Nuclear Information System (INIS)

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

2014-01-01

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

Compression force behaviours: An exploration of the beliefs and values influencing the application of breast compression during screening mammography

International Nuclear Information System (INIS)

Murphy, Fred; Nightingale, Julie; Hogg, Peter; Robinson, Leslie; Seddon, Doreen; Mackay, Stuart

2015-01-01

This research project investigated the compression behaviours of practitioners during screening mammography. The study sought to provide a qualitative understanding of ‘how’ and ‘why’ practitioners apply compression force. With a clear conflict in the existing literature and little scientific evidence base to support the reasoning behind the application of compression force, this research project investigated the application of compression using a phenomenological approach. Following ethical approval, six focus group interviews were conducted at six different breast screening centres in England. A sample of 41 practitioners were interviewed within the focus groups together with six one-to-one interviews of mammography educators or clinical placement co-ordinators. The findings revealed two broad humanistic and technological categories consisting of 10 themes. The themes included client empowerment, white-lies, time for interactions, uncertainty of own practice, culture, power, compression controls, digital technology, dose audit-safety nets, numerical scales. All of these themes were derived from 28 units of significant meaning (USM). The results demonstrate a wide variation in the application of compression force, thus offering a possible explanation for the difference between practitioner compression forces found in quantitative studies. Compression force was applied in many different ways due to individual practitioner experiences and behaviour. Furthermore, the culture and the practice of the units themselves influenced beliefs and attitudes of practitioners in compression force application. The strongest recommendation to emerge from this study was the need for peer observation to enable practitioners to observe and compare their own compression force practice to that of their colleagues. The findings are significant for clinical practice in order to understand how and why compression force is applied

Analysis of medical exposures in digital mammography

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Science.gov (United States)

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

2015-07-01

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

Screening mammography beliefs and recommendations: a web-based survey of primary care physicians

Directory of Open Access Journals (Sweden)

Yasmeen Shagufta

2012-02-01

Full Text Available Abstract Background The appropriateness and cost-effectiveness of screening mammography (SM for women younger than 50 and older than 74 years is debated in the clinical research community, among health care providers, and by the American public. This study explored primary care physicians' (PCPs perceptions of the influence of clinical practice guidelines for SM; the recommendations for SM in response to hypothetical case scenarios; and the factors associated with perceived SM effectiveness and recommendations in the US from June to December 2009 before the United States Preventive Services Task Force (USPSTF recently revised guidelines. Methods A nationally representative sample of 11,922 PCPs was surveyed using a web-based questionnaire. The response rate was 5.7% (684; (41% 271 family physicians (FP, (36% 232 general internal medicine physicians (IM, (23% 150 obstetrician-gynaecologists (OBG, and (0.2% 31 others. Cross-sectional analysis examined PCPs perceived effectiveness of SM, and recommendation for SM in response to hypothetical case scenarios. PCPs responses were measured using 4-5 point adjectival scales. Differences in perceived effectiveness and recommendations for SM were examined after adjusting for PCPs specialty, race/ethnicity, and the US region. Results Compared to IM and FP, OBG considered SM more effective in reducing breast cancer mortality among women aged 40-49 years (p = 0.003. Physicians consistently recommended mammography to women aged 50-69 years with no differences by specialty (p = 0.11. However, 94% of OBG "always recommended" SM to younger and 86% of older women compared to 81% and 67% for IM and 84% and 59% for FP respectively (p = p = Conclusions A majority of physicians, especially OBG, favour aggressive breast cancer screening for women from 40 through 79 years of age, including women with short life expectancy. Policy interventions should focus on educating providers to provide tailored recommendations for

A computerized expert system for mammography

International Nuclear Information System (INIS)

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

1988-01-01

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

Patients Mammographic Dose Survey in a Sample of Slovak Mammography Departments

International Nuclear Information System (INIS)

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

2008-01-01

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

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)

Comparison of TLD air kerma measurements in mammography

International Nuclear Information System (INIS)

Pernicka, F.

2002-01-01

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

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)

[Commentary on the planned restructuring of mammography screening in Austria].

Science.gov (United States)

Vutuc, Christian; Haidinger, Gerald

2011-08-01

With regards to the planned reorganisation of screening mammography in Austria - from an opportunistic to an organised system - the problems related with such a change are depicted from an epidemiological point of view. We were able to demonstrate earlier that opportunistic screening mammography matches the results of controlled screening mammography in Finland and Sweden. Switching to a controlled system in Austria would - besides the need for a change in legislation - lead to enormous expenditures in terms of resources needed and moreover, it could be not evaluated for years.

Breast cancer screening: the underuse of mammography

International Nuclear Information System (INIS)

Fox, S.; Baum, J.K.; Klos, D.S.; Tsou, C.V.

1985-01-01

The early detection of breast cancer is promoted by the American Cancer Society (ACS) and the American College of Radiology (ACR) by encouraging the regular use of three types of screening: breast self-examination (BSE), the clinical breast examination, and mammography. In August 1983, the ACS publicized seven recommendations pertaining to screening, including a revised statement about the routine use of mammography for women between the ages of 40 and 49 years. In response to the ACS statement, the present study assessed compliance with the updated recommendations for all three types of screening. The results show reasonable rates of compliance for the BSE (53%-69%) and clinical examination (70%-78%). In contrast, only 19% of the women between the ages of 35 and 49 and 25% of the women older than 50 reported complying with the recommendation to undergo one baseline screening mammogram. Some implications for health education by physicians and the professional education of physicians in the use of mammography are discussed

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.

Could parenchymal enhancement on contrast-enhanced spectral mammography (CESM) represent a new breast cancer risk factor? Correlation with known radiology risk factors.

Science.gov (United States)

Savaridas, S L; Taylor, D B; Gunawardana, D; Phillips, M

2017-12-01

To compare background parenchymal enhancement (BPE) on contrast-enhanced (CE) spectral mammography (CESM) with CE magnetic resonance imaging (MRI), and evaluate how these relate to hormonal status, mammographic breast density (MBD) and MRI fibroglandular tissue volume (FGTV). Between June 2012 to October 2015, participants in a cancer staging study underwent full-field digital mammography (FFDM), CEMRI, and CESM. Two readers independently rated FGTV, MBD, and BPE using the Breast Imaging-Reporting and Data System (BI-RADS) criteria. Inter-reader reliability was estimated using weighted kappa (k) and correlations between BPE, MBD, and FGTV calculated using Spearman's correlation coefficient. Associations with hormonal status were evaluated using multilevel ordinal regression analysis. Of the 96 eligible participants, 66 women (35-77 years) underwent CESM and CEMRI. Reasons for exclusion were declined or withdrawn consent (n=18), inadequate renal function (n=2), claustrophobia (n=2), previous reaction to contrast medium (n=2), mild reaction to contrast medium following CESM (n=2), lack of vascular access (n=1), neoadjuvant chemotherapy (n=1), CESM equipment failure (n=1), and unclear in one case. Inter-reader agreement was substantial (k=0.67) for CESM BPE, slight (k=0.19) for CEMRI BPE, moderate (k=0.57) for MRI FGTV and fair (k=0.35) for MBD. CESM BPE showed significant correlation with MBD (rho=0.36, p<0.0001), FGTV (rho=0.52, p<0.0001), and MRI BPE (rho=0.49, p<0.0001). BPE was significantly reduced in the post-menopausal group for CEMRI and CESM (p<0.05). CESM BPE did not significantly fluctuate during the menstrual cycle. CESM BPE is correlated with MBD, FGTV, and CEMRI BPE, has better inter-reader reliability than CEMRI, and is not influenced by the menstrual cycle. Grading the degree of BPE on CESM could be a useful addition to breast cancer risk assessment tools. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights

Mammography Screening Uptake among Female Health Care Workers in Primary Health Care Centers in Palestine - Motivators and Barriers.

Science.gov (United States)

Nazzal, Zaher; Sholi, Hisham; Sholi, Suha; Sholi, Mohammad; Lahaseh, Rawya

2016-01-01

important factors that would improve the acceptance and compliance for mammography screening programs.

Usefulness of breast MRI for diagnosing an extensive intraductal component of breast cancer: comparison with mammography and ultrasonography

International Nuclear Information System (INIS)

Kim, Tae Hee; Kang, Doo Kyung; Jung, Yong Sik; Yim, Hyun Ee

2006-01-01

An extensive intraductal component of breast cancer is a principal risk factor for local recurrence, and this is difficult to diagnose with performing only mammography. We investigated the usefulness of breast MRI for evaluating an extensive intraductal component of breast cancer, and we compared this modality with mammography and ultrasonography (US). From March 2003 to July 2004, 90 patients underwent breast MRI among all the patients who were suffering with breast cancer and for whom and EIC was ultimately revealed to be present or not. A total 83 patients with stage I and II breast cancer were finally included in this study. EIC positivity was defined according to the imaging data as follows: 1) microcalcifications beyond the tumor shadow or malignant microcalcifications without a tumor mass on mammography, 2) tubular hypoechoic structures adjacent to the tumor or architectural distortion with calcifications beyond the tumor on US, and 3) linear or ductal enhancement, segmental or regional clumped enhancement, and spotty nodular or reticular enhancement adjacent to the tumor on MRI. EIC was present in 41 patients and this finding was negative in 42 patients. The results were then compared those results from mammography and US. The sensitivities of detecting EIC by mammography, US and MRI were 48.6%, 67.5% and 80.5%, respectively, and the corresponding specificities were 92.3%, 73.2% and 69.0%, respectively. In the cases that were suspected to be EIC positive on more than two imaging modality, the positive predictive value (PPV) was 78.1%. In cases that were suspected of being EIC positive on just one imaging modality, the negative predictive value (NPV) was 75.0%. Breast MRI provides good information about an EIC of breast cancer and it is a more sensitive study than mammography and US, yet the specificity for the detection of EIC is highest on mammography. A combined evaluation by mammography, US and MRI is the most accurate way to diagnose an EIC of breast

Local recurrences after conservative surgery and irradiation for breast cancer: Diagnosis with mammography and ultrasound. Mammographie und Sonographie in der Rezidivdiagnostik nach brusterhaltender Therapie des Mammakarzinoms

Energy Technology Data Exchange (ETDEWEB)

Buchberger, W; Hamberger, L; Schoen, G [Innsbruck Univ. (Austria). Universitaetsklinik fuer Radiodiagnostik; Steixner, G; Fritsch, E [Innsbruck Univ. (Austria). Universitaetsklinik fuer Strahlentherapie

1991-06-01

89 patients, who underwent conservative surgery for breast cancer were followed up with mammography and real-time sonography. 78 patients underwent postoperative irradiation. Depending on the time interval between irradiation and examination various alterations in mammographic and sonographic patterns were evident. Of 14 biospy-confirmed local recurrences, 11 were diagnosed by mammography and 12 by sonography. Combined use of mammography and sonography should therefore lead to better results in the diagnosis of local recurrences and to a reduction of unnecessary biopsies. (orig./GDG).

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

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2003-01-01

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

Benefits, risks, and costs of mammography

International Nuclear Information System (INIS)

Richter, B.; Rausch, L.

1977-01-01

The risk seems to be acceptable if the age-dependency of the frequency of breast cancer is disregarded, i.e. if calculation is done with average values, as is being done frequently (15, 25, 32, 48). This procedure however veils the real circumstances in the examination of young women thus also veiling a risk which could otherwise be made precise and avoidable. The risk of radiation-induced cancerogenesis in the female breast was verified by similar statements made by several empiric investigations on man. The course of the dose-effect-relation in the region of few rad is still unexplained however, although the results do not contradict to the assumption of a linear dose-effect-relation. Thus it seems not advisable to ignore the induction of carcinomas by x-radiation for the sphere of mammography with the doses usually applied today. A reduction of radiation exposition by dose-saving measures to one tenth of the present value (or less) however would make the risk highly unimportant. Advantage/risk/cost-analyses should encourage the responsible persons to make reasonable proposals for the application of methods, in this case mammography. The discouraging of patients whom mammography is indicated for would be a side-effect which is not desired. Just as wrong would be the stimulation of an unjustified feeling of being sure and the demand for costly medical measures by uncritical reports of success. The indication of the considerably high costs of mammography should, together with the advantage expected, be a quantitative criterion for the optimal distribution of limited means the necessity of which cannot be denied. (orig.) [de

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

SU-E-I-88: Mammography Imaging: Does Positioning Matter?

