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Sample records for mammography

  1. Mammography

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Mammography Mammography is a specific type of breast imaging ... What are the limitations of Mammography? What is Mammography? Mammography is specialized medical imaging that uses a ...

  2. Mammography

    MedlinePlus

    ... first test. TYPES OF MAMMOGRAPHY Traditional mammography uses film, similar to routine x-rays. Digital mammography is ... risk of dying of breast cancer compared to film mammography. Three-dimensional (3D) mammography is a type ...

  3. Mammography

    PubMed Central

    Samuels, Taube H.

    1992-01-01

    The combination of mammography and clinical examination provides the best means available to detect breast cancer. This article attempts to familiarize the family physician with mammographic terms and to clarify the role of mammography in detecting breast cancer. ImagesFigure 1Figure 2Figures 3-4Figure 5Figure 5Figure 6 PMID:21229125

  4. FDA Certified Mammography Facilities

    MedlinePlus

    ... Products Radiation-Emitting Products Home Radiation-Emitting Products Mammography Quality Standards Act and Program Consumer Information (MQSA) ... it Email Print This list of FDA Certified Mammography Facilities is updated weekly. If you click on ...

  5. Frequently Asked Questions about Digital Mammography

    MedlinePlus

    ... Consumer Information (MQSA) Frequently Asked Questions About Digital Mammography Share Tweet Linkedin Pin it More sharing options ... mammography exams, such as DBT? What is digital mammography? Full field digital mammography (FFDM, also known simply ...

  6. Regulatory Compliance in Mammography.

    PubMed

    Loesch, Jennifer

    2016-03-01

    Although the Mammography Quality Standards Act (MQSA) passed when analog mammography and film processors were used across the United States, now most health care facilities have full-field digital mammography. This article reviews MQSA requirements including qualifications for personnel, the clinical image evaluation process, and components of a quality control program. In light of technological advances, the U.S. Food and Drug Administration's extension certificate for digital breast tomosynthesis is discussed, along with the American College of Radiology's Breast Imaging Center of Excellence designation and laws regarding density notification. PMID:26952076

  7. Mammography technology overview.

    PubMed

    Yohe, C W

    2001-01-01

    As you can see, there are many options in mammography units. This article is not meant to recommend one unit or manufacturer over another, but rather to inform consumers that all units have assets to help technologists acquire the perfect mammogram. This article is meant to make you think about the pros and cons as you consider purchasing new mammography equipment. Though it may seem wise and certainly easier to equip your multiple-unit site(s) with one manufacturer's equipment or even one model, it might truly be wise to have a little variety; this addresses shortcomings of a particular unit. If you provide technologists with a mammography system with which they are comfortable and feel they can address any issues-accommodating disabled patients, patients with breast implants or patients with dense breast tissue-you will see the perfect mammograms you desire. PMID:11431847

  8. Controversies in Screening Mammography.

    PubMed

    Swain, Monique; Jeudy, Myrlene; Pearlman, Mark D

    2016-06-01

    The utility and effectiveness of screening mammography in diagnosing breast cancer at earlier stages and reducing disease-specific mortality remain controversial especially as to when to start and stop routine mammographic screening, and whether mammograms should be performed annually or biennially in average-risk women. This manuscript will analyze the available moderate and high-quality data to analyze both the benefits (lives saved and life-years saved) and inconveniences/harms (additional views, extra biopsies/overdiagnosis, and overtreatment of ductal carcinoma in situ) of different mammography screening guidelines to assist the practitioner in counseling their patients in clinical practice. PMID:27101240

  9. Mammography: What You Need to Know

    MedlinePlus

    ... Products For Consumers Home For Consumers Consumer Updates Mammography: What You Need to Know Share Tweet Linkedin ... Lerner, FDA medical officer in the Division of Mammography Quality Standards, discusses the importance of mammography and ...

  10. Positron emission mammography imaging

    SciTech Connect

    Moses, William W.

    2003-10-02

    This paper examines current trends in Positron Emission Mammography (PEM) instrumentation and the performance tradeoffs inherent in them. The most common geometry is a pair of parallel planes of detector modules. They subtend a larger solid angle around the breast than conventional PET cameras, and so have both higher efficiency and lower cost. Extensions to this geometry include encircling the breast, measuring the depth of interaction (DOI), and dual-modality imaging (PEM and x-ray mammography, as well as PEM and x-ray guided biopsy). The ultimate utility of PEM may not be decided by instrument performance, but by biological and medical factors, such as the patient to patient variation in radiotracer uptake or the as yet undetermined role of PEM in breast cancer diagnosis and treatment.

  11. Mammography accreditation program

    SciTech Connect

    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.

  12. Patient Dosimetry for Mammography

    SciTech Connect

    Michielsen, K.; Jacobs, J.; Bosmans, H.

    2007-11-26

    We describe a method to conduct a dose study for mammography screening units using established methods and conversion factors. We establish a dose reference curve, giving a dose reference level for different sizes of breasts instead of establishing one reference level for an average size breast so we can compare the results with the achievable and acceptable dose levels from the European guidelines. We notice that, especially for smaller breasts, work is needed to get doses in Belgium below acceptable European levels.

  13. REVIEW: The development of mammography

    NASA Astrophysics Data System (ADS)

    Law, J.

    2006-07-01

    This review traces the development of mammography physics over the last 50 years, concentrating mainly on technological changes and their inter-relations. It has been written for physicists with no specific mammography experience but a general interest in radiology, as much as for those with recent involvement in mammography. Topics covered include industrial film, xerography, intensifying screens, x-ray tube developments, image quality test objects, patient dose and performance checks. Some of these developments were necessary before population screening of healthy women could be considered, while others have resulted from increased opportunities for equipment manufactures which screening programmes created. The standpoint of this review is that of a physicist with long experience in a UK centre where mammography was performed on dedicated equipment well over 40 years ago and where screening has been performed continuously for 30 years.

  14. Synchrotron Radiation Mammography: Clinical Experimentation

    SciTech Connect

    Arfelli, Fulvia; Dreossi, Diego; Longo, Renata; Rokvic, Tatjana; Castelli, Edoardo; Abrami, Alessandro; Chenda, Valentina; Menk, Ralf-Hendrik; Quai, Elisa; Tromba, Giuliana; Bregant, Paola; De Guarrini, Fabio; Cova, Maria A.; Tonutti, Maura; Zanconati, Fabrizio

    2007-01-19

    For several years a large variety of in-vitro medical imaging studies were carried out at the SYRMEP (Synchrotron Radiation for Medical Physics) beamline of the synchrotron radiation facility ELETTRA (Trieste, Italy) utilizing phase sensitive imaging techniques. In particular low dose Phase Contrast (PhC) in planar imaging mode and computed tomography were utilized for full field mammography. The results obtained on in-vitro samples at the SYRMEP beamline in PhC breast imaging were so encouraging that a clinical program on a limited number of patients selected by radiologists was launched to validate the improvements of synchrotron radiation in mammography. PhC mammography with conventional screen-film systems is the first step within this project. A digital system is under development for future applications. During the last years the entire beamline has been deeply modified and a medical facility dedicated to in-vivo mammography was constructed. The facility for PhC synchrotron radiation mammography is now operative in patient mode. The system reveals a prominent increase in image quality with respect to conventional mammograms even at lower delivered dose.

  15. Quality Imaging - Comparison of CR Mammography with Screen-Film Mammography

    SciTech Connect

    Gaona, E.; Azorin Nieto, J.; Iran Diaz Gongora, J. A.; Arreola, M.; Casian Castellanos, G.; Perdigon Castaneda, G. M.; Franco Enriquez, J. G.

    2006-09-08

    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.

  16. The psychosocial consequences of mammography.

    PubMed

    Rimer, B K; Bluman, L G

    1997-01-01

    Increasing numbers of mammograms being performed in the United States will be accompanied inevitably by an increasing number of false positives. According to reliable estimates from a survey of radiology facilities, U.S. women in their forties experience close to one million false positive mammograms every year. To determine the impact of false positive mammograms and the broader psychological impact of mammography, we conducted literature searches of Medline, CancerLit, and PsycInfo. We identified nine studies examining the impact of false positive mammograms. Most found short-term increases in such psychological measures as anxiety, distress, and intrusive thoughts. One study found substantial effects on these measures three months after an abnormal mammogram. Another study found an 18-month impact on anxiety. Few studies have used behavioral outcomes, but one reported overpractice of breast self-exam among women who had received false positive results. Another found no reduction in adherence to mammography among women who have had an abnormal test. The more general mammography literature suggests that many women are anxious about mammography before the exam; women with lower levels of education, African Americans, and women with a family history of breast cancer may be more vulnerable to distress. Unfortunately, this literature suffers major limitations, such as small sample sizes, inconsistent and sometimes inappropriate measures, variations in the time frames for measurement, few studies with women aged 40-49, and a paucity of U.S. research. More research is needed to characterize at-risk women and to test interventions designed to reduce the negative impact of abnormal mammograms. Improved communication is also needed throughout the entire mammography process. PMID:9709289

  17. Breast Cancer and Mammography: Summary of the Educational Impact of a Low-Cost Mammography Program.

    ERIC Educational Resources Information Center

    Gresham, Louise S.; And Others

    1988-01-01

    A mammography public education program which used newspaper press releases, local talk shows, news segments, and announcements, flyers, advertisements, and presentations to companies and select populations increased public awareness and decreased misconceptions about mammography. (CB)

  18. What Makes a Good Mammography Image?

    SciTech Connect

    Brandan, Maria-Ester

    2007-11-26

    The early detection of breast cancer requires a high quality image, which is provided by mammography. The main indicators of technical image quality, contrast, spatial resolution, noise and absence of artifacts, are described, as well as the elements responsible for their values in a mammography unit. Since screening mammography is applied to asymptomatic subjects, the optimization of the imparted dose compatible with required image quality is of importance.

  19. Digital mammography: current state and future aspects.

    PubMed

    Fischer, U; Hermann, K P; Baum, F

    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. PMID:16132935

  20. Rayleigh imaging in spectral mammography

    NASA Astrophysics Data System (ADS)

    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.

  1. Barriers to Mammography among Inadequately Screened Women

    ERIC Educational Resources Information Center

    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…

  2. [Evaluation of radiation doses in mammography].

    PubMed

    Lee, S K; Hwang, S K; Lee, L N; Lou, G C; Wang, C A; Hsu, W J

    1993-03-01

    A dedicated X-ray mammography was introduced to our hospital from 1987 and an imaging receptor of xeroradiography was applied. We reported previously that the average air exposure was 0.79R and that the absorption dose of skin was 1.00 rad. These data are similar to literature reports. Screen-film mammography was introduced recently. To select the best breast imaging and the least radiation exposure, diverse methods were investigated. A dosimetry (Capintec model 192) and a PS-033 parallel ionization chamber were applied to compare the absorption dose on polystyrene phantom between various exposure factors, the application of breast clamp and the size of exposure field. Retrospective estimation of the radiation dose was obtained from the exposure factors of previous mammography since July, 1990 to May, 1992. There were 1035 xeromammographic examinations and 358 examinations with medium-speed screen-film mammography. Another 61 craniocaudal and 96 mediolateral projections with high-speed screen-film mammography were recruited during the recent two months. An ionization chamber (Exradin, Shonka-Wyckoff A5) with an electrometer (Keithley 617) wer selected to obtain the dose equivalent from air exposure between selected exposure factors. The radiation dose of mammography is linearly correlated with voltage/kV and current/mAs. The application of a breast clump reduces 10% of the skin dose. The average exposure factors of xeromammography are 45.6 kV, 163.5 mAs. These results remain the same as in our previous report. Xeromammography has a greater exposure to air, estimated average glandular dose and absorbed dose than screen-film mammography. The mean exposure factor of rapid screen-film mammography gains half the value of medium screen-film mammography, ie. 26.6 kV, 87.0 mAs vs. 26.0 kV, 164.5 mAs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8490794

  3. Do Appalachian Women Attending a Mobile Mammography Program Differ from Those Visiting a Stationary Mammography Facility?

    PubMed Central

    Madhavan, Suresh; Kelly, Kimberly; Metzger, Aaron; Schreiman, Judith; Remick, Scot

    2016-01-01

    To compare the characteristics (demographic, access to care, health-related behavioral, self and family medical history, psychosocial) of women aged 40 years and above who utilize a mobile mammography unit with those women aged 40 years and above who obtain mammography screening at a stationary facility. A cross-sectional study design was used with participant cohorts comprised of women age 40 years and above throughout West Virginia (WV) who utilized mobile mammography unit to get mammogram and those who had mammography screening at the stationary facility and completed the Mammography Screening and Preventive Care Survey. A total of 1,161 women who utilized the mobile mammography unit and 1,104 women who utilized stationary facility were included in the analysis. In logistic regression after adjusting for all the variables, women who utilized mobile mammography unit were more likely to be in age group 40–49, with lower income, with no health insurance coverage, not visit doctor or obstetrician/gynecologist (OB/GYN) in the past year, not adherent to clinical breast exam and mammography screening guidelines, with lower perceived five-year risk of developing breast cancer and with high knowledge about mammography screening. Women who utilize mobile unit are not adherent to mammography screening guidelines thereby suggesting that the mobile mammography unit is indeed reaching a rural vulnerable population who may not routinely access preventive health services. Financial and insurance constraints, as well as access to medical care, restricted WV women from receiving mammography screening from the stationary screening facilities. PMID:23504266

  4. Digital Mammography and Digital Breast Tomosynthesis.

    PubMed

    Moseley, Tanya W

    2016-06-01

    Breast imaging technology has advanced significantly from the 1930s until the present. American women have a 1 in 8 chance of developing breast cancer. Mammography has been proven in multiple clinical trials to reduce breast cancer mortality. Although a mainstay of breast imaging and improved from film-screen mammography, digital mammography is not a perfect examination. Overlapping obscuring breast tissue limits mammographic interpretation. Breast digital tomosynthesis reduces and/or eliminates overlapping obscuring breast tissue. Although there are some disadvantages with digital breast tomosynthesis, this relatively lost-cost technology may be used effectively in the screening and diagnostic settings. PMID:27101241

  5. Assessing elements of women's decisions about mammography.

    PubMed

    Rakowski, W; Dube, C E; Marcus, B H; Prochaska, J O; Velicer, W F; Abrams, D B

    1992-01-01

    We investigated motivational and cognitive processes of behavior change with respect to mammography screening. One hundred forty-two women (ages 40 and older) recruited from three worksites answered a 41-item questionnaire consisting of statements based on constructs from the transtheoretical model of behavior change. Principal-components analysis identified two factors: a six-item component representing positive perceptions of mammography (Pros) and a six-item component representing avoidance of mammography (Cons). Analysis of variance showed that Pros, Cons, and a derived Decisional Balance measure (Pros minus Cons) were associated with stage of mammography adoption. Results are consistent with applications of the model to smoking cessation. The model is also discussed as it relates to other theories of behavior change and as a general strategy for analyzing perceptual data pertinent to health-related actions and intentions for behavioral change. PMID:1582379

  6. Family/Friend Recommendations and Mammography Intentions: The Roles of Perceived Mammography Norms and Support

    ERIC Educational Resources Information Center

    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…

  7. Mammography

    SciTech Connect

    Letreut, A.; Dilhuydy, M.H.

    1990-01-01

    This book interprets screen/film mammograms, covering a wide range of clinical situations. It is divided into four sections: radiologic technology, diagnosis, use of mammograms in special conditions, and general considerations.

  8. Mammography calibration qualities establishment in a Mo- Mo clinical system

    NASA Astrophysics Data System (ADS)

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

    2016-07-01

    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.

  9. Breast dosimetry in clinical mammography

    NASA Astrophysics Data System (ADS)

    Benevides, Luis Alberto Do Rego

    The objective of this study was show that a clinical dosimetry protocol that utilizes a dosimetric breast phantom series based on population anthropometric measurements can reliably predict the average glandular dose (AGD) imparted to the patient during a routine screening mammogram. In the study, AGD was calculated using entrance skin exposure and dose conversion factors based on fibroglandular content, compressed breast thickness, mammography unit parameters and modifying parameters for homogeneous phantom (phantom factor), compressed breast lateral dimensions (volume factor) and anatomical features (anatomical factor). The protocol proposes the use of a fiber-optic coupled (FOCD) or Metal Oxide Semiconductor Field Effect Transistor (MOSFET) dosimeter to measure the entrance skin exposure at the time of the mammogram without interfering with diagnostic information of the mammogram. The study showed that FOCD had sensitivity with less than 7% energy dependence, linear in all tube current-time product stations, and was reproducible within 2%. FOCD was superior to MOSFET dosimeter in sensitivity, reusability, and reproducibility. The patient fibroglandular content was evaluated using a calibrated modified breast tissue equivalent homogeneous phantom series (BRTES-MOD) designed from anthropomorphic measurements of a screening mammography population and whose elemental composition was referenced to International Commission on Radiation Units and Measurements Report 44 tissues. The patient fibroglandular content, compressed breast thickness along with unit parameters and spectrum half-value layer were used to derive the currently used dose conversion factor (DgN). The study showed that the use of a homogeneous phantom, patient compressed breast lateral dimensions and patient anatomical features can affect AGD by as much as 12%, 3% and 1%, respectively. The protocol was found to be superior to existing methodologies. In addition, the study population anthropometric

  10. Elasto-Mammography: Elastic Property Reconstruction in Breast Tissues

    SciTech Connect

    Wang, Z. G.; Liu, Y.; Wang, G.; Sun, L. Z.

    2008-02-15

    Mammography is the primary method for screening and detecting breast cancers. However, it frequently fails to detect small tumors and is not quite specific in terms of tumor benignity and malignancy. The objective of this paper is to develop a new imaging modality called elasto-mammography that generates the modulus elastograms based on conventional mammographs. A new elastic reconstruction method is described based on elastography and mammography for breast tissues. Elastic distribution can be reconstructed through the measurement of displacement provided by mammographic projection. It is shown that the proposed elasto-mammography provides higher sensitivity and specificity than the conventional mammography on its own for breast cancer diagnosis.

  11. Improving the timeliness of written patient notification of mammography results by mammography centers.

    PubMed

    Boudreau, Robert M; McNally, Colleen; Rensing, Edna M; Campbell, Miriam K

    2004-01-01

    Timely reporting of mammogram results helps to reduce anxiety for women with negative results and speeds up diagnosis or treatment in the case of abnormal results. The goal of this project was to improve the rate at which Virginia mammography centers provide a written report to women in lay terms within 30 days of a mammogram. The project included six intervention and five control mammography centers. The baseline period was prior to when new regulations in the Mammography Quality Standards Act (MQSA) took effect in April 1999. The re-measurement period was after April 1999. Data were obtained from abstraction of mammography reports and patient notification letters from a sample of patients with negative and abnormal mammography results at each mammography center. Each intervention mammography center received a notebook that included numerous tools on systems for patient notification and tracking, baseline notification rates and other abstracted information, biopsy recommendations, sample results letters, and a copy of the MQSA. For negative mammograms, the intervention group in aggregate increased from 24% at baseline to 79% at re-measurement in their rate of notification within 30 days. The control group increased from 25% to 46%. For abnormal mammograms, increases were from 35% to 85% and from 25% to 58%, respectively. The intervention group's increases were considerably higher, suggesting an effect due to the interventions that involved technical assistance, education, and system change. All increases were statistically significant (p < 0.01). At baseline, three intervention centers and two controls had policies for written notification. All 11 had policies at re-measurement. However, only two of the five control centers could provide clear supporting documentation for dates of notification at re-measurement. Mammography centers can benefit from guidance in the form of intervention materials specifically designed to address the MQSA sections that apply to

  12. Does Gender Discrimination Impact Regular Mammography Screening? Findings from the Race Differences in Screening Mammography Study

    PubMed Central

    DAILEY, AMY B.; KASL, STANISLAV V.; JONES, BETH A.

    2011-01-01

    Objective To determine if gender discrimination, conceptualized as a negative life stressor, is a deterrent to adherence to mammography screening guidelines. Methods 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. Results 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 ≥$50,000 (OR 1.99, 95% CI 1.33, 2.98) and did not differ across racial/ethnic group. Conclusions 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. PMID:18321171

  13. The mammography project at the SYRMEP beamline.

    PubMed

    Dreossi, D; Abrami, A; Arfelli, F; Bregant, P; Casarin, K; Chenda, V; Cova, M A; Longo, R; Menk, R-H; Quai, E; Quaia, E; Rigon, L; Rokvic, T; Sanabor, D; Tonutti, M; Tromba, G; Vascotto, A; Zanconati, F; Castelli, E

    2008-12-01

    A clinical program for X-ray phase contrast (PhC) mammography with synchrotron radiation (SR) has been started in March 2006 at the SYRMEP beamline of Elettra, the SR facility in Trieste, Italy. The original beamline layout has been modified substantially and a clinical facility has been realized. In order to fulfill all security requirements, dedicated systems have been designed and implemented, following redundancy criteria and "fail safe" philosophy. Planar radiographic images are obtained by scanning simultaneously the patient and the detector through the stationary and laminar SR beam. In this first phase of the project a commercial screen-film system has been used as image receptor. Upon approval by the respective authorities, the mammography program is about half way to conclusion. Up to now about 50 patients have been examined. The patients are volunteers recruited by the radiologist after conventional examinations at the hospital resulted in an uncertain diagnosis. As an example one case of PhC SR mammography is shown and compared to conventional digital mammography. Preliminary analysis shows the high diagnostic quality of the PhC SR images that were acquired with equal or less delivered dose compared to the conventional ones. PMID:18617344

  14. Beyond the mammography debate: a moderate perspective

    PubMed Central

    Kaniklidis, C

    2015-01-01

    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. PMID:26089721

  15. Physical measures of image quality in mammography

    NASA Astrophysics Data System (ADS)

    Chakraborty, Dev P.

    1996-04-01

    A recently introduced method for quantitative analysis of images of the American College of Radiology (ACR) mammography accreditation phantom has been extended to include signal- to-noise-ratio (SNR) measurements, and has been applied to survey the image quality of 54 mammography machines from 17 hospitals. Participants sent us phantom images to be evaluated for each mammography machine at their hospital. Each phantom was loaned to us for obtaining images of the wax insert plate on a reference machine at our institution. The images were digitized and analyzed to yield indices that quantified the image quality of the machines precisely. We have developed methods for normalizing for the variation of the individual speck sizes between different ACR phantoms, for the variation of the speck sizes within a microcalcification group, and for variations in overall speeds of the mammography systems. In terms of the microcalcification SNR, the variability of the x-ray machines was 40.5% when no allowance was made for phantom or mAs variations. This dropped to 17.1% when phantom variability was accounted for, and to 12.7% when mAs variability was also allowed for. Our work shows the feasibility of practical, low-cost, objective and accurate evaluations, as a useful adjunct to the present ACR method.

  16. Development Of A Digital Mammography System

    NASA Astrophysics Data System (ADS)

    Yaffe, M. J.; Nishikawa, R. M.; Maidment, A. D. A.; Fenster, A.

    1988-06-01

    A digital breast imaging system is under development to provide improved detectability of breast cancer. In previous work, the limitations of screen-film mammography were studied using both theoretical and experimental techniques. Important limitations were found in both the acquisition and the display components of imaging. These have been addressed in the design of a scanned-projection digital mammography system. A high resolution x-ray image intensifier (XRII), optically coupled to a self-scanned linear photodiode array, is used to record the image. Pre- and post-patient collimation virtually eliminates scattered radiation and veiling glare of the XRII with only a 20% increase in dose due to penumbra. Geometric magnification of 1.6 times is employed to achieve limiting spatial resolution of 7 1p/mm. For low-contrast objects as small as 0.1 mm in diameter, the digital system is capable of producing images with higher contrast and signal-to-noise ratio than optimally-exposed conventional film-screen mammography systems. Greater latitude is obtainable on the digital system because of its wide dynamic range and linearity. The slit system is limited due to long image acquisition times, and poor quantum efficiency. This motivated our current work on a slot beam digital mammography system which is based on a fiber-optic x-ray detector. Preliminary results of this system will be presented.

  17. Barriers to mammography among inadequately screened women.

    PubMed

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

    2015-02-01

    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 screening status, and to examine whether number and type of barriers are different for never-screened and off-schedule women. A total of 182 women aged 40 years or older completed a computer kiosk facilitated survey as part of a larger patient navigator intervention. Logistic regression analysis indicated that breast cancer knowledge predicted whether a woman had ever had a mammogram (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 1.02-1.06, p = .0003), while the number of emotional, structural, and communication barriers predicted whether a woman was on-schedule for mammograms (OR = 0.79, 95% CI = 0.65-0.95, p = .0127). The results suggest that to increase the use of mammography at recommended regular intervals, interventions should be tailored toward current screening status. PMID:24722216

  18. Beyond the mammography debate: a moderate perspective.

    PubMed

    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. PMID:26089721

  19. Screening Mammography in Older Women: A Review

    PubMed Central

    Walter, Louise C.; Schonberg, Mara A.

    2015-01-01

    Importance Guidelines recommend individualizing screening mammography decisions for women 75 and older. However, little pragmatic guidance is available to inform this approach. Objective To provide an evidence-based approach to individualizing decision-making about screening mammography that considers older women's risk of breast cancer and the potential benefits and harms of screening in the context of varying life expectancies and preferences. Evidence Acquisition We searched PubMed for English-language studies in peer-reviewed journals published from January 1, 1990 to February 1, 2014 to identify risk factors for late-life breast cancer in women 65 and older and to quantify the benefits and harms of screening mammography for women 75 and older. Findings Age is the major risk factor for late-life breast cancer. In general, traditional breast cancer risk factors (e.g., age at first birth, age at menarche) that represent hormonal exposures in the distant past are less predictive of late-life breast cancer than factors indicating recent exposure to endogenous hormones (e.g., bone mass, obesity). None of the randomized trials of screening mammography included women over age 74, such that it is uncertain whether screening mammography is beneficial in these women. Observational data favor extending screening mammography to older women who have a life expectancy > 5-10 years. Modeling studies suggest approximately 2 fewer women per 1,000 die from breast cancer if women in their 70's continue biennial screening for 10 years, versus stopping screening at age 69. Potential benefits must be weighed with potential harms of continued screening over ten years, which include false-positive mammograms (~200 per 1,000 women screened) and overdiagnosis (~13 per 1,000 women screened). Providing these frequencies both verbally and graphically may help inform older women's decision-making. Conclusions and Relevance For women with less than a 5-10 year life expectancy

  20. 2D vs. 3D mammography observer study

    NASA Astrophysics Data System (ADS)

    Fernandez, James Reza F.; Hovanessian-Larsen, Linda; Liu, Brent

    2011-03-01

    Breast cancer is the most common type of non-skin cancer in women. 2D mammography is a screening tool to aid in the early detection of breast cancer, but has diagnostic limitations of overlapping tissues, especially in dense breasts. 3D mammography has the potential to improve detection outcomes by increasing specificity, and a new 3D screening tool with a 3D display for mammography aims to improve performance and efficiency as compared to 2D mammography. An observer study using a mammography phantom was performed to compare traditional 2D mammography with this ne 3D mammography technique. In comparing 3D and 2D mammography there was no difference in calcification detection, and mass detection was better in 2D as compared to 3D. There was a significant decrease in reading time for masses, calcifications, and normals in 3D compared to 2D, however, as well as more favorable confidence levels in reading normal cases. Given the limitations of the mammography phantom used, however, a clearer picture in comparing 3D and 2D mammography may be better acquired with the incorporation of human studies in the future.

