Elsevier

Seminars in Roentgenology

Volume 42, Issue 4, October 2007, Pages 236-242
Seminars in Roentgenology

Digital Mammography: Clinical Implementation and Clinical Trials

https://doi.org/10.1053/j.ro.2007.06.004Get rights and content

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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