Energy Technology Data Exchange (ETDEWEB)

Zhang, J; Szabunio, M [University of Kentucky, Lexington, KY (United States)

2014-06-01

Purpose: In mammography, compression is imperative for quality images and glandular radiation exposure dose. The thickness of the compressed breast directly determines mammography acquisition parameters. The compressed thickness varies due to variation in technologist practice, even for the same patient imaged at different time. This study is to investigate potential effect of the variation in breast positioning on radiation dose and image quality. Methods: Radiation dose at different thicknesses was measured with a BR-12 breast phantom for both conventional craniocaudal view and tomosynthesis in a Hologic Tomosynthesis mammography system. The CIRS stereotactic needle biopsy training phantom embedded dense masses and microcalcification in various sizes were imaged for image quality evaluation. Radiologists evaluated images. Clinical mammograms from the same patient but acquired at different time were retrospectively retrieved to evaluate potential effects of variation in positioning. Results: Acquisition parameters (kVp and mAs) increase with the increased phantom thickness. Radiation exposure increases following an exponential trend. The stereotactic phantom images showed loss of spatial and contrast resolution with inappropriate positioning. The compressed pressure may not be a good indicator for appropriate positioning. The inclusion of different amount of pectoralis muscle may lead to the same compressed pressure but different compressed thickness. The initial retrospective study of 3 patients showed that there were potential large variations in positioning the same patient at different examination time, resulting in large variations in patient radiation dose and image quality. Conclusion: Variations in patient positioning potentially influence patient radiation dose and image quality. The technologist has the critical responsibility to position patient to provide quality images in spite of different breast and body types. To reduce intra and inter practice

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.

Quality Control in Mammography: Image Quality and Patient Doses

International Nuclear Information System (INIS)

Ciraj Bjelac, O.; Arandjic, D.; Boris Loncar, B.; Kosutic, D.

2008-01-01

Mammography is method of choice for early detection of breast cancer. The purpose of this paper is preliminary evaluation the mammography practice in Serbia, in terms of both quality control indicators, i.e. image quality and patient doses. 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. Correlation between image contrast and mean glandular doses was demonstrated. Systematic implementation of quality control protocol should provide satisfactory performance of mammography units and maintain satisfactory image quality and keep patient doses as low as reasonably practicable. (author)

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)

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

International Nuclear Information System (INIS)

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

2001-01-01

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

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.

Dose measurements in mammography

International Nuclear Information System (INIS)

Kainberger, F.; Kallinger, W.

1977-01-01

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

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.

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.)

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)

Mammography in breast screening and in the evaluation and management of breast cancer

International Nuclear Information System (INIS)

Onyesoh, C.N.

2006-01-01

This paper aims to discuss the importance of breast screening most especially amongst women above the age of 40 years.the limitation of the screening procedure is due to lack of special machines and power awareness campaigns. the application of Mammography and ultrasound in the examination of the breast and other breast imaging techniques will be considered in this paper. The paper will look at the indications for mammography, indications for breast ultrasound, signs of breast carcinoma on mammography, breast enlargement and also the need for breast ultrasound in cases of discrete Mammography

Mammography screening: A major issue in medicine.

Science.gov (United States)

Autier, Philippe; Boniol, Mathieu

2018-02-01

Breast cancer mortality is declining in most high-income countries. The role of mammography screening in these declines is much debated. Screening impacts cancer mortality through decreasing the incidence of number of advanced cancers with poor prognosis, while therapies and patient management impact cancer mortality through decreasing the fatality of cancers. The effectiveness of cancer screening is the ability of a screening method to curb the incidence of advanced cancers in populations. Methods for evaluating cancer screening effectiveness are based on the monitoring of age-adjusted incidence rates of advanced cancers that should decrease after the introduction of screening. Likewise, cancer-specific mortality rates should decline more rapidly in areas with screening than in areas without or with lower levels of screening but where patient management is similar. These two criteria have provided evidence that screening for colorectal and cervical cancer contributes to decreasing the mortality associated with these two cancers. In contrast, screening for neuroblastoma in children was discontinued in the early 2000s because these two criteria were not met. In addition, overdiagnosis - i.e. the detection of non-progressing occult neuroblastoma that would not have been life-threatening during the subject's lifetime - is a major undesirable consequence of screening. Accumulating epidemiological data show that in populations where mammography screening has been widespread for a long time, there has been no or only a modest decline in the incidence of advanced cancers, including that of de novo metastatic (stage IV) cancers at diagnosis. Moreover, breast cancer mortality reductions are similar in areas with early introduction and high penetration of screening and in areas with late introduction and low penetration of screening. Overdiagnosis is commonplace, representing 20% or more of all breast cancers among women invited to screening and 30-50% of screen

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

International Nuclear Information System (INIS)

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

2003-01-01

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

Breast compression in mammography: how much is enough?

Science.gov (United States)

Poulos, Ann; McLean, Donald; Rickard, Mary; Heard, Robert

2003-06-01

The amount of breast compression that is applied during mammography potentially influences image quality and the discomfort experienced. The aim of this study was to determine the relationship between applied compression force, breast thickness, reported discomfort and image quality. Participants were women attending routine breast screening by mammography at BreastScreen New South Wales Central and Eastern Sydney. During the mammographic procedure, an 'extra' craniocaudal (CC) film was taken at a reduced level of compression ranging from 10 to 30 Newtons. Breast thickness measurements were recorded for both the normal and the extra CC film. Details of discomfort experienced, cup size, menstrual status, existing breast pain and breast problems were also recorded. Radiologists were asked to compare the image quality of the normal and manipulated film. The results indicated that 24% of women did not experience a difference in thickness when the compression was reduced. This is an important new finding because the aim of breast compression is to reduce breast thickness. If breast thickness is not reduced when compression force is applied then discomfort is increased with no benefit in image quality. This has implications for mammographic practice when determining how much breast compression is sufficient. Radiologists found a decrease in contrast resolution within the fatty area of the breast between the normal and the extra CC film, confirming a decrease in image quality due to insufficient applied compression force.

Radiology workstation for mammography: preliminary observations, eyetracker studies, and design

Science.gov (United States)

Beard, David V.; Johnston, Richard E.; Pisano, Etta D.; Hemminger, Bradley M.; Pizer, Stephen M.

1991-07-01

For the last four years, the UNC FilmPlane project has focused on constructing a radiology workstation facilitating CT interpretations equivalent to those with film and viewbox. Interpretation of multiple CT studies was originally chosen because handling such large numbers of images was considered to be one of the most difficult tasks that could be performed with a workstation. The authors extend the FilmPlane design to address mammography. The high resolution and contrast demands coupled with the number of images often cross- compared make mammography a difficult challenge for the workstation designer. This paper presents the results of preliminary work with workstation interpretation of mammography. Background material is presented to justify why the authors believe electronic mammographic workstations could improve health care delivery. The results of several observation sessions and a preliminary eyetracker study of multiple-study mammography interpretations are described. Finally, tentative conclusions of what a mammographic workstation might look like and how it would meet clinical demand to be effective are presented.

XERG-mammography system: a solution to the dose-quality problem

Energy Technology Data Exchange (ETDEWEB)

Friedrich, M

1981-05-01

The XERG (Xonics-Electron-Radio-Graphy) system is the first ionographic system (High-Pressure-Gas-Iono-graphy) suitable for clinical application which became available for testing. The basic principle, the function and imaging qualities of the XERG system are described and first clinical experiences reported. The XERG mammogram is a transparent X-ray negative image, the image quality of which is characterized by good general image contrast, a moderate edge-effect and a high quantum-noise level but giving an extremely low dose rate (4.5% compared to screenless mammography film). Although the XERG quality is not satisfactory in contact technique, it yields results which are equal in quality, when using a 1.5-fold magnification technique, to the results obtained with screenless film mammography at one-tenth of the dose, and is superior to any commercially available film-screen system. Hence, in our opinion, the XERG mammography system is a step forward towards high-quality low-dose mammography.

American Indian Women and Screening Mammography: Findings from a Qualitative Study in Oklahoma

Science.gov (United States)

Tolma, Eleni; Batterton, Chasity; Hamm, Robert M.; Thompson, David; Engelman, Kimberly K.

2012-01-01

Background: Breast cancer is an important public health issue within the American Indian (AI) community in Oklahoma; however, there is limited information to explain the low screening mammography rates among AI women. Purpose: To identify the motivational factors affecting an AI woman's decision to obtain a mammogram. Methods: Through the use of…

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)

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

Breast dose variability in a bi-racial population undergoing screening mammography

International Nuclear Information System (INIS)

Schubauer-Berigan, M.K.; Baron, L.; Frey, G.D.; Hoel, D.G.

2002-01-01

This study evaluated individual and population dose variability during screening mammography among 570 white and black women in South Carolina, USA. Aspects of dosimetry that were considered include compressed breast thickness (CBT), number of films per screening session, and dose in previous or subsequent sessions. Breast dose was log-normally distributed in the population, with a geometric mean of 6.6 mGy per session. Doses were significantly higher for black women, for women with high CBT or who receive more than two views per breast, and for the mediolateral oblique, compared to the craniocaudal view. No relationship was observed between age and dose. Total dose per breast varied by a factor of 20 across the study population, but the individual's dose varied little among repeat screening sessions, especially after adjusting for the number of films received per session. These results may inform assessments of the projected risks of inducing breast cancer from screening mammography. (author)

CAD in breast imaging. Application in mammography and MR mammography

International Nuclear Information System (INIS)

Obenauer, S.; Hermann, K.P.

2012-01-01

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

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

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-02-15

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

Screening for breast cancer with mammography

International Nuclear Information System (INIS)

Sickles, E.A.

1991-01-01

Mammography is generally accepted as a useful problem-solving clinical tool in characterizing known breast lesions, so that appropriate and timely treatment can be given. However, it remains grossly underutilized at what it does best: screening. The major strengths of mammography are (a) its ability to detect breast cancer at a smaller, potentially more curable stage than any other examination, and (b) its proved efficacy in reducing breast cancer mortality in asymptomatic women aged 40-74. If, as has recently been estimated, screening with mammography and physical examination can be expected to lower breast cancer deaths by 40%-50% among those actually examined (13), then the lives of almost 20,000 U.S. women might be saved each year if screening were to become very widely used. The challenges of the next decade are clear, to mount much more effective campaigns to educate physicians and lay women about the life-saving benefits of breast cancer screening, to devise increasingly effective and lower cost screening strategies, to further improve the current high quality of mammographic imaging despite its increasing proliferation, and to train large numbers of breast imaging specialists to guarantee that the growing case load of screening and problem-solving mammograms is interpreted with a very high level of skill

Is Short-Interval Mammography Necessary After Breast Conservation Surgery and Radiation Treatment in Breast Cancer Patients?

International Nuclear Information System (INIS)

Hymas, Richard V.; Gaffney, David K.; Parkinson, Brett T.; Belnap, Thomas W.; Sause, William T.

2012-01-01

Purpose: The optimum timing and frequency of mammography in breast cancer patients after breast-conserving therapy (BCT) are controversial. The American Society of Clinical Oncology recommends the first posttreatment mammogram 1 year after diagnosis but no earlier than 6 months after completion of radiotherapy. The National Comprehensive Cancer Network recommends annual mammography. Intermountain Healthcare currently follows a more frequent mammography schedule during the first 2 years in BCT patients. This retrospective study was undertaken to determine the cancer yield mammography during the first 2 years after BCT. Methods and Materials: 1,435 patients received BCT at Intermountain Healthcare between 2003 and 2007, inclusive. Twenty-three patients had bilateral breast cancer (1,458 total breasts). Patients were followed up for 24 months after diagnosis. The 1- and 2-year mammography yields were determined and compared with those of the general screening population. Results: 1,079 breasts had mammography at less than 1 year, and two ipsilateral recurrences (both noninvasive) were identified; 1,219 breasts had mammography during the second year, and nine recurrences (three invasive, six noninvasive) were identified. Of the 11 ipsilateral recurrences during the study, three presented with symptoms and eight were identified by mammography alone. The mammography yield was 1.9 cancers per 1,000 breasts the first year and 4.9 per 1,000 the second year. Conclusions: These data demonstrate that the mammography yield during the first 2 years after BCT is not greater than that in the general population, and they support the policy for initiating followup mammography at 1 year after BCT.

Hidden costs of low-cost screening mammography

International Nuclear Information System (INIS)

Cyrlak, D.

1987-01-01

Twenty-two hundred women in Orange County, California, took part in a low-cost mammography screening project sponsored by the American Cancer Society and the KCBS-TV. Patients were followed up by telephone and questioned about actual costs incurred as a result of screening mammography, including costs of repeated and follow-up mammograms, US examinations and surgical consultations. The total number of biopsies, cancers found, and the costs involved were investigated. The authors' results suggest that particularly in centers with a high positive call rate, the cost of screening mammograms accounts for only a small proportion of the medical costs

Focused two-dimensional antiscatter grid for mammography

International Nuclear Information System (INIS)

Makarova, O.V.; Moldovan, N.; Tang, C.-M.; Mancini, D.C.; Divan, R.; Zyryanov, V.N.; Ryding, D.C.; Yaeger, J.; Liu, C.