  1. Mammography-oncogenecity at low doses.

    PubMed

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

    2009-06-01

    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

  2. Establishing a statewide mammography database in Arkansas: overcoming the barriers.

    PubMed

    Jazieh, Abdul Rahman

    2003-01-01

    To determine patterns of mammography utilization in Arkansas, the Arkansas Mammography Data Collection Project (MDCP) was established. The project's objective was to compile into one database statewide information about mammograms performed. All mammography centers were invited to participate in the project. Many barriers were encountered that were center related, data related, or personnel related; different interventions were implemented for each barrier. At the conclusion of the project, 92 out of 112 centers (82%) participated in the project, creating a database of 157,976 mammography data sets. Identifying and overcoming many of the barriers were crucial steps in the project's success. PMID:12552932

  3. Screening mammography. A risk versus risk decision

    SciTech Connect

    Ritenour, E.R.; Hendee, W.R.

    1989-01-01

    The potential risk of a radiologic procedure often is compared with the potential benefit of the procedure. While risk vs. benefit analysis has been useful as a step toward increased communication and understanding among radiologists, referring physicians, and the general public, it has the disadvantage that risk and benefit are fundamentally different quantities. Hence, their juxtaposition for purposes of comparison presents contextual difficulties. In this article, the concept is presented of comparing the risk of doing a procedure with the risk of choosing not to do the procedure. An example of risk vs. risk analysis of screening mammography for women over the age of 50 is given, with the conclusion that the risk of having yearly mammograms is less than 1/10 the risk of early death caused by failure to diagnose breast cancer by x-ray mammography. This approach to risk analysis would yield interesting data for examinations that are part of more complicated diagnostic pathways.19 references.

  4. Toward Clinically Compatible Phase-Contrast Mammography

    PubMed Central

    Scherer, Kai; Willer, Konstantin; Gromann, Lukas; Birnbacher, Lorenz; Braig, Eva; Grandl, Susanne; Sztrókay-Gaul, Anikó; Herzen, Julia; Mayr, Doris; Hellerhoff, Karin; Pfeiffer, Franz

    2015-01-01

    Phase-contrast mammography using laboratory X-ray sources is a promising approach to overcome the relatively low sensitivity and specificity of clinical, absorption-based screening. Current research is mostly centered on identifying potential diagnostic benefits arising from phase-contrast and dark-field mammography and benchmarking the latter with conventional state-of-the-art imaging methods. So far, little effort has been made to adjust this novel imaging technique to clinical needs. In this article, we address the key points for a successful implementation to a clinical routine in the near future and present the very first dose-compatible and rapid scan-time phase-contrast mammograms of both a freshly dissected, cancer-bearing mastectomy specimen and a mammographic accreditation phantom. PMID:26110618

  5. A glass-ceramic plate for mammography.

    SciTech Connect

    Johnson, J. A.; Schweizer, S.; Lubinsky, A. R.; Nuclear Engineering Division; Univ. of Paderborn; State Univ. of New York at Stony Brook

    2007-01-01

    We developed translucent glass-ceramic image plates for digital mammography. The glass ceramics are based on europium-doped fluorozirconate glasses, which were additionally doped with chlorine to initiate the nucleation of barium chloride nanoparticles therein. The X-ray image is stored in the form of stable electron-hole pairs, which can be read out afterwards with a scanning laser beam in a 'photostimulated luminescence' (PSL) process. Measurements of the required stimulating exposure, integrated PSL signal, and optical light spreading of the stimulating laser light were performed to allow projection of the detective quantum efficiency (DQE) for the proposed X-ray storage phosphor system. The projected DQE is compared with commercially available electronic mammography systems.

  6. Digital Mammography: Improvements in Breast Cancer Diagnostic

    SciTech Connect

    Montano Zetina, Luis Manuel

    2006-01-06

    X-ray mammography is the most sensitive imaging technique for early detection of breast cancer (diagnostics). It is performed by a radiological system equipped with a rotating molybdenum (Mo) anode tube with an additional Mo filter. In the production of X-ray, bremsstrahlung photons produce an intense diffuse radiation, affecting the contrast between normal and cancerous tissue. So it is known that a good mammographic imaging can help to detect cancer in the first stages avoiding surgery, amputation or even death. In the last years there has been some developments in new imaging techniques to improve the contrast spatial resolution between different tissues: digital imaging, or the so call digital mammography. Digital mammographic imaging is considered an improvement in the prevention of breast cancer due to the advantages it offers.

  7. Authenticity and integrity of digital mammography images.

    PubMed

    Zhou, X Q; Huang, H K; Lou, S L

    2001-08-01

    Data security becomes more and more important in telemammography which uses a public high-speed wide area network connecting the examination site with the mammography expert center. Generally, security is characterized in terms of privacy, authenticity and integrity of digital data. Privacy is a network access issue and is not considered in this paper. We present a method, authenticity and integrity of digital mammography, here which can meet the requirements of authenticity and integrity for mammography image (IM) transmission. The authenticity and integrity for mammography (AIDM) consists of the following four modules. 1) Image preprocessing: To segment breast pixels from background and extract patient information from digital imaging and communication in medicine (DICOM) image header. 2) Image hashing: To compute an image hash value of the mammogram using the MD5 hash algorithm. 3) Data encryption: To produce a digital envelope containing the encrypted image hash value (digital signature) and corresponding patient information. 4) Data embedding: To embed the digital envelope into the image. This is done by replacing the least significant bit of a random pixel of the mammogram by one bit of the digital envelope bit stream and repeating for all bits in the bit stream. Experiments with digital IMs demonstrate the following. 1) In the expert center, only the user who knows the private key can open the digital envelope and read the patient information data and the digital signature of the mammogram transmitted from the examination site. 2) Data integrity can be verified by matching the image hash value decrypted from the digital signature with that computed from the transmitted image. 3) No visual quality degradation is detected in the embedded image compared with the original. Our preliminary results demonstrate that AIDM is an effective method for image authenticity and integrity in telemammography application. PMID:11513029

  8. Quantitative mammography contrast threshold test tool.

    PubMed

    Wagner, A J; Frey, G D

    1995-02-01

    Mammographic contrast is commonly evaluated by visualizing small objects of varying size or mass divided by projected area. These qualitative contrast determinations are commonly performed by imaging a phantom like the American College of Radiology accreditation phantom at clinical mammographic settings. However, this contrast assessment does not take into account the kVp of the machine. This work describes a quantitative mammography contrast threshold test tool which examines light object contrast on a uniform background for a contrast range of 0.32% to 1.38% at 25 kVp. For this mammography contrast threshold test tool, contrast is defined by delta I/I = loge (psi O/ psi b), where psi O is the target energy flux, and psi b is the background energy flux. Contrast threshold is defined as the lowest contrast value for which the objects are visible. Unlike traditional assessments of mammographic contrast, this measurement of contrast threshold is kVp corrected. The mammography contrast threshold test tool is constructed out of common plastics and provides a quantitative means of assessing contrast threshold for individual mammographic units and total mammographic systems. PMID:7565343

  9. [Film-screen combinations for mammography].

    PubMed

    Säbel, M; Aichinger, H

    1991-05-01

    Optimizing and standardizing mammography as well as its quality assurance are gaining in importance with regard to the screening programmes that are being initiated for the early detection of breast cancer. In Germany, the guidelines of the Bundesärztekammer, the directives implementing section 4 and section 16 of the Röntgenverordnung and the standards DIN 6868, Part 7 and 52 are available. The data in these standards concerning tolerances and guide values for physical variables of the imaging system are only partially consistent. This also applies to the comparison with the document "Quality criteria for x-ray exposures in medical diagnostics" of the Commission of the European Communities. The different statements concerning the switch-off value of the dose in particular, reflect an uncertainty as to how unsharpness and noise of the image receptor impair the medical value of the images. With regard to the increased demands for visual resolution capacity, it can be stated that the "Medical quality requirements" and the "Radiographic guide-lines" harmonize with one another only inadequately. Contrast is one of the most important image quality parameters in mammography. Practically no statement is made on this in the available documents. One reason for the present unsatisfactory situation is certainly the especially high demands placed on image quality in mammography. In the present paper, these points of criticism are discussed in detail and proposals for closer specification and better delineation of the physical image quality parameters are submitted. PMID:1878377

  10. Optimized exposure control in digital mammography

    NASA Astrophysics Data System (ADS)

    Shramchenko, Nataliya; Blin, Philippe; Mathey, Claude; Klausz, Remy

    2004-05-01

    A method for the determination of optimal operating points of digital mammography systems is described. The digital mammography equipment uses a flat panel detector and a bi-metal molybdenum/rhodium x-ray tube. An operating point is defined by the selection of the x-ray tube target material, x-ray filtration, kVp and detector entrance dose. Breast thickness and composition are estimated from a low dose pre-exposure, then used to index tables containing sets of operating points. The operating points are determined using a model of the image chain, which computes contrast to noise ratio (CNR) and average glandular dose (AGD) for all possible exposure conditions and breast thickness and composition combinations. The selected operating points are those which provide the required CNR for the lowest AGD. An AGD reduction of 30% to 50% can be achieved for comparable Image Quality, relative to current operating points. Resulting from the optimization process, the rhodium target is used in more than 75% of cases. Measurements of CNR and AGD have been performed on various tissue equivalent materials with good agreement between calculated and measured values. The proposed method provides full Image Quality benefit of digital mammography while minimizing dose to patients in a controlled and predictive way.

  11. Promoting screening mammography: insight or uptake?

    PubMed

    Keen, John D

    2010-01-01

    The US Preventive Services Task Force has emphasized individualized decision-making regarding participation in screening mammography for women ages 40 to 49. Positive public opinion regarding screening mammography is understandable given that screening advocates have heavily promoted the slogan "early detection saves lives" while ignoring screening harms. The goal of mammography screening advocates is to increase screening participation or uptake. The purpose of this paper is to promote physician and patient insight by presenting the age-related benefit and harms of screening. At age 50, routine screening saves approximately 1 woman per 1000 over 10 years. The life-saving proportion of screen-detected cancers is 5%, which means mammograms must detect 21 cancers to save one life. Almost half of screen-detected cancers represent pseudo-disease and would never become symptomatic yet alone lethal during a woman's lifetime. Consequently, 40- and 50-year-old women are 10 times more likely to experience overdiagnosis and overtreatment than to have their lives saved. Analysis of events and outcomes per single screening round for women ages 40 to 49 show that approximately 9600 screening mammograms, 960 diagnostic exams, and 90 to 140 biopsies are required to save one life. Given the substantial harms of screening, advocates should refocus their priority from promoting uptake to promoting insight. PMID:21057074

  12. Screening Mammography Utilization in Tennessee Women: The Association with Residence

    ERIC Educational Resources Information Center

    Brown, Kathleen C.; Fitzhugh, Eugene C.; Neutens, James J.; Klein, Diane A.

    2009-01-01

    Context: Approximately 70% of US women over age 40 report mammography screening within 2 years. However, rates are likely to vary by age, income, educational level, and residence. Purpose: To describe the prevalence of screening mammography and associated factors in women living in rural and urban areas of Tennessee. Methods: Using pooled data…

  13. Psychosocial variables, external barriers, and stage of mammography adoption.

    PubMed

    Lauver, Diane Ruth; Henriques, Jeffrey B; Settersten, Lori; Bumann, Mary Carson

    2003-11-01

    Guided by H. Triandis's (1980) theory of behavior and the transtheoretical model, the study purpose was to examine differences in psychosocial variables and external conditions by stage of mammography adoption. Sampled from a statewide population, participants (N=509) were women aged 51-80. They had been contacted by telephone, screened for eligibility (e.g., no history of cancer or recent mammogram), and interviewed 3-6 months later. Higher utility beliefs, social influences, and practitioner interactions about mammography were associated with improved stage of adoption, as were lower negative affect and external barriers regarding mammography. Higher decisional balance scores, with and without negative affect toward mammography were associated with improved stage. Controlling for variables reflecting pros and cons, negative affect toward mammography further distinguished among stages. A richer set of pros and cons measures could explain screening more fully. PMID:14640864

  14. TL dosimetry for quality control of CR mammography imaging systems

    NASA Astrophysics Data System (ADS)

    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.

  15. Mammography Screening – as of 2013

    PubMed Central

    Heywang-Koebrunner, S.; Bock, K.; Heindel, W.; Hecht, G.; Regitz-Jedermann, L.; Hacker, A.; Kaeaeb-Sanyal, V.

    2013-01-01

    Introduction: Since 2008 the German Mammography Screening Programme has been available throughout Germany to all women aged between 50 and 69. The programme strictly follows the European Guidelines. There are controversial discussions in the media as well as in the specialised press. Materials and Methods: Overview of the available data with regard to an evaluation of randomised studies and with regard to quality-assured screening programmes in accordance with EU Guidelines (including data from 18 screening countries). Results: Positive effects of screening: reduction in mortality, less invasive treatment. Negative effects: False-positive diagnoses and biopsy recommendations, so-called overdiagnoses, radiation dose. Limits of screening: Interval carcinomas, incomplete reduction in mortality. A mathematical synopsis of the latest publications from the European screening programmes with the diagnosis rates in Germany determined from > 4.6 million screening examinations produces the following: a total of 10 000 mammograms are created for 1000 women (P) taking part in the Mammography Screening Programme (each of whom undergoes 10 mammograms in 20 years). Overall, the risk of triggering breast cancer through a mammogram is very clearly below the annual natural risk of suffering from breast cancer. In the German screening, of these 1000 women, an average of 288 women are called back once in 20 years as a result of changes that are ultimately benign (< 3 % per cycle). Of these, 74 of the 288 women undergo a biopsy due to a benign change (false-positive biopsy recommendations, usually punch or vacuum biopsies). According to EUROSCREEN, 71 carcinomas develop among participants (56 are discovered in the screening, 15 in the interval), and 67 carcinomas among non-participants (N-P) (in some cases, several years later) during this period. The 4 additional diagnoses among the Ps are referred to as overdiagnoses, as they do not contribute to a reduction in mortality

  16. United States radiological health activities: inspection results of mammography facilities

    PubMed Central

    Spelic, DC; Kaczmarek, RV; Hilohi, M; Belella, S

    2007-01-01

    Purpose: The Mammography Quality Standards Act (MQSA) was enacted in 1992 to set national standards for high-quality mammography, including standards for mammographic X-ray equipment, patient dose, clinical image quality, and related technical parameters. The MQSA also requires minimum qualifications for radiologic technologists, interpreting physicians and medical physicists, mandates acceptable practices for quality-control, quality-assurance, and requires processes to audit medical outcomes. This paper presents the findings of MQSA inspections of facilities, which characterize significant factors affecting mammography quality in the United States. Materials and Methods: Trained inspectors collected data regarding X-ray technical factors, made exposure measurements for the determination of mean glandular dose (MGD), evaluated image quality, and inspected the quality of the film-processing environment. The average annual facility and total U.S. screening exam workloads were computed using workload data reported by facilities. Results: Mammography facilities have made technical improvements as evidenced by a narrower distribution of doses, higher phantom-film background optical densities associated with higher phantom image-quality scores, and better film processing. It is estimated that approximately 36 million screening mammography exams were conducted in 2006, a rate that is almost triple the exam volume estimated for 1997. Digital mammography (DM) is now in use at approximately 14% (1,191 of 8,834) of MQSA-certified mammography facilities. The results indicate that DM can offer lower dose to the patient while providing comparable or better image quality. PMID:21614276

  17. The geographic distribution of mammography resources in Mississippi

    PubMed Central

    Nichols, Elizabeth N.; Bradley, Denae L.; Zhang, Xu; Faruque, Fazlay; Duhé, Roy J.

    2014-01-01

    OBJECTIVE: To determine whether the availability of mammography resources affected breast cancer incidence rates, stage of disease at initial diagnosis, mortality rates and/or mortality-to-incidence ratios throughout Mississippi. METHODS: Mammography facilities were geocoded and the numbers of residents residing within a thirty minute drive of a mammography facility were calculated. Other data were extracted from the Mississippi Cancer Registry, the U.S. Census, and the Mississippi Behavioral Risk Factor Surveillance Survey (BRFSS). RESULTS & DISCUSSION: There were no statistically-significant differences between breast cancer incidence rates in Black versus White females in Mississippi; however, there were significant differences in the use of mammography, percentages of advanced-stage initial diagnoses, mortality rates, and mortality-to-incidence ratios, where Black females fared worse in each category. No statistically-significant correlations were observed between breast cancer outcomes and the availability of mammography facilities. The use of mammography was negatively correlated with advanced stage of disease at initial diagnosis. By combining Black and White subsets, a correlation between mammography use and improved survival was detected; this was not apparent in either subset alone. There was also a correlation between breast cancer mortality-to-incidence ratios and the percentage of the population living below the poverty level. CONCLUSIONS: The accessibility and use of mammography resources has a greater impact on breast cancer in Mississippi than does the geographic resource distribution per se. Therefore, intensified mammography campaigns to reduce the percentage of advanced-stage breast cancers initially diagnosed in Black women, especially in communities with high levels of poverty, are warranted in Mississippi. PMID:24678379

  18. Preliminary experience with monoenergetic photon mammography

    SciTech Connect

    Johnston, R.E.; Washburn, D.; Pisano, E.; Thomlinson, W.C.; Chapman, D.; Gmur, N.F.; Zhong, Zhong; Sayers, D.

    1995-12-31

    We are using a beam port at the National Synchrotron Light Source facility at Brookhaven National Laboratory as a source of monoenergetic photons. The photon source is radiation from a bending magnet on the X-ray storage ring and provides a usable X-ray spectrum from 5 keV to over 50 keV. A tunable crystal monochromotor is used for energy selection. The beam is 79mm wide and 0.5 mm high. We imaged the ACR mammography phantom and a contrast-detail phantom using a phosphor plate as the unaging detector. Phantom images were obtained at 16, 18, 20 and 22 keV. Phantom thickness varied from 15 mm to 82 mm. These images were compared to images obtained with a conventional dedicated mammography unit. Subjective preliminary results show that image contrast of the monoenergetic images is similar to those obtained from the conventional x-ray source with somewhat sharper and cleaner images from the monoenergetic source. Quantitative analysis shows that the monoenergetic images have improved contrast compared to the polyenergetic derived images. Entrance skin dose measurements show a factor of 5 to 10 times less radiation for the monoenergetic images with equivalent or better contrast Although there remain a number of technical problems to be addressed and much more work to be done, we are encouraged to further explore the use of monoenergetic imaging.

  19. An assessment of American Indian women's mammography experiences

    PubMed Central

    2010-01-01

    Background Mortality from breast cancer has increased among American Indian/Alaskan Native (AI/AN) women. Despite this alarming reality, AI/AN women have some of the lowest breast cancer screening rates. Only 37% of eligible AI/AN women report a mammogram within the last year and 52% report a mammogram within the last two years compared to 57% and 72% for White women. The experiences and satisfaction surrounding mammography for AI/AN women likely are different from that of women of other racial/ethnic groups, due to cultural differences and limited access to Indian Health Service sponsored mammography units. The overall goals of this study are to identify and understand the mammography experiences and experiential elements that relate to satisfaction or dissatisfaction with mammography services in an AI/AN population and to develop a culturally-tailored AI/AN mammography satisfaction survey. Methods and Design The three project aims that will be used to guide this work are: 1) To compare the mammography experiences and satisfaction with mammography services of Native American/Alaska Native women with that of Non-Hispanic White, Hispanic, and Black women, 2) To develop and validate the psychometric properties of an American Indian Mammography Survey, and 3) To assess variation among AI/AN women's assessments of their mammography experiences and mammography service satisfaction. Evaluations of racial/ethnic differences in mammography patient satisfaction have received little study, particularly among AI/AN women. As such, qualitative study is uniquely suited for an initial examination of their experiences because it will allow for a rich and in-depth identification and exploration of satisfaction elements. Discussion This formative research is an essential step in the development of a validated and culturally tailored AI/AN mammography satisfaction assessment. Results from this project will provide a springboard from which a maximally effective breast cancer

  20. CR mammography: Design and implementation of a quality control program

    SciTech Connect

    Moreno-Ramirez, A.; Brandan, M. E.; Villasenor-Navarro, Y.; Galvan, H. A.; Ruiz-Trejo, C.

    2012-10-23

    Despite the recent acquisition of significant quantities of computed radiography CR equipment for mammography, Mexican regulations do not specify the performance requirements for digital systems such as those of CR type. The design of a quality control program QCP specific for CR mammography systems was thus considered relevant. International protocols were taken as reference to define tests, procedures and acceptance criteria. The designed QCP was applied in three CR mammography facilities. Important deficiencies in spatial resolution, noise, image receptor homogeneity, artifacts and breast thickness compensation were detected.

  1. A proposal for a national mammography database: content, purpose, and value.

    PubMed

    Osuch, J R; Anthony, M; Bassett, L W; DeBor, M; D'Orsi, C; Hendrick, R E; Linver, M; Smith, R

    1995-06-01

    A national mammography database is a centralized, computerized method of data collection consisting of two possible parts: a national mammography audit and a system for monitoring and tracking patients. A national mammography audit refers to collecting and analyzing medical audit data of individual mammography practices at a national level and is a critical step in improving the interpretive component of mammography. The monitoring and tracking component refers to a centralized system that provides women and physicians with a recruitment and follow-up mechanism to optimize participation in mammography services. Both parts of a national mammography database represent important components in the improvement of mammography quality. However, unique scientific, legal, and fiscal concerns are important to consider before establishing a national mammography database. PMID:7754870

  2. The negative impact of MQSA (Mammography Quality Standards Act) on rural mammography programs.

    PubMed

    Inman, M

    1998-01-01

    Since Roentgen's discovery in 1895, physicians and scientists have found ways to use x-ray to evaluate and diagnose disease. In 1960, Dr. Richard Egan modified an x-ray machine to image the breast, for example. In 1982, one study found that deaths from breast cancer could be reduced 40 percent by using screening mammography. In 1991, Congress appropriated $90 million for breast cancer research, a figure that rose to $406 million several years later. The Mammography Quality Standards Act (MQSA), passed in 1992, requires all mammography facilities to meet minimum quality standards for equipment, radiologists, physicists and technologists. Regulations require extensive records of medical audit and outcome analysis, personnel qualification and medical reporting. Inspection and certification are now the responsibility of the Food and Drug Administration (FDA). Although they ensure compliance with the law, these inspections cost each facility $1,549 annually and the average cost to reach compliance with MQSA is $18,000. These fees are easily absorbed by high-volume centers but are burdensome for smaller, lower volume centers. Screening exams, to be useful, must be simple, accessible and cost-effective. MQSA's regulations have added significant costs and in most cases, the smaller centers will be forced to raise prices or discontinue offering mammography for a segment of the population with little or no other recourse for screening. The FDA should look for ways to perform more cost-effective inspections that still enforce regulations and monitor quality. Inspections should be unannounced and fines raised for violations. Implementation costs must be more realistic and the amount of paperwork reduced. PMID:10181470

  3. Digital mammography, cancer screening: Factors important for image compression

    NASA Technical Reports Server (NTRS)

    Clarke, Laurence P.; Blaine, G. James; Doi, Kunio; Yaffe, Martin J.; Shtern, Faina; Brown, G. Stephen; Winfield, Daniel L.; Kallergi, Maria

    1993-01-01

    The use of digital mammography for breast cancer screening poses several novel problems such as development of digital sensors, computer assisted diagnosis (CAD) methods for image noise suppression, enhancement, and pattern recognition, compression algorithms for image storage, transmission, and remote diagnosis. X-ray digital mammography using novel direct digital detection schemes or film digitizers results in large data sets and, therefore, image compression methods will play a significant role in the image processing and analysis by CAD techniques. In view of the extensive compression required, the relative merit of 'virtually lossless' versus lossy methods should be determined. A brief overview is presented here of the developments of digital sensors, CAD, and compression methods currently proposed and tested for mammography. The objective of the NCI/NASA Working Group on Digital Mammography is to stimulate the interest of the image processing and compression scientific community for this medical application and identify possible dual use technologies within the NASA centers.

  4. A novel method to assess incompleteness of mammography reports.

    PubMed

    Gimenez, Francisco J; Wu, Yirong; Burnside, Elizabeth S; Rubin, Daniel L

    2014-01-01

    Mammography has been shown to improve outcomes of women with breast cancer, but it is subject to inter-reader variability. One well-documented source of such variability is in the content of mammography reports. The mammography report is of crucial importance, since it documents the radiologist's imaging observations, interpretation of those observations in terms of likelihood of malignancy, and suggested patient management. In this paper, we define an incompleteness score to measure how incomplete the information content is in the mammography report and provide an algorithm to calculate this metric. We then show that the incompleteness score can be used to predict errors in interpretation. This method has 82.6% accuracy at predicting errors in interpretation and can possibly reduce total diagnostic errors by up to 21.7%. Such a method can easily be modified to suit other domains that depend on quality reporting. PMID:25954448

  5. A Novel Method to Assess Incompleteness of Mammography Reports

    PubMed Central

    Gimenez, Francisco J.; Wu, Yirong; Burnside, Elizabeth S.; Rubin, Daniel L.

