DIGITAL MAMMOGRAPHY

Course Project: Digital Mammography

Stacy Thibodeau

DeVry University

Professor Alexandros Veletsos

IS: 566 Informatics

Table of Contents

Executive Summary4

1. Introduction6

2. Materials and methods8

2.1. Patients? inclusion and exclusion criteria8

2.2. Digital mammography9

2.3. FFDM9

2.4. DSPM11

2.5. Mammography quality control11

2.6. Data acquisition11

2.6.1. Image Quality11

2.6.2. Lesion detection and diagnostic efficacy13

2.6.2.1. Lesion detection13

2.6.2.2. Diagnostic efficacy13

2.6.2.3. Diagnostic efficacy for malignant lesions14

2.6.3. Histologic and follow-up correlations14

2.6.3.1. Statistical analysis15

3. Results16

3.1. Image quality16

3.2. Lesion detection and diagnostic efficacy18

3.2.1. Lesion detection18

3.2.2. Diagnostic efficacy21

3.2.3. Diagnostic efficacy for malignant lesions21

3.3. Histologic and follow-up correlations23

4. Discussion25

5. Conclusion31

References33

Executive Summary

To compare image quality? the lesion detection? and the diagnostic efficacy of full-field digital mammography (FFDM) and computed radiography-based mammography using digital storage phosphor plates (DSPM) in the evaluation of breast lesions. In this prospective study? 150 patients with suspicious breast lesions underwent FFDM and DSPM. Nine aspects of image quality (brightness? contrast? sharpness? noise? artifacts? and the detection of anatomic structures? i.e.? skin? retromamillary space? glandular tissue? and calcifications) were evaluated by five radiologists. In addition? the detection of breast lesions and the diagnostic efficacy? based on the BI-RADS classification? were evaluated with histologic and follow-up correlation. For contrast? sharpness? and the detection of all anatomic structures? FFDM was rated significantly better (p < 0.05). Mass lesions were equally detected? whereas FFDM detected more lesions consisting of calcifications (85 versus 75). DSPM yielded two false-negative results. Both lesions were rated BI-RADS 4 with FFDM? but BI-RADS 2 with DSPM. Both were invasive carcinoma at histology. The sensitivity? specificity? PPV? NPV? and accuracy of FFDM were 1.0? 0.397? 0.636? 1.0? and 0.707? compared to 0.974? 0.397? 0.630? 0.935? and 0.693 of DSPM. Based on image quality parameters? FFDM is? in part? significantly better than DSPM. Furthermore? the detection of breast lesions with calcifications is favorable with FFDM. However? the diagnostic efficacy of FFDM and DSPM was equal. The interpretation of the false-negative results suggests that the perception and characterization of breast lesions is not defined solely by the digital mammography system but is strongly influenced by the radiologist? who one of the determinants in the interpretation of breast is imaging.

Digital Mammography

1. Statement of the Business Scenario

Digital technology is replacing film-screen systems in all areas of radiology? and mammography has been the last field to make this transition. Digital mammography offers the potential for improved detection of breast lesions. The results of a large prospective study? which was designed to compare film-screen mammography with digital mammography? suggested that digital mammography may be better at detecting breast cancer? particularly for women with heterogeneously or extremely dense breast tissue. These data have stimulated the discussion of digital mammography technology among the women's health and radiology communities? and may encourage additional breast centers to purchase digital mammography systems.

Two digital mammography systems? based on different physical concepts? have been introduced in the last few years and. These are full-field digital mammography (hereafter? FFDM) and computed radiography-based mammography using digital storage phosphor plates (hereafter? DSPM). In FFDM? amorphous silicium or selenium flat-panel detectors convert X-rays into electrical signals. In DSPM? the image is recorded on a digital storage phosphor ...