2002-01-01

We are developing freestanding high-aspect-ratio, focused, two-dimensional antiscatter grids for mammography using deep x-ray lithography and copper electroforming. The exposure is performed using x-rays from bending magnet beamline 2-BM at the Advanced Photon Source (APS) of Argonne National Laboratory. A 2.8-mm-thick prototype freestanding copper antiscatter grid with 25 (micro)m-wide parallel cell walls and 550 (micro)m periodicity has been fabricated. The progress in developing a dynamic double-exposure technique to create the grid with the cell walls aligned to a point x-ray source of the mammography system is discussed

Transformative learning theory: facilitating mammography screening in rural women.

Science.gov (United States)

Purtzer, Mary Anne; Overstreet, Lindsey

2014-03-01

To use transformative learning to investigate what experiences serve as catalysts for mammography screening, the cognitive and affective responses that result from the catalyst, and how screening behavior is impacted. A descriptive qualitative study. Southeastern Wyoming. 25 low-income, rural women aged 40 years and older. Four focus group interviews. Cancer experiences triggered universal responses of fear by screeners and nonscreeners. The manner in which that fear response was interpreted was a critical factor in the facilitation of, or impedance to, screening. Dichotomous interpretations of fear responses provided the context for screening behavior. Immobilizing and isolating experiences were associated with nonscreening behavior, whereas motivation and self-efficacy were associated with screening behavior. Transformative learning theory is a useful framework from which to explain differences in mammography screening behavior. Creating opportunities that facilitate dialogue and critical reflection hold the potential to change immobilizing and isolating frames of reference in nonscreening women. To help women transcend their fear and become self-efficacious, nurses can assess how cancer and the screening experience is viewed and, if indicated, move beyond standard education and offer opportunities for dialogue and critical reflection.

Mammography Clinical Image Quality and the False Positive Rate in a Canadian Breast Cancer Screening Program.

Science.gov (United States)

Guertin, Marie-Hélène; Théberge, Isabelle; Zomahoun, Hervé Tchala Vignon; Dufresne, Michel-Pierre; Pelletier, Éric; Brisson, Jacques

2018-05-01

The study sought to determine if mammography quality is associated with the false positive (FP) rate in the Quebec breast cancer screening program in 2004 and 2005. Mammography quality of a random sample of screen-film mammograms was evaluated by an expert radiologist following the criteria of the Canadian Association of Radiologists. For each screening examination, scores ranging from 1 (poor quality) to 5 (excellent quality) were attributed for positioning, compression, contrast, exposure level, sharpness, and artifacts. A final overall quality score (lower or higher) was also given. Poisson regression models with robust estimation of variance and adjusted for potential confounding factors were used to assess associations of mammography quality with the FP rate. Among 1,209 women without cancer, there were 104 (8.6%) FPs. Lower overall mammography quality is associated with an increase in the FP rate (risk ratio [RR], 1.4; 95% confidence interval [CI], 1.0-2.1; P = .07) but this increase was not statistically significant. Artifacts were associated with an increase in the FP rate (RR, 2.1; 95% CI, 1.3-3.3; P = .01) whereas lower quality of exposure level was related to a reduction of the FP rate (RR, 0.4; 95% CI, 0.1-1.0; P = .01). Lower quality scores for all other quality attributes were related to a nonstatistically significant increase in the FP rate of 10%-30%. Artifacts can have a substantial effect on the FP rate. The effect of overall mammography quality on the FP rate may also be substantial and needs to be clarified. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Artificial Neural Networks in Mammography Interpretation and Diagnostic Decision Making

Directory of Open Access Journals (Sweden)

Turgay Ayer

2013-01-01

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

Abnormality Detection in Mammography using Deep Convolutional Neural Networks

OpenAIRE

Xi, Pengcheng; Shu, Chang; Goubran, Rafik

2018-01-01

Breast cancer is the most common cancer in women worldwide. The most common screening technology is mammography. To reduce the cost and workload of radiologists, we propose a computer aided detection approach for classifying and localizing calcifications and masses in mammogram images. To improve on conventional approaches, we apply deep convolutional neural networks (CNN) for automatic feature learning and classifier building. In computer-aided mammography, deep CNN classifiers cannot be tra...

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

Science.gov (United States)

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

2013-03-01

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

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.)

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

International Nuclear Information System (INIS)

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

1999-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1999-08-01

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

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)

Managed Care Penetration and the Use of Screening Mammography by Uninsured Women

National Research Council Canada - National Science Library

Garg, Pushkal

2003-01-01

..., and increased waiting times for mammography. In this study, we examined whether there was an association between managed care penetration and rates of mammography among uninsured women between 50 and 64 years of age...

On the possibility of reducing doses received by patients during mammography screening

International Nuclear Information System (INIS)

Tolwinski, J.; Fabiszewska, E.; Gwiazdowska, B.; Bulski, W.

2005-01-01

The aim of the study was to collect and to evaluate a set of data of a large group of patients examined with different mammography units, and to compare the individual doses (Di) with the standard average glandular dose (standard AGD) established for a particular mammography unit. The comparison was intended to allow to formulate recommendations of procedures in order to limit the exposure of patients, procedures which are beyond the scope of routine testing of mammography facilities. The presented analysis bases on the results of the measurements of the standard AGD, taken from 82 protocols of quality control of mammography equipment; - 16 histograms of dose distribution for individual patients (Di) examined with 16 different mammography units; - 2 histograms for patients examined with one mammography unit by the radiographer before and after training; - histograms of individual doses (Di), corresponding high-voltage (kV) and tube-loading (mAs) values, for one mammography unit (Elscint-Glory 2001) which was equipped with an automatic optimisation of contrast (AOC) system. The measurements were carried out according to the procedures of the American College of Radiology (ACR). Basing upon the constructed histograms we performed a comparison of the standard AGD values with the individual doses (Di). The frequency distribution of the standard AGDs (Figure 1) shows a considerable dispersion of values, ranging between 0.5 and 2.5 mGy. The histograms of the individual glandular doses (Di) calculated for individual patients, examined with different units (Figure 2) suggest that the choice of high voltage made by the radiographers may be incorrect i.e. the high voltage was not increased sufficiently with the increase of breast thickness. The incorrect value of the high voltage (low value) may be also set up by the AOC system (Figure 4). Two histograms for patients examined with one mammography unit by the radiographer before and after training (Figure 3) indicate the

Entrance surface dose measurements in mammography using thermoluminescence technique

International Nuclear Information System (INIS)

Rivera, T.; Vega C, H.R.; Manzanares A, E; Azorin, J.; Gonzalez, P.R.

2007-01-01

Full text: Of the various techniques that can be used for personnel dosimetry, thermoluminescence dosimetry (TLD) has emerged as a superior technique due to its manifold advantages over other methods of dose estimation. Various phosphors have been therefore investigated regarding their suitability for dosimetry. In this paper, a dosimetry system based on thermally stimulated luminescence (TSL) from zirconium oxide phosphors embedded in polytetrafluorethylene (ZrO 2 +PTFE) was developed for entrance surface doses (ES) measurements in mammography. Small ZrO 2 pellets of 5 mm in diameter and 0.8 mm in thickness were used. The reproducibility of measurements and linearity of ZrO 2 were also studied. The results were compared with those obtained from LiF:Mg,Cu,P usually used for the determination of absorbed dose in mammography. Measurements both per unit air kerma and In vivo were performed using a mammography unit model DMR (General Electric). The results showed that ZrO 2 TLDs can be used for the same X-ray dosimetry applications as LiF:Mg,Cu,P, with each type having the disadvantage of a response dependent on energy, particularly at low energies. These results indicate a considerable potential for use in routine control and In vivo ES measurements in mammography. (Author)

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.

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

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

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

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

Science.gov (United States)

Frischbier, H J

1994-01-01

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

Implications of Overdiagnosis: Impact on Screening Mammography Practices

Science.gov (United States)

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

2015-01-01

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

Audit of mammography performed in our hospital

International Nuclear Information System (INIS)

Kantharia, Surita

2013-09-01

A medical audit is a compilation of patient outcomes over a certain period of time. Audit of Mammography provides an objective criterion of the appropriateness and accuracy in image interpretation, and is the best measure of a mammographer's performance. The audit assesses 3 important outcomes: i) detection of the percentage of cancers in a population, ii) finding these cancers while they are still curable (small and node negative), iii) finding these cancers through an acceptably low number of recalls and biopsies. With this background, I am presenting an audit of Mammography done at our centre from the period May 2010 to April 2013. (author)

Managed Care Penetration and the Use of Screening Mammography by Uninsured Women

National Research Council Canada - National Science Library

Garg, Pushkal

2002-01-01

..., and increased waiting times for mammography. In this study we propose to examine whether there is an association between managed care penetration and rates of mammography among uninsured women between 50 and 64 years of age...

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

DEFF Research Database (Denmark)

Jensen, Allan; Rank, Fritz; Dyreborg, Uffe

2006-01-01

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

Studies of breast masses in Korean woman using tungsten anode mammography

International Nuclear Information System (INIS)

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

1979-01-01

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

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

Mammography Screening Among African-American Women with a Family History of Breast Cancer

National Research Council Canada - National Science Library

Lipkus, Issac

1997-01-01

Comparisons were made between African-American women with and without a family history of breast cancer with respect to mammography screening, attitudes towards mammography screening and perceptions...

Dosimetry in a torso phantom during a mammography

International Nuclear Information System (INIS)

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

2009-10-01

Two dosimetric magnitudes, the absorbed dose and the kerma in air to the entrance of torso have been determined. These dosimetric magnitudes are due to the radiation that is dispersed in the mammary gland when the patient undergoes a mammography study. The kerma to the entrance of the torso and the absorbed dose by the torso was obtained in a phantom of paraffin and with thermoluminescent dosemeters of ZrO 2 . The dosemeters were placed on the surface of the torso phantom while the mammography was carried out. (author)

Classification of breast tissue for protocols development in mammography exam;Classificacao dos tecidos mamarios para elaboracao de protocolos em exames de mamografia

Energy Technology Data Exchange (ETDEWEB)

Teixeira, M. Ines; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Chohfi, Adriana C.S.; Figueiredo, Zenaide A. [Universidade Nove de Julho (UNINOVE), Sao Paulo, SP (Brazil). Dept. da Saude. Radiologia Medica

2009-07-01

For accomplishment of a mammogram should be considered several factors such as equipment used and the classification of breast cancer patients. The density of the breast is different of patient to patient, thus making it difficult many precocious diagnostic of breast cancer. There is a significant variation in the breast to be radiographed, depending on several factors presented in the breast tissue of breast prosthesis with or without breasts or with implants. This work had as objective main to make a survey of the factors that influence in the classification of mammary fabrics. With this survey and classification it can be better adjusted the protocols which will be more efficient in the mammography exam, preventing excess of radiation dose, stress for the patient, economy of raw material, control of the quality and rapidity in the process of image attainment. (author)

Breast imaging and reporting data system - Mammography. ACR BI-RADS registered -Mammography

International Nuclear Information System (INIS)

Fischer, U.; Helbrich, T.

2006-01-01

ACR BI-RADS registered mammography is an established technique in all German-speaking countries and has become a standard part of all mammographic findings. The first German-language edition three years ago made a significant contribution to this. This is the second, revised and edited edition. It is based on the fourth English-language edition of the ACR which was published in 2003. (orig.)

Identification of Breast Cancer Using Integrated Information from MRI and Mammography.

Directory of Open Access Journals (Sweden)

Shih-Neng Yang

Full Text Available Integration of information from corresponding regions between the breast MRI and an X-ray mammogram could benefit the detection of breast cancer in clinical diagnosis. We aimed to provide a framework of registration from breast MRI to mammography and to evaluate the diagnosis using the combined information.43 patients with 46 lesions underwent both MRI and mammography scans, and the interval between the two examinations was around one month. The distribution of malignant to benign lesions was 31/46 based on histological results. Maximum intensity projection and thin-plate spline methods were applied for image registration for MRI to mammography. The diagnosis using integrated information was evaluated using results of histology as the reference. The assessment of annotations and statistical analysis were performed by the two radiologists.For the cranio-caudal view, the mean post-registration error between MRI and mammography was 2.2±1.9 mm. For the medio-lateral oblique view, the proposed approach performed even better with a mean error of 3.0±2.4 mm. In the diagnosis using MRI assessment with information of mammography, the sensitivity was 91.9±2.3% (29/31, 28/31, specificity 70.0±4.7% (11/15, 10/15, accuracy 84.8±3.1% (40/46, 38/46, positive predictive value 86.4±2.1% (29/33, 28/33 and negative predictive value 80.8±5.4% (11/13, 10/13.MRI with the aid of mammography shows potential improvements of sensitivity, specificity, accuracy, PPV and NPV in clinical breast cancer diagnosis compared to the use of MRI alone.