    2014-01-01

    Mammography has been shown to improve outcomes of women with breast cancer, but it is subject to inter-reader variability. One well-documented source of such variability is in the content of mammography reports. The mammography report is of crucial importance, since it documents the radiologist’s imaging observations, interpretation of those observations in terms of likelihood of malignancy, and suggested patient management. In this paper, we define an incompleteness score to measure how incomplete the information content is in the mammography report and provide an algorithm to calculate this metric. We then show that the incompleteness score can be used to predict errors in interpretation. This method has 82.6% accuracy at predicting errors in interpretation and can possibly reduce total diagnostic errors by up to 21.7%. Such a method can easily be modified to suit other domains that depend on quality reporting. PMID:25954448

  6. Influence of advertisement on women's attitudes toward mammography screening.

    PubMed

    Collins, C; Davis, L S; Rentz, K; Vannoy, D

    1997-01-01

    This project represents an effort to incorporate a feminist perspective into research on mammography screening. The purpose of this study was to assess women's attitudes toward four advertisements designed to encourage mammography screening. The goal was to create awareness about women's attitudes toward mammography advertisements in order to encourage the development of more effective and responsive motivational materials. The results indicated that each ad communicated different messages about the seriousness of breast cancer and the efficacy of mammography in detecting early breast cancer. Each ad also affected women differently regarding their feelings of control over breast cancer, their perceived loss of sex appeal resulting from a breast cancer diagnosis, and their general fear of breast cancer. PMID:9384078

  7. Variability and errors when applying the BIRADS mammography classification.

    PubMed

    Boyer, Bruno; Canale, Sandra; Arfi-Rouche, Julia; Monzani, Quentin; Khaled, Wassef; Balleyguier, Corinne

    2013-03-01

    To standardize mammographic reporting, the American College of Radiology mammography developed the Breast Imaging Reporting and Data System (BIRADS) lexicon. However, wide variability is observed in practice in the application of the BIRADS terminology and this leads to classification errors. This review analyses the reasons for variations in BIRADS mammography, describes the types of errors made by readers with illustrated examples, and details BIRADS category 3 which is the most difficult category to use in practice. PMID:22483607

  8. X-ray source for mammography

    DOEpatents

    Logan, C.M.

    1994-12-20

    An x-ray source is described utilizing anode material which shifts the output spectrum to higher energy and thereby obtains higher penetrating ability for screening mammography application, than the currently utilized anode material. The currently used anode material (molybdenum) produces an energy x-ray spectrum of 17.5/19.6 keV, which using the anode material of this invention (e.g. silver, rhodium, and tungsten) the x-ray spectrum would be in the 20-35 keV region. Thus, the anode material of this invention provides for imaging of breasts with higher than average x-ray opacity without increase of the radiation dose, and thus reduces the risk of induced breast cancer due to the radiation dose administered for mammograms. 6 figures.

  9. Characterizing mammography reports for health analytics

    SciTech Connect

    Rojas, Carlos C; Patton, Robert M; Beckerman, Barbara G

    2010-01-01

    As massive collections of digital health data are becoming available, the opportunities for large scale automated analysis increase. In particular, the widespread collection of detailed health information is expected to help realize a vision of evidence-based public health and patient-centric health care. Within such a framework for large scale health analytics we describe several methods to characterize and analyze free-text mammography reports, including their temporal dimension, using information retrieval, supervised learning, and classical statistical techniques. We present experimental results with a large collection of mostly unlabeled reports that demonstrate the validity and usefulness of the approach, since these results are consistent with the known features of the data and provide novel insights about it.

  10. X-ray source for mammography

    DOEpatents

    Logan, Clinton M.

    1994-01-01

    An x-ray source utilizing anode material which shifts the output spectrum to higher energy and thereby obtains higher penetrating ability for screening mammography application, than the currently utilized anode material. The currently used anode material (molybdenum) produces an energy x-ray spectrum of 17.5/19.6 keV, which using the anode material of this invention (e.g. silver, rhodium, and tungsten) the x-ray spectrum would be in the 20-35 keV region. Thus, the anode material of this invention provides for imaging of breasts with higher than average x-ray opacity without increase of the radiation dose, and thus reduces the risk of induced breast cancer due to the radiation dose administered for mammograms.

  11. Contrast-Enhanced Digital Mammography and Angiogenesis

    SciTech Connect

    Rosado-Mendez, I.; Palma, B. A.; Villasenor, Y.; Benitez-Bribiesca, L.; Brandan, M. E.

    2007-11-26

    Angiogenesis could be a means for pouring contrast media around tumors. In this work, optimization of radiological parameters for contrast-enhanced subtraction techniques in mammography has been performed. A modification of Lemacks' analytical formalism was implemented to model the X-ray absorption in the breast with contrast medium and detection by a digital image receptor. Preliminary results of signal-to-noise ratio analysis show the advantage of subtracting two images taken at different energies, one prior and one posterior to the injection of contrast medium. Preliminary experimental results using a custom-made phantom have shown good agreement with calculations. A proposal is presented for the clinical application of the optimized technique, which aims at finding correlations between angiogenesis indicators and dynamic variables of contrast medium uptake.

  12. Image toggling saves time in mammography.

    PubMed

    Drew, Trafton; Aizenman, Avi M; Thompson, Matthew B; Kovacs, Mark D; Trambert, Michael; Reicher, Murray A; Wolfe, Jeremy M

    2016-01-01

    When two images are perfectly aligned, even subtle differences are readily detected when the images are "toggled" back and forth in the same location. However, substantial changes between two photographs can be missed if the images are misaligned ("change blindness"). Nevertheless, recent work from our lab, testing nonradiologists, suggests that toggling misaligned photographs leads to superior performance compared to side-by-side viewing (SBS). In order to determine if a benefit of toggling misaligned images may be observed in clinical mammography, we developed an image toggling technique where pairs of new and prior breast imaging exam images could be efficiently toggled back and forth. Twenty-three radiologists read 10 mammograms evenly divided in toggle and SBS modes. The toggle mode led to a 6-s benefit in reaching a decision [[Formula: see text], [Formula: see text

  13. Instrumentation optimization for positron emission mammography

    SciTech Connect

    Moses, William W.; Qi, Jinyi

    2003-06-05

    The past several years have seen designs for PET cameras optimized to image the breast, commonly known as Positron Emission Mammography or PEM cameras. The guiding principal behind PEM instrumentation is that a camera whose field of view is restricted to a single breast has higher performance and lower cost than a conventional PET camera. The most common geometry is a pair of parallel planes of detector modules, although geometries that encircle the breast have also been proposed. The ability of the detector modules to measure the depth of interaction (DOI) is also a relevant feature. This paper finds that while both the additional solid angle coverage afforded by encircling the breast and the decreased blurring afforded by the DOI measurement improve performance, the ability to measure DOI is more important than the ability to encircle the breast.

  14. [Future of mammography-based imaging].

    PubMed

    Schulz-Wendtland, R; Wittenberg, T; Michel, T; Hartmann, A; Beckmann, M W; Rauh, C; Jud, S M; Brehm, B; Meier-Meitinger, M; Anton, G; Uder, M; Fasching, P A

    2014-03-01

    Mammography is the central diagnostic method for clinical diagnostics of breast cancer and the breast cancer screening program. In the clinical routine complementary methods, such as ultrasound, tomosynthesis and optional magnetic resonance imaging (MRI) are already combined for the diagnostic procedure. Future developments will utilize investigative procedures either as a hybrid (combination of several different imaging modalities in one instrument) or as a fusion method (the technical fusion of two or more of these methods) to implement fusion imaging into diagnostic algorithms. For screening there are reasonable hypotheses to aim for studies that individualize the diagnostic process within the screening procedure. Individual breast cancer risk prediction and individualized knowledge about sensitivity and specificity for certain diagnostic methods could be tested. The clinical implementation of these algorithms is not yet in sight. PMID:24570108

  15. Triple-energy contrast enhanced digital mammography

    NASA Astrophysics Data System (ADS)

    Puong, Sylvie; Milioni de Carvalho, Pablo; Muller, Serge

    2010-04-01

    With the injection of iodine, Contrast Enhanced Digital Mammography (CEDM) provides functional information about breast tumour angiogenesis that can potentially help in cancer diagnosis. In order to generate iodine images in which the gray level is proportional to the iodine thickness, temporal and dual-energy approaches have already been considered. The dual-energy method offers the advantage of less patient motion artifacts and better comfort during the exam. However, this approach requires knowledge of the breast thickness at each pixel. Generally, as compression is applied, the breast thickness at each pixel is taken as the compression thickness. Nevertheless, in the breast border region, this assumption is not correct anymore and this causes inaccuracies in the iodine image. Triple-Energy CEDM could overcome these limitations by providing supplemental information in the form of a third image acquired with a different spectrum than the other two. This precludes the need of a priori knowledge of the breast thickness. Moreover, with Triple-Energy CEDM, breast thickness and glandularity maps could potentially be derived. In this study, we first focused on the method to recombine the three images in order to generate the iodine image, analyzing the performance of either quadratic, cubic or conic recombination functions. Then, we studied the optimal acquisition spectra in order to maximize the iodine SDNR in the recombined image for a given target total glandular dose. The concept of Triple-Energy CEDM was validated on simulated textured images and poly-energetic images acquired with a conventional X-ray mammography tube.

  16. Do Social Network Characteristics Predict Mammography Screening Practices?

    PubMed Central

    Allen, Jennifer D.; Stoddard, Anne M.; Sorensen, Glorian C.

    2010-01-01

    Background Many breast cancer screening programs are based on the assumption that dissemination of information through social networks and the provision of social support are effective strategies for promoting mammography use. This paper examines the prospective relationship between social network characteristics and breast cancer screening practices among employed women. Methods Women age 40 and over employed in 26 worksites participating in a randomized intervention trial completed baseline and two-year follow-up assessments. These analyses include women in the embedded cohort (n = 1,475). Measures included social network characteristics (size, social influences and support), breast cancer screening practices, and socio-demographic characteristics. Adherence to screening guidelines at follow-up (mammogram within the past two years) was modeled as a function of social network characteristics at baseline. Results The majority of women in this sample were adherent with mammography screening guidelines at baseline. Baseline adherence explained the vast majority of variation in screening practices at follow-up. Only after removing the effects of previous mammography screening did we find statistically significant relationships between network characteristics and screening status. Specifically, among women age 40–51, subjective norms and encouragement by family/friends to have a mammogram at baseline were each significantly associated with screening adherence at follow-up (OR = 2.20 and 1.18, respectively). For women age 52+, the perception that screening was normative among one’s peers was associated with increased likelihood of recent mammography at follow-up (OR = 1.46). Conclusions Previous mammography use is strongly predictive of future screening. Among employed women with high baseline screening rates, the impact of social network characteristics was modest. As previous use of screening is highly associated with future use, programs should focus on reaching

  17. 42 CFR 405.535 - Special rule for nonparticipating physicians and suppliers furnishing screening mammography...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... suppliers furnishing screening mammography services before January 1, 2002. 405.535 Section 405.535 Public... Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002. The provisions in this section apply for screening mammography services...

  18. 42 CFR 405.534 - Limitation on payment for screening mammography services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Limitation on payment for screening mammography... for Determining Reasonable Charges § 405.534 Limitation on payment for screening mammography services... January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31,...

  19. 42 CFR 413.123 - Payment for screening mammography performed by hospitals on an outpatient basis.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for screening mammography performed by... SKILLED NURSING FACILITIES Specific Categories of Costs § 413.123 Payment for screening mammography... mammographies performed by hospitals. (b) Payment to hospitals for outpatient services. Payment to hospitals...

  20. The Assessment of the Likelihood of Mammography Usage with Relevant Factors among Women with Disabilities

    ERIC Educational Resources Information Center

    Kung, Pei-Tseng; Tsai, Wen-Chen; Chiou, Shang-Jyh

    2012-01-01

    Research that identifies the determinants of low mammography use among disabled people is scant. This study examines the determining factors related to the low usage of mammography among women with disabilities. To identify the barriers that prevent women with disabilities from participating in mammography screening can help authorities conceive…

  1. 42 CFR 405.535 - Special rule for nonparticipating physicians and suppliers furnishing screening mammography...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... suppliers furnishing screening mammography services before January 1, 2002. 405.535 Section 405.535 Public... Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002. The provisions in this section apply for screening mammography services...

  2. 42 CFR 405.535 - Special rule for nonparticipating physicians and suppliers furnishing screening mammography...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... suppliers furnishing screening mammography services before January 1, 2002. 405.535 Section 405.535 Public... Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002. The provisions in this section apply for screening mammography services...

  3. 42 CFR 405.534 - Limitation on payment for screening mammography services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Limitation on payment for screening mammography... for Determining Reasonable Charges § 405.534 Limitation on payment for screening mammography services... January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31,...

  4. 42 CFR 413.123 - Payment for screening mammography performed by hospitals on an outpatient basis.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Payment for screening mammography performed by... SKILLED NURSING FACILITIES Specific Categories of Costs § 413.123 Payment for screening mammography... mammographies performed by hospitals. (b) Payment to hospitals for outpatient services. Payment to hospitals...

  5. 42 CFR 413.123 - Payment for screening mammography performed by hospitals on an outpatient basis.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payment for screening mammography performed by... SKILLED NURSING FACILITIES Specific Categories of Costs § 413.123 Payment for screening mammography... mammographies performed by hospitals. (b) Payment to hospitals for outpatient services. Payment to hospitals...

  6. 42 CFR 405.534 - Limitation on payment for screening mammography services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Limitation on payment for screening mammography... for Determining Reasonable Charges § 405.534 Limitation on payment for screening mammography services... January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31,...

  7. 42 CFR 413.123 - Payment for screening mammography performed by hospitals on an outpatient basis.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Payment for screening mammography performed by... SKILLED NURSING FACILITIES Specific Categories of Costs § 413.123 Payment for screening mammography... mammographies performed by hospitals. (b) Payment to hospitals for outpatient services. Payment to hospitals...

  8. 42 CFR 405.534 - Limitation on payment for screening mammography services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Limitation on payment for screening mammography... for Determining Reasonable Charges § 405.534 Limitation on payment for screening mammography services... January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31,...

  9. 42 CFR 405.535 - Special rule for nonparticipating physicians and suppliers furnishing screening mammography...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... suppliers furnishing screening mammography services before January 1, 2002. 405.535 Section 405.535 Public... Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002. The provisions in this section apply for screening mammography services...

  10. 75 FR 70011 - Guidance for Industry, Mammography Quality Standards Act Inspectors, and Food and Drug...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ...The Food and Drug Administration (FDA) is announcing the availability of the guidance entitled ``The Mammography Quality Standards Act Final Regulations: Modifications and Additions to Policy Guidance Help System 13.'' This document is intended to assist mammography facilities and their personnel in meeting the requirements of the Mammography Quality Standards Act (MQSA)...

  11. Mammography screening. Benefits, harms, and informed choice.

    PubMed

    Jørgensen, Karsten Juhl

    2013-04-01

    The rationale for breast cancer screening with mammography is deceptively simple: catch it early and reduce mortality from the disease and the need for mastectomies. But breast cancer is a complex problem, and complex problems rarely have simple solutions. Breast screening brings forward the time of diagnosis only slightly compared to the lifetime of a tumour, and screen-detected tumours have a size where metastases are possible. A key question is if screening can prevent metastases, and if the screen-detected tumours are small enough to allow breast conserving surgery rather than mastectomy. A mortality reduction can never justify a medical intervention in its own right, but must be weighed against the harms. Overdiagnosis is the most important harm of breast screening, but has gained wider recognition only in recent years. Screening leads to the detection and treatment of breast cancers that would otherwise never have been detected because they grow very slowly or not at all and would not have been detected in the woman's lifetime in the absence of screening. Screening therefore turns women into cancer patients unnecessarily, with life-long physical and psychological harms. The debate about the justification of breast screening is therefore not a simple question of whether screening reduces breast cancer mortality. This dissertation quantifies the primary benefits and harms of screening mammography. Denmark has an unscreened "control group" because only two geographical regions offered screening over a long time-period, which is unique in an international context. This was used to study breast cancer mortality, overdiagnosis, and the use of mastectomies. Also, a systematic review of overdiagnosis in five other countries allowed us to show that about half of the screen-detected breast cancers are overdiagnosed. An effect on breast cancer mortality is doubtful in today's setting, and overdiagnosis causes an increase in the use of mastectomies. These findings are

  12. Optimizing Imaging Instruments for Emission Mammography

    NASA Astrophysics Data System (ADS)

    Weinberg, Irving N.

    1996-05-01

    Clinical studies have demonstrated that radiotracer methods can noninvasively detect breast cancers in vivo(L.P. Adler, J.P.Crowe, N.K. Al-Kaisis, et al, Radiology 187,743-750 (1993)) (I. Khalkhali, I. Mena, E. Jouanne, et al, J. Am. Coll. Surg. 178, 491-497 (1994)). Due to spatial resolution and count efficiency considerations, users of conventional nuclear medicine instruments have had difficulty in detecting subcentimeter cancers. This limitation is unfortunate, since cancer therapy is generally most efficacious when tumor diameter at detection is less than a centimeter. A more subtle limitation of conventional nuclear medicine imaging instruments is that they are poorly suited to guiding interventions. With the assistance of C.J. Thompson from McGill University, and the CEBAF Detector Physics Group, we have explored the possibility of configuring detectors for nuclear medicine imaging devices into geometries that resemble conventional x-ray mammography cameras(I.N. Weinberg, U.S.Patent 5,252,830 (1993)). Phantom and pilot clinical studies suggest that applying breast compression within such geometries may offer several advantages(C.J. Thompson, K. Murthy, I.N. Weinberg, et al, Med. Physics 21, 259-538 (1994)): For coincident detection of positron emitters, efficiency and spatial resolution are improved by bringing the detectors very close to the source (the breast tumor). For single-photon detection, attenuation due to overlying tissue is reduced. Since, for a high-efficiency collimator, spatial resolution worsens with increasing source to collimator distance, adoption of compression allows more efficient collimators to be employed. Economics are favorable in that detectors can be deployed in the region of interest, rather than around the entire body, and that such detectors can be mounted in conventional mammographic gantries. The application of conventional mammographic geometry promises to assist physicians in conducting radiotracer-guided biopsies, and in

  13. Satellite teleradiology test bed for digital mammography

    NASA Astrophysics Data System (ADS)

    Barnett, Bruce G.; Dudding, Kathryn E.; Abdel-Malek, Aiman A.; Mitchell, Robert J.

    1996-05-01

    Teleradiology offers significant improvement in efficiency and patient compliance over current practices in traditional film/screen-based diagnosis. The increasing number of women who need to be screened for breast cancer, including those in remote rural regions, make the advantages of teleradiology especially attractive for digital mammography. At the same time, the size and resolution of digital mammograms are among the most challenging to support in a cost effective teleradiology system. This paper will describe a teleradiology architecture developed for use with digital mammography by GE Corporate Research and Development in collaboration with Massachusetts General Hospital under National Cancer Institute (NCI/NIH) grant number R01 CA60246-01. The testbed architecture is based on the Digital Imaging and Communications in Medicine (DICOM) standard, created by the American College of Radiology and National Electrical Manufacturers Association. The testbed uses several Sun workstations running SunOS, which emulate a rural examination facility connected to a central diagnostic facility, and uses a TCP-based DICOM application to transfer images over a satellite link. Network performance depends on the product of the bandwidth times the round- trip time. A satellite link has a round trip of 513 milliseconds, making the bandwidth-delay a significant problem. This type of high bandwidth, high delay network is called a Long Fat Network, or LFN. The goal of this project was to quantify the performance of the satellite link, and evaluate the effectiveness of TCP over an LFN. Four workstations have Sun's HSI/S (High Speed Interface) option. Two are connected by a cable, and two are connected through a satellite link. Both interfaces have the same T1 bandwidth (1.544 Megabits per second). The only difference was the round trip time. Even with large window buffers, the time to transfer a file over the satellite link was significantly longer, due to the bandwidth-delay. To

  14. Influence of Detector Radiation Damage on CR Mammography Quality Control.

    PubMed

    Moriwaki, Atsumi; Ishii, Mie; Terazono, Shiho; Arao, Keiko; Ishii, Rie; Sanada, Taizo; Yoshida, Akira

    2016-05-01

    Recently, radiation damage to the detector apparatus employed in computed radiography (CR) mammography has become problematic. The CR system and the imaging plate (IP) applied to quality control (QC) program were also used in clinical mammography in our hospital, and the IP to which radiation damage has occurred was used for approximately 5 years (approximately 13,000 exposures). We considered using previously acquired QC image data, which is stored in a server, to investigate the influence of radiation damage to an IP. The mammography unit employed in this study was a phase contrast mammography (PCM) Mermaid (KONICA MINOLTA) system. The QC image was made newly, and it was output in the film, and thereafter the optical density of the step-phantom image was measured. An input (digital value)-output (optical density) conversion curve was plotted using the obtained data. The digital values were then converted to optical density values using a reference optical density vs. digital value curve. When a high radiation dose was applied directly, radiation damage occurred at a position on the IP where no object was present. Daily QC for mammography is conducted using an American College of Radiology (ACR) accreditation phantom and acrylic disc, and an environmental background density measurement is performed as one of the management indexes. In this study, the radiation damage sustained by the acrylic disc was shown to differ from that of the background. Thus, it was revealed that QC results are influenced by radiation damage. PMID:27211088

  15. Response costs of mammography adherence: Iranian women’s perceptions

    PubMed Central

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

    2016-01-01

    Background: 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. Methods: 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). Results: 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." Conclusion: 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. PMID:27386423

  16. Scatter radiation intensities around full-field digital mammography units.

    PubMed

    Judge, M A; Keavey, E; Phelan, N

    2013-01-01

    The aim of this study was to investigate the scatter radiation intensity around digital mammography systems and apply these data to standard shielding calculations to reveal whether shielding design of existing breast screening rooms is adequate for the use of digital mammography systems. Three digital mammography systems from GE Healthcare, Hologic and Philips were employed in the study. A breast-equivalent phantom was imaged under clinical workload conditions and scatter radiation intensities around the digital mammography systems were measured for a range of angles in three planes using an ionisation chamber. The results were compared with those from previous studies of film-screen systems. It may be deduced from the results that scattering in the backward direction is significant for all three systems, while scattering in the forward direction can be significant for some planes around the GE and Hologic systems. Measurements at typical clinical settings on each system revealed the Philips system to have markedly lower scatter radiation intensities than the other systems. Substituting the measured scattered radiation intensity into shielding calculations yielded barrier requirements similar to those already in place at the screening centres operating these systems. Current radiation protection requirements based on film-screen technology remain sufficient when applied to rooms with digital mammography installations and no alteration is required to the structural shielding. PMID:23239693

  17. Wavelet processing techniques for digital mammography

    NASA Astrophysics Data System (ADS)

    Laine, Andrew F.; Song, Shuwu

    1992-09-01

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

  18. Advantages and Disadvantages of Mammography Screening

    PubMed Central

    Heywang-Köbrunner, Sylvia H.; Hacker, Astrid; Sedlacek, Stefan

    2011-01-01

    Summary Mammography screening is the only method presently considered appropriate for mass screening of asymptomatic women. Its frequent use, however, warrants diligent analysis of potential side effects. Radiation risk is far below the natural yearly risk of breast cancer and should not be used as an argument against screening. False-positive calls lead to additional imaging or histopathological assessment, mainly percutaneous breast biopsy. These measures are tolerated and accepted fairly well. Their number is limited by strict quality assurance and constant training. Interval cancers represent a limitation of breast screening that should prompt further research for optimization. Evaluation of overdiagnosis is a highly debated topic in the literature. According to the probably most realistic available calculations, overdiagnosis is acceptable as it is compensated by the potential mortality reduction. Nonetheless, this potential side effect warrants optimal adjustment of therapy to the patient's individual risk. The mortality reduction seen in randomized studies was confirmed by results from national screening programs. A recent case referent study indicated that improvements in mortality reduction run parallel to improved mammographic techniques. Use of less aggressive therapies is another valuable effect of screening. Awareness of potential problems, strict quality assurance, and further research should help to further develop screening programs. PMID:21779225

  19. Digital mammography: tradeoffs between 50- and 100-micron pixel size

    NASA Astrophysics Data System (ADS)

    Freedman, Matthew T.; Steller Artz, Dorothy E.; Jafroudi, Hamid; Lo, Shih-Chung B.; Zuurbier, Rebecca A.; Katial, Raj; Hayes, Wendelin S.; Wu, Chris Y.; Lin, Jyh-Shyan; Steinman, Richard M.; Tohme, Walid G.; Mun, Seong K.

    1995-05-01

    Improvements in mammography equipment related to a decrease in pixel size of digital mammography detectors raise questions of the possible effects of these new detectors. Mathematical modeling suggested that the benefits of moving from 100 to 50 micron detectors were slight and might not justify the cost of these new units. Experiments comparing screen film mammography, a storage phosphor 100 micron digital detector, a 50 micron digital breast spot device, 100 micron film digitization and 50 micron film digitization suggests that object conspicuity should be better for digital compared to conventional systems, but that there seemed to be minimal advantage to going from 100 to 50 microns. The 50 micron pixel system appears to provide a slight advantage in object contrast and perhaps in shape definition, but did not allow smaller objects to be detected.

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

    SciTech Connect

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

    2008-04-15

    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

  1. Monte Carlo simulation studies of backscatter factors in mammography

    SciTech Connect

    Chan, H.P.; Doi, K.

    1981-04-01

    Experimentally determined backscatter factors in mammography can contain significant systematic errors due to the energy response, dimensions, and location of the dosimeter used. In this study, the Monte Carlo method was applied to simulate photon scattering in tissue-equivalent media and to determine backscatter factors without the interference of a detector. The physical processes of measuring backscatter factors with a lithium fluoride thermoluminescent dosimeter (TLD) and an ideal tissue-equivalent detector were also simulated. Computed results were compared with the true backscatter factors and with measured values reported by other investigators. It was found that the TLD method underestimated backscatter factors in mammography by as much as 10% at high energies.

