Digital Mammography: Clinical Implementation and Clinical Trials
Section snippets
Principles, Technique, and Equipment
Full field digital mammography (FFDM) offers potential improvements over the limitations of SFM.3 While film acts both as the detector and as the display medium for the breast, digital technique can separate these two functions with the possibility of maximizing the performance of each independently. In addition, digital mammography viewed with softcopy display (cathode ray tube [CRT] or liquid crystal display [LCD]) provides the ability to manipulate contrast and brightness. In addition, while
Clinical Trials
If digital technique is to have an effect on breast imaging, FFDM must be at least as sensitive as SFM and preferably should be more sensitive and specific. Lewin at al20, 21 conducted the first blinded prospective study comparing SFM to FFDM. Six thousand seven hundred thirty women participated in the trial. The design was a paired study where the women received both a SFM and a FFDM no more than 3 days apart. Patients with breasts larger than could be fit on a 24 × 30 cm cassette were
Clinical Implications
Digital imaging with softcopy read is continually changing both for radiology in general and for mammography in particular. The method of display and interpretation is arguably the weakest link in the mammography imaging/interpretation chain. Perhaps the most critical link is display.27 Softcopy display would maintain many of the advantages of digital mammography (ability to manipulate the image, apply various algorithms for enhancement) used for interpretation. The next logical question is
Conclusion
What have we learned from the clinical trials regarding implementation of digital mammography? The technology is here to stay and appears to possibly be of benefit for women who are pre- or peri-menopausal with dense breasts. The units are expensive and reading efficiency will be reduced to some extent. This may be compounded by the initial difficulty of comparing digital to prior analog exams. When considering softcopy read, LCDs have the best compromise with regard to detection and size but
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Cited by (10)
The Basics and Implementation of Digital Mammography
2010, Radiologic Clinics of North AmericaCitation Excerpt :From a technical point of view, the efficient use of the x-ray beam and the resultant quality of the image is dictated by the materials of the system and the method by which the x-ray beam information is recorded. There are several types of technology deployed in digital detectors.11–14 Detectors are classified as either direct or indirect capture.
Present Role of Mammography/Digital Mammography in Breast Cancer Management
2009, PET ClinicsCitation Excerpt :The direct digital detectors, often called “flat panel detectors,” directly convert x-rays into a digital image. These use scintillators of amorphous selenium.6 The overall design of the mammography unit (including x-ray tube, gantry, compression paddles), technique of performing the mammography, amount of radiation involved, and interpretation and reporting remain similar to those of screen-film mammography.
Role of mammography in screening for breast cancer: Is it still the gold standard?
2012, Diagnostic and Therapeutic Applications of Breast Imaging