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

International Nuclear Information System (INIS)

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

2017-01-01

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

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

Science.gov (United States)

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

2018-05-01

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

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

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)

Si-strip photon counting detectors for contrast-enhanced spectral mammography

Science.gov (United States)

Chen, Buxin; Reiser, Ingrid; Wessel, Jan C.; Malakhov, Nail; Wawrzyniak, Gregor; Hartsough, Neal E.; Gandhi, Thulasi; Chen, Chin-Tu; Iwanczyk, Jan S.; Barber, William C.

2015-08-01

We report on the development of silicon strip detectors for energy-resolved clinical mammography. Typically, X-ray integrating detectors based on scintillating cesium iodide CsI(Tl) or amorphous selenium (a-Se) are used in most commercial systems. Recently, mammography instrumentation has been introduced based on photon counting Si strip detectors. The required performance for mammography in terms of the output count rate, spatial resolution, and dynamic range must be obtained with sufficient field of view for the application, thus requiring the tiling of pixel arrays and particular scanning techniques. Room temperature Si strip detector, operating as direct conversion x-ray sensors, can provide the required speed when connected to application specific integrated circuits (ASICs) operating at fast peaking times with multiple fixed thresholds per pixel, provided that the sensors are designed for rapid signal formation across the X-ray energy ranges of the application. We present our methods and results from the optimization of Si-strip detectors for contrast enhanced spectral mammography. We describe the method being developed for quantifying iodine contrast using the energy-resolved detector with fixed thresholds. We demonstrate the feasibility of the method by scanning an iodine phantom with clinically relevant contrast levels.

Postmortem validation of breast density using dual-energy mammography

OpenAIRE

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

2014-01-01

Purpose: Mammographic density has been shown to be an indicator of breast cancer risk and also reduces the sensitivity of screening mammography. Currently, there is no accepted standard for measuring breast density. Dual energy mammography has been proposed as a technique for accurate measurement of breast density. The purpose of this study is to validate its accuracy in postmortem breasts and compare it with other existing techniques. Methods: Forty postmortem breasts were imaged using a dua...

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

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 ...

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

International Nuclear Information System (INIS)

Novak, D.

1983-01-01

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

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)

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.

Mammography screening in Nigeria – A critical comparison to other countries

International Nuclear Information System (INIS)

Lawal, O.; Murphy, F.J.; Hogg, P.; Irurhe, N.; Nightingale, J.

2015-01-01

Breast cancer is a leading cause of death among women, and according to the World Health Organisation (WHO) there will be a significant increase in the incidence of breast cancer in developing countries such as Nigeria by 2030. However, mammography screening can significantly reduce the mortality and morbidity of women as a result of breast cancer. Therefore, the aim of this review is to evaluate the mammography screening program in Nigeria, compare it with four developed countries and then draw inferences. The Nigerian screening program was evaluated using the following factors: - mode of invitation, frequency of screening, age of the participants, image projections, imaging staff, quality assurance program, and availability. Similarities exist between Nigeria and four developed countries (the United States of America, United Kingdom, Australia and Canada), for instance trained Radiographers do the imaging and the image projections obtained are the same. However, important differences exist, these include mode of invitation, financial model, quality assurance program and availability. On comparison with the four developed countries, various issues have been identified within the Nigerian breast screening programmes. No one simple solution can be offered to address these as the challenges are multi-factorial. - Highlights: • The mammography screening program in Nigeria is compared to four structured screening programs. • There is poor participation of Nigerian women in the screening program. • The cost of mammogram is associated with poor attendance. • The Nigerian screening program lags behind with the age of women invited for screening and lack of quality assurance program.

Some practical possibilities of optimization of the radiological protection of patients in mammography

International Nuclear Information System (INIS)

Milu, C.; Dumitrescu, A.; Marin, R.

2006-01-01

The mammography for the cancer breast detection is a diagnosis procedure with X-rays in a permanent development in our country and it represent an important measurement for the public health. The experience of the other countries has demonstrated that this utilisation can not be extended without an adequate program for Quality Control and Assurance (A.Q./C.Q.). This paper has been part of an Research Program co-ordinate by the IAEA-Vienna, named 'the image quality and optimization of the patient dose in the East European Countries' which has been done in 2000- 2001. The reason of the IAEA project was to establish a methodology for the implementation of an AQ program in mammography and to make an exercise about evaluation of the image quality and of the patient dose. This study has been done in a few countries of the East Europe including Romania. All of the three mammography installations from the three centers, are relative new and the results of the quality tests and the percent doses have been right: H.V.L. (in mm Al) for the Mo/Mo combination was in the 0.3-0.4 mm Al, the reproducibility of the exposure it was under ± 5%; the exposure linearity was better than ±10%; the absorbed dose at the skin was lower than 10 mGy. Even in this conditions, the missing of the adequate systems for the image processing and the corespondent viewing boxes influenced in the worse way the quality of the image. By the application of the remediation actions it was realised an important reduction of the rejected rate and an improve of the quality image. Significant reductions of the patient dose have been obtained in one of the centre by using the automat work system (instead of the manual work system) and by using of the Mo/Rh combination in the adequate situations (big breast or very dens). It is very important in Romania to organise Workshops about quality criteria in mammography, as used in the European Union. (authors)

Mammography: What You Need to Know

Science.gov (United States)

... While standing in front of the machine, a technologist will position your breast on a small platform. ... mammography or additional 3D imaging methods, such as ultrasound or MRI, are options for you. Ochs adds: “ ...

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

Science.gov (United States)

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

2018-05-01

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

Knowledge discovery from structured mammography reports using inductive logic programming.

Science.gov (United States)

Burnside, Elizabeth S; Davis, Jesse; Costa, Victor Santos; Dutra, Inês de Castro; Kahn, Charles E; Fine, Jason; Page, David

2005-01-01

The development of large mammography databases provides an opportunity for knowledge discovery and data mining techniques to recognize patterns not previously appreciated. Using a database from a breast imaging practice containing patient risk factors, imaging findings, and biopsy results, we tested whether inductive logic programming (ILP) could discover interesting hypotheses that could subsequently be tested and validated. The ILP algorithm discovered two hypotheses from the data that were 1) judged as interesting by a subspecialty trained mammographer and 2) validated by analysis of the data itself.

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

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

Assessment of mean glandular dose for patients in mammography in some Hospitals in Khartoum state

International Nuclear Information System (INIS)

Abu Elmola, Alaa Mahdi

2016-12-01

A mammography examination facilitates the early detection of breast cancer. However, the potential risk of radiation- induced carcinogenesis is also increased with such a procedure. Thus assessment of the breast dose is important. The objective of this study was to determine the mean glandular dose (MGD) resulting from cranio caudal(CC) and mediolateral oblique (MLO) views in one breast and the total dose per woman in Sudan, and to identify the factors affecting it. Measurements were performed to estimate mean glandular doses for 60 patients who underwent mammography examination in two clinics in Khartoum, Sudan.Doses were studied in RCH and NDC, centers which were using computed radiography(CR)devices. The piranha system was used for determining the MGD in this work. The characteristics of the radiographic equipment and the exposure data of each patient were recorded using designed format. The MGD was calculated from the measured incident Air kerma using appropriate conversion coefficients. The range of CBT was (1-7)cm for two projections. The respective averages for the CC and MLO projections were (4.55±1.38)mGy and (4.15±1.33) mGy, respectively. The average MGD per image was (4.3±1.35)mGy. The MGD per women was (8.6±1.35)mGy. The mean±SD MGD per image in the present study was lower than most of similar reports. The average MGD values recorded in this study were above the limiting value of the Institute of Physical Sciences in Medicine(2.0 mGy) and American College of Radiology (3.0 mGy recommendation. This suggests that mammography x-ray generators in this case are not capable of achieving acceptable dose levels for patients safety. Therefore, with consideration of all other factors, quality control program tests must be carried out periodically and frequently of the mammography equipment.(Author)

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)

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

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

Diagnosis of fibroadenoma and breast cancer: ultrasonography vs. X-ray mammography

Energy Technology Data Exchange (ETDEWEB)

Song, Jong Gi; Im, Jung gi; Choi, Byung Ihn; Kim, Choo Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1993-12-15

To evaluate the clinical value of ultrasonography in the diagnosis of fibroadenoma and carcinoma as compared with mammography, we performed a blind retrospective analysis of 85 sonograms and 40 mammograms of 85 breasts that were proved pathologically to have diseases. The lesions included 30 ductal carcinomas, 29 fibroadenomas, 14mammary dysplasias, 2 medullary carcinomas, 1 intraductal papillary carcinoma, and 9 cases of other pathology. The sonograms were reviewed in regards to the border, shape and internal echo pattern of the lesion and the shadows from the margin of the lesion. The mammograms were reviewed in regards to the parenchymal pattern, shape, margin,and calcification of the lesion. The accuracy, sensitivity, and specificity of mammography and ultrasonography in the diagnosis of fibroadenoma were 77%/92%, 40%/93%, and 100%/92%, respectively. The accuracy, sensitivity, and specificity of mammography and ultrasonography in the diagnosis of carcinoma were 85%/85%, 76%/82%, and 91%/86%,respectively. Ultrasonography is more accurate and more sensitive than mammography in the diagnosis offibroadenoma, but not in the diagnosis of carcinoma

Diagnosis of fibroadenoma and breast cancer: ultrasonography vs. X-ray mammography

International Nuclear Information System (INIS)

Song, Jong Gi; Im, Jung gi; Choi, Byung Ihn; Kim, Choo Wan

1993-01-01

To evaluate the clinical value of ultrasonography in the diagnosis of fibroadenoma and carcinoma as compared with mammography, we performed a blind retrospective analysis of 85 sonograms and 40 mammograms of 85 breasts that were proved pathologically to have diseases. The lesions included 30 ductal carcinomas, 29 fibroadenomas, 14mammary dysplasias, 2 medullary carcinomas, 1 intraductal papillary carcinoma, and 9 cases of other pathology. The sonograms were reviewed in regards to the border, shape and internal echo pattern of the lesion and the shadows from the margin of the lesion. The mammograms were reviewed in regards to the parenchymal pattern, shape, margin,and calcification of the lesion. The accuracy, sensitivity, and specificity of mammography and ultrasonography in the diagnosis of fibroadenoma were 77%/92%, 40%/93%, and 100%/92%, respectively. The accuracy, sensitivity, and specificity of mammography and ultrasonography in the diagnosis of carcinoma were 85%/85%, 76%/82%, and 91%/86%,respectively. Ultrasonography is more accurate and more sensitive than mammography in the diagnosis offibroadenoma, but not in the diagnosis of carcinoma

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

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.

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.

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).

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.

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.

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)

Malignant and benign diseases of the breast in 41 male patients: mammography, sonography and pathological correlations; Maligne und benigne Erkrankungen der Brust bei 41 maennlichen Patienten: Mammographie und Sonographie mit histopathologischer Korrelation

Energy Technology Data Exchange (ETDEWEB)

Partik, B.; Mallek, R.; Pokieser, P.; Wunderbaldinger, P.; Helbich, T.H. [Vienna Univ. (Austria). Klinik fuer Radiodiagnostik; Rudas, M. [Vienna Univ. (Austria). Inst. fuer Klinische Pathologie

2001-11-01

Aim: The goal of our study was to evaluate findings in mammography and sonography in male patients with pathohistologically proven diseases of the breast. Material and Methods: Mammographies and sonographies, which were obtained in 41 male patients in a 6-year period, were retrospectively evaluated in accordance with the BI-RADS trademark classification. Results: Histologically 13 carcinomas, 21 gynecomastias, 3 pseudogynecomastias, 2 epithelial inclusion cysts and 2 other benign lesions were diagnosed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of mammography in differentiation of benign versus malignant disease were 92%, 89%, 80%, 96% and 90%, respectively. Additional sonography did not change these results. However, sonography increased diagnostic confidence in 18.2% (2/11) of suspicious lesions. Conclusion: In our study the invasive ductal carcinoma of male patients was a predominantly lobulated, ill-defined lesion in mammography and sonography. The differentiation of carcinoma to pseudogynecomastia and diffuse or dendritic gynecomastia was securely feasible. However, we could not reliably distinguish between carcinoma and some benign mass lesions. In cases of mammographically diagnosed masses or unclear mammography, additional sonography should be performed to increase the diagnostic confidence. (orig.) [German] Ziel: Die Befunde von Mammographie und Sonographie bei histologisch gesicherten malignen und benignen Mammaerkrankungen maennlicher Patienten zu evaluieren. Material und Methode: Retrospektiv wurden die in einem Zeitraum von 6 Jahren durchgefuehrten Mammographien und Sonographien bei 41 maennlichen Patienten in Anlehnung an die BI-RADS trademark Klassifikation ausgewertet. Resultate: Es wurden 13 Karzinome, 21 Gynaekomastien, 3 Pseudogynaekomastien, 2 Atherome und 2 weitere benigne Laesionen histologisch diagnostiziert. Die Mammographie zeigte in der Differenzierung maligne versus benigne Laesion

2-D or 3-D Mammography?: The Future of Breast Cancer Detection | NIH MedlinePlus the Magazine

Science.gov (United States)

... Future of Breast Cancer Detection Follow us 2-D or 3-D Mammography?: The Future of Breast Cancer Detection NIH- ... will test two types of imaging tools—2-D and 3-D mammography. 2-D mammography takes ...