  2. Convolutional neural networks for mammography mass lesion classification.

    PubMed

    Arevalo, John; Gonzalez, Fabio A; Ramos-Pollan, Raul; Oliveira, Jose L; Guevara Lopez, Miguel Angel

    2015-08-01

    Feature extraction is a fundamental step when mammography image analysis is addressed using learning based approaches. Traditionally, problem dependent handcrafted features are used to represent the content of images. An alternative approach successfully applied in other domains is the use of neural networks to automatically discover good features. This work presents an evaluation of convolutional neural networks to learn features for mammography mass lesions before feeding them to a classification stage. Experimental results showed that this approach is a suitable strategy outperforming the state-of-the-art representation from 79.9% to 86% in terms of area under the ROC curve. PMID:26736382

  3. Cost as a barrier to screening mammography among underserved women

    PubMed Central

    McAlearney, Ann Scheck; Reeves, Katherine W.; Tatum, Cathy; Paskett, Electra D.

    2015-01-01

    Background Breast cancer is a troublesome health problem, particularly among underserved and minority women. Early detection through screening mammography can reduce the impact of this disease, yet it remains underused. Objective We examined cost as a barrier to screening mammography and studied the accuracy of women’s perceptions of the cost of a mammogram among a rural, low-income, tri-racial (white, Native American and African American) population in need of a mammogram. Design We interviewed 897 women age 40 and older, asking about cost as a barrier to mammography and perceptions about the actual costs of a screening mammogram. Face-to-face interviews were conducted between 1998 and 2000 among women participating in a randomized, controlled study to evaluate a health education intervention to improve mammography screening rates in an underserved population. All data used in these analyses were from the baseline interviews. Results Cost acted as a barrier to screening mammography for a majority of the participants (53%). More than half of these women (52%), however, overestimated the cost of a screening mammogram, and overestimation of the cost was significantly related to mentioning cost as a barrier (OR 1.56, 95% CI 1.04–2.33). Higher estimates of out-of-pocket costs were associated with reporting cost as a barrier to mammography (OR 2.25, 95% CI 1.43–3.52 for $1–50 and OR 12.64, 95% CI 6.61–24.17 for > $50). Factors such as race, income and employment status were not related to reporting cost as a barrier to screening mammography. Conclusions Among a group of tri-racial, low-income, rural women who were in need of a mammogram, cost was a common barrier. Overestimating the cost, however, was significantly and positively associated with reporting cost as a barrier. Providing information about the actual cost women have to pay for mammograms may lessen the role of cost as a barrier to mammography screening, especially for underserved women, potentially

  4. Mammography use and mode of detection among breast cancer patients in Estonia.

    PubMed

    Innos, Kaire; Valvere, Vahur; Padrik, Peeter; Eelma, Evelyn; Kütner, Riina; Lehtsaar, Jaak; Tekkel, Mare

    2016-01-01

    The aim of this study was to examine past mammography use and mode of detection among breast cancer (BC) patients in Estonia, a country that has low screening coverage and high BC mortality. Women newly diagnosed with primary BC in Estonia in 2008-2010 were interviewed. Determinants of past mammography use and the detection of BC by mammography were studied using multivariate logistic regression. Among 977 participants, almost half reported no mammograms prior to the detection of BC. Overall, 22% of the cases were detected by mammography (16% by screening mammography). Detection by mammography was strongly related to age, past mammography use, and obesity. Among cases detected by mammography, 10% were stage III/IV at diagnosis (32% among cases detected by other modes). This study showed low mammography utilization and high rate of self-detection of BC in Estonia. Increased detection by mammography would help diagnose the disease at an earlier stage and consequently avoid premature BC deaths. Efforts should be undertaken to increase participation in screening and improve the availability of mammography among older and high-risk women. The results are likely to be relevant for other countries and population groups with low screening coverage. PMID:26327255

  5. Comparison of Image Quality Criteria between Digital Storage Phosphor Plate in Mammography and Full-Field Digital Mammography in the Detection of Breast Cancer

    PubMed Central

    Thevi Rajendran, Pushpa; Krishnapillai, Vijayalakshmi; Tamanang, Sulaiman; Kumari Chelliah, Kanaga

    2012-01-01

    Background: Digital mammography is slowly replacing screen film mammography. In digital mammography, 2 methods are available in acquiring images: digital storage phosphor plate and full-field digital mammography. The aim of this study was to compare the image quality acquired from the 2 methods of digital mammography in the detection of breast cancer. Methods: The study took place at the National Cancer Society, Kuala Lumpur, and followed 150 asymptomatic women for the duration of 1 year. Participating women gave informed consent and were exposed to 4 views from each system. Two radiologists independently evaluated the printed images based on the image quality criteria in mammography. McNemar’s test was used to compare the image quality criteria between the systems. Results: The agreement between the radiologists for the digital storage phosphor plate was к = 0.551 and for full-field digital mammography was к = 0.523. Full-field digital mammography was significantly better compared with the digital storage phosphor plate in right and left mediolateral oblique views (P < 0.05) in the detection of microcalcifications, which are early signs of breast cancer. However, both systems were comparable in all other aspects of image quality. Conclusion: Digital mammography is a useful screening tool for the detection of early breast cancer and ensures better prognosis and quality of life. PMID:22977375

  6. Disclosing Harmful Mammography Errors to Patients1

    PubMed Central

    Gallagher, Thomas H.; Cook, Andrea J.; Brenner, R. James; Carney, Patricia A.; Miglioretti, Diana L.; Geller, Berta M.; Kerlikowske, Karla; Onega, Tracy L.; Rosenberg, Robert D.; Yankaskas, Bonnie C.; Lehman, Constance D.; Elmore, Joann G.

    2009-01-01

    Purpose: To assess radiologists’ attitudes about disclosing errors to patients by using a survey with a vignette involving an error interpreting a patient's mammogram, leading to a delayed cancer diagnosis. Materials and Methods: We conducted an institutional review board–approved survey of 364 radiologists at seven geographically distinct Breast Cancer Surveillance Consortium sites that interpreted mammograms from 2005 to 2006. Radiologists received a vignette in which comparison screening mammograms were placed in the wrong order, leading a radiologist to conclude calcifications were decreasing in number when they were actually increasing, delaying a cancer diagnosis. Radiologists were asked (a) how likely they would be to disclose this error, (b) what information they would share, and (c) their malpractice attitudes and experiences. Results: Two hundred forty-three (67%) of 364 radiologists responded to the disclosure vignette questions. Radiologists’ responses to whether they would disclose the error included “definitely not” (9%), “only if asked by the patient” (51%), “probably” (26%), and “definitely” (14%). Regarding information they would disclose, 24% would “not say anything further to the patient,” 31% would tell the patient that “the calcifications are larger and are now suspicious for cancer,” 30% would state “the calcifications may have increased on your last mammogram, but their appearance was not as worrisome as it is now,” and 15% would tell the patient “an error occurred during the interpretation of your last mammogram, and the calcifications had actually increased in number, not decreased.” Radiologists’ malpractice experiences were not consistently associated with their disclosure responses. Conclusion: Many radiologists report reluctance to disclose a hypothetical mammography error that delayed a cancer diagnosis. Strategies should be developed to increase radiologists’ comfort communicating with

  7. Positron Emission Mammography with Multiple Angle Acquisition

    SciTech Connect

    Mark F. Smith; Stan Majewski; Raymond R. Raylman

    2002-11-01

    Positron emission mammography (PEM) of F-18 fluorodeoxyglucose (FDG) uptake in breast tumors with dedicated detectors typically has been accomplished with two planar detectors in a fixed position with the breast under compression. The potential use of PEM imaging at two detector positions to guide stereotactic breast biopsy has motivated us to use PEM coincidence data acquired at two or more detector positions together in a single image reconstruction. Multiple angle PEM acquisition and iterative image reconstruction were investigated using point source and compressed breast phantom acquisitions with 5, 9, 12 and 15 mm diameter spheres and a simulated tumor:background activity concentration ratio of 6:1. Image reconstruction was performed with an iterative MLEM algorithm that used coincidence events between any two detector pixels on opposed detector heads at each detector position. This present study compared two acquisition protocols: 2 angle acquisition with detector angular positions of -15 and +15 degrees and 11 angle acquisition with detector positions spaced at 3 degree increments over the range -15 to +15 degrees. Three- dimensional image resolution was assessed for the point source acquisitions, and contrast and signal-to-noise metrics were evaluated for the compressed breast phantom with different simulated tumor sizes. Radial and tangential resolutions were similar for the two protocols, while normal resolution was better for the 2 angle acquisition. Analysis is complicated by the asymmetric point spread functions. Signal- to-noise vs. contrast tradeoffs were better for 11 angle acquisition for the smallest visible 9 mm sphere, while tradeoff results were mixed for the larger and more easily visible 12 mm and 15 mm diameter spheres. Additional study is needed to better understand the performance of limited angle tomography for PEM. PEM tomography experiments with complete angular sampling are planned.

  8. Positron Emission Mammography with Multiple Angle Acquisition

    SciTech Connect

    Mark F. Smith; Stan Majewski; Raymond R. Raylman

    2002-11-01

    Positron emission mammography (PEM) of F-18 fluorodeoxyglucose (FbG) uptake in breast tumors with dedicated detectors typically has been accomplished with two planar detectors in a fixed position with the breast under compression. The potential use of PEM imaging at two detector positions to guide stereotactic breast biopsy has motivated us to use PEM coincidence data acquired at two or more detector positions together in a single image reconstruction. Multiple angle PEM acquisition and iterative image reconstruction were investigated using point source and compressed breast phantom acquisitions with 5, 9, 12 and 15 mm diameter spheres and a simulated tumor:background activity concentration ratio of 6:1. Image reconstruction was performed with an iterative MLEM algorithm that used coincidence events between any two detector pixels on opposed detector heads at each detector position. This present study compared two acquisition protocols: 2 angle acquisition with detector angular positions of -15 and +15 degrees and 11 angle acquisition with detector positions spaced at 3 degree increments over the range -15 to +15 degrees. Three-dimensional image resolution was assessed for the point source acquisitions, and contrast and signal-to-noise metrics were evaluated for the compressed breast phantom with different simulated tumor sizes. Radial and tangential resolutions were similar for the two protocols, while normal resolution was better for the 2 angle acquisition. Analysis is complicated by the asymmetric point spread functions. Signal- to-noise vs. contrast tradeoffs were better for 11 angle acquisition for the smallest visible 9 mm sphere, while tradeoff results were mixed for the larger and more easily visible 12 mm and 15 mm diameter spheres. Additional study is needed to better understand the performance of limited angle tomography for PEM. PEM tomography experiments with complete angular sampling are planned.

  9. Implications of Overdiagnosis: Impact on Screening Mammography Practices

    PubMed Central

    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

  10. An equivalent relative utility metric for evaluating screening mammography

    PubMed Central

    Abbey, Craig K.; Eckstein, Miguel P.; Boone, John M.

    2009-01-01

    Comparative studies of performance in screening mammography are often ambiguous. A new method will frequently show a higher sensitivity or detection rate than an existing standard with a concomitant increase in false positives or recalls. We propose an equivalent relative utility (ERU) metric based on signal detection theory to quantify screening performance in such comparisons. The metric is defined as the relative utility, as defined in classical signal detection theory, needed to make two systems equivalent. ERU avoids the problem of requiring a predefined putative relative utility, which has limited application of utility theory in ROC analysis. The metric can be readily estimated from recall and detection rates commonly reported in comparative clinical studies. An important practical advantage of ERU is that in prevalence matched populations, the measure can be estimated without an independent estimate of disease prevalence. Thus estimating ERU does not require a study with long term follow up to find cases of missed disease. The approach is applicable to any comparative screening study that reports results in terms of recall and detection rates, although we focus exclusively on screening mammography in this work. We derive the ERU from the definition of utility given in classical treatments of signal detection theory. We also investigate reasonable values of relative utility in screening mammography for use in interpreting ERU using data from a large clinical study. As examples of application of ERU, we re-analyze two recently published reports using recall and detection rates in screening mammography. PMID:19706880

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

    NASA Astrophysics Data System (ADS)

    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.

  12. Evaluation of image quality in computed radiography based mammography systems

    NASA Astrophysics Data System (ADS)

    Singh, Abhinav; Bhwaria, Vipin; Valentino, Daniel J.

    2011-03-01

    Mammography is the most widely accepted procedure for the early detection of breast cancer and Computed Radiography (CR) is a cost-effective technology for digital mammography. We have demonstrated that CR mammography image quality is viable for Digital Mammography. The image quality of mammograms acquired using Computed Radiography technology was evaluated using the Modulation Transfer Function (MTF), Noise Power Spectrum (NPS) and Detective Quantum Efficiency (DQE). The measurements were made using a 28 kVp beam (RQA M-II) using 2 mm of Al as a filter and a target/filter combination of Mo/Mo. The acquired image bit depth was 16 bits and the pixel pitch for scanning was 50 microns. A Step-Wedge phantom (to measure the Contrast-to-noise ratio (CNR)) and the CDMAM 3.4 Contrast Detail phantom were also used to assess the image quality. The CNR values were observed at varying thickness of PMMA. The CDMAM 3.4 phantom results were plotted and compared to the EUREF acceptable and achievable values. The effect on image quality was measured using the physics metrics. A lower DQE was observed even with a higher MTF. This could be possibly due to a higher noise component present due to the way the scanner was configured. The CDMAM phantom scores demonstrated a contrast-detail comparable to the EUREF values. A cost-effective CR machine was optimized for high-resolution and high-contrast imaging.

  13. Physicians' recommendations for mammography: do tailored messages make a difference?

    PubMed Central

    Skinner, C S; Strecher, V J; Hospers, H

    1994-01-01

    OBJECTIVES. Message tailoring, based on individual needs and circumstances, is commonly used to enhance face-to-face patient counseling. Only recently has individual tailoring become feasible for printed messages. This study sought to determine whether printed tailored recommendations addressing women's specific screening and risk status and perceptions about breast cancer and mammography are more effective than standardized printed recommendations. METHODS. Computer-assisted telephone interviews were conducted with 435 women, aged 40 to 65 years, who had visited family practice groups within the previous 2 years. Subjects were randomly allocated to receive individually tailored or standardized mammography recommendation letters mailed from physicians to patients' homes. Follow-up interviews were conducted 8 months later. RESULTS. Tailored letter recipients were more likely to remember and to have read more of their letters than standardized version recipients. After controlling for baseline status, tailored letter receipt was associated with more favorable follow-up mammography status for women with incomes below $26,000 and for Black women. CONCLUSIONS. Tailored messages are a more effective medium for physicians' mammography recommendations; tailoring may be especially important for women of low socioeconomic status. PMID:8279610

  14. Reactions to Uncertainty and the Accuracy of Diagnostic Mammography

    PubMed Central

    Yi, Joyce P.; Abraham, Linn A.; Miglioretti, Diana L.; Aiello, Erin J.; Gerrity, Martha S.; Reisch, Lisa; Berns, Eric A.; Sickles, Edward A.; Elmore, Joann G.

    2007-01-01

    Background Reactions to uncertainty in clinical medicine can affect decision making. Objective To assess the extent to which radiologists’ reactions to uncertainty influence diagnostic mammography interpretation. Design Cross-sectional responses to a mailed survey assessed reactions to uncertainty using a well-validated instrument. Responses were linked to radiologists’ diagnostic mammography interpretive performance obtained from three regional mammography registries. Participants One hundred thirty-two radiologists from New Hampshire, Colorado, and Washington. Measurement Mean scores and either standard errors or confidence intervals were used to assess physicians’ reactions to uncertainty. Multivariable logistic regression models were fit via generalized estimating equations to assess the impact of uncertainty on diagnostic mammography interpretive performance while adjusting for potential confounders. Results When examining radiologists’ interpretation of additional diagnostic mammograms (those after screening mammograms that detected abnormalities), a 5-point increase in the reactions to uncertainty score was associated with a 17% higher odds of having a positive mammogram given cancer was diagnosed during follow-up (sensitivity), a 6% lower odds of a negative mammogram given no cancer (specificity), a 4% lower odds (not significant) of a cancer diagnosis given a positive mammogram (positive predictive value [PPV]), and a 5% higher odds of having a positive mammogram (abnormal interpretation). Conclusion Mammograms interpreted by radiologists who have more discomfort with uncertainty have higher likelihood of being recalled. PMID:17356992

  15. Screening mammography intervals among postmenopausal hormone therapy users and nonusers

    PubMed Central

    Onega, Tracy; MacKenzie, Todd; Weiss, Julia; Goodrich, Martha; Titus-Ernstoff, Linda

    2013-01-01

    Background The recent decline in US breast cancer incidence rates has been attributed to the marked reduction in use of postmenopausal hormone therapy (HT). An alternative explanation is that women who are not routinely seeking medical care to renew HT prescriptions may be less adherent to recommendations for mammographic screening. To investigate the latter possibility, we compared mammographic intervals according to HT use. Methods Using data (1995–2007) from the New Hampshire Mammography Network (NHMN), a state-based mammography registry, we assessed mammographic intervals corresponding to HT use or nonuse among postmenopausal women. We used linear mixed effects models to assess whether the length of screening mammogram intervals differed according to HT use. Results A total of 310,185 mammograms, representing 76,192 postmenopausal women and 319,353 person-years of screening, were included in the analysis. The median screening interval corresponding to HT use overall was 13.0 months (interquartile range: 12.4–15.1) and for nonuse was 13.1 (interquartile range: 12.4–15.8). Virtually, all screening mammograms occurred within a 2-year interval regardless of HT use or nonuse (98.5 and 98.1%, respectively). Conclusions Our findings indicate that screening mammography intervals are similar whether or not women are using HT. Thus, reduced utilization of screening mammography is unlikely to account for the decrease in breast cancer incidence seen soon after the WHI report. PMID:19844798

  16. What is the point: will screening mammography save my life?

    PubMed Central

    2009-01-01

    Background We analyzed the claim "mammography saves lives" by calculating the life-saving absolute benefit of screening mammography in reducing breast cancer mortality in women ages 40 to 65. Methods To calculate the absolute benefit, we first estimated the screen-free absolute death risk from breast cancer by adjusting the Surveillance, Epidemiology and End Results Program 15-year cumulative breast cancer mortality to account for the separate effects of screening mammography and improved therapy. We calculated the absolute risk reduction (reduction in absolute death risk), the number needed to screen assuming repeated screening, and the survival percentages without and with screening. We varied the relative risk reduction from 10%–30% based on the randomized trials of screening mammography. We developed additional variations of the absolute risk reduction for a screening intervention, including the average benefit of a single screen, as well as the life-saving proportion among patients with earlier cancer detection. Results Because the screen-free absolute death risk is approximately 1% overall but rises with age, the relative risk reduction from repeated screening mammography is about 100 times the absolute risk reduction between the starting ages of 50 and 60. Assuming a base case 20% relative risk reduction, repeated screening starting at age 50 saves about 1.8 (overall range, 0.9–2.7) lives over 15 years for every 1000 women screened. The number needed to screen repeatedly is 1000/1.8, or 570. The survival percentage is 99.12% without and 99.29% with screening. The average benefit of a single screening mammogram is 0.034%, or 2970 women must be screened once to save one life. Mammography saves 4.3% of screen-detectable cancer patients' lives starting at age 50. This means 23 cancers must be found starting at age 50, or 27 cancers at age 40 and 21 cancers at age 65, to save one life. Conclusion The life-saving absolute benefit of screening mammography

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

    PubMed Central

    2016-01-01

    Introduction 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. Materials and Methods 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. Results 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%). Conclusion 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 throughput, 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. PMID:27134963

  18. Predicting Malignancy from Mammography Findings and Surgical Biopsies

    PubMed Central

    Ferreira, Pedro; Fonseca, Nuno A.; Dutra, Inês; Woods, Ryan; Burnside, Elizabeth

    2013-01-01

    Breast screening is the regular examination of a woman’s breasts to find breast cancer earlier. The sole exam approved for this purpose is mammography. Usually, findings are annotated through the Breast Imaging Reporting and Data System (BIRADS) created by the American College of Radiology. The BIRADS system determines a standard lexicon to be used by radiologists when studying each finding. Although the lexicon is standard, the annotation accuracy of the findings depends on the experience of the radiologist. Moreover, the accuracy of the classification of a mammography is also highly dependent on the expertise of the radiologist. A correct classification is paramount due to economical and humanitarian reasons. The main goal of this work is to produce machine learning models that predict the outcome of a mammography from a reduced set of annotated mammography findings. In the study we used a data set consisting of 348 consecutive breast masses that underwent image guided or surgical biopsy performed between October 2005 and December 2007 on 328 female subjects. The main conclusions are threefold: (1) automatic classification of a mammography, independent on information about mass density, can reach equal or better results than the classification performed by a physician; (2) mass density seems to be a good indicator of malignancy, as previous studies suggested; (3) a machine learning model can predict mass density with a quality as good as the specialist blind to biopsy, which is one of our main contributions. Our model can predict malignancy in the absence of the mass density attribute, since we can fill up this attribute using our mass density predictor. PMID:24363962

  19. Postmortem validation of breast density using dual-energy mammography

    SciTech Connect

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

    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.

  20. Predicting Malignancy from Mammography Findings and Surgical Biopsies.

    PubMed

    Ferreira, Pedro; Fonseca, Nuno A; Dutra, Inês; Woods, Ryan; Burnside, Elizabeth

    2011-11-01

    Breast screening is the regular examination of a woman's breasts to find breast cancer earlier. The sole exam approved for this purpose is mammography. Usually, findings are annotated through the Breast Imaging Reporting and Data System (BIRADS) created by the American College of Radiology. The BIRADS system determines a standard lexicon to be used by radiologists when studying each finding. Although the lexicon is standard, the annotation accuracy of the findings depends on the experience of the radiologist. Moreover, the accuracy of the classification of a mammography is also highly dependent on the expertise of the radiologist. A correct classification is paramount due to economical and humanitarian reasons. The main goal of this work is to produce machine learning models that predict the outcome of a mammography from a reduced set of annotated mammography findings. In the study we used a data set consisting of 348 consecutive breast masses that underwent image guided or surgical biopsy performed between October 2005 and December 2007 on 328 female subjects. The main conclusions are threefold: (1) automatic classification of a mammography, independent on information about mass density, can reach equal or better results than the classification performed by a physician; (2) mass density seems to be a good indicator of malignancy, as previous studies suggested; (3) a machine learning model can predict mass density with a quality as good as the specialist blind to biopsy, which is one of our main contributions. Our model can predict malignancy in the absence of the mass density attribute, since we can fill up this attribute using our mass density predictor. PMID:24363962

  1. Automated Analysis of Mammography Phantom Images

    NASA Astrophysics Data System (ADS)

    Brooks, Kenneth Wesley

    The present work stems from the hypothesis that humans are inconsistent when making subjective analyses of images and that human decisions for moderately complex images may be performed by a computer with complete objectivity, once a human acceptance level has been established. The following goals were established to test the hypothesis: (1) investigate observer variability within the standard mammographic phantom evaluation process; (2) evaluate options for high-resolution image digitization and utilize the most appropriate technology for standard mammographic phantom film digitization; (3) develop a machine-based vision system for evaluating standard mammographic phantom images to eliminate effects of human variabilities; and (4) demonstrate the completed system's performance against human observers for accreditation and for manufacturing quality control of standard mammographic phantom images. The following methods and procedures were followed to achieve the goals of the research: (1) human variabilities in the American College of Radiology accreditation process were simulated by observer studies involving 30 medical physicists and these were compared to the same number of diagnostic radiologists and untrained control group of observers; (2) current digitization technologies were presented and performance test procedures were developed; three devices were tested which represented commercially available high, intermediate and low-end contrast and spatial resolution capabilities; (3) optimal image processing schemes were applied and tested which performed low, intermediate and high-level computer vision tasks; and (4) the completed system's performance was tested against human observers for accreditation and for manufacturing quality control of standard mammographic phantom images. The results from application of the procedures were as follows: (1) the simulated American College of Radiology mammography accreditation program phantom evaluation process demonstrated

  2. Breast cancer and mammography: knowledge, attitudes, practices and patient satisfaction post-mammography at the San Fernando General Hospital, Trinidad.

    PubMed

    Gosein, Maria A; Pinto Pereira, Snehal M; Narinesingh, Dylan; Ameeral, Anthony

    2014-02-01

    Self-administered questionnaires were completed by 314 Trinidadian women, 40 years and older, to ascertain their breast cancer knowledge, attitudes, and practices. Those with higher education had greater knowledge of the benefits of early breast cancer detection (p < .01) and knew that an abnormal mammography result (p = .01) or recall (p < .01) was not necessarily indicative of breast cancer. Inaccurate beliefs particularly that breast compression causes cancer were more likely among those with the least education (p = .04). Obesity and alcohol were identified as risk factors by 29.3% and 12.4%, respectively. Over two-thirds (70%) of mammograms were primarily the doctor's decision. Over 90% of women were satisfied post-mammography, most (94.6%) with plans for future use. Some (15.6%) reported pain and 48.7% reported discomfort, with over 70% of these finding the examination less painful than anticipated. Targeted culturally sensitive awareness campaigns are needed. Clinicians must be sensitized to their importance in recommending mammography. Data on patient satisfaction and pain perception can be publicized to encourage women who are hesitant about mammography. PMID:24509017

  3. Experience with a proposed teleradiology system for digital mammography

    NASA Astrophysics Data System (ADS)

    Saulnier, Emilie T.; Mitchell, Robert J.; Abdel-Malek, Aiman A.; Dudding, Kathryn E.

    1995-05-01

    Teleradiology offers significant improvement in efficiency and effectiveness over current practices in traditional film/screen-based diagnosis. In the context of digital mammography, the increasing number of women who need to be screened for breast cancer, including those in remote rural regions, make the advantages of teleradiology especially attractive for digital mammography. At the same time, the size and resolution of digital mammograms are among the most challenging to support in a cost effective teleradiology system. This paper describes a teleradiology architecture developed for use with digital mammography by GE Corporate Research and Development in collaboration with Massachusetts General Hospital under National Cancer Institute (NCI/NIH) grant number R01 CA60246-01. Experience with a testbed prototype is described. The telemammography architecture is intended to consist of a main mammography diagnostic site serving several remote screening sites. As patient exams become available, they are forwarded by an image server to the diagnostic site over a WAN communications link. A radiologist at the diagnostic site views a patient exam as it arrives, interprets it, and then relays a report back to the technician at the remote site. A secondary future scenario consists of mobile units which forward images to a remote site, which then forwards them to the main diagnostic site. The testbed architecture is based on the Digital Imaging and Communications in Medicine (DICOM) standard, created by the American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA). A specification of vendor-independent data formats and data transfer services for digital medical images, DICOM specifies a protocol suite starting at the application layer downward, including the TCP/IP layers. The current DICOM definition does not provide an information element that is specifically tailored to mammography, so we have used the DICOM secondary capture data format

  4. CJS debate: Is mammography useful in average-risk screening for breast cancer?

    PubMed Central

    Brackstone, Muriel; Latosinsky, Steven; Saettler, Elizabeth; George, Ralph

    2016-01-01

    Summary Given the recent debate over breast cancer screening that was reignited by the 25-year follow-up data from the Canadian National Breast Screening Study, the Canadian Journal of Surgery commissioned a group of Canadian experts to debate the value of screening mammography. We discuss the Canadian study and summarize the arguments in favour of and against screening mammography for average-risk patients. We also provide summary recommendations for the use of mammography. PMID:26574707

  5. Mammographic density is the main correlate of tumors detected on ultrasound but not on mammography.

    PubMed

    Häberle, Lothar; Fasching, Peter A; Brehm, Barbara; Heusinger, Katharina; Jud, Sebastian M; Loehberg, Christian R; Hack, Carolin C; Preuss, Caroline; Lux, Michael P; Hartmann, Arndt; Vachon, Celine M; Meier-Meitinger, Martina; Uder, Michael; Beckmann, Matthias W; Schulz-Wendtland, Rüdiger

    2016-11-01

    Although mammography screening programs do not include ultrasound examinations, some diagnostic units do provide women with both mammography and ultrasonography. This article is concerned with estimating the risk of a breast cancer patient diagnosed in a hospital-based mammography unit having a tumor that is visible on ultrasound but not on mammography. A total of 1,399 women with invasive breast cancer from a hospital-based diagnostic mammography unit were included in this retrospective study. For inclusion, mammograms from the time of the primary diagnosis had to be available for computer-assisted assessment of percentage mammographic density (PMD), as well as Breast Imaging Reporting and Data System (BIRADS) assessment of mammography. In addition, ultrasound findings were available for the complete cohort as part of routine diagnostic procedures, regardless of any patient or imaging characteristics. Logistic regression analyses were conducted to identify predictors of mammography failure, defined as BIRADS assessment 1 or 2. The probability that the visibility of a tumor might be masked at diagnosis was estimated using a regression model with the identified predictors. Tumors were only visible on ultrasound in 107 cases (7.6%). PMD was the strongest predictor for mammography failure, but age, body mass index and previous breast surgery also influenced the risk, independently of the PMD. Risk probabilities ranged from 1% for a defined low-risk group up to 40% for a high-risk group. These findings might help identify women who should be offered ultrasound examinations in addition to mammography. PMID:27389655

  6. Sister chromatid exchanges in peripheral lymphocytes after preoperative mammography

    SciTech Connect

    Husum, B.; Wulf, H.C.; Niebuhr, E.

    1981-09-01

    Examination of sister chromatid exchanges (SCE) in peripheral lymphocytes may be useful for evaluating in vivo exposure to chemical mutagens. In vitro exposure of human lymphocytes to low levels of ionizing radiation has failed to produce increased SCE rates. Scarcity of information about the SCE test system and in vivo exposure to radiation prompted the present study of SCE rates in peripheral lymphocytes in women investigated with mammography prior to operation because of a tumor of the breast. In 64 of a total of 131 women a mammography was performed before the operation. The two groups of patients were identical with respect to age, smoking habits, and incidence of malignancy of the mammary tumors. SCE rates were examined in 30 metaphases from each patient following cultivation of peripheral blood lymphocytes using the BrdU/Giemsa technique.

  7. Single photon counter for digital x-ray mammography tomosynthesis

    SciTech Connect

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

    2006-05-15

    Photon counting is an emerging detection technique that is promising for mammography tomosynthesis imagers. In photon counting systems, the value of each image pixel is equal to the number of photons that interact with the detector. In this research, we introduce the design and implementation of a low noise, photon counting pixel for digital mammography tomosynthesis in 0.18 {mu}m crystalline silicon complementary metal-oxide semiconductor technology. The design comprises of a low noise, charge-integrating amplifier, a low offset voltage comparator, a decision-making unit, a mode selector, and a pseudorandom counter. Theoretical calculations and simulation results of linearity, gain, and noise of the photon counting pixel are presented.

  8. A comparison of the performance of digital mammography systems

    SciTech Connect

    Monnin, P.; Gutierrez, D.; Bulling, S.; Guntern, D.; Verdun, F. R.

    2007-03-15

    An objective analysis of image quality parameters was performed for six digital mammography systems. The presampled modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) for the systems were determined at different doses, for 28 kVp with a Mo/Mo or W/Al target/filter combination and 2 mm of additional aluminium filtration. The flat-panel units have higher MTF and DQE in the mid to high frequency range than standard CR systems. The highest DQE, over the whole dose range, is for the slit-scanning direct photon counting system. Dual-side read CR can overcome the inherent x-ray absorption and signal collection limitations of standard CR mammography, improving the low-frequency DQE by 40%, to the same level as full-field systems, but it does not improve the poor spatial resolution of phosphor.

  9. An SVM Based Approach for the Analysis Of Mammography Images

    SciTech Connect

    Gan, X.; Kapsokalivas, L.; Skaliotis, A.; Steinhoefel, K.; Tangaro, S.

    2007-09-06

    Mammography is among the most popular imaging techniques used in the diagnosis of breast cancer. Nevertheless distinguishing between healthy and ill images is hard even for an experienced radiologist, because a single image usually includes several regions of interest (ROIs). The hardness of this classification problem along with the substantial amount of data, gathered from patients' medical history, motivates the use of a machine learning approach as part of a CAD (Computer Aided Detection) tool, aiming to assist radiologists in the characterization of mammography images. Specifically, our approach involves: i) the ROI extraction, ii) the Feature Vector extraction, iii) the Support Vector Machine (SVM) classification of ROIs and iv) the characterization of the whole image. We evaluate the performance of our approach in terms of the SVM's training and testing error and in terms of ROI specificity - sensitivity. The results show a relation between the number of features used and the SVM's performance.

  10. Motion artifacts in dual-energy contrast-enhanced mammography

    NASA Astrophysics Data System (ADS)

    Allec, Nicholas; Abbaszadeh, Shiva; Lewin, John M.; Karim, Karim S.

    2012-03-01

    Several strategies have been investigated to acquire both low- and high-energy images simultaneously for contrastenhanced mammography (CEM). However, for the dual-energy technique where the existing conventional mammography infrastructure can be leveraged, low- and high-energy images are acquired using two separate exposures and the finite time between image acquisition leads to motion artifacts in the combined image. Motion artifacts lead to greater noise in the combined image and affect image quality, however the relationship between them is not clear. In this study we examine motion artifacts in dual-energy CEM and their impact on anatomical noise in the combined image and tumor detectability. To study the impact of motion artifacts, a cascaded systems model is extended to include such motion artifacts. An ideal observer model is used to quantify the performance and CEM images from a previous clinical study are used for comparison of the extended model.

  11. A comparison of the performance of digital mammography systems.

    PubMed

    Monnin, P; Gutierrez, D; Bulling, S; Guntern, D; Verdun, F R

    2007-03-01

    An objective analysis of image quality parameters was performed for six digital mammography systems. The presampled modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) for the systems were determined at different doses, for 28 kVp with a Mo/Mo or W/Al target/filter combination and 2 mm of additional aluminium filtration. The flat-panel units have higher MTF and DQE in the mid to high frequency range than standard CR systems. The highest DQE, over the whole dose range, is for the slit-scanning direct photon counting system. Dual-side read CR can overcome the inherent x-ray absorption and signal collection limitations of standard CR mammography, improving the low-frequency DQE by 40%, to the same level as full-field systems, but it does not improve the poor spatial resolution of phosphor. PMID:17441236

  12. Mammography X-Ray Spectra Simulated with Monte Carlo

    SciTech Connect

    Vega-Carrillo, H. R.; Gonzalez, J. Ramirez; Manzanares-Acuna, E.; Hernandez-Davila, V. M.; Villasana, R. Hernandez; Mercado, G. A.

    2008-08-11

    Monte Carlo calculations have been carried out to obtain the x-ray spectra of various target-filter combinations for a mammography unit. Mammography is widely used to diagnose breast cancer. Further to Mo target with Mo filter combination, Rh/Rh, Mo/Rh, Mo/Al, Rh/Al, and W/Rh are also utilized. In this work Monte Carlo calculations, using MCNP 4C code, were carried out to estimate the x-ray spectra produced when a beam of 28 keV electrons did collide with Mo, Rh and W targets. Resulting x-ray spectra show characteristic x-rays and continuous bremsstrahlung. Spectra were also calculated including filters.

  13. [First results of mammography with a screen film (author's transl)].

    PubMed

    Paterok, E M; Säbel, M; Weishaar, J

    1979-01-01

    In order to find a convenient, "dose sparing" mammography method, 152 breasts were examined comparatively with a conventional film without intensifying screens (Definix Medical of Kodak) and with a screen film (screen: MR 50, film: Mammoray RP 3 PE FW of Agfa Gevaert). The quality of the low-dose pictures was generally satisfactory. With regard to the exposure to radiation of the breast which is considerably lower if a screen film is used, it seems necessary to develop an automatic exposure control for this method, to further ameliorate films and screens, and to optimize the technical conditions for mammography. The authors underline the possibility to use simultaneously the oblique exposure methods, which would be a further step towards a reduction of the dose. PMID:760273

  14. Nonlinear Elasto-Mammography for Characterization of Breast Tissue Properties

    PubMed Central

    Wang, Z. G.; Liu, Y.; Wang, G.; Sun, L. Z.

    2011-01-01

    Quantification of the mechanical behavior of normal and cancerous tissues has important implication in the diagnosis of breast tumor. The present work extends the authors' nonlinear elastography framework to incorporate the conventional X-ray mammography, where the projection of displacement information is acquired instead of full three-dimensional (3D) vector. The elastic parameters of normal and cancerous breast tissues are identified by minimizing the difference between the measurement and the corresponding computational prediction. An adjoint method is derived to calculate the gradient of the objective function. Simulations are conducted on a 3D breast phantom consisting of the fatty tissue, glandular tissue, and cancerous tumor, whose mechanical responses are hyperelastic in nature. The material parameters are identified with consideration of measurement error. The results demonstrate that the projective displacements acquired in X-ray mammography provide sufficient constitutive information of the tumor and prove the usability and robustness of the proposed method and algorithm. PMID:22235197

  15. An SVM Based Approach for the Analysis Of Mammography Images

    NASA Astrophysics Data System (ADS)

    Gan, X.; Kapsokalivas, L.; Skaliotis, A.; Steinhöfel, K.; Tangaro, S.

    2007-09-01

    Mammography is among the most popular imaging techniques used in the diagnosis of breast cancer. Nevertheless distinguishing between healthy and ill images is hard even for an experienced radiologist, because a single image usually includes several regions of interest (ROIs). The hardness of this classification problem along with the substantial amount of data, gathered from patients' medical history, motivates the use of a machine learning approach as part of a CAD (Computer Aided Detection) tool, aiming to assist radiologists in the characterization of mammography images. Specifically, our approach involves: i) the ROI extraction, ii) the Feature Vector extraction, iii) the Support Vector Machine (SVM) classification of ROIs and iv) the characterization of the whole image. We evaluate the performance of our approach in terms of the SVM's training and testing error and in terms of ROI specificity—sensitivity. The results show a relation between the number of features used and the SVM's performance.

  16. How should we interpret noncompliance with screening mammography?

    PubMed Central

    Bryant, H

    1996-01-01

    Primary care practitioners have an important role to play in recommending breast cancer screening to patients in the target age group. In this issue of CMAJ (see pages 1335 to 1343) Dr. Marie-Dominique Beaulieu and associates report the results of a program designed to maximize utilization of screening mammography. Only two thirds of eligible women for whom screening mammography was prescribed obtained a mammogram within the 2-month study period. However, when taken in context, this compliance rate is fairly encouraging. There are many possible reasons for noncompliance such as a need for more information or for repeated suggestions. Family physicians should not become disheartened in their efforts to increase the use of screening procedures and may find that collaboration with others in giving consistent messages will help to maximize screening rates within their patient population. PMID:8616738

  17. Screening Ultrasound in Women with Negative Mammography: Outcome Analysis

    PubMed Central

    Hwang, Ji-Young; Ko, Eun Young; Shin, Jung Hee; Hahn, Soo Yeon; Nam, Mee Young

    2015-01-01

    Purpose To show the results of an audit of screening breast ultrasound (US) in women with negative mammography in a single institution and to analyze US-detected cancers within a year and interval cancers. Materials and Methods During the year of 2006, 1974 women with negative mammography were screened with US in our screening center, and 1727 among them had pathologic results or any follow up breast examinations more than a year. We analyzed the distribution of Breast Imaging Reporting and Data System (BI-RADS) category and the performance outcome through follow up. Results Among 1727 women (age, 30-76 years, median 49.5 years), 1349 women (78.1%) showed dense breasts on mammography, 762 (44.1%) had previous breast US, and 25 women (1.4%) had a personal history of breast cancers. Test negatives were 94.2% (1.627/1727) [BI-RADS category 1 in 885 (51.2%), 2 in 742 (43.0%)]. The recall rate (=BI-RADS category 3, 4, 5) was 5.8%. Eight cancers were additionally detected with US (yield, 4.6 per 1000). The sensitivity, specificity, and positive predictive value (PPV1, PPV2) were 88.9%, 94.6%, 8.0%, and 28.0%, respectively. Eight of nine true positive cancers were stage I or in-situ cancers. One interval cancer was stage I cancer from BI-RADS category 2. Conclusion Screening US detected 4.6 additional cancers among 1000. The recall rate was 5.8%, which is in lower bound of acceptable range of mammography (5-12%), according to American College of Radiology standard. PMID:26256979

  18. Patient Care, Communication, and Safety in the Mammography Suite.

    PubMed

    Arnold, Leisa

    2016-09-01

    Producing high-quality mammograms requires excellent technical skills along with exemplary communication. Mammographers must be able to address differences in patients' mental states, body habitus, and physical ability to obtain an optimal examination. In addition, every mammographer must practice consistently with patient safety, care, and satisfaction in mind. This article discusses verbal and nonverbal communication strategies, barriers to communication, and the care and safety of patients in the mammography suite who present special challenges. PMID:27601710

  19. A task-based quality control metric for digital mammography.

    PubMed

    Bloomquist, A K Maki; Mainprize, J G; Mawdsley, G E; Yaffe, M J

    2014-11-01

    A reader study was conducted to tune the parameters of an observer model used to predict the detectability index (dʹ ) of test objects as a task-based quality control (QC) metric for digital mammography. A simple test phantom was imaged to measure the model parameters, namely, noise power spectrum,modulation transfer function and test-object contrast. These are then used ina non-prewhitening observer model, incorporating an eye-filter and internal noise, to predict dʹ. The model was tuned by measuring dʹ of discs in a four-alternative forced choice reader study. For each disc diameter, dʹ was used to estimate the threshold thicknesses for detectability. Data were obtained for six types of digital mammography systems using varying detector technologies and x-ray spectra. A strong correlation was found between measured and modeled values of dʹ, with Pearson correlation coefficient of 0.96. Repeated measurements from separate images of the test phantom show an average coefficient of variation in dʹ for different systems between 0.07 and 0.10. Standard deviations in the threshold thickness ranged between 0.001 and 0.017 mm. The model is robust and the results are relatively system independent, suggesting that observer model dʹ shows promise as a cross platform QC metric for digital mammography. PMID:25325670

  20. Behavioral Constructs and Mammography in Five Ethnic Groups

    PubMed Central

    Stewart, Susan L.; Rakowski, William; Pasick, Rena J.

    2010-01-01

    Intention, self-efficacy, perceived susceptibility, perceived benefits, and subjective norms are key constructs of health behavior theories; their predictive validity for cancer screening has not been ascertained in multiethnic populations. Participants were 1,463 African American, Chinese, Filipina, Latina, and White women aged 40 to 74 interviewed by telephone in their preferred languages. The relationship between base-line constructs and mammography 2 years later was assessed using multivariable logistic regression. Intention predicted mammography overall and among Whites (odds ratio [OR] = 5.0, 95% confidence interval [CI] = 2.4, 10), with racial/ethnic differences in association (p = .020). Self-efficacy predicted mammography overall and among Whites (OR = 3.5, 95% CI = 1.1, 11), with no racial/ethnic interaction. Perceived benefits and subjective norms were associated with screening overall and in some racial/ethnic groups. These results generally support cross-cultural applicability of four of the five constructs to screening with mixed predictive value of measures across racial/ethnic groups. Additional in-depth inquiry is required to refine assessment of constructs. PMID:19805790

  1. Toward a standard reference database for computer-aided mammography

    NASA Astrophysics Data System (ADS)

    Oliveira, Júlia E. E.; Gueld, Mark O.; de A. Araújo, Arnaldo; Ott, Bastian; Deserno, Thomas M.

    2008-03-01

    Because of the lack of mammography databases with a large amount of codified images and identified characteristics like pathology, type of breast tissue, and abnormality, there is a problem for the development of robust systems for computer-aided diagnosis. Integrated to the Image Retrieval in Medical Applications (IRMA) project, we present an available mammography database developed from the union of: The Mammographic Image Analysis Society Digital Mammogram Database (MIAS), The Digital Database for Screening Mammography (DDSM), the Lawrence Livermore National Laboratory (LLNL), and routine images from the Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen. Using the IRMA code, standardized coding of tissue type, tumor staging, and lesion description was developed according to the American College of Radiology (ACR) tissue codes and the ACR breast imaging reporting and data system (BI-RADS). The import was done automatically using scripts for image download, file format conversion, file name, web page and information file browsing. Disregarding the resolution, this resulted in a total of 10,509 reference images, and 6,767 images are associated with an IRMA contour information feature file. In accordance to the respective license agreements, the database will be made freely available for research purposes, and may be used for image based evaluation campaigns such as the Cross Language Evaluation Forum (CLEF). We have also shown that it can be extended easily with further cases imported from a picture archiving and communication system (PACS).

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

    PubMed Central

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

    2015-01-01

    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). PMID:26171373

  3. Quality control programme in mammography: second level quality controls.

    PubMed

    Nassivera, E; Nardin, L

    1997-06-01

    Mammography is the most reliable method by which to detect lesions in the breast. Since contrast between normal and pathological areas in the breast is extremely low, mammographic image quality should reach high standards without exceeding acceptable exposure levels for the breast. A quality control programme in mammography has been implemented. This programme is subdivided into two levels. The first consists of simple daily checks of image quality and film processing, while the second deals with more complex checks of mammographic unit, screen-film system, darkroom, illuminators, viewing conditions and reference dose determination. The values of all the parameters undergoing measurement are compared with the limiting values given by National and International Protocols. This paper describes the second level controls carried out every 6 months by the medical physicist. The parameters described are only those which have been studied and analysed in detail since the quality control programme in mammography was implemented. Such parameters (kilovoltage, focal spot dimension, half value layer, tube output, automatic exposure control system, screen-film characteristic curve and mean glandular dose) were measured during the period 1991-1995 and the results summarised. The values obtained prove the constant correct functioning of the equipment. PMID:9227255

  4. Image and Dose Simulation in Support of New Mammography Modalities

    SciTech Connect

    Kuruvilla Verghese

    2002-04-05

    This report summarizes the highlights of the research performed under the 2-year NEER grant from the Department of Energy. The primary outcome of the work was a new Monte Carlo code, MCMIS-DS, for Monte Carlo for Mammography Image Simulation including Differential Sampling. The code was written to generate simulated images and dose distributions from two different new digital x-ray imaging modalities, namely, synchrotron imaging (SI) and a slot geometry digital mammography system called Fisher Senoscan. A differential sampling scheme was added to the code to generate multiple images that included variations in the parameters of the measurement system and the object in a single execution of the code. The code is to serve multiple purposes; (1) to answer questions regarding the contribution of scattered photons to images, (2) for use in design optimization studies, and (3) to do up to second-order perturbation studies to assess the effects of design parameter variations and/or physical parameters of the object (the breast) without having to re-run the code for each set of varied parameters. The accuracy and fidelity of the code were validated by a large variety of benchmark studies using published data and also using experimental results from mammography phantoms on both imaging modalities.

  5. Spectral lesion characterization on a photon-counting mammography system

    NASA Astrophysics Data System (ADS)

    Erhard, Klaus; Fredenberg, Erik; Homann, Hanno; Roessl, Ewald

    2014-03-01

    Spectral X-ray imaging allows to differentiate between two given tissue types, provided their spectral absorption characteristics differ measurably. In mammography, this method is used clinically to determine a decomposition of the breast into adipose and glandular tissue compartments, from which the glandular tissue fraction and, hence, the volumetric breast density (VBD) can be computed. Another potential application of this technique is the characterization of lesions by spectral mammography. In particular, round lesions are relatively easily detected by experienced radiologists, but are often difficult to characterize. Here, a method is described that aims at discriminating cystic from solid lesions directly on a spectral mammogram, obtained with a calibrated spectral mammography system and using a hypothesis-testing algorithm based on a maximum likelihood approach. The method includes a parametric model describing the lesion shape, compression height variations and breast composition. With the maximum likelihood algorithm, the model parameters are estimated separately under the cyst and solid hypothesis. The resulting ratio of the maximum likelihood values is used for the final tissue characterization. Initial results using simulations and phantom measurements are presented.

  6. The acceptance and completion of mammography by older black women.

    PubMed Central

    Burack, R C; Liang, J

    1989-01-01

    We assessed the relation of patient characteristics, knowledge and beliefs to the utilization of mammography in an inner-city setting by 187 Black women over the age of 50. Thirty per cent of those who were offered mammography initially declined the offer and 40 per cent were subsequently unable to complete the procedure. Patient interviews were used to derive 27 potential knowledge and health belief predictor scales. In multiple regression analysis, two health belief scales and two knowledge scales accounted for 15 per cent of the observed variance in the model of acceptance. The strongest predictor of subsequent completion was initial acceptance. The presence of breast symptoms and two health belief scales together with initial acceptance accounted for 26 per cent of variance in the model of completion. These results suggest that the successful accomplishment of mammography requires coordinated efforts at the level of the provider, patient, and setting. Health beliefs may influence the patient's behavior in this process, but their effect appears to be modest. PMID:2729469

  7. Optimization of peak kilovoltage and spectral shape for digital mammography

    NASA Astrophysics Data System (ADS)

    Fahrig, Rebecca; Maidment, Andrew D. A.; Yaffe, Martin J.

    1992-06-01

    X-ray mammography is one of the most demanding radiological techniques, simultaneously requiring excellent image quality and low dose to the breast. In current mammographic practice, both image quality and dose are found to vary over a wide range of values. Previous attempts to define the optimum operating parameters for mammography systems have been limited due to the lack of realistic attenuation coefficients and absorbed dose data. These data are now available, and have been incorporated into an energy transport model which describes the image acquisition process. The model includes measured x-ray spectra and considers beam filtration, breast thickness and composition, lesion size and composition, scatter, grid transmission, and the production and propagation of light in a phosphor-based image receptor. The applied kilovoltage for molybdenum and tungsten target x-ray sources with various spectral filters and average breast composition (50% adipose, 50% fibroglandular) has been optimized with respect to signal-to-noise ratio and absorbed dose and was found to vary between 19 and 29 kVp as breast thickness increased from 4 to 8 cm. Preliminary results for various breast compositions and lesions, and experimental verification of the model are presented. The model may be extended to include either mammographic film or new detector designs for digital mammography.

  8. A task-based quality control metric for digital mammography

    NASA Astrophysics Data System (ADS)

    Maki Bloomquist, A. K.; Mainprize, J. G.; Mawdsley, G. E.; Yaffe, M. J.

    2014-11-01

    A reader study was conducted to tune the parameters of an observer model used to predict the detectability index (dʹ ) of test objects as a task-based quality control (QC) metric for digital mammography. A simple test phantom was imaged to measure the model parameters, namely, noise power spectrum, modulation transfer function and test-object contrast. These are then used in a non-prewhitening observer model, incorporating an eye-filter and internal noise, to predict dʹ. The model was tuned by measuring dʹ of discs in a four-alternative forced choice reader study. For each disc diameter, dʹ was used to estimate the threshold thicknesses for detectability. Data were obtained for six types of digital mammography systems using varying detector technologies and x-ray spectra. A strong correlation was found between measured and modeled values of dʹ, with Pearson correlation coefficient of 0.96. Repeated measurements from separate images of the test phantom show an average coefficient of variation in dʹ for different systems between 0.07 and 0.10. Standard deviations in the threshold thickness ranged between 0.001 and 0.017 mm. The model is robust and the results are relatively system independent, suggesting that observer model dʹ shows promise as a cross platform QC metric for digital mammography.

  9. Characteristics of YouTube™ Videos Related to Mammography.

    PubMed

    Basch, Corey H; Hillyer, Grace Clarke; MacDonald, Zerlina L; Reeves, Rachel; Basch, Charles E

    2015-12-01

    With a monthly total of more than one billion unique visitors, YouTube™ is one of the Internet's most visited websites and contributes to the growing amount of health-related information on the Internet. The purpose of this study was to analyze coverage of mammography screening in popular YouTube™ videos. A total of 173 videos were included in the analysis. Compared with professionally created videos, consumer-created videos had a significantly greater number of comments (>9 comments 38.0% for consumer vs. 11.8% for professional videos, p=<0.001). Videos created by professionals more often portrayed general mammography information (97.1 vs. 88.7%) compared to those created by consumers. The vast majority of videos presented general information (93.6%) related to mammography, and almost two thirds addressed preparing for the test. Less than 20% dealt with other types of examinations. Approximately 30% discussed pain associated with the examination (35.3%) and addressed issues of anxiety (32.4%) and fear (29.5%). Nearly half of the videos presented information about the test results (46.2%). Over 25% covered medical or family history. The majority did not pertain to a specific age group. Future research should focus on analyzing the accuracy of the information in the videos. PMID:25502853

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

    PubMed

    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). PMID:26171373

  11. Comparison of slot scanning digital mammography system with full-field digital mammography system

    SciTech Connect

    Lai, C.-J.; Shaw, Chris C.; Geiser, William; Chen, Lingyun; Arribas, Elsa; Stephens, Tanya; Davis, Paul L.; Ayyar, Geetha P.; Dogan, Basak E.; Nguyen, Victoria A.; Whitman, Gary J.; Yang, Wei T.