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.

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.

A phantom for quality control in mammography

International Nuclear Information System (INIS)

Gambaccini, M.; Rimondi, O.; Marziani, M.; Toti, A.

1989-01-01

A phantom for evaluating image quality in mammography has been designed and will be used in the Italian national programme ''Dose and Quality in Mammography''. The characteristics of the phantom are (a) about the same X-ray transmission as a 5 cm 50% fat and 50% water breast for energies between 15 and 50 keV and (b) optimum energies for imaging of the test objects (included in the phantom) in very close agreement with the optimum energies for imaging of calcifications and tumours in a 5 cm 50% fat and 50% water breast. An experimental comparison between the prototype and some commercial phantoms was carried out. Measurements are in progress to test the phantom's ability to evaluate the performances of mammographic systems quantitatively. (author)

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.

Specialized software for optimization of the quality control of the mammography units

International Nuclear Information System (INIS)

Stoeva, M.; Vassileva, J.

2004-01-01

Quality control is essential to ensure the equipment used is reliable and consistent in order to maintain radiation does as low as reasonably achievable whilst optimizing image quality and performance in mammography. The effectiveness of mammographic screening is highly dependent on the consistent production of high quality diagnostic images. Mammography is highly dependent on the equipment status, which requires an effective Quality Control (QC) program to provide tools for continuous assessment of the equipment performance and also data storage and analysis of the protocols' data. The objective of this paper is to present the specialized software for Quality Control of the Mammography Units, as tool providing additional functionality for optimizations of the Mammography QC data storage and management. The PC program was developed according to the requirements stated in the European protocol for Quality Control of the Mammography Screening and the data collected as a result of its application in several Bulgarian hospitals. The Structured Analysis method was used in order to perform a case, which resulted in the development of the specialized software with a database module, providing the following functionality: Data Storage, Preliminary Data Processing and Post-Processing, Manual Data Entry, Data Import from XLS format, Data Export to XLS format, Printing, Data Filters, Automated Calculation, Automated Graphical Representation, Archiving The development of specialized QC software with a database for mammography units facilitates the process of QC data storage and handling and minimizes the errors. The electronic format for data storage is especially useful in case of long-term storage and periodical data analysis/access. The integrated data processing functionality and the automated import/export features based on standard platform increase the compatibility of the data. (authors)

Indicators of image quality and doses in mammography

International Nuclear Information System (INIS)

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

2007-01-01

Full text: The purpose of the study was to determine the values of the image quality indicators and their relationship with the dose in mammography of screen-film that they allowed the detection of a bigger number of objects in the images obtained with the mannequin (phantom) authorized of the ACR/FDA. The study was carried out in four mammography services in a period of 12 months. The indicators of the image quality are the half optic density (DOM), contrast (differences of densities), the number of observed objects in the images and the dose for image. The minimum acceptable values by the ACR/FDA are a half optical density of 1.4, contrast of 0.4 and the one numbers minimum of objects observed in the image of the mannequin of mammography of 10 (4 fibers, 3 groups of calcifications and 3 masses), with a maximum dose by image of 3 mGy. The found results are half optical density of 1.9, contrast of 0.56 and the average number of objects observed in the images of 12, with a dose in the interval of 1.6 mGy to 2.4 mGy. The doses were measured by thermoluminescent dosimetry and ionization chamber. Once carried out the analysis of the tendencies of the indicators of image quality and their distributions is found that for a p < 0.05, the bigger number of objects observed in the images is in the interval from 1.8 to 1.9 of DOM. When comparing both mammography system, the system screen-film has a lower variability in the distribution of objects associated to a DOM. (Author)

Combined assessment (aspiration cytology and mammography) of ...

African Journals Online (AJOL)

Combined assessment (aspiration cytology and mammography) of clinically suspicious breast masses. W.F. van Wyk, D Dent, E Anne Hacking, Genevieve Learmonth, R.E. Kottler, C Anne Gudgeon, A Tiltman ...

Factors Influencing of Social Conflict

Directory of Open Access Journals (Sweden)

Suwandi Sumartias

2013-07-01

Full Text Available Social conflicts that occur in several areas in Indonesia lately, one of them is caused by the weakness of law certainty. This is feared to threaten the integration of the Republic of Indonesia. This study aims to determine the factors that affect social conflict in Manis Lor village in Kuningan district. The method used the explanatory quantitative methods, the statistical test Path Analysis. The study population was a formal and informal community leaders (village chief, clergy, and youth, and the people who involved in a conflict in Manis Lor village Kuningan regency. The result shows a There is no significant influence between social identity factors with social conflict anarchist. b There is significant influence between socio-economic factors with social conflict anarchists. c There is no significant influence between the credibility factor anarchist leaders with social conflict. d There is no significant influence between the motive factor with anarchist social conflict. e There is significant influence between personality factors/beliefs with anarchist social conflict. f There is significant influence of behavioral factors anarchist communication with social conflict.

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

Statistical Texture Model for mass Detection in Mammography

Directory of Open Access Journals (Sweden)

Nicolás Gallego-Ortiz

2013-12-01

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

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.

Contrast to Noise Ratio and Contrast Detail Analysis in Mammography:A Monte Carlo Study

International Nuclear Information System (INIS)

Metaxas, V; Delis, H; Panayiotakis, G; Kalogeropoulou, C; Zampakis, P

2015-01-01

The mammographic spectrum is one of the major factors affecting image quality in mammography. In this study, a Monte Carlo (MC) simulation model was used to evaluate image quality characteristics of various mammographic spectra. The anode/filter combinations evaluated, were those traditionally used in mammography, for tube voltages between 26 and 30 kVp. The imaging performance was investigated in terms of Contrast to Noise Ratio (CNR) and Contrast Detail (CD) analysis, by involving human observers, utilizing a mathematical CD phantom. Soft spectra provided the best characteristics in terms of both CNR and CD scores, while tube voltage had a limited effect. W-anode spectra filtered with k-edge filters demonstrated an improved performance, that sometimes was better compared to softer x-ray spectra, produced by Mo or Rh anode. Regarding the filter material, k-edge filters showed superior performance compared to Al filters. (paper)

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

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.

Daily quality control in computed radiography mammography using the manufacturer phantom

International Nuclear Information System (INIS)

Jakubiak, Rosangela R.; Messias, Pricila C.; Oliveira, Carlla M.

2011-01-01

The quality control (QC) in mammography system involves a large amount of test tools, which implies a large space for storage and a high number of exposure. This work describes a QC system using a phantom, Fuji Computed Radiography (FCR) One Shot Phantom M Plus, that evaluates several parameters with just one exposure. The software offers tests with annual, semi-annual, quarterly, weekly and daily periodicity, and analyzes the conformities of the mammography equipment, image plate and cassettes. Because of the high number of tests, it was evaluated the daily test only for seven months in two mammography equipment. The test, through the software and its image, allows the analysis of ten parameters in QC. The evaluation of these parameters was realized by the average of the values provided by the software. Only one of the evaluated items showed not conformity, but this was observed and the necessary corrections were realized. The monitoring of use of FCR Mammography QC software with the FCR One Shot Phantom M Plus was realized and through this we could investigate that the quality program provided by the system is appropriate for the radiology services that has the Fuji Computed Radiography system. (author)

Breast cancer mortality in Norway after the introduction of mammography screening

DEFF Research Database (Denmark)

Olsen, Anne Helene; Lynge, Elsebeth; Njor, Sisse H

2013-01-01

An organized mammography screening program was gradually implemented in Norway during the period 1996-2004. Norwegian authorities have initiated an evaluation of the program. Our study focused on breast cancer mortality. Using Poisson regression, we compared the change in breast cancer mortality ...... to the program, the implementation of the organized mammography screening program was associated with a statistically nonsignificant decrease in breast cancer mortality of around 11%....

Extension of ductal carcinoma in situ. Histopathological association with MR imaging and mammography

International Nuclear Information System (INIS)

Shiraishi, Akihiko; Kurosaki, Yoshihisa; Maehara, Tadayuki

2003-01-01

The purpose of this study is to evaluate the capability of breast MRI (magnetic resonance imaging) and mammography in determining tumor extent and the detectability of ductal carcinoma in situ (DCIS) in association with histopathological features. Thirty women with breast cancer underwent 3D dynamic MRI. Twelve women had pure DCIS and 18 women had DCIS with microinvasion. We analyzed the results of preoperative MRI and mammography with histopathologic results, retrospectively. The mean lesion size was 55.1 mm from the histopathologic results. Twenty-six lesions were detected through the MRI (a sensitivity of 86.7%). MRI depicted eight lesions without mammographically detected microcalcification. In seven cases, MRI showed tumor extent accurately compared with mammography, and the combined diagnosis improved the accuracy of evaluating tumor extent. MRI can complement mammography in guiding surgical treatment of DCIS by providing better assessment of the extent of the lesion. (author)

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.

Quality assurance programme for screen film mammography

International Nuclear Information System (INIS)

2009-01-01

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

Technical and dosimetric aspects of quality control in mammography

International Nuclear Information System (INIS)

Zoetelief, J.; Wit, N.J.P. de; Broerse, J.J.

1989-01-01

Before screening programmes using mammography are implemented, a cost benefit analysis has to be made and quality-control programme for the technical and dosimetric aspects adopted, including daily checks on film processing and total mammography procedure (radiography of a reference phantom, for which the average density, limiting value ± 0.20%, and focal charge is determined and which allows assessment of physical image quality) The installation of a MAs meter is essential for daily checks and can be used for determination of absorbed dose. Accurate determination of tube voltage (limiting value ±0.5 kV) is essential in regard to absorbed dose variations. Focal spot size should be measured rather than relying on the value specified by the manufacturer. The determination of the focal charge (mAs) value for actual radiographs of female breasts combined with a measurement of compressed breast thickness provides information on absorbed dose values for actual radiographs. An approximately 50 mm thick poly(methyl methacrylate) phantom can be used for determination of absorbed dose in mammography. (author)

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-09-15

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

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.)

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.)

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

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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.

Synthesized Mammography: Clinical Evidence, Appearance, and Implementation

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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.

Body weight and sensitivity of screening mammography

DEFF Research Database (Denmark)

Njor, Sisse H.; von Euler-Chelpin, My; Tjønneland, Anne

2016-01-01

benefit more from screening than other women. Methods: We combined data from the Danish Diet, Cancer and Health study and the organised population-based screening mammography programme in Copenhagen, Denmark. Women were categorised according to body mass index (BMI) (...Aim: Obese women tend to participate less in breast cancer screening than normal weight women. However, obese women have fattier breast than normal weight women, and screening mammography works better in fatty than in dense breasts. One might, therefore, hypothesise that obese women would actually......, and 35+). We measured recall rate, sensitivity and specificity for subsequent screens with a 2-year follow-up period. Results: The study included 6787 women. The recall rate varied from 1.4% for women with BMI women with BMI 35+, test for trend p = 0.86. Sensitivity varied from 42% (95...

Breast Cancer Screening, Mammography, and Other Modalities.

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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.

Screening mammography uptake within Australia and Scotland in rural and urban populations.

Science.gov (United States)

Leung, Janni; Macleod, Catriona; McLaughlin, Deirdre; Woods, Laura M; Henderson, Robert; Watson, Angus; Kyle, Richard G; Hubbard, Gill; Mullen, Russell; Atherton, Iain

2015-01-01

To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of the 1946-51 cohort of the Australian Longitudinal Study on Women's Health (N = 9890 women). Contrary to our hypothesis, results indicated that women living in rural areas were not less likely to attend for screening mammography compared to women living in urban areas in both Scotland (OR for rural = 1.17, 95% CI = 1.06-1.29) and Australia (OR for rural = 1.15, 95% CI = 1.01-1.31). The absence of rural-urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography.

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.

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)

From facts to arguments: A study of the 2014 Swiss controversy over systematic mammography screening.

Science.gov (United States)

Perrenoud, Caroline; Stiefel, Friedrich; Bourquin, Céline

2018-06-01

The Swiss Medical Board (SMB) has recently revived the controversy over mammography screening by recommending to stop the introduction of new systematic mammography screening programs. This study aimed to examine the Swiss media coverage of the release of the SMB report. The dataset consisted of 25 newspaper and "medical magazine" articles, and TV/radio interviews. The analytic approach was based on argumentation theory. Authority and community arguments were the most frequent types of arguments. With respect to authority arguments, stakeholders for instance challenged or supported the expertise of the SMB by referring to the competence of external figures of authority. Community arguments were based on common values such as life (saved thanks to systematic mammography screening) and money (costs associated with unnecessary care induced by systematic mammography screening). The efficiency of mammography screening which was the key issue of the debate appeared to be largely eluded, and the question of what women should do endures. While interpersonal and interprofessional communication has become a major topic of interest in the medical community, it appears that media communication on mammography screening is still rather ineffective. We call in particular for a more fact-based discussion. Copyright © 2017 Elsevier B.V. All rights reserved.

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...

A Radial Sclerosing Lesion Mimicking Breast Cancer on Mammography in a Young Woman

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Masashi Furukawa

2012-02-01

Full Text Available A spiculated mass on a mammogram is highly suggestive of malignancy. We report the case of a 32-year-old woman with a radial sclerosing lesion that mimicked breast cancer on mammography. She visited her physician after palpating a lump in her left breast. Mammography showed architectural distortion in the upper inner quadrant of the left breast. Ultrasonography showed a low echoic area with an ambiguous boundary. Core needle biopsy was performed because of the suspicion of malignancy. Histological examination did not reveal any malignant cells. After 6 months, the breast lump became larger and the patient was referred to our hospital. Mammography performed in our hospital showed a spiculated mass, and therefore mammotome biopsy was performed. Histological examination revealed dense fibroelastic stroma with a wide variety of mastopathic changes, leading to a diagnosis of a radial sclerosing lesion. One year after the biopsy, the lump on her left breast had disappeared and mammography showed no spiculated mass.

Thermoluminescence of zirconium oxide nanostructured to mammography X-ray beams

International Nuclear Information System (INIS)

Palacios, L.L.; Rivera, T.; Roman, J.; Azorín, J.; Gaona, E.

2012-01-01

In the present work thermoluminescent (TL) response of zirconium oxide (ZrO 2 ) nanostructured induced by mammography X-ray radiation was investigated. Measurements were made of the response per unit air kerma of ZrO 2 with mammography equipment parameters (semiautomatic exposure control, 24 kVp and 108 mAs). The calibration curves were obtained by simultaneously irradiating ZrO 2 samples and ion chamber. Samples of ZrO 2 showed a linear response as a function of entrance skin air kerma. The observed results in TL properties suggest that ZrO 2 nanostructured could be considered as an effective material for X-ray beams dosimetry if appropriate calibration procedures are performed. - Highlights: ► X-ray low energy thermoluminescent of ZrO 2 dosimeter is developed. ► Air kerma measurements were made by thermoluminescent dosimeter ZrO 2 using mammography equipment parameters. ► Entrance surface skin doses were made using thermoluminescent dosimeter of ZrO 2 to X-ray beam quality control.

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)

Development of special ionization chambers for a quality control program in mammography

International Nuclear Information System (INIS)

Silva, Jonas Oliveira da

2013-01-01

Mammography is an imaging method that uses X-rays. The use of ionization chambers in mammography quality control programs presents an essential role which is to verify whether the parameters of the patient exposure are correct. However, the commercial ionization chambers for dosimetry in mammography represent a high cost for small and medium size clinics that wish to have this equipment or for professionals that work with quality control programs. The innovative feature of this work was to develop ionization chambers for this purpose. In this work ionization chambers for X radiation beams in the mammography energy range were designed, constructed and characterized. The ionization chambers were tested in standard X radiation beams at the LCI/IPEN. The main characterization tests performed with the ionization chambers were: saturation curve, linearity of response, angular and energy dependence. The response stability tests of the ionization chambers were also conducted at the LCI, presenting results within 2.0 % for long-term stability. The results of the remaining tests are in accordance with international standards. These ionization chambers were also submitted to quality control tests of mammography equipment: linearity of the air kerma rates, determination of half-value layers and mean glandular doses. The results for air kerma rate linearity were less than 10 %, as recommended in international standards. The mean glandular dose obtained with the developed chambers presented values comparable to those of commercial ionization chambers tested, with an estimated variation within international standards. (author)

Breast compression – An exploration of problem solving and decision-making in mammography

International Nuclear Information System (INIS)

Nightingale, J.M.; Murphy, F.J.; Robinson, L.; Newton-Hughes, A.; Hogg, P.

2015-01-01

Objective: Breast compression decreases radiation dose and reduces potential for motion and geometric unsharpness, yet there is variability in applied compression force within and between some centres. This article explores the problem solving process applied to the application of breast compression force from the mammography practitioners' perspective. Methods: A qualitative analysis was undertaken using an existing full data set of transcribed qualitative data collected in a phenomenological study of mammography practitioner values, behaviours and beliefs. The data emerged from focus groups conducted at six NHS breast screening centres in England (participant n = 41), and semi-structured interviews with mammography educators (n = 6). A researcher followed a thematic content analysis process to extract data related to mammography compression problem solving, developing a series of categories, themes and sub-themes. Emerging themes were then peer-validated by two other researchers, and developed into a model of practice. Results: Seven consecutive stages contributed towards compression force problem solving: assessing the request; first impressions; explanations and consent; handling the breast and positioning; applying compression force; final adjustments; feedback. The model captures information gathering, problem framing, problem solving and decision making which inform an ‘ideal’ compression scenario. Behavioural problem solving, heuristics and intuitive decision making are reflected within this model. Conclusion: The application of compression should no longer be considered as one single task within mammography, but is now recognised as a seven stage problem solving continuum. This continuum model is the first to be applied to mammography, and is adaptable and transferable to other radiography practice settings. - Highlights: • Mammography compression should no longer be considered as one single examination task. • A seven stage breast

Stereotaxic cytology of nonpalpable lesions detected at mammography

International Nuclear Information System (INIS)

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

1991-01-01

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

Barriers to Mammography Screening: How to Overcome Them

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Yasmin Hassoun

2015-10-01

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

Computed tomographic mammography using a conventional body scanner.

Science.gov (United States)

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

1982-03-01

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

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

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

1997-09-01

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

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

International Nuclear Information System (INIS)

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

1997-01-01

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

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

Technical aspects of quality assurance in mammography: Preliminary results from Serbia

Directory of Open Access Journals (Sweden)

Živković Monika M.

2010-01-01

Full Text Available Mammography is the method of choice for early detection of breast cancer. In Serbia, mammography is performed only clinically, although there is a plan to introduce mammography as a screening method. Currently, there are 60 mammographic units in practice, resulting in 70 000 mammographies annually. The survey was conducted in order to investigate mammographic practice in Serbia, identify weak points and suggest appropriate corrective measures. Basic technical parameters of the X-ray tube and generator, processing, image quality, and patient doses in 20 mammographic units were studied. The survey demonstrated considerable variations in technical parameters that affect image quality, and patients doses. Patient dose levels, in terms of the mean glandular dose, were fairly consistent with current European reference levels: 1.8 (0.40-4.3 mGy. However, due to inappropriate image receptors, image processing and viewing conditions and automatic exposure control adjustment, suboptimal image quality was a common finding. Simple improvements of the radiographic technique and maintenance procedure, along with the rigid implementation of the quality control procedure and training of the operating staff, would improve the performance levels of mammographic practice in Serbia, i. e. result in the production of high quality images with a reasonably low radiation risk to patients.

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

Science.gov (United States)

Warren-Forward, H M; Taylor, J

2017-02-01

There is a projected shortage of radiographers working in breast screening and this study aimed to examine comments from open response questions from a mixed methods survey of current diagnostic radiography students on their perceptions of working in mammography. The survey asked three open ended questions: Justification of choice of modality in which they would want to specialise, why they believed there was a shortage of radiographers working in breast screening and any other comment about mammography. Reasons given for specialising in any modality was interest, feature of a modality, amount of clinical exposure during the degree program, personal issues and career prospects. Few current diagnostic radiography students indicated that they would be interested in specialising in breast imaging. They considered there to be a shortage of radiographers as breast imaging was seen to be repetitive, high pressure, intimate and gender biased. Lack of education, clinical exposure, limited career prospects and low pay were also discussed. Increasing education to the modality during the degree, allowing males to be involved in breast imaging and promoting part-time work in mammography while also working in other modalities may alter the perception that mammography offers a limited career pathway. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Colour application on mammography image segmentation

Science.gov (United States)

Embong, R.; Aziz, N. M. Nik Ab.; Karim, A. H. Abd; Ibrahim, M. R.

2017-09-01

The segmentation process is one of the most important steps in image processing and computer vision since it is vital in the initial stage of image analysis. Segmentation of medical images involves complex structures and it requires precise segmentation result which is necessary for clinical diagnosis such as the detection of tumour, oedema, and necrotic tissues. Since mammography images are grayscale, researchers are looking at the effect of colour in the segmentation process of medical images. Colour is known to play a significant role in the perception of object boundaries in non-medical colour images. Processing colour images require handling more data, hence providing a richer description of objects in the scene. Colour images contain ten percent (10%) additional edge information as compared to their grayscale counterparts. Nevertheless, edge detection in colour image is more challenging than grayscale image as colour space is considered as a vector space. In this study, we implemented red, green, yellow, and blue colour maps to grayscale mammography images with the purpose of testing the effect of colours on the segmentation of abnormality regions in the mammography images. We applied the segmentation process using the Fuzzy C-means algorithm and evaluated the percentage of average relative error of area for each colour type. The results showed that all segmentation with the colour map can be done successfully even for blurred and noisy images. Also the size of the area of the abnormality region is reduced when compare to the segmentation area without the colour map. The green colour map segmentation produced the smallest percentage of average relative error (10.009%) while yellow colour map segmentation gave the largest percentage of relative error (11.367%).

Radiation hazards of X-ray mammography

International Nuclear Information System (INIS)

Bailar, J.C. III

1978-01-01

X-ray mammography delivers significant amounts of ionizing radiation to the breast, and the female breast is more susceptible to radiation carcinogenesis than any other human organ. On the other hand, breast cancer is least likely to cause serious illness and death when it is detected at a very early stage. The risks and benefits of mammography can be estimated. This paper summarizes current risk estimates, then proceeds to a comparison of risks and benefits. As for breast cancer mortality, the addition of mammography to a programme of annual breast examinations of average U.S. women is of questionable value for women under age 50 but it is probably beneficial for older women. However, the break-even point is closely related to the average radiation exposure of breast tissue, and would be earlier in a few centres now using optimum techniques and equipment. For women with below-average risks of breast cancer, the age would be higher, and for a few women with a high probability of developing breast cancer it would be lower. Breast cancer screening programmes have been improved significantly since criticisms were first publicized in mid-1975. Partial improvements include reduction in radiation exposure (at least in some centres), guidelines from the National Cancer Institute (NCI) and the American Cancer Society (ACS) for restricting the screening of women under age 50, and changes in the patient consent form signed by participants in the NCI-ACS programme. Professional and public awareness of the need to balance the benefits of screening with its risks and costs has rapidly and markedly increased. Future improvements should further define the optimum design and application of breast cancer screening programmes

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

Is mammography screening history a predictor of future breast cancer risk?

DEFF Research Database (Denmark)

Andersen, Sune Bangsbøll; Törnberg, Sven; Kilpeläinen, Sini

2015-01-01

Inspired by the model by Walter and Day for risk of cervical cancer following negative screens, one might hypothesize that women in a mammography screening programme with a certain number of negative screens had a lower remaining breast cancer risk than that of women in general. We studied whether...... number of negative screens was a predictor for a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Copenhagen and Funen. Data were collected from the mammography screening programmes in Stockholm, Sweden (1989-2012), Copenhagen, Denmark (1991......-2009) and Funen, Denmark (1993-2009), and linked to the respective cancer registries. We calculated cumulative hazard rates for breast cancer in women in cohorts defined by age at entry and number of negative screens for the maximum follow-up period in each screening centre. For all centres and cohorts...

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

Preparing women for breast screening mammography: A feasibility study to determine the potential value of an on-line social network and information hub

International Nuclear Information System (INIS)

Robinson, L.; Griffiths, M.; Wray, J.; Ure, C.; Shires, G.; Stein-Hodgins, J.R.; Hill, C.; Hilton, B.

2015-01-01

This feasibility study explored the attitudes of women towards social media for support about breast screening mammography. It sought their ideas about what a dedicated breast screening hub or Digital Support Network (DSN) might comprise; how they would network with other women on the DSN; what format information might take; and whether a health professional should be available on the DSN. Data comprised 94 survey questionnaires and two focus groups; one comprised women in the breast screening population age group, the other was a younger group. A socio-ecological framework was used to identify key influencers and potential barriers for the implementation of a mammography DSN. The study identified issues related to three intersecting concepts which influenced women's behaviour: on-line conversations about health in general; on-line conversations about breast screening mammography and the culture of privacy which makes conversing about intimate health (either face to face or on-line) difficult. Also, the transient nature of the mammography episode (three yearly), could mean an on-line breast screening digital network is challenging to sustain. super-users’ may be needed to continue on-line conversations. The health professional was also seen as essential for moderating potential misinformation shared by women although the participants were also insistent that ‘truth’ be shared. - Highlights: • Ensure factual information is provided that is in textual format with images and video. • Provide option to network in private. • Develop health practitioners who can provide a balanced perspective in facilitating the sharing of true experiences. • Work with employers to implement organisational changes. • Target certain groups in more direct ways (i.e. those with lower self-efficacy in terms of on-line skills).