    2008-06-15

    The purpose of this study was to evaluate and compare microcalcification detectability of two commercial full-field digital mammography (DM) systems. The first unit was a flat panel based DM system (FFDM) which employed an anti-scatter grid method to reject scatter, and the second unit was a charge-coupled device-based DM system (SSDM) which used scanning slot imaging geometry to reduce scatter radiation. Both systems have comparable scatter-to-primary ratios. In this study, 125-160 and 200-250 {mu}m calcium carbonate grains were used to simulate microcalcifications and imaged by both DM systems. The calcium carbonate grains were overlapped with a 5-cm-thick 50% adipose/50% glandular simulated breast tissue slab and an anthropomorphic breast phantom (RMI 165, Gammex) for imaging at two different mean glandular dose levels: 0.87 and 1.74 mGy. A reading study was conducted with seven board certified mammographers with images displayed on review workstations. A five-point confidence level rating was used to score each detection task. Receiver operating characteristic (ROC) analysis was performed and the area under the ROC curve (A{sub z}) was used to quantify and compare the performances of these two systems. The results showed that with the simulated breast tissue slab (uniform background), the SSDM system resulted in higher A{sub z}'s than the FFDM system at both MGD levels with the difference statistically significant at 0.87 mGy only. With the anthropomorphic breast phantom (tissue structure background), the SSDM system performed better than the FFDM system at 0.87 mGy but worse at 1.74 mGy. However, the differences were not found to be statistically significant.

  12. Comparison of slot scanning digital mammography system with full-field digital mammography system

    PubMed Central

    Lai, Chao-Jen; Shaw, Chris C.; Geiser, William; Chen, Lingyun; Arribas, Elsa; Stephens, Tanya; Davis, Paul L.; Ayyar, Geetha P.; Dogan, Basak E.; Nguyen, Victoria A.; Whitman, Gary J.; Yang, Wei T.

    2008-01-01

    The purpose of this study was to evaluate and compare microcalcification detectability of two commercial full-field digital mammography (DM) systems. The first unit was a flat panel based DM system (FFDM) which employed an anti-scatter grid method to reject scatter, and the second unit was a charge-coupled device-based DM system (SSDM) which used scanning slot imaging geometry to reduce scatter radiation. Both systems have comparable scatter-to-primary ratios. In this study, 125–160 and 200–250 μm calcium carbonate grains were used to simulate microcalcifications and imaged by both DM systems. The calcium carbonate grains were overlapped with a 5-cm-thick 50% adipose∕50% glandular simulated breast tissue slab and an anthropomorphic breast phantom (RMI 165, Gammex) for imaging at two different mean glandular dose levels: 0.87 and 1.74 mGy. A reading study was conducted with seven board certified mammographers with images displayed on review workstations. A five-point confidence level rating was used to score each detection task. Receiver operating characteristic (ROC) analysis was performed and the area under the ROC curve (Az) was used to quantify and compare the performances of these two systems. The results showed that with the simulated breast tissue slab (uniform background), the SSDM system resulted in higher Az’s than the FFDM system at both MGD levels with the difference statistically significant at 0.87 mGy only. With the anthropomorphic breast phantom (tissue structure background), the SSDM system performed better than the FFDM system at 0.87 mGy but worse at 1.74 mGy. However, the differences were not found to be statistically significant. PMID:18649467

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

    SciTech Connect

    Brateman, Libby F.; Heintz, Philip H.

    2015-02-15

    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

  14. Mammography utilization pattern throughout the state of Arkansas: a challenge for the future.

    PubMed

    Jazieh, A R; Soora, I

    2001-08-01

    The Mammography Data Collection Project (MDCP) was aimed at determining the 1997 mammography rate and screening practice patterns throughout the state of Arkansas. The MDCP conducted a comprehensive survey of mammography centers to collect individual patient demographic data, and mammography data. Data elements pertinent to patients' age, race, insurance, type of mammogram, date of mammogram, and the zip code were obtained from participating centers. Analysis was performed to determine the mammography rate by age group and areas of residence. Of the 112 eligible mammography centers contacted, 92 centers (82%) participated. A total of 157,976 mammography data sets were obtained. The total number of women imaged was 148,586 with 90% of them over the age of 40 years. The mammography rate was 24.1% for women 50 years of age and older and 19.4% for women 40-49 years of age. Most of the women imaged had private insurance (52%). This study revealed that only a small fraction of women ages 40 years and older obtained annual mammograms in 1997, thus highlighting the need for intensifying efforts to increase the utilization of this lifesaving test. PMID:11488514

  15. Cultural Views, Language Ability, and Mammography Use in Chinese American Women

    ERIC Educational Resources Information Center

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

    2009-01-01

    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…

  16. Attitudes and Beliefs Associated with Mammography in a Multiethnic Population in Israel

    ERIC Educational Resources Information Center

    Baron-Epel, Orna

    2010-01-01

    This article highlights beliefs, attitudes, and barriers that are associated with mammography use in four distinct cultural and ethnic groups in Israel: veteran, ultra-orthodox, and immigrant Jewish and Arab women. A random telephone survey of 1,550 women was performed. Information from claims records concerning mammography use was obtained for…

  17. Latinas’ Mammography Intention Following a Home-Based Promotores–Led Intervention

    PubMed Central

    Scheel, John R.; Molina, Yamile; Briant, Katherine J.; Ibarra, Genoveva; Lehman, Constance D.; Thompson, Beti

    2015-01-01

    Despite increases in mammography rates among Latinas, screening rates remain lower than in non-Latina Whites (NLW) and Latinas typically present with breast cancer at a later stage. Trained lay community workers (promotores) have been successfully used to increase screening mammography intention in Latinas. Little is known, however, about the potential mechanisms of these interventions, such as increased breast cancer knowledge (knowledge) and social interactions concerning mammography practices (social engagement). This prospective pre-post study examined this gap in the literature by 1) documenting changes in knowledge and social engagement after receipt of a promotores-based intervention; and 2) establishing if post-intervention knowledge and social engagement predicted mammography intention, after adjusting for socio-demographic and lifetime mammography history. There were significant increases in knowledge and social engagement about mammography. Finally, post-intervention social engagement was a significant predictor of mammography intention. Future promotores-based interventions should focus on enhancing social engagement to improve mammography intention and use. PMID:26063674

  18. Peripheral cues and involvement level: influences on acceptance of a mammography message.

    PubMed

    Kirby, S D; Ureda, J R; Rose, R L; Hussey, J

    1998-01-01

    The elaboration likelihood model (ELM) suggests that some communication elements are processed differently depending on a receiver's involvement with the message topic. We hypothesized that women with high levels of breast cancer involvement would be more influenced by a mammography message's arguments than by the message's peripheral cues and, conversely, that women with low levels of involvement would be more influenced by a mammography message's peripheral cues than by the message's arguments. We exposed 89 low-income African American women aged 40 to 65 years to two repetitions of a mammography promotion public service announcement embedded as a commercial within a television talk show. We used a 2 (involvement level) x 2 (argument strength) x 2 (peripheral cue favorability) factorial posttest-only design. The analysis detected a significant main effect for involvement and an interaction between peripheral cue favorability and involvement. High-involvement women reported stronger intentions than did low-involvement women to seek additional mammography information, regardless of argument strength or cue favorability. Low-involvement women reported stronger intentions to seek more mammography information only when exposed to the favorable cue condition. The analysis detected no effect for argument strength in high- or low-involvement women. The ELM appears useful for designing mammography messages. As many women may have low involvement with breast cancer, mammography promotion messages that include favorable peripheral cues may be more likely to impact mammography information seeking than argument-based-only messages. PMID:10977249

  19. Does Distance Matter? Distance to Mammography Facilities and Stage at Diagnosis of Breast Cancer in Kentucky

    ERIC Educational Resources Information Center

    Huang, Bin; Dignan, Mark; Han, Daikwon; Johnson, Owen

    2009-01-01

    Background: National and regional data indicate that breast cancer early detection is low in Kentucky, especially rural regions, perhaps because access to mammography services can be problematic. Objective: This study examined the distance between residences of women diagnosed with breast cancer and the nearest mammography facility, as a risk…

  20. Applicability of ACR breast dosimetry methodology to a digital mammography system

    SciTech Connect

    Tomon, John J.; Johnson, Thomas E.; Swenson, Kristin N.; Schauer, David A.

    2006-03-15

    Determination of mean glandular dose (MGD) to breast tissue is an essential aspect of mammography equipment evaluations and exposure controls. The American College of Radiology (ACR) Quality Control Manual outlines the procedure for MGD determination in screen-film mammography based upon conversions of entrance skin exposures (ESEs) measured with an ionization chamber (IC). The development of digital mammography has increased with the demand for improved object resolution and tissue contrast. This change in image receptor from screen-film to a solid-state detector has led to questions about the applicability of the ACR MGD methodology to digital mammography. This research has validated the applicability of the ACR MGD methodology to digital mammography in the GE digital mammography system Senographe 2000D[reg]. MGD was determined using light output measurements from thermoluminescent dosimeters (MGD{sub TL}), exposure measurements from an IC (MGD{sub IC}) and conversion factors from the ACR Mammography Quality Control Manual. MGD{sub TL} and MGD{sub IC} data indicate that there is a statistically significant difference between the two measurements with the Senographe 2000D[reg]. However, the applicability of the ACR's methodology was validated by calculating MGD at various depths in a 50/50 breast phantom. Additionally, the results of backscatter measurements from the image receptors of both mammography modalities indicate there is a difference (all P values <0.001) in the radiation backscattered from each image receptor.

  1. Cultural Views, Language Ability, and Mammography Use in Chinese American Women

    PubMed Central

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

    2013-01-01

    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. PMID:19233947

  2. Characterization of a CMOS detector for limited-view mammography

    NASA Astrophysics Data System (ADS)

    Elbakri, Idris A.

    2007-03-01

    Sensors based on complementary metal oxide semiconductors (CMOS) technology have recently been considered for mammography applications. CMOS offers the advantages of lower cost and relative ease of fabrications. We report on the evaluation of a CMOS imager (C9730DK, Hamamatsu Corporation) with 14-bit digitization and 50-micron detector element (del) resolution. The imager has an active area of 5 x 5 cm and uses 160-micron layer of needle-crystal CsI (55 mg/cc) to convert x-rays to light. The detector is suitable for spot and specimen imaging and image-guided biopsy. To evaluate resolution performance, we measured the modulation transfer function (MTF) using the slanted edge method. We also measured the normalized noise power spectrum (NNPS) using Fourier analysis of uniform images. The MTF and NNPS were used to determine the detective quantum efficiency (DQE) of the detector. The detector was characterized using a molybdenum target/molybdenum filter mammography x-ray source operated at 28 kVp with 44mm of PMMA added to mimic clinical beam quality (HVL = 0.62 mm Al). Our analysis showed that the imager had a linear response. The MTF was 28% at 5 lp/mm and 8% at 10 lp/mm. The product of the NNPS and exposure showed that the detector was quantum limited. The DQE near 0 lp/mm was in the 55-60% range. The DQE and MTF performance of the CMOS detector are comparable to published values for other digital mammography detectors.

  3. Optimal x-ray spectra for screen-film mammography.

    PubMed

    Jennings, R J; Eastgate, R J; Siedband, M P; Ergun, D L

    1981-01-01

    Theoretical and experimental techniques have been used to study optimal x-ray for screen-film mammography. A simple model of mammographic imaging predicts optimum x-ray energies which are significantly higher than the K-characteristic energies of Mo. A subjective comparison of x-ray spectra from Mo-anode and W-anode tubes indicates that spectra produced by a W-anode tube filtered with materials of atomic number just above that of Mo are more suitable for screen-film mammography than spectra produced by the Mo-anode/Mo-filter system. The imaging performance of K-edge filtered, W-anode tube spectra was compared to the performance of Mo-anode spectra using phantom measurements and mastectomy specimen radiography. It was shown that optimal W-anode spectra can produce equal contrast with an exposure reduction of a factor of two to three, a dose reduction of a factor of two, and equal or reducing tube loading, compared to Mo-anode spectra. A computer simulation was carried out to extend the initial, monoenergetic theory to the case of real, polychromatic sources. The effects of varying filter material and thickness, tube operating potential, and breast thickness were all studied. Since W-anode x-ray tubes are considered to be better for Xerox mammography than Mo-anode tubes, this study has shown that both Xerox and screen-film techniques can be performed optimally with a single, properly designed, W-anode x-ray tube. PMID:7290015

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

    SciTech Connect

    Zhang, J; Szabunio, M

    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

  5. [New mammography technologies and their impact on radiation dose].

    PubMed

    Chevalier del Rio, M

    2013-12-01

    This article reviews new mammography technologies resulting from advances in digital detectors and processing techniques. Most are just starting to be commercialized or are in the clinical trial phase. The results of clinical trials with the new 2D techniques (contrast-enhanced techniques or stereotactic techniques) show they are useful for diagnosing cancer. However, the greater complexity of the image acquisition process suggests that their use will be limited to particular cases such as inconclusive lesions or women with high risk for developing breast cancer. Among the 3D technologies (breast tomography and breast tomosynthesis), only breast tomosynthesis has been implemented in clinical practice, so it is the only technique for which it is possible to know the sensitivity, specificity, and radiation dose delivered. This article describes the principles underlying the way breast tomosynthesis works and the techniques used for image acquisition and reconstruction. It also summarizes the main results obtained in clinical studies, which generally show that breast tomosynthesis increases the breast cancer detection rate while decreasing the recall rate and number of biopsies taken. The protocol for breast tomosynthesis approved by the Food and Drug Administration (USA) consists of two conventional mammography projections for each breast and two tomosynthesis projections for each breast. This means multiplying the risks of inducing cancer and death associated with 2D mammography by a factor between 2 and 3 (2.6-3.3 and 0.7-0.9 per 100,000 women exposed when 50 years old, respectively). The protocol for breast tomosynthesis examinations is one of the aspects that is essential to determine when including tomosynthesis in screening programs and routine breast imaging. PMID:24246883

  6. Predictors of Self-reported Adherence to Mammography Screening Guidelines in West Virginia Women Visiting a Stationary Facility

    PubMed Central

    Vyas, Ami; Madhavan, Suresh; Kelly, Kimberly; Metzger, Aaron; Schreiman, Judith; Remick, Scott

    2016-01-01

    The objectives of this study are to describe the characteristics of women age 40 years and above who utilize a stationary mammography facility and to determine the predictors of self-reported adherence to mammography screening guidelines. Data were analyzed using the expanded version of Andersen Behavioral Model of Healthcare Utilization. Of the 1,104 women included in the analysis, 1,019 women (92.3%) reported having had a mammogram in the past two years. In logistic regression after adjusting for all the variables, older age, having health insurance, not having delayed medical care due to transportation problem, being adherent to clinical breast exam (CBE), Pap test and other routine screenings and having positive views about mammography screening significantly predicted adherence to mammography screening. Adherence to mammography screening was very high in this sample, and enabling and need-related factors and positive views about mammography screening predicted adherence to mammography screening guidelines. PMID:24902464

  7. Knowledge Discovery from Structured Mammography Reports Using Inductive Logic Programming

    PubMed Central

    Burnside, Elizabeth S.; Davis, Jesse; Costa, Vítor Santos; de Castro Dutra, Inês; 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. PMID:16779009

  8. Digital Mammography with a Mosaic of CCD Arrays

    NASA Technical Reports Server (NTRS)

    Jalink, Antony, Jr. (Inventor); McAdoo, James A. (Inventor)

    1998-01-01

    A digital mammography device uses a mosaic of electronic digital imaging arrays to scan an x-ray image is discussed. The mosaic of arrays is repositioned several times to expose different portions of the image, until the entire image is scanned. The data generated by the arrays during each exposure is stored in a computer. After the final exposure, the computer combines data of the several partial images to produce a composite of the original x-ray image. An aperture plate is used to reduce scatter and the overall exposure of the patient to x-rays.

  9. Compositional breast imaging using a dual-energy mammography protocol

    SciTech Connect

    Laidevant, Aurelie D.; Malkov, Serghei; Flowers, Chris I.; Kerlikowske, Karla; Shepherd, John A.

    2010-01-15

    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

  10. Breast cancer classification with mammography and DCE-MRI

    NASA Astrophysics Data System (ADS)

    Yuan, Yading; Giger, Maryellen L.; Li, Hui; Sennett, Charlene

    2009-02-01

    Since different imaging modalities provide complementary information regarding the same lesion, combining information from different modalities may increase diagnostic accuracy. In this study, we investigated the use of computerized features of lesions imaged via both full-field digital mammography (FFDM) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the classification of breast lesions. Using a manually identified lesion location, i.e. a seed point on FFDM images or a ROI on DCE-MRI images, the computer automatically segmented mass lesions and extracted a set of features for each lesion. Linear stepwise feature selection was firstly performed on single modality, yielding one feature subset for each modality. Then, these selected features served as the input to another feature selection procedure when extracting useful information from both modalities. The selected features were merged by linear discriminant analysis (LDA) into a discriminant score. Receiver operating characteristic (ROC) analysis was used to evaluate the performance of the selected feature subset in the task of distinguishing between malignant and benign lesions. From a FFDM database with 321 lesions (167 malignant and 154 benign), and a DCE-MRI database including 181 lesions (97 malignant and 84 benign), we constructed a multi-modality dataset with 51 lesions (29 malignant and 22 benign). With leave-one-out-by-lesion evaluation on the multi-modality dataset, the mammography-only features yielded an area under the ROC curve (AUC) of 0.62 +/- 0.08 and the DCE-MRI-only features yielded an AUC of 0.94+/-0.03. The combination of these two modalities, which included a spiculation feature from mammography and a kinetic feature from DCE-MRI, yielded an AUC of 0.94. The improvement of combining multi-modality information was statistically significant as compared to the use of mammography only (p=0.0001). However, we failed to show the statistically significant improvement as

  11. Comparison of 2D versus 3D mammography with screening cases: an observer study

    NASA Astrophysics Data System (ADS)

    Fernandez, James Reza; Deshpande, Ruchi; Hovanessian-Larsen, Linda; Liu, Brent

    2012-02-01

    Breast cancer is the most common type of non-skin cancer in women. 2D mammography is a screening tool to aid in the early detection of breast cancer, but has diagnostic limitations of overlapping tissues, especially in dense breasts. 3D mammography has the potential to improve detection outcomes by increasing specificity, and a new 3D screening tool with a 3D display for mammography aims to improve performance and efficiency as compared to 2D mammography. An observer study using human studies collected from was performed to compare traditional 2D mammography with this new 3D mammography technique. A prior study using a mammography phantom revealed no difference in calcification detection, but improved mass detection in 2D as compared to 3D. There was a significant decrease in reading time for masses, calcifications, and normals in 3D compared to 2D, however, as well as more favorable confidence levels in reading normal cases. Data for this current study is currently being obtained, and a full report should be available in the next few weeks.

  12. Predicting stages of adoption of mammography screening in a general population.

    PubMed

    Chamot, E; Charvet, A I; Perneger, T V

    2001-10-01

    This study assessed predictions of the Transtheoretical Model (TTM) of behaviour change applied to mammography screening in a random sample of 909 Swiss women aged 40-80 years. We examined stages of mammography adoption, positive and negative attitudes toward screening (pros, cons and decisional balance), and additional predisposing, enabling and reinforcing characteristics. The stage of mammography adoption was defined for 827 women, of whom 46.9% reported on-schedule screening (action 10.2%, maintenance 29.7%, relapse risk 7.0%) and 53% did not (precontemplation 23.1%, contemplation 13.5%, relapse 16.4%). Independent factors associated with more advanced stages (from precontemplation to maintenance) were high pros, low cons, belief that mammography screening is recommended every 2 years, high objective risk of breast cancer, being married and higher income. Independent correlates of stage regression (from action/maintenance to relapse) were high cons, belief that mammography screening is recommended every 4 years or not at all and not being married. Perceived utility of an organised screening programme and reluctance to pay for a mammogram were independently associated with only certain transitions between stages of adoption. Our results confirm the applicability of the TTM to mammography screening in a European context. They also suggest that constructs other than pros and cons may be useful in predicting mammography use. PMID:11576843

  13. Diagnostic clinical benefits of digital spot and digital 3D mammography following analysis of screening findings

    NASA Astrophysics Data System (ADS)

    Lehtimaki, Mari; Pamilo, Martti; Raulisto, Leena; Roiha, Marja; Kalke, Martti; Siltanen, Samuli; Ihamäki, Timo

    2003-05-01

    The purpose of this study is to find out the impact of 3-dimensional digital mammography and digital spot imaging following analysis of the abnormal findings of screening mammograms. Over a period of eight months, digital 3-D mammography imaging TACT Tuned Aperture Computed Tomography+, digital spot imaging (DSI), screen-film mammography imaging (SFM) and diagnostic film imaging (DFM) examinations were performed on 60 symptomatic cases. All patients were recalled because it was not possible to exclude the presence of breast cancer on screening films. Abnormal findings on the screening films were non-specific tumor-like parenchymal densities, parenchymal asymmetries or distortions with or without microcalcifications or just microcalcifications. Mammography work-up (film imaging) included spot compression and microfocus magnification views. The 3-D softcopy reading in all cases was done with Delta 32 TACT mammography workstation, while the film images were read using a mammography-specific light box. During the softcopy reading only windowing tools were allowed. The result of this study indicates that the clinical diagnostic image quality of digital 3-D and digital spot images are better than in film images, even in comparison with diagnostic work-up films. Potential advantages are to define if the mammography finding is caused by a real abnormal lesion or by superimposition of normal parenchymal structures, to detect changes in breast tissue which would otherwise be missed, to verify the correct target for biopsies and to reduce the number of biopsies performed.

  14. Characterization of scatter radiation in cone beam CT mammography

    NASA Astrophysics Data System (ADS)

    Liu, Bob; Glick, Stephen J.; Groiselle, Corinne

    2005-04-01

    Cone beam CT mammography (CBCTM) is an emerging breast imaging technology and is currently under intensive investigation [1-3]. One of the major challenges in CBCTM is to understand the characteristics of scatter radiation and to find ways to reduce or correct its degrading effects. Since the breast shape, geometry and image formation process are significantly different from conventional mammography, all system components and parameters such as target/filter combination, kVp range, source to image distance, detector design etc. should be examined and optimized. In optimizing CBCTM systems, it is important to have knowledge of how different imaging parameters affect the recorded scatter within the image. In this study, a GEANT4 based Monte Carlo simulation package (GATE) was used to investigate the scatter magnitude and its" distribution in CBCTM. The influences of different air gaps, kVp settings, breast sizes and breast composition on the scatter primary ratio (SPR) and scatter profiles were examined. In general, the scatter to primary ratio (SPR) is strongly dependent on the breast size and air gap, and is only moderately dependent on the kVp setting and breast composition. These results may be used for optimization of CBCTM systems, as well as for developing scatter correction methods.

  15. Priming cases disturb visual search patterns in screening mammography

    NASA Astrophysics Data System (ADS)

    Lewis, Sarah J.; Reed, Warren M.; Tan, Alvin N. K.; Brennan, Patrick C.; Lee, Warwick; Mello-Thoms, Claudia

    2015-03-01

    Rationale and Objectives: To investigate the effect of inserting obvious cancers into a screening set of mammograms on the visual search of radiologists. Previous research presents conflicting evidence as to the impact of priming in scenarios where prevalence is naturally low, such as in screening mammography. Materials and Methods: An observer performance and eye position analysis study was performed. Four expert breast radiologists were asked to interpret two sets of 40 screening mammograms. The Control Set contained 36 normal and 4 malignant cases (located at case # 9, 14, 25 and 37). The Primed Set contained the same 34 normal and 4 malignant cases (in the same location) plus 2 "primer" malignant cases replacing 2 normal cases (located at positions #20 and 34). Primer cases were defined as lower difficulty cases containing salient malignant features inserted before cases of greater difficulty. Results: Wilcoxon Signed Rank Test indicated no significant differences in sensitivity or specificity between the two sets (P > 0.05). The fixation count in the malignant cases (#25, 37) in the Primed Set after viewing the primer cases (#20, 34) decreased significantly (Z = -2.330, P = 0.020). False-Negatives errors were mostly due to sampling in the Primed Set (75%) in contrast to in the Control Set (25%). Conclusion: The overall performance of radiologists is not affected by the inclusion of obvious cancer cases. However, changes in visual search behavior, as measured by eye-position recording, suggests visual disturbance by the inclusion of priming cases in screening mammography.

  16. CCD mosaic technique for large-field digital mammography

    SciTech Connect

    Jalink, A.; McAdoo, J.; Halama, G.; Liu, H.

    1996-06-01

    The authors present a novel technique for large-field digital mammography. The instrument uses a mosaic of electronic digital imaging [charge coupled device (CCD)] arrays, novel area scanning, and a radiation exposure and scatter reducing mechanism. The imaging arrays are mounted on a carrier platform in a checker-board pattern mosaic. To fill in the gaps between array-active areas the platform is repositioned three times and four X-ray exposures are made. The multiple image areas are then recombined by a digital computer to produce a composite image of the entire region. To reduce X-ray scatter and exposure, a lead aperture plate is interposed between X-ray source and patient. The aperture plate has a mosaic of square holes in alignment with the imaging array pattern and the plate is repositioned in synchronism with the carrier platform. The authors discuss proof-of-concept testing demonstrating technical feasibility of their approach. The instrument should be suitable for incorporation into standard mammography units. Unique features of the new technique are: large field coverage (18 x 24 cm); high spatial resolution (14--17 lp/mm); scatter rejection; and excellent contrast characteristics and lesion detectability under clinical conditions.

  17. Thickness-dependent scatter correction algorithm for digital mammography

    NASA Astrophysics Data System (ADS)

    Gonzalez Trotter, Dinko E.; Tkaczyk, J. Eric; Kaufhold, John; Claus, Bernhard E. H.; Eberhard, Jeffrey W.