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

Science.gov (United States)

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

2017-09-01

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

MR mammography (MRM)

Energy Technology Data Exchange (ETDEWEB)

Kaiser, W.A.

1993-01-01

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

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.

Development of an excel spreadsheet formean glandular dose in mammography

International Nuclear Information System (INIS)

Nagoshi, Kazuyo; Fujisaki, Tatsuya

2008-01-01

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

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)

Dissemination of periodic mammography and patterns of use, by birth cohort, in Catalonia (Spain)

Science.gov (United States)

Rue, Montserrat; Carles, Misericordia; Vilaprinyo, Ester; Martinez-Alonso, Montserrat; Espinas, Josep-Alfons; Pla, Roger; Brugulat, Pilar

2008-01-01

Background In Catalonia (Spain) breast cancer mortality has declined since the beginning of the 1990s. The dissemination of early detection by mammography and the introduction of adjuvant treatments are among the possible causes of this decrease, and both were almost coincident in time. Thus, understanding how these procedures were incorporated into use in the general population and in women diagnosed with breast cancer is very important for assessing their contribution to the reduction in breast cancer mortality. In this work we have modeled the dissemination of periodic mammography and described repeat mammography behavior in Catalonia from 1975 to 2006. Methods Cross-sectional data from three Catalan Health Surveys for the calendar years 1994, 2002 and 2006 was used. The dissemination of mammography by birth cohort was modeled using a mixed effects model and repeat mammography behavior was described by age and survey year. Results For women born from 1938 to 1952, mammography clearly had a period effect, meaning that they started to have periodic mammograms at the same calendar years but at different ages. The age at which approximately 50% of the women were receiving periodic mammograms went from 57.8 years of age for women born in 1938–1942 to 37.3 years of age for women born in 1963–1967. Women in all age groups experienced an increase in periodic mammography use over time, although women in the 50–69 age group have experienced the highest increase. Currently, the target population of the Catalan Breast Cancer Screening Program, 50–69 years of age, is the group that self-reports the highest utilization of periodic mammograms, followed by the 40–49 age group. A higher proportion of women of all age groups have annual mammograms rather than biennial or irregular ones. Conclusion Mammography in Catalonia became more widely implemented during the 1990s. We estimated when cohorts initiated periodic mammograms and how frequently women are receiving them

Mammography fixture

International Nuclear Information System (INIS)

Henkes, J.L. Jr.

1979-01-01

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

Studies on the calibration of mammography automatic exposure mode with computed radiology

International Nuclear Information System (INIS)

Zhu Hongzhou; Shao Guoliang; Shi Lei; Liu Qing

2010-01-01

Objective: To realize the optimization of image quality and radiation dose by correcting mammography automatic exposure, according to automatic exposure controlled mode of mammography film-screen system. Methods: The film-screen system (28 kV) was applied to perform automatic exposure of plexiglass (40 mm) and get the standard dose of exposure, the exposure mode of CR base on LgM=2.0 was rectified, which was divided into 10 steps. Mammary glands pattern (Fluke NA18-220) were examined with CR (26, 28, and 30 kV) by the automatic exposure mode corrected. The exposure values (mAs) were recorded. CR image was diagnosed and evaluated in double blind way by 4 radiologists according to American Collage of Radiology (ACR) standard. Results: Based on the standard of CR automatic exposure with the dose higher than the traditional exposure of film-screen system, the calibration of mammography automatic exposure was accomplished. The test results of the calibrated mode was better than the scoring system of ACR. Conclusions: Comparative study showed improvement in acquiring high-quality image and reduction of radiation dose. The corrected mammography automatic exposure mode might be a better method for clinical use. (authors)

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

Energy Technology Data Exchange (ETDEWEB)

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

2005-07-01

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

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

Are benefits and harms in mammography screening given equal attention in scientific articles? A cross-sectional study.

Science.gov (United States)

Jørgensen, Karsten Juhl; Klahn, Anders; Gøtzsche, Peter C

2007-05-30

The CONSORT statement specifies the need for a balanced presentation of both benefits and harms of medical interventions in trial reports. However, invitations to screening and newspaper articles often emphasize benefits and downplay or omit harms, and it is known that scientific articles can be influenced by conflicts of interest. We wanted to determine if a similar imbalance occurs in scientific articles on mammography screening and if it is related to author affiliation. We searched PubMed in April 2005 for articles on mammography screening that mentioned a benefit or a harm and that were published in 2004 in English. Data extraction was performed by three independent investigators, two unblinded and one blinded for article contents, and author names and affiliation, as appropriate. The extracted data were compared and discrepancies resolved by two investigators in a combined analysis. We defined three groups of authors: (1) authors in specialties unrelated to mammography screening, (2) authors in screening-affiliated specialties (radiology or breast cancer surgery) who were not working with screening, or authors funded by cancer charities, and (3) authors (at least one) working directly with mammography screening programmes. We used a data extraction sheet with 17 items described as important benefits and harms in the 2002 WHO/IARC-report on breast cancer screening. We identified 854 articles, and 143 were eligible for the study. Most were original research. Benefits were mentioned more often than harms (96% vs 62%, P articles mentioned only benefits, whereas seven (5%) mentioned only harms (P articles (24%), but was more often downplayed or rejected in articles that had authors working with screening, (6/15; 40%) compared with authors affiliated by specialty or funding (1/6; 17%), or authors unrelated with screening (1/14; 7%) (P = 0.03). Benefits in terms of reduced breast cancer mortality were mentioned in 109 (76%) articles, and was more often provided as a

Information on mammography-screening - from deception to insight

International Nuclear Information System (INIS)

Muehlhauser, I.; Hoeldke, B.

2002-01-01

Information about mammography-screening as a basis for informed-decision making has to be evidence-based and presented in an unbiased format. This includes communication of results about effectiveness/lack of effectiveness of screening programmes (breast cancer mortality, total mortality), the quality of mammography as a screening test (sensitivity, specificity, positive and negative predictive values), and possible harm (consequences of false positive and false negative results, overdiagnosis of breast cancer, overtreatment). Outcome data have to be communicated as natural frequencies rather than relative differences. In order to avoid framing of data equal emphasis has to be put on the proportion of persons who are likely to benefit and those who are unlikely to benefit or likely to be harmed. (orig.) [de

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

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

International Nuclear Information System (INIS)

Culpan, A.M.

2016-01-01

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

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.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2011-12-15

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

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.)

Performance tests of a special ionization chamber for X-rays in mammography energy range

Energy Technology Data Exchange (ETDEWEB)

Silva, J.O., E-mail: jonas.silva@ufg.br [Universidade Federal de Goiás (UFG), Goiânia (Brazil). Instituto de Física; Caldas, L.V.E. [Instituto de Pesquisas Energéticas e Nucleares (IPEN-CNEN/SP), São Paulo, SP (Brazil). Centro de Metrologia das Radiações

2017-07-01

A special mammography homemade ionization chamber was developed to be applied for mammography energy range dosimetry. This chamber has a total sensitive volume of 6 cm{sup 3} and is made of a PMMA body and graphite coated collecting electrode. Performance tests as saturation, ion collection efficiency, linearity of chamber response versus air kerma rate and energy dependence were determined. The results obtained with this special homemade ionization chamber are within the limits stated in international recommendations. This chamber can be used in quality control programs of mammography energy range. All measurements were carried out at the Calibration Laboratory of IPEN. (author)

Associations Between Religion-Related Factors and Breast Cancer Screening Among American Muslims

Science.gov (United States)

Padela, Aasim I.; Murrar, Sohad; Adviento, Brigid; Liao, Chuanhong; Hosseinian, Zahra; Peek, Monica; Curlin, Farr

2015-01-01

American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77 % of respondents had at least one mammogram in their lifetime, yet 37 % had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions. PMID:24700026

Associations between religion-related factors and breast cancer screening among American Muslims.

Science.gov (United States)

Padela, Aasim I; Murrar, Sohad; Adviento, Brigid; Liao, Chuanhong; Hosseinian, Zahra; Peek, Monica; Curlin, Farr

2015-06-01

American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77% of respondents had at least one mammogram in their lifetime, yet 37% had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions.

Validation of the Spanish Version of the Mammography-Specific Self-Efficacy Scale.

Science.gov (United States)

Jerome-D'Emilia, Bonnie; Suplee, Patricia; Akincigil, Ayse

2015-05-01

To consider psychometric estimates of the validity and reliability of the Spanish translation of a mammography-specific self-efficacy scale. A cross-sectional study. Three primarily Hispanic churches and a Hispanic community center in a low-income urban area of New Jersey. 153 low-income Hispanic women aged 40-85 years. The translated scale was administered to participants during a six-month period. Internal consistency, reliability, and construct and predictive validity were assessed. Demographic variables included income and insurance status. Outcome variables included total mammography-specific self-efficacy and having had a mammogram within the past two years. Preliminary evidence of reliability and validity were found, and predictive validity was demonstrated. The health needs of specific populations can be addressed only when research instruments have been appropriately validated and all relevant factors are considered. Diverse groups of low-income women face similar challenges and barriers in their efforts to get screened. Nurses are in an ideal position to help women with preventive care decision making (e.g., screening for breast cancer). Understanding how a woman's level of self-efficacy affects her decision making should be considered when counseling a client.

Thermoluminescence of zirconium oxide nanostructured to mammography X-ray beams

Energy Technology Data Exchange (ETDEWEB)

Palacios, L.L. [Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada-Legaria, IPN. Av. Legaria 694, 11500 Mexico D.F. (Mexico); Rivera, T., E-mail: trivera@ipn.mx [Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada-Legaria, IPN. Av. Legaria 694, 11500 Mexico D.F. (Mexico); Roman, J. [Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada-Legaria, IPN. Av. Legaria 694, 11500 Mexico D.F. (Mexico); Azorin, J. [Universidad Autonoma Metropolitana-Iztapalapa. Av. San Rafael Atlixco 187, 09340 Mexico D.F. (Mexico); Gaona, E. [Universidad Autonoma Metropolitana-Xochimilco. Calz. Del Hueso 1100, 04960 Mexico D.F. (Mexico)

2012-07-15

In the present work thermoluminescent (TL) response of zirconium oxide (ZrO{sub 2}) nanostructured induced by mammography X-ray radiation was investigated. Measurements were made of the response per unit air kerma of ZrO{sub 2} with mammography equipment parameters (semiautomatic exposure control, 24 kVp and 108 mAs). The calibration curves were obtained by simultaneously irradiating ZrO{sub 2} samples and ion chamber. Samples of ZrO{sub 2} showed a linear response as a function of entrance skin air kerma. The observed results in TL properties suggest that ZrO{sub 2} nanostructured could be considered as an effective material for X-ray beams dosimetry if appropriate calibration procedures are performed. - Highlights: Black-Right-Pointing-Pointer X-ray low energy thermoluminescent of ZrO{sub 2} dosimeter is developed. Black-Right-Pointing-Pointer Air kerma measurements were made by thermoluminescent dosimeter ZrO{sub 2} using mammography equipment parameters. Black-Right-Pointing-Pointer Entrance surface skin doses were made using thermoluminescent dosimeter of ZrO{sub 2} to X-ray beam quality control.

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.

Reduction in interval cancer rates following the introduction of two-view mammography in the UK breast screening programme

Science.gov (United States)

Dibden, A; Offman, J; Parmar, D; Jenkins, J; Slater, J; Binysh, K; McSorley, J; Scorfield, S; Cumming, P; Liao, X-H; Ryan, M; Harker, D; Stevens, G; Rogers, N; Blanks, R; Sellars, S; Patnick, J; Duffy, S W

2014-01-01

Background: The introduction of two-view mammography at incident (subsequent) screens in the National Health Service Breast Screening Programme (NHSBSP) has led to an increased number of cancers detected at screen. However, the effect of two-view mammography on interval cancer rates has yet to be assessed. Methods: Routine screening and interval cancer data were collated from all screening programmes in the United Kingdom for women aged 50–64, screened between 1 April 2003 and 31 March 2005. Interval cancer rates were compared based on whether two-view mammography was in use at the last routine screen. Results: The reduction in interval cancers following screening using two-view mammography compared with one view was 0.68 per 1 000 women screened. Overall, this suggests the introduction of two-view mammography at incident screen was accompanied by a 15–20% reduction in interval cancer rates in the NHSBSP. Conclusion: The introduction of two-view mammography at incident screens is associated with a reduction in incidence of interval cancers. This is consistent with previous publications on a contemporaneous increase in screen-detected cancers. The results provide further evidence of the benefit of the use of two-view mammography at incident screens. PMID:24366303

Mammographic density measurements are not affected by mammography system.

Science.gov (United States)

Damases, Christine N; Brennan, Patrick C; McEntee, Mark F

2015-01-01

Mammographic density (MD) is a significant risk factor for breast cancer and has been shown to reduce the sensitivity of mammography screening. Knowledge of a woman's density can be used to predict her risk of developing breast cancer and personalize her imaging pathway. However, measurement of breast density has proven to be troublesome with wide variations in density recorded using radiologists' visual Breast Imaging Reporting and Data System (BIRADS). Several automated methods for assessing breast density have been proposed, each with their own source of measurement error. The use of differing mammographic imaging systems further complicates MD measurement, especially for the same women imaged over time. The purpose of this study was to investigate whether having a mammogram on differing manufacturer's equipment affects a woman's MD measurement. Raw mammographic images were acquired on two mammography imaging systems (General Electric and Hologic) one year apart and processed using VolparaDensity™ to obtain the Volpara Density Grade (VDG) and average volumetric breast density percentage (AvBD%). Visual BIRADS scores were also obtained from 20 expert readers. BIRADS scores for both systems showed strong positive correlation ([Formula: see text]; [Formula: see text]), while the VDG ([Formula: see text]; [Formula: see text]) and AvBD% ([Formula: see text]; [Formula: see text]) showed stronger positive correlations. Substantial agreement was shown between the systems for BIRADS ([Formula: see text]; [Formula: see text]), however, the systems demonstrated an almost perfect agreement for VDG ([Formula: see text]; [Formula: see text]).

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.

What Do Patients Want to Know? Questions and Concerns Regarding Mammography Expressed Through Social Media.

Science.gov (United States)

Charlie, Abbas M; Gao, Yiming; Heller, Samantha L

2017-12-05

The purpose of this project is to identify questions and concerns patients have regarding breast cancer screening mammography to establish priorities in patient education and health care communication. A content analysis of posted questions (June 2010 to February 2017) containing the keywords mammogram and mammography was conducted on the social media question and answer website Quora (Quora Inc, Mountainview, California). Question topic, responses, and number of views were recorded. Comparisons were made by respondent type (medical professional or nonmedical professional) for screening recommendations and accompanying evidence. Descriptive statistics were employed to summarize the results. Overall, 197,620 views of mammography-related questions were identified, focused on 51 questions and 172 responses (51 of 172 [29.7%] by medical professionals [n = 25]; 121 of 172 [70.3%] by nonmedical professionals [n = 121]). Mammographic efficacy (16 of 51 [31.4%]) and screening guidelines (10 of 51 [19.6%]) were the most frequently queried topics. Overall, the majority of respondents were supportive of screening mammography. Most medical professionals recommended screening mammography starting at age 40, even after revisions in guidelines. Among nonmedical professionals, 4 of 22 (18.2%) were against screening mammography with less consensus regarding appropriate age of initial screen. Health society websites and journal articles were the most commonly referenced sources among medical and nonmedical professionals, respectively. A considerable interest in screening mammography guidelines and mammographic efficacy exists among users who seek health information on a social media question and answer website. Awareness of such platforms allows a unique opportunity for targeted health education and dissemination of accurate information, which may be able to reach a potentially untapped or hard-to-reach patient population. Copyright © 2017 American College of Radiology

Mammography combined with breast dynamic contrast-enhanced-magnetic resonance imaging for the diagnosis of early breast cancer

Institute of Scientific and Technical Information of China (English)

Yakun He; Guohui Xu; Jin Ren; Bin Feng; Xiaolei Dong; Hao Lu; Changjiu He

2016-01-01

Objective The aim of this study was to investigate the application of mammography combined with breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the diagnosis of early breast cancer. Methods Mammography and DCE-MRI were performed for 120 patients with breast cancer (malignant, 102; benign; 18). Results The sensitivity of mammography for early diagnosis of breast cancer was 66.67%, specificity was 77.78%, and accuracy was 68.33%. The sensitivity of MRI for early diagnosis of breast cancer was 94.12%, specificity was 88.89%, and accuracy was 93.33%. However, the sensitivity of mammography combined with DCE-MRI volume imaging with enhanced water signal (VIEWS) scanning for early diagnosis of breast cancer was 97.06%, specificity was 94.44%, and accuracy was 96.67%. Conclusion Mammography combined with DCE-MRI increased the sensitivity, specificity, and accuracy of diagnosing early breast cancer.

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Significance of screening mammography in the detection of breast diseases

International Nuclear Information System (INIS)

Ham, Soo Youn; Kim, Kyoung Ah; Oh, Yu Whan; Kim, Hong In; Chung, Kyoo Byung

1995-01-01

To evaluate the clinical significance of the screening mammography in the detection of the breast diseases, especially breast carcinoma. We analyzed 1,800 cases of mammography retrospectively. The mammography was done as a part of routine check in Health Counselling Center, Korea University Medical Center, during 9 months from November 1993 to July 1994. The age range was from 23 years to 76 years, mean 49.8 years, and the largest age group was 6th decade (31.4%). According to the mammographic findings, we divided the subjects into three groups; normal group, abnormal group in need of follow-up study, abnormal group requiring biopsy. On mammography, the normal group consisted of 1,534 cases (85%), and the abnormal group consisted of 266 cases (15%). The abnormal findings were benign-looking calcification (n = 140), fibroadeno ma (n = 29), fibrocystic changes (n = 27), cyst (n = 23), malignant lesion (n = 15) lipoma (n = 7), and others. In four of 15 cases, which were suspected to be malignant on mammograms, breast carcinoma was confirmed pathologically. In four cases of breast carcinoma, one was under 40 and the other 3 were over 50 years of age. All of the breast cancers were under 3 cm in size, and the mammographic findings of breast cancer included spiculated margin (n = 3), parenchymal distortion (n = 3), malignant calcification (n = 2) and enlarged axillary node (n = 1). Screening mammogram is helpful for early detection of non-palpable breast cancer, especially for women over 50 years of age

Significance of screening mammography in the detection of breast diseases

Energy Technology Data Exchange (ETDEWEB)

Ham, Soo Youn; Kim, Kyoung Ah; Oh, Yu Whan; Kim, Hong In; Chung, Kyoo Byung [College of Medicine Korea University, Seoul (Korea, Republic of)

1995-02-15

To evaluate the clinical significance of the screening mammography in the detection of the breast diseases, especially breast carcinoma. We analyzed 1,800 cases of mammography retrospectively. The mammography was done as a part of routine check in Health Counselling Center, Korea University Medical Center, during 9 months from November 1993 to July 1994. The age range was from 23 years to 76 years, mean 49.8 years, and the largest age group was 6th decade (31.4%). According to the mammographic findings, we divided the subjects into three groups; normal group, abnormal group in need of follow-up study, abnormal group requiring biopsy. On mammography, the normal group consisted of 1,534 cases (85%), and the abnormal group consisted of 266 cases (15%). The abnormal findings were benign-looking calcification (n = 140), fibroadeno ma (n = 29), fibrocystic changes (n = 27), cyst (n = 23), malignant lesion (n = 15) lipoma (n = 7), and others. In four of 15 cases, which were suspected to be malignant on mammograms, breast carcinoma was confirmed pathologically. In four cases of breast carcinoma, one was under 40 and the other 3 were over 50 years of age. All of the breast cancers were under 3 cm in size, and the mammographic findings of breast cancer included spiculated margin (n = 3), parenchymal distortion (n = 3), malignant calcification (n = 2) and enlarged axillary node (n = 1). Screening mammogram is helpful for early detection of non-palpable breast cancer, especially for women over 50 years of age.

The radiation metrology network related to the field of mammography: implementation and uncertainty analysis of the calibration system

Science.gov (United States)

Peixoto, J. G. P.; de Almeida, C. E.

2001-09-01

It is recognized by the international guidelines that it is necessary to offer calibration services for mammography beams in order to improve the quality of clinical diagnosis. Major efforts have been made by several laboratories in order to establish an appropriate and traceable calibration infrastructure and to provide the basis for a quality control programme in mammography. The contribution of the radiation metrology network to the users of mammography is reviewed in this work. Also steps required for the implementation of a mammography calibration system using a constant potential x-ray and a clinical mammography x-ray machine are presented. The various qualities of mammography radiation discussed in this work are in accordance with the IEC 61674 and the AAPM recommendations. They are at present available at several primary standard dosimetry laboratories (PSDLs), namely the PTB, NIST and BEV and a few secondary standard dosimetry laboratories (SSDLs) such as at the University of Wisconsin and at the IAEA's SSDL. We discuss the uncertainties involved in all steps of the calibration chain in accord with the ISO recommendations.

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.

Optimization procedures in mammography: First results

International Nuclear Information System (INIS)

Espana Lopez, M. L.; Marcos de Paz, L.; Martin Rincon, C.; Jerez Sainz, I.; Lopez Franco, M. P.

2001-01-01

Optimization procedures in mammography using equipment with a unique target/filter combination can be carried out through such diverse factors as target optical density, technique factors for exposure, screen film combination or processing cycle, in order to obtain an image adequate for the diagnosis with an acceptable risk benefit balance. Diverse studies show an increase in the Standardised Detection Rate of invasive carcinomas with an increase in the optical density among others factors. In our hospital an optimisation process has been established, and as previous step, the target optical density has been increased up to 1,4 DO. The aim of this paper is to value the impact of optical density variation as much in the quality of image as in the entrance surface dose and the average dose to the glandular tissue, comparing them with the results obtained in a previous study. The study has been carried out in a sample of 106 patients, with an average age of 53,4 years, considering 212 clinical images corresponding to the two projections of a same breast with an average compressed thickness of 4,86 cm. An increase of 16,6% on the entrance surface dose and 18% on the average dose to the glandular tissue has been recorded. All the clinical images has been evaluated for the physician as adequate for diagnosis. (Author) 16 refs

Radiation dose in mammography: an energy-balance approach

International Nuclear Information System (INIS)

Shrivastava, P.N.

1981-01-01

An energy-balance approach for calculation of mean, integral, and midpoint doses in mammography is introduced. Estimation of mean absorbed dose for individual applications is described. Calculations made for a range of xeromammographic techniques used at various breast cancer detection centers show that although increasing the beam h.v.l. dramatically decreases breast surface exposure, it is insignificant in lowering mean breast dose or radiation risk. Thus selection of a moderate h.v.l. to optimize image quality in xeromammography may be more beneficial than unduly increasing h.v.l. merely to reduce surface exposure. The mean breast dose per mammogram with low h.v.l. screen-film techniques was 3 to 9 times lower than for xeromammography, suggesting that general acceptance of screen-film techniques can significantly reduce the risk associated with mammography

Patient comfort from the technologist perspective: factors to consider in mammographic imaging

Directory of Open Access Journals (Sweden)

Mendat CC

2017-05-01

Full Text Available Christina C Mendat,1 Dave Mislan,2 Lisa Hession-Kunz2 1Human Factors MD, Charlotte, NC, 2Hologic Inc., Marlborough, MA, USA Abstract: A sample size of 280 certified mammography technologists were surveyed to understand what factors affect patient discomfort during breast imaging. Given mammography technologists’ level of patient involvement, they are uniquely positioned to observe factors that affect patient comfort. The findings suggest that according to technologists, multiple factors, including patient ethnicity, breast density, previous biopsy and lumpectomy experience, as well as psychological factors, impact breast discomfort during mammography. Additionally, with respect to imaging protocols, technologists attributed 80% of moderate-to-extreme discomfort to “length of compression time” (27% and “compression force” (53%. Technologists also attributed “pinching at chest wall” and “hard edges of breast platform” to “very high” discomfort significantly more times (P<0.05 than “coolness and edges of paddle”. These findings confirm some of what has been reported to date and challenge other findings. Given that recent decline in breast cancer mortality has been attributed to improvements in early detection and treatment, approaches to reduce discomfort should be considered in order to promote screening compliance. Although more research is needed, it is apparent that the patient experience of comfort and pain during mammography is an area warranting increased research and solutions. Keywords: mammography, discomfort, pain, density, compliance, breast

Human factors influencing decision making

OpenAIRE

Jacobs, Patricia A.

1998-01-01

This report supplies references and comments on literature that identifies human factors influencing decision making, particularly military decision making. The literature has been classified as follows (the classes are not mutually exclusive): features of human information processing; decision making models which are not mathematical models but rather are descriptive; non- personality factors influencing decision making; national characteristics influencing decision makin...

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

Energy Technology Data Exchange (ETDEWEB)

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