    2002-05-01

    We have implemented a scatter-correction algorithm (SCA) for digital mammography based on an iterative restoration filter. The scatter contribution to the image is modeled by an additive component that is proportional to the filtered unattenuated x-ray photon signal and dependent on the characteristics of the imaged object. The SCA's result is closer to the scatter-free signal than when a scatter grid is used. Presently, the SCA shows improved contrast-to-noise performance relative to the scatter grid for a breast thickness up to 3.6 cm, with potential for better performance up to 6 cm. We investigated the efficacy of our scatter-correction method on a series of x-ray images of anthropomorphic breast phantoms with maximum thicknesses ranging from 3.0 cm to 6.0 cm. A comparison of the scatter-corrected images with the scatter-free signal acquired using a slit collimator shows average deviations of 3 percent or less, even in the edge region of the phantoms. These results indicate that the SCA is superior to a scatter grid for 2D quantitative mammography applications, and may enable 3D quantitative applications in X-ray tomosynthesis.

  18. High-speed large angle mammography tomosynthesis system

    NASA Astrophysics Data System (ADS)

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

    2006-03-01

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

  19. Local image registration a comparison for bilateral registration mammography

    NASA Astrophysics Data System (ADS)

    Celaya-Padilaa, José M.; Rodriguez-Rojas, Juan; Trevino, Victor; Tamez-Pena, José G.

    2013-11-01

    Early tumor detection is key in reducing the number of breast cancer death and screening mammography is one of the most widely available and reliable method for early detection. However, it is difficult for the radiologist to process with the same attention each case, due the large amount of images to be read. Computer aided detection (CADe) systems improve tumor detection rate; but the current efficiency of these systems is not yet adequate and the correct interpretation of CADe outputs requires expert human intervention. Computer aided diagnosis systems (CADx) are being designed to improve cancer diagnosis accuracy, but they have not been efficiently applied in breast cancer. CADx efficiency can be enhanced by considering the natural mirror symmetry between the right and left breast. The objective of this work is to evaluate co-registration algorithms for the accurate alignment of the left to right breast for CADx enhancement. A set of mammograms were artificially altered to create a ground truth set to evaluate the registration efficiency of DEMONs , and SPLINE deformable registration algorithms. The registration accuracy was evaluated using mean square errors, mutual information and correlation. The results on the 132 images proved that the SPLINE deformable registration over-perform the DEMONS on mammography images.

  20. The role of Compton scattering in scinti-mammography

    SciTech Connect

    Pani, R.; Scopinaro, F.; Pergola, A.

    1996-12-31

    Functional breast imaging using {sup 99m}Tc MIBI is showing that this technique is able to detect cancer with more than 90% specificity. Using a dedicated gamma camera, with the breast under compression, i.e. in similar conditions of mammography, the detection of sub-centimeter cancers can be improved. A number of factors affects the detection of small cancers as: thickness of the breast, distance between tumor and collimator, cardiac activity. Radioactivity emitted from the body can obscure the breast activity mainly due to the large difference on radioactivity concentration. In this work we analyze the intensity and the energy distribution of Compton scattering coming from the breast by a Germanium detector and by a dedicated imager with a small FOV placed in a geometrical condition similar to mammography. In vivo measurements were performed in patients with a breast cancer ranging between 8 mm and 15 mm. Intensity of Compton scattering from 4 to 10 times greater than full energy peak events resulted. Measurements were compared with ones obtained by a phantom simulating the breast without chest activity demonstrating how large is the Compton contribution from the chest.

  1. Multiple-Instance Learning for Anomaly Detection in Digital Mammography.

    PubMed

    Quellec, Gwenole; Lamard, Mathieu; Cozic, Michel; Coatrieux, Gouenou; Cazuguel, Guy

    2016-07-01

    This paper describes a computer-aided detection and diagnosis system for breast cancer, the most common form of cancer among women, using mammography. The system relies on the Multiple-Instance Learning (MIL) paradigm, which has proven useful for medical decision support in previous works from our team. In the proposed framework, breasts are first partitioned adaptively into regions. Then, features derived from the detection of lesions (masses and microcalcifications) as well as textural features, are extracted from each region and combined in order to classify mammography examinations as "normal" or "abnormal". Whenever an abnormal examination record is detected, the regions that induced that automated diagnosis can be highlighted. Two strategies are evaluated to define this anomaly detector. In a first scenario, manual segmentations of lesions are used to train an SVM that assigns an anomaly index to each region; local anomaly indices are then combined into a global anomaly index. In a second scenario, the local and global anomaly detectors are trained simultaneously, without manual segmentations, using various MIL algorithms (DD, APR, mi-SVM, MI-SVM and MILBoost). Experiments on the DDSM dataset show that the second approach, which is only weakly-supervised, surprisingly outperforms the first approach, even though it is strongly-supervised. This suggests that anomaly detectors can be advantageously trained on large medical image archives, without the need for manual segmentation. PMID:26829783

  2. Spousal influence on mammography screening: a life course perspective.

    PubMed

    Missinne, Sarah; Colman, Elien; Bracke, Piet

    2013-12-01

    Recently, researchers have challenged the basic tenet that marriage is universally protective for all individuals. We scrutinize socio-economic differences between married couples to shed light on the mechanisms underlying the effects of marriage. We introduce the life course perspective to investigate if differences in positive health behavior between couples are related to their early life conditions. Within the theoretical framework of cultural health capital, we hypothesize that the accumulation of cultural health capital proceeds at the marriage level when partners provide each other with health-related information and norms. For this purpose, we examine the influence of the childhood preventive health care behavior of both wives and husbands on the initiation of mammography screening for a sample of Belgian women (N = 734). Retrospective life histories of both partners are provided by the Survey of Health, Ageing and Retirement (SHARE) and are examined by means of event history analysis. The results show that a partner's cultural health capital affects the initiation of mammography screening by a woman in later life, even after her own cultural health capital and traditional measures of socio-economic status (SES) are taken into account. In line with cumulative advantage theory, it seems that inequalities in cultural health capital are accumulated at the marriage level. In order to shed further light on the spousal influence on health behavior, researchers should revert to early life in order to discern the attribution of premarital and marital conditions. PMID:24331883

  3. Dosimetry in Mammography: Average Glandular Dose Based on Homogeneous Phantom

    NASA Astrophysics Data System (ADS)

    Benevides, Luis A.; Hintenlang, David E.

    2011-05-01

    The objective of this study was to demonstrate that a clinical dosimetry protocol that utilizes a dosimetric breast phantom series based on population anthropometric measurements can reliably predict the average glandular dose (AGD) imparted to the patient during a routine screening mammogram. AGD was calculated using entrance skin exposure and dose conversion factors based on fibroglandular content, compressed breast thickness, mammography unit parameters and modifying parameters for homogeneous phantom (phantom factor), compressed breast lateral dimensions (volume factor) and anatomical features (anatomical factor). The patient fibroglandular content was evaluated using a calibrated modified breast tissue equivalent homogeneous phantom series (BRTES-MOD) designed from anthropomorphic measurements of a screening mammography population and whose elemental composition was referenced to International Commission on Radiation Units and Measurements Report 44 and 46 tissues. The patient fibroglandular content, compressed breast thickness along with unit parameters and spectrum half-value layer were used to derive the currently used dose conversion factor (DgN). The study showed that the use of a homogeneous phantom, patient compressed breast lateral dimensions and patient anatomical features can affect AGD by as much as 12%, 3% and 1%, respectively. The protocol was found to be superior to existing methodologies. The clinical dosimetry protocol developed in this study can reliably predict the AGD imparted to an individual patient during a routine screening mammogram.

  4. Dosimetry in Mammography: Average Glandular Dose Based on Homogeneous Phantom

    SciTech Connect

    Benevides, Luis A.; Hintenlang, David E.

    2011-05-05

    The objective of this study was to demonstrate that a clinical dosimetry protocol that utilizes a dosimetric breast phantom series based on population anthropometric measurements can reliably predict the average glandular dose (AGD) imparted to the patient during a routine screening mammogram. AGD was calculated using entrance skin exposure and dose conversion factors based on fibroglandular content, compressed breast thickness, mammography unit parameters and modifying parameters for homogeneous phantom (phantom factor), compressed breast lateral dimensions (volume factor) and anatomical features (anatomical factor). The patient fibroglandular content was evaluated using a calibrated modified breast tissue equivalent homogeneous phantom series (BRTES-MOD) designed from anthropomorphic measurements of a screening mammography population and whose elemental composition was referenced to International Commission on Radiation Units and Measurements Report 44 and 46 tissues. The patient fibroglandular content, compressed breast thickness along with unit parameters and spectrum half-value layer were used to derive the currently used dose conversion factor (DgN). The study showed that the use of a homogeneous phantom, patient compressed breast lateral dimensions and patient anatomical features can affect AGD by as much as 12%, 3% and 1%, respectively. The protocol was found to be superior to existing methodologies. The clinical dosimetry protocol developed in this study can reliably predict the AGD imparted to an individual patient during a routine screening mammogram.

  5. Diagnostic criteria for mass lesions differentiating in electrical impedance mammography

    NASA Astrophysics Data System (ADS)

    A, Karpov; M, Korotkova

    2013-04-01

    The purpose of this research was to determine the diagnostic criteria for differentiating volumetric lesions in the mammary gland in electrical impedance mammography. The research was carried out utilizing the electrical impedance computer mammograph llMEIK v.5.6gg®, which enables to acquire images of 3-D conductivity distribution layers within mamma's tissues up to 5 cm depth. The weighted reciprocal projection method was employed to reconstruct the 3-D electric conductivity distribution of the examined organ. The results of 3,710 electrical impedance examinations were analyzed. The analysis of a volumetric lesion included assessment of its shape, contour, internal electrical structure and changes of the surrounding tissues. Moreover, mammary gland status was evaluated with the help of comparative and age-related electrical conductivity curves. The diagnostic chart is provided. Each criterion is measured in points. Using the numerical score for evaluation of mass and non-volumetric lesions within the mammary gland in electrical impedance mammography allowed comparing this information to BI-RADS categories developed by American College of Radiology experts. The article is illustrated with electrical impedance mammograms and tables.

  6. Characterization tests of a homemade ionization chamber in mammography standard radiation beams

    NASA Astrophysics Data System (ADS)

    Silva, J. O.; Nonato, F. B. C.; Caldas, L. V. E.

    2014-02-01

    A mammography homemade ionization chamber was developed to be applied for mammography energy range dosimetry. This chamber has a sensitive volume of 6 cm3 and is made of a Lucite body and graphite coated collecting electrode. Characteristics such as saturation, ion collection efficiency, linearity of chamber response versus air kerma rate and energy dependence were determined. The results obtained with the mammography homemade ionization chamber are within the limits stated in international recommendations. This chamber can be used in quality control programs in the diagnostic radiology area. All measurements were carried out at the Calibration Laboratory of IPEN.

  7. Characterization of scatter in digital mammography from physical measurements

    SciTech Connect

    Leon, Stephanie M. Wagner, Louis K.; Brateman, Libby F.

    2014-06-15

    Purpose: That scattered radiation negatively impacts the quality of medical radiographic imaging is well known. In mammography, even slight amounts of scatter reduce the high contrast required for subtle soft-tissue imaging. In current clinical mammography, image contrast is partially improved by use of an antiscatter grid. This form of scatter rejection comes with a sizeable dose penalty related to the concomitant elimination of valuable primary radiation. Digital mammography allows the use of image processing as a method of scatter correction that might avoid effects that negatively impact primary radiation, while potentially providing more contrast improvement than is currently possible with a grid. For this approach to be feasible, a detailed characterization of the scatter is needed. Previous research has modeled scatter as a constant background that serves as a DC bias across the imaging surface. The goal of this study was to provide a more substantive data set for characterizing the spatially-variant features of scatter radiation at the image detector of modern mammography units. Methods: This data set was acquired from a model of the radiation beam as a matrix of very narrow rays or pencil beams. As each pencil beam penetrates tissue, the pencil widens in a predictable manner due to the production of scatter. The resultant spreading of the pencil beam at the detector surface can be characterized by two parameters: mean radial extent (MRE) and scatter fraction (SF). The SF and MRE were calculated from measurements obtained using the beam stop method. Two digital mammography units were utilized, and the SF and MRE were found as functions of target, filter, tube potential, phantom thickness, and presence or absence of a grid. These values were then used to generate general equations allowing the SF and MRE to be calculated for any combination of the above parameters. Results: With a grid, the SF ranged from a minimum of about 0.05 to a maximum of about 0

  8. Primary Non-Hodgkin Lymphoma of the Breast: Ultrasonography, Elastography, Digital Mammography, Contrast-Enhanced Digital Mammography, and Pathology Findings.

    PubMed

    Gkali, Christina An; Chalazonitis, Athanasios N; Feida, Eleni; Giannos, Aris; Sotiropoulou, Maria; Dimitrakakis, Constantine; Loutradis, Dimitrios

    2015-12-01

    Lymphomas constitute approximately 0.15% of malignant mammary neoplasms. Less than 0.5% of all malignant lymphomas involve the breast primarily. Primary non-Hodgkin breast lymphoma is usually right sided. The combined therapy approach, with chemotherapy and radiotherapy, is the most successful treatment. Mastectomy offers no benefit in the treatment of primary non-Hodgkin breast lymphoma. To the author's knowledge, this is the first published case of primary non-Hodgkin breast lymphoma reported with conventional ultrasonography, elastography (both freehand and acoustic radiation force impulse imaging), digital mammography, contrast-enhanced digital mammography, and pathology findings. A 45-year-old woman presented with a lump in the right breast for 2 months. There was no evidence of systemic lymphoma or leukemia when the breast lesion was detected. Imaging findings were negative for lymphoma. Ipsilateral lymph nodes were not palpable. The mass was resected, and histopathology findings were diagnostic of non-Hodgkin lymphoma. Immunohistochemistry was confirmatory of non-Hodgkin lymphoma, diffuse large cell type of B-cell lineage. Although primary and secondary lymphomas of the breast are rare entities, they should be considered in the differential diagnosis of breast malignancies. PMID:25831151

  9. Confirmatory analysis of opinions regarding the pros and cons of mammography.

    PubMed

    Rakowski, W; Andersen, M R; Stoddard, A M; Urban, N; Rimer, B K; Lane, D S; Fox, S A; Costanza, M E

    1997-09-01

    This investigation extends prior research to apply decision-making constructs from the transtheoretical model (TTM) of behavior change to mammography screening. Study subjects were 8,914 women ages 50-80, recruited from 40 primarily rural communities in Washington State. Structural equation modeling showed that favorable and unfavorable opinions about mammography (i.e., pros and cons) fit the observed data. Analysis of variance supported the associations between readiness to obtain screening (i.e., stage of adoption) and opinions about mammography (i.e., decisional balance) previously found in research using smaller samples from another geographic region. This report extends these earlier studies by using structural equation modeling, opinion scales based both on principal component analyses and on a priori definitions, a developmental sample and a confirmatory sample, and by sampling from a different geographic region. It is recommended that future research examine whether opinions regarding the cons of mammography are more individually specific than the pros. PMID:9302540

  10. A Close Call: The Role of Screening Mammography in the Fight Against Breast Cancer

    PubMed Central

    Sadeghpour, Mona

    2011-01-01

    A multidisciplinary panel debated the role of screening mammography in fighting breast cancer during the Health and Medicine for Women continuing medical education (CME) conference at Yale Medical School in September 2010. Different guidelines from professional societies have presented conflicting recommendations for patients regarding both the benefits of mammography and the appropriate age and frequency of screening. In addition, a recent longitudinal study argues that screening mammography may only offer a modest benefit in terms of reducing cancer mortality. In light of these considerations, the panel debated whether mammography should be an informed decision that must be discussed and individualized for each patient based on the context of risk factors such as family history, age, and genetic dispositions. PMID:21451784

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

    PubMed Central

    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 < .05). The average pooled specificity of the combined test was 96%, an absolute increase in the false-positive rate of 2% relative to mammography 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

  12. Optimization of exposure parameters in full field digital mammography

    SciTech Connect

    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.

    2008-06-15

    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

  13. Comparative Study Of Image Enhancement Algorithms For Digital And Film Mammography

    SciTech Connect

    Delgado-Gonzalez, A.

    2008-08-11

    Here we discuss the application of edge enhancement algorithms on images obtained with a Mammography System which has a Selenium Detector and on the other hand, on images obtained from digitized film mammography. Comparative analysis of such images includes the study of technical aspects of image acquisition, storage, compression and display. A protocol for a local database has been created as a result of this study.

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

    PubMed Central

    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. PMID:25914223

  15. Dosimetry and kVp standardization for quality assurance of mammography

    NASA Astrophysics Data System (ADS)

    Chu, Chien-Hau; Yuan, Ming-Chen; Huang, Wen-Sheng; Hsieh, Bor-Tsung

    2014-11-01

    Breast cancer mortality rates were significantly reduced in Taiwan after achieving early-stage monitoring with mammography screening. This study establishes an appropriate and traceable calibration infrastructure, which offers calibration services for mammography X-ray quality assurance instrumentation, which is performed clinically on a regular basis. The entrance air kerma, HVL, and kVp of mammography equipment with five different target/filter combinations can be taken as adequate indicators for the level of average glandular dose (AGD). The primary dose standard in mammography uses a free-air ionization chamber to estimate the rate of air kerma. Several correction factors were determined by Monte Carlo simulations and experiments. A secondary kVp standard in mammography is in accordance with the IEC 61676 recommendations. The calibration system of kVp meter uses a high-voltage divider, which is traceable to ITRI primary standard in Taiwan. Dose and kVp verifications were conducted by mammography instruments, which were previously calibrated by NIST and PTB. The evaluation results indicate that the capabilities of this irradiation system met the ISO 4037-1 requirements. The expanded uncertainties (k=2) were 1.03% and 1.6% when the mammography X-ray air kerma rate and kVp meter calibration factors were evaluated using ISO GUM. Experimental verification and a comparison with NIST using transfer ionization chambers yielded differences in calibration factors. Comparison with the PTB using kVp meter indicated a less than 1% difference. The results showed that dose and kVp standards were in reasonable agreement with standard uncertainty. The low uncertainties associated with the obtained results in this work show that the standardization employed can be accurately used for calibration of instrument in mammography in Taiwan.

  16. Use of mammography screening among older Samoan women in Los Angeles county: a diffusion network approach.

    PubMed

    Levy-Storms, Lené; Wallace, Steven P

    2003-09-01

    Minority migrant populations, such as older Samoan women, are likely to underuse preventive health services, including mammography screening. The purpose of this paper is to explore how informal (lay peers from churches) and formal (health care providers) health communication networks influence mammography screening use among older Samoan women. To do so, we apply diffusion of innovation theory and network analysis to understand how interpersonal networks may affect mammography use in this urban-dwelling, migrant population. The data come from a survey of 260 Samoan women, aged 50 years or older, who attended 39 randomly sampled Samoan churches in Los Angeles County (USA) between 1996 and 1997. Retrospective data, based over a 20-year period from this sample's year of first use of mammography screening, suggest that interpersonal networks may have accounted for the dramatic increase in the rate of adoption within the past 5 years of the survey. Using this information, we categorized women into mutually exclusive stages of mammography use and regressed these stages of mammography use on formal (had a provider referral) and informal (level of connectedness with peers in churches) health communication networks. The results indicated that being well-connected within women's informal, church-based health communication networks increased the likelihood of being in the decision (planned to have) and implementation and confirmation (had a recent mammogram) stages, but having a provider referral for a mammogram (formal networks) only increased the likelihood of being in the latter stages compared to women in the knowledge and persuasion stages. Formal and informal health communication networks influence recent use of mammography screening, but informal networks, in and of themselves, are also influential on future intention to use mammography screening. PMID:12878100

  17. Geographic Disparities in Mammography Capacity in the South: A Longitudinal Assessment of Supply and Demand

    PubMed Central

    Eberth, Jan M; Eschbach, Karl; Morris, Jeffrey S; Nguyen, Hoang T; Hossain, Md Monir; Elting, Linda S

    2014-01-01

    ObjectiveStudies have shown that there is sufficient availability of mammography; however, little is known about geographic variation in capacity. The purpose of this study was to determine the locations and extent of over/undersupply of mammography in 14 southern states from 2002 to 2008. Data SourcesMammography facility data were collected from the U.S. Food and Drug Administration (FDA). Population estimates, used to estimate the potential demand for mammography, were obtained from GeoLytics Inc. Study DesignUsing the two-step floating catchment area method, we calculated spatial accessibility at the block group level and categorized the resulting index to represent the extent of under/oversupply relative to the potential demand. Principal FindingsResults show decreasing availability of mammography over time. The extent of over/undersupply varied significantly across the South. Reductions in capacity occurred primarily in areas with an oversupply of machines, resulting in a 68 percent decrease in the percent of women living in excess capacity areas from 2002 to 2008. The percent of women living in poor capacity areas rose by 10 percent from 2002 to 2008. ConclusionsOur study found decreasing mammography availability and capacity over time, with substantial variation across states. This information can assist providers and policy makers in their business planning and resource allocation decisions. PMID:23829179

  18. [Socioeconomic and geographic constraints to access mammography in Brasil, 2003-2008].

    PubMed

    de Oliveira, Evangelina Xavier Gouveia; Pinheiro, Rejane Sobrino; Melo, Enirtes Caetano Praates; Carvalho, Marilia Sá

    2011-09-01

    This study examined the effect of population characteristics and geographic location of residences and services on the odds of receiving a mammography in 2003 and 2008. Patterns of mammography use were analyzed using data from the Health Supplements of the National Household Sample Survey for women aged over 25, using prevalence ratios, and for women over 40 using multivariate logistic regression, correcting for complex sample design effects. In 2003, 54.6% of women of 50-69 years of age reported having had a mammography, in 2008, 71.5%. The odds are higher for those 50 to 69 years old, and increase with family income, education, being married, having consulted a doctor and having health insurance. Living in a metropolitan area trebles the chance of mammography. Compared to the Northern region, residents in all other regions have greater odds, greater distances decrease the odds. Coverage increased in the age range targeted by national policy, and inequalities due to income and education on access to mammography were reduced but regional convergence was not marked. Increased access seems to relate more to policies of income distribution and social inclusion, and to the availability of the examination in the Unified Health System, than to an increasing number of mammography units. PMID:21987309

  19. Development of the LBNL positron emission mammography camera

    SciTech Connect

    Huber, Jennifer S.; Choong, Woon-Seng; Wang, Jimmy; Maltz, Jonathon S.; Qi, Jinyi; Mandelli, Emanuele; Moses, William W.

    2002-12-19

    We present the construction status of the LBNL Positron Emission Mammography (PEM) camera, which utilizes a PET detector module with depth of interaction measurement consisting of 64 LSO crystals (3x3x30 mm3) coupled on one end to a single photomultiplier tube (PMT) and on the opposite end to a 64 pixel array of silicon photodiodes (PDs). The PMT provides an accurate timing pulse, the PDs identify the crystal of interaction, the sum provides a total energy signal, and the PD/(PD+PMT) ratio determines the depth of interaction. We have completed construction of all 42 PEM detector modules. All data acquisition electronics have been completed, fully tested and loaded onto the gantry. We have demonstrated that all functions of the custom IC work using the production rigid-flex boards and data acquisition system. Preliminary detector module characterization and coincidence data have been taken using the production system, including initial images.

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

    SciTech Connect

    Isa, Norriza Mohd; Wan Hassan, Wan Muhamad Saridan

    2010-01-05

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

  1. Discussing the benefits and harms of screening mammography.

    PubMed

    Brennan, Meagan; Houssami, Nehmat

    2016-10-01

    Mammographic screening programs were established around the world following randomised clinical trials showing that women who were screened had a significant reduction in the risk of dying from breast cancer. Now, decades later, several harms of screening have become apparent and the degree of risk reduction is being debated. This article aims to provide clinicians with evidence-based information about the benefits and harms of screening mammography to enable them to confidently discuss the issues with their patients. The issues around screening for breast cancer in asymptomatic women at average risk are complex. Women need accurate, balanced information to make an informed decision about whether they wish to participate in screening. The decision will vary from one woman to another, depending on her level of anxiety about cancer and recall, her personal values and her philosophy about health care. PMID:27621253

  2. Mammography for older women: who uses, who benefits?

    PubMed

    Mor, V; Pacala, J T; Rakowski, W

    1992-11-01

    In order to juxtapose the health, social, and behavioral factors associated with use of screening mammography with short-term mortality among elderly women, we analyzed the NHIS Cancer Epidemiology Supplemental Survey and the Longitudinal Study of Aging. After controlling for sociodemographic factors, having a usual source of care of and knowledge of screening guidelines, we found that a woman's health status is unrelated to having had a screening mammogram. Analyses of the LSOA, however, revealed that health factors were strongly related to 4-year mortality, particularly among women 75 and over. As it is unlikely that the subpopulation of older women who are at high risk of death within 4 years will benefit from a program of universal screening, outreach program messages and physician education programs should probably be designed to proactively recruit those most likely to benefit. PMID:1430881

  3. Lesion detection and quantitation of positron emission mammography

    SciTech Connect

    Qi, Jinyi; Huesman, Ronald H.

    2001-12-01

    A Positron Emission Mammography (PEM) scanner dedicated to breast imaging is being developed at our laboratory. We have developed a list mode likelihood reconstruction algorithm for this scanner. Here we theoretically study the lesion detection and quantitation. The lesion detectability is studied theoretically using computer observers. We found that for the zero-order quadratic prior, the region of interest observer can achieve the performance of the prewhitening observer with a properly selected smoothing parameter. We also study the lesion quantitation using the test statistic of the region of interest observer. The theoretical expressions for the bias, variance, and ensemble mean squared error of the quantitation are derived. Computer simulations show that the theoretical predictions are in good agreement with the Monte Carlo results for both lesion detection and quantitation.

  4. A comprehensive model for quantum noise characterization in digital mammography.

    PubMed

    Monnin, P; Bosmans, H; Verdun, F R; Marshall, N W

    2016-03-01

    A version of cascaded systems analysis was developed specifically with the aim of studying quantum noise propagation in x-ray detectors. Signal and quantum noise propagation was then modelled in four types of x-ray detectors used for digital mammography: four flat panel systems, one computed radiography and one slot-scan silicon wafer based photon counting device. As required inputs to the model, the two dimensional (2D) modulation transfer function (MTF), noise power spectra (NPS) and detective quantum efficiency (DQE) were measured for six mammography systems that utilized these different detectors. A new method to reconstruct anisotropic 2D presampling MTF matrices from 1D radial MTFs measured along different angular directions across the detector is described; an image of a sharp, circular disc was used for this purpose. The effective pixel fill factor for the FP systems was determined from the axial 1D presampling MTFs measured with a square sharp edge along the two orthogonal directions of the pixel lattice. Expectation MTFs were then calculated by averaging the radial MTFs over all possible phases and the 2D EMTF formed with the same reconstruction technique used for the 2D presampling MTF. The quantum NPS was then established by noise decomposition from homogenous images acquired as a function of detector air kerma. This was further decomposed into the correlated and uncorrelated quantum components by fitting the radially averaged quantum NPS with the radially averaged EMTF(2). This whole procedure allowed a detailed analysis of the influence of aliasing, signal and noise decorrelation, x-ray capture efficiency and global secondary gain on NPS and detector DQE. The influence of noise statistics, pixel fill factor and additional electronic and fixed pattern noises on the DQE was also studied. The 2D cascaded model and decompositions performed on the acquired images also enlightened the observed quantum NPS and DQE anisotropy. PMID:26895467

  5. A comprehensive model for quantum noise characterization in digital mammography

    NASA Astrophysics Data System (ADS)

    Monnin, P.; Bosmans, H.; Verdun, F. R.; Marshall, N. W.

    2016-03-01

    A version of cascaded systems analysis was developed specifically with the aim of studying quantum noise propagation in x-ray detectors. Signal and quantum noise propagation was then modelled in four types of x-ray detectors used for digital mammography: four flat panel systems, one computed radiography and one slot-scan silicon wafer based photon counting device. As required inputs to the model, the two dimensional (2D) modulation transfer function (MTF), noise power spectra (NPS) and detective quantum efficiency (DQE) were measured for six mammography systems that utilized these different detectors. A new method to reconstruct anisotropic 2D presampling MTF matrices from 1D radial MTFs measured along different angular directions across the detector is described; an image of a sharp, circular disc was used for this purpose. The effective pixel fill factor for the FP systems was determined from the axial 1D presampling MTFs measured with a square sharp edge along the two orthogonal directions of the pixel lattice. Expectation MTFs were then calculated by averaging the radial MTFs over all possible phases and the 2D EMTF formed with the same reconstruction technique used for the 2D presampling MTF. The quantum NPS was then established by noise decomposition from homogenous images acquired as a function of detector air kerma. This was further decomposed into the correlated and uncorrelated quantum components by fitting the radially averaged quantum NPS with the radially averaged EMTF2. This whole procedure allowed a detailed analysis of the influence of aliasing, signal and noise decorrelation, x-ray capture efficiency and global secondary gain on NPS and detector DQE. The influence of noise statistics, pixel fill factor and additional electronic and fixed pattern noises on the DQE was also studied. The 2D cascaded model and decompositions performed on the acquired images also enlightened the observed quantum NPS and DQE anisotropy.

  6. Four Principles to Consider Before Advising Women on Screening Mammography

    PubMed Central

    Jørgensen, Karsten J.

    2015-01-01

    Abstract This article reviews four important screening principles applicable to screening mammography in order to facilitate informed choice. The first principle is that screening may help, hurt, or have no effect. In order to reduce mortality and mastectomy rates, screening must reduce the rate of advanced disease, which likely has not happened. Through overdiagnosis, screening produces substantial harm by increasing both lumpectomy and mastectomy rates, which offsets the often-promised benefit of less invasive therapy. Next, all-cause mortality is the most reliable way to measure the efficacy of a screening intervention. Disease-specific mortality is biased due to difficulties in attribution of cause of death and to increased mortality due to overdiagnosis and the resulting overtreatment with radiotherapy and chemotherapy. To enhance participation, the benefit from screening is often presented in relative instead of absolute terms. Third, some screening statistics must be interpreted with caution. Increased survival time and the percentage of early-stage tumors at detection sound plausible, but are affected by lead-time and length biases. In addition, analyses that only include women who attend screening cannot reliably correct for selection bias. The final principle is that accounting for tumor biology is important for accurate estimates of lead time, and the potential benefit from screening. Since “early detection” is actually late in a tumor's lifetime, the time window when screen detection might extend a woman's life is narrow, as many tumors that can form metastases will already have done so. Instead of encouraging screening mammography, physicians should help women make an informed decision as with any medical intervention. PMID:26496048

  7. Mammographic density measurements are not affected by mammography system

    PubMed Central

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

    2015-01-01

    Abstract. 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 (ρ=0.904; p<0.001), while the VDG (ρ=0.978; p<0.001) and AvBD% (ρ=0.973; p<0.001) showed stronger positive correlations. Substantial agreement was shown between the systems for BIRADS (κ=0.692; p<0.001), however, the systems demonstrated an almost perfect agreement for VDG (κ=0.933; p<0.001). PMID:26158085

  8. Systematic review of 3D mammography for breast cancer screening.

    PubMed

    Hodgson, Robert; Heywang-Köbrunner, Sylvia H; Harvey, Susan C; Edwards, Mary; Shaikh, Javed; Arber, Mick; Glanville, Julie

    2016-06-01

    This review investigated the relative performance of digital breast tomosynthesis (DBT) (alone or with full field digital mammography (FFDM) or synthetic digital mammography) compared with FFDM alone for detecting breast cancer lesions in asymptomatic women. A systematic review was carried out according to systematic reviewing principles provided in the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. A protocol was developed a priori. The review was registered with PROSPERO (number CRD42014013949). Searches were undertaken in October 2014. Following selection, five studies were eligible. Higher cancer detection rates were observed when comparing DBT + FFDM with FFDM in two European studies: the summary difference per 1000 screens was 2.43 (95% CI: 1.8 to 3.1). Both European studies found lower false positive rates for individual readers. One found a lower recall rate based on conditional recall. The second study was not designed to compare post-arbitration recall rates between FFDM and DBT + FFDM. One European study presented data on interval cancer rates; sensitivity and specificity for DBT + FFDM were both higher compared to FFDM. One large multicentre US study showed a higher cancer detection rate for DBT + FFDM, while two smaller US studies did not find statistically significant differences. Reductions in recall and false positive rates were observed in the US studies in favour of DBT + FFDM. In comparison to FFDM, DBT, as an adjunct to FFDM, has a higher cancer detection rate, increasing the effectiveness of breast cancer screening. Additional benefits of DBT may also include reduced recalls and, consequently, reduced costs and distress caused to women who would have been recalled. PMID:27212700

  9. Four Principles to Consider Before Advising Women on Screening Mammography.

    PubMed

    Keen, John D; Jørgensen, Karsten J

    2015-11-01

    This article reviews four important screening principles applicable to screening mammography in order to facilitate informed choice. The first principle is that screening may help, hurt, or have no effect. In order to reduce mortality and mastectomy rates, screening must reduce the rate of advanced disease, which likely has not happened. Through overdiagnosis, screening produces substantial harm by increasing both lumpectomy and mastectomy rates, which offsets the often-promised benefit of less invasive therapy. Next, all-cause mortality is the most reliable way to measure the efficacy of a screening intervention. Disease-specific mortality is biased due to difficulties in attribution of cause of death and to increased mortality due to overdiagnosis and the resulting overtreatment with radiotherapy and chemotherapy. To enhance participation, the benefit from screening is often presented in relative instead of absolute terms. Third, some screening statistics must be interpreted with caution. Increased survival time and the percentage of early-stage tumors at detection sound plausible, but are affected by lead-time and length biases. In addition, analyses that only include women who attend screening cannot reliably correct for selection bias. The final principle is that accounting for tumor biology is important for accurate estimates of lead time, and the potential benefit from screening. Since "early detection" is actually late in a tumor's lifetime, the time window when screen detection might extend a woman's life is narrow, as many tumors that can form metastases will already have done so. Instead of encouraging screening mammography, physicians should help women make an informed decision as with any medical intervention. PMID:26496048

  10. Relationship Between Perceived Risk and Physician Recommendation and Repeat Mammography in the Female Population in Tehran, Iran.

    PubMed

    Moshki, Mahdi; Taymoori, Parvaneh; Khodamoradi, Sahmireh; Roshani, Daem

    2016-01-01

    Iranian women are at high risk of low compliance with repeat mammography due to a lack of awareness about breast cancer, negative previous experiences, cultural beliefs, and no regular visits to a physician. Thus research is needed to explore factors associated with repeated mammography participation. Applying the concept of perceived risk as the guiding model, this study aimed to test the fit and strength of the relationship between perceived risk and physician recommendation in explaining repeat mammography. A total of 601 women, aged 50 years and older referred to mammography centers in region 6, were recruited via a convenience sampling method. Using path analysis, family history of breast cancer and other types of cancer were modeled as antecedent perceived risk, and physician recommendation and knowledge were modeled as an antecedent of the number of mammography visits. The model explained 49% of the variance in repeat mammography. The two factors of physician recommendation and breast self-examination had significant direct effects (P < 0.05) on repeat mammography. Perceived risk, knowledge, and family history of breast cancer had significant indirect effects on repeat mammography through physician recommendation. The results of this study provide a background for further research and interventions not only on Iranian women but also on similar cultural groups and immigrants who have been neglected to date in the mammography literature. PMID:27165251

  11. Comparison of the Mammography, Contrast-Enhanced Spectral Mammography and Ultrasonography in a Group of 116 patients.

    PubMed

    Luczyńska, Elzbieta; Heinze, Sylwia; Adamczyk, Agnieszka; Rys, Janusz; Mitus, Jerzy W; Hendrick, Edward

    2016-08-01

    Mammography (MG) is the gold-standard in breast cancer detection - the only method documented to reduce breast cancer mortality. Breast ultrasound (US) has been shown to increase sensitivity to breast cancers in screening women with dense breasts. Contrast-enhanced spectral mammography (CESM) is a novel technique intensively developed in the last few years. The goal of this study was to compare the sensitivity, specificity and accuracy of MG, US and CESM in detecting malignant breast lesions. The study included 116 patients. All patients were symptomatic and underwent MG, US and CESM. A radiologist with 20 years of experience in US and MG breast imaging and 1 year of experience in CESM reviewed images acquired in each of the three modalities separately, within an interval of 14-30 days. All identified lesions were confirmed at core biopsy. BI-RADS classifications on US, MG and CESM were compared to histopathology. MG, CESM and US were compared among 116 patients with 137 lesions encountered. Sensitivity of CESM was 100%, significantly higher than that of MG (90%, p<0.004) or US (92%, p<0.01). CESM accuracy was 78%, also higher than MG (69%, p<0.004) and US (70%, p=0.03). There was no statistically significant difference between AUCs for CESM and US (both 0.83). The AUCs of both US and CESM, however, were significantly larger than that of MG (p<0.0004 for each). CESM permitted better detection of malignant lesions than both MG and US, read individually. CESM found lesion enhancement in some benign lesions, as well, yielding a rate of false-positive diagnoses similar to that of MG and US. PMID:27466557

  12. Mammography use among older women of seven Latin American and Caribbean cities

    PubMed Central

    Reyes-Ortiz, Carlos A.; Freeman, Jean L.; Peláez, Martha; Markides, Kyriakos S.; Goodwin, James S.

    2007-01-01

    Background To describe the prevalence of mammography use, and to estimate its association with sociodemographics. Methods A sample of 6207 women aged 60 and older from the first interview of Health, Well-Being and Aging in Latin America and the Caribbean Study (SABE) in seven cities (Buenos Aires, Bridgetown, Havana, Mexico, Montevideo, Santiago, and Sao Paulo). The outcome was reporting a mammogram within the last 2 years. Results Prevalence of mammography use ranged from 9.8% in Havana to 34.4% in Sao Paulo. Independent predictors of mammography use across cities were older age (lowest odds ratio [OR] = 0.92, 95% confidence interval [CI] 0.89–0.95), higher education (highest OR = 1.14, 95% CI 1.08–1.20), public health insurance (lowest OR = 0.28, 95% CI 0.11–0.76), or no insurance (lowest OR = 0.08, 95% CI 0.02–0.34) compared with private insurance. In a combined sample of six cities, higher education was associated with higher mammography use, but older age and insurance (public: OR = 0.54, 95% CI 0.45–0.65; no insurance: OR = 0.30, 95% CI 0.23–0.40; compared with private insurance) were associated with lower mammography use. Conclusions Prevalence of mammography use across cities was lower than that reported for Hispanic populations in the US. In the overall sample, mammography use was increased in highly educated people and decreased in people without insurance. PMID:16563480

  13. REPEAT MAMMOGRAPHY SCREENING AMONG UNMARRIED WOMEN WITH AND WITHOUT A DISABILITY

    PubMed Central

    Clark, Melissa A.; Rogers, Michelle L.; Wen, Xiaozhong; Wilcox, Victoria; McCarthy-Barnett, Kate; Panarace, Jeanne; Manning, Carol; Allen, Susan; Rakowski, William

    2009-01-01

    Objectives Unmarried women with disabilities may be a particularly vulnerable group for underutilization of repeat mammography screening. Our goal was to compare the breast cancer screening experiences of unmarried women with disabilities (WWD) versus women with no disabilities (WND), and determine whether these experiences are associated with adherence to repeat screening. Methods We conducted a matched cohort study of 93 WWD and 93 WND to compare mammography experiences by disability status, examine rates of repeat mammography by disability status, and identify factors that are associated with repeat mammography. Results WWD were less likely to be on-schedule than WND in univariable (54.8% vs. 71.0%; relative risk = 0.77, 95% CL = 0.61, 0.97), but not multivariable, analyses. In multivariable analyses, there was a significant interaction between disability status and positive experiences as the reasons for returning to the same mammography facility. Among WND, repeat screening ranged from 59% to 86%, depending on the number of positive experiences endorsed (range=1–5). In contrast, among WWD, screening rates were only 37% among those who did not report any positive experiences and increased to a maximum of 60% regardless of whether women endorsed one to four or all five positive experiences. Severity and type of disability were not associated with repeat screening. Conclusions WWD may be less likely than WND to remain on-schedule for mammography. WWD who do not report any positive experiences as reasons for returning to a mammography facility may be at particularly high risk of underutilization of screening. PMID:19775912

  14. Perspectives on Mammography After Receipt of Secondary Screening Due to a False Positive

    PubMed Central

    Siminoff, Laura A.

    2014-01-01

    BACKGROUND The utility of mammography screening as an efficacious tool for early detection is being contested due to the risk of potential harms including psychological distress and exposure to unnecessary procedures associated with FPs and over-diagnosis. Yet there is little research regarding women’s experiences, values or preferences for participating in mammography programs. Our aim was to explore women’s actual experiences of a FP mammography screen and their perceptions of the value, risks and benefits given their recent experience. METHODS We conducted semi-structured interviews with 40 women who experienced a recent FP mammogram. Interviews were recorded and transcribed verbatim. A directed content analysis was used to identify and explore primary themes. Knowledge of breast cancer risk was also assessed. FINDINGS Receiving a FP mammography screen generated significant worry among 60% (n=24) of women. Yet 70% maintained that mammography screening was necessary despite the worry incurred. Women also described the experience as stimulating greater interest in additional cancer prevention activities (32.5%; n=13) and one third discussed needing more information about the risks and benefits of mammography screening. Less than one quarter of women (22.5%; n=9) correctly identified a women’s lifetime risk of developing breast cancer, 20% (n=8) overestimated and 57.5% (n=23) underestimated this risk. CONCLUSION Women reported needing more information about the risks and benefits of mammography screening but also considered FPs an acceptable risk. Further, our results suggest that breast cancer screening programs may provide a unique opportunity to deliver additional breast cancer prevention interventions. PMID:25648490

  15. Validating self-reported mammography use in vulnerable communities: findings and recommendations

    PubMed Central

    Allgood, Kristi L.; Rauscher, Garth H.; Whitman, Steven; Vasquez-Jones, Giselle; Shah, Ami M.

    2014-01-01

    Background Most health surveys ask women whether they have had a recent mammogram, all of which report mammography use (past two years) at about 70–80% regardless of race or residence. We examined the potential extent of over-reporting of mammography use in low income African-American and Latina women, and whether self-report inaccuracies might bias estimated associations between patient characteristics and mammography use. Methods Using venue based sampling in two poor communities on the west side of Chicago, we asked eligible women living in two west side communities of Chicago to complete a survey about breast health (n=2,200) and to provide consent to view their medical record. Of the n=1,909 women who screened eligible for medical record review, n=1,566 consented (82%). We obtained medical records of all women who provided both permission and a valid local mammography facility (n=1,221). We compared the self-reported responses from the survey to the imaging reports found in the medical record (documented). To account for missing data we conducted multiple imputations for key demographic variables and report standard measures of accuracy. Results Although 73% of women self-reported a mammogram in the last 2 years, only 45% of self-reports were documented. Over-reporting of mammography use was observed for all three ethnic groups. Conclusions These results suggest considerable over-estimation of prevalence of use in these vulnerable populations. Impact Relying on known faulty self-reported mammography data as a measure of mammography use provides an overly optimistic picture of utilization, a problem that may be exacerbated in vulnerable minority communities. PMID:24859870

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

    SciTech Connect

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

    2012-06-01

    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.

  17. Impact of the Introduction of Digital Mammography in an Organized Screening Program on the Recall and Detection Rate.

    PubMed

    Campari, Cinzia; Giorgi Rossi, Paolo; Mori, Carlo Alberto; Ravaioli, Sara; Nitrosi, Andrea; Vacondio, Rita; Mancuso, Pamela; Cattani, Antonella; Pattacini, Pierpaolo

    2016-04-01

    In 2012, the Reggio Emilia Breast Cancer Screening Program introduced digital mammography in all its facilities at the same time. The aim of this work is to analyze the impact of digital mammography introduction on the recall rate, detection rate, and positive predictive value. The program actively invites women aged 45-74 years. We included women screened in 2011, all of whom underwent film-screen mammography, and all women screened in 2012, all of whom underwent digital mammography. Double reading was used for all mammograms, with arbitration in the event of disagreement. A total of 42,240 women underwent screen-film mammography and 45,196 underwent digital mammography. The recall rate increased from 3.3 to 4.4% in the first year of digital mammography (relative recall adjusted by age and round 1.46, 95% CI = 1.37-1.56); the positivity rate for each individual reading, before arbitration, rose from 3 to 5.7%. The digital mammography recall rate decreased during 2012: after 12 months, it was similar to the recall rate with screen-film mammography. The detection rate was similar: 5.9/1000 and 5.2/1000 with screen-film and digital mammography, respectively (adjusted relative detection rate 0.95, 95% CI = 0.79-1.13). The relative detection rate for ductal carcinoma in situ remained the same. The introduction of digital mammography to our organized screening program had a negative impact on specificity, thereby increasing the recall rate. The effect was limited to the first 12 months after introduction and was attenuated by the double reading with arbitration. We did not observe any relevant effects on the detection rate. PMID:26537932

  18. Physical characteristics of five clinical systems for digital mammography

    SciTech Connect

    Lazzari, B.; Belli, G.; Gori, C.; Rosselli Del Turco, M.

    2007-07-15

    The purpose of this study was to evaluate and compare the physical characteristics of five clinical systems for digital mammography (GE Senographe 2000D, Lorad Selenia M-IV, Fischer Senoscan, Agfa DM 1000, and IMS Giotto) currently in clinical use. The basic performances of the mammography systems tested were assessed on the basis of response curve, modulation transfer function (MTF), noise power spectrum, noise equivalent quanta (NEQ), and detective quantum efficiency (DQE) in an experimental setting closely resembling the clinical one. As expected, all the full field digital mammography systems show a linear response curve over a dynamic range from 3.5 to 500 {mu}Gy (0.998

  19. Physical characteristics of five clinical systems for digital mammography.

    PubMed

    Lazzari, B; Belli, G; Gori, C; Rosselli Del Turco, M

    2007-07-01

    The purpose of this study was to evaluate and compare the physical characteristics of five clinical systems for digital mammography (GE Senographe 2000D, Lorad Selenia M-IV, Fischer Senoscan, Agfa DM 1000, and IMS Giotto) currently in clinical use. The basic performances of the mammography systems tested were assessed on the basis of response curve, modulation transfer function (MTF), noise power spectrum, noise equivalent quanta (NEQ), and detective quantum efficiency (DQE) in an experimental setting closely resembling the clinical one. As expected, all the full field digital mammography systems show a linear response curve over a dynamic range from 3.5 to 500 microGy (0.998

  20. The usefulness of F-18 FDG PET/CT-mammography for preoperative staging of breast cancer: comparison with conventional PET/CT and MR-mammography

    PubMed Central

    Moon, Eun-Ha; Lim, Seok Tae; Han, Yeon-Hee; Jeong, Young Jin; Kang, Yun-Hee; Jeong, Hwan-Jeong; Sohn, Myung-Hee

    2013-01-01

    Background The objective of the study was to compare the diagnostic efficacy of an integrated Fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT-mammography (mammo-PET/CT) with conventional torso PET/CT (supine-PET/CT) and MR-mammography for initial assessment of breast cancer patients. Patients and methods Forty women (52.0 ± 12.0 years) with breast cancer who underwent supine-PET/CT, mammo-PET/CT, and MR-mammography from April 2009 to August 2009 were enrolled in the study. We compared the size of the tumour, tumour to chest wall distance, tumour to skin distance, volume of axillary fossa, and number of meta-static axillary lymph nodes between supine-PET/CT and mammo-PET/CT. Next, we assessed the difference of focality of primary breast tumour and tumour size in mammo-PET/CT and MR-mammography. Histopathologic findings served as the standard of reference. Results In the comparison between supine-PET/CT and mammo-PET/CT, significant differences were found in the tumour size (supine-PET/CT: 1.3 ± 0.6 cm, mammo-PET/CT: 1.5 ± 0.6 cm, p < 0.001), tumour to thoracic wall distance (1.8 ± 0.9 cm, 2.2 ± 2.1 cm, p < 0.001), and tumour to skin distance (1.5 ± 0.8 cm, 2.1 ± 1.4 cm, p < 0.001). The volume of axillary fossa was significantly wider in mammo-PET/CT than supine-PET/CT (21.7 ± 8.7 cm3 vs. 23.4 ± 10.4 cm3, p = 0.03). Mammo-PET/CT provided more correct definition of the T-stage of the primary tumour than did supine-PET/CT (72.5% vs. 67.5%). No significant difference was found in the number of metastatic axillary lymph nodes. Compared with MR-mammography, mammo-PET/CT provided more correct classification of the focality of lesion than did MR-mammography (95% vs. 90%). In the T-stage, 72.5% of cases with mammo-PET/CT and 70% of cases with MR-mammography showed correspondence with pathologic results. Conclusions Mammo-PET/CT provided more correct definition of the T-stage and evaluation of axillary fossa may also be delineated more clearly than with supine

  1. Algorithmic scatter correction in dual-energy digital mammography

    SciTech Connect

    Chen, Xi; Mou, Xuanqin; Nishikawa, Robert M.; Lau, Beverly A.; Chan, Suk-tak; Zhang, Lei

    2013-11-15

    Purpose: Small calcifications are often the earliest and the main indicator of breast cancer. Dual-energy digital mammography (DEDM) has been considered as a promising technique to improve the detectability of calcifications since it can be used to suppress the contrast between adipose and glandular tissues of the breast. X-ray scatter leads to erroneous calculations of the DEDM image. Although the pinhole-array interpolation method can estimate scattered radiations, it requires extra exposures to measure the scatter and apply the correction. The purpose of this work is to design an algorithmic method for scatter correction in DEDM without extra exposures.Methods: In this paper, a scatter correction method for DEDM was developed based on the knowledge that scattered radiation has small spatial variation and that the majority of pixels in a mammogram are noncalcification pixels. The scatter fraction was estimated in the DEDM calculation and the measured scatter fraction was used to remove scatter from the image. The scatter correction method was implemented on a commercial full-field digital mammography system with breast tissue equivalent phantom and calcification phantom. The authors also implemented the pinhole-array interpolation scatter correction method on the system. Phantom results for both methods are presented and discussed. The authors compared the background DE calcification signals and the contrast-to-noise ratio (CNR) of calcifications in the three DE calcification images: image without scatter correction, image with scatter correction using pinhole-array interpolation method, and image with scatter correction using the authors' algorithmic method.Results: The authors' results show that the resultant background DE calcification signal can be reduced. The root-mean-square of background DE calcification signal of 1962 μm with scatter-uncorrected data was reduced to 194 μm after scatter correction using the authors' algorithmic method. The range of

  2. Engaging diverse underserved communities to bridge the mammography divide

    PubMed Central

    2011-01-01

    Background Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN) and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations. Methods/Design In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas - Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI2) intervention or a comparison general breast cancer

  3. Women with abnormal screening mammography lost to follow-up

    PubMed Central

    Kuo, Chia-Sheng; Chen, Guan-Ru; Hung, Shou-Hung; Liu, Yi-Lien; Huang, Kuo-Chin; Cheng, Shao-Yi

    2016-01-01

    Abstract Breast cancer has the highest incidence among all cancers for women in Taiwan. The current screening policy in Taiwan suggested a biennial mammography for all women 40 to 69 years of age. A recommendation for additional testing is recommended for women with a BI-RADS result of 0 or 4; a request made via postal mail. Approximately 20% of high-risk patients do not receive additional follow-up. Therefore, we aimed to explore the causes of these patients being lost to follow-up, despite an abnormal mammogram. Two questionnaires were designed separately according to the conceptual framework of the Health Belief Model. Study participants, women who received a screening mammography at the National Taiwan University Hospital in 2011 with a BI-RAD of 0 or 4, were interviewed via telephone. The dependent variable was receipt of follow-up or not. The analyses were performed by using χ2 tests and logistic regression models. In total, 528 women were enrolled in the study: 51.2% in BI-RADS 0 group and 56.6% in BI-RADS 4, respectively. In the BI-RADS 0 group, those patients who received a follow-up examination cited the most likely causes to be physician suggestion, health implications, and concerns regarding breast cancer. Patients who did not receive a follow-up examination cited a lack of time and a perception of good personal health as primary reasons. In the BI-RADS 4 group, those patients who received a follow-up examination cited the physician's recommendation and a recognition of the importance of follow-up examinations. Patients who did not receive a follow-up examination cited having received follow-up at another hospital and a desire for a second opinion. In the BI-RADS 0 group, multivariate analysis showed that patients with higher scores in the “perceived benefits” domain were statistically more likely to receive a follow-up examination. There was no significant difference in perceived threats, perceived barriers, action cues, or self-efficacy between

  4. Objective models of compressed breast shapes undergoing mammography

    SciTech Connect

    Feng, Steve Si Jia; Patel, Bhavika; Sechopoulos, Ioannis

    2013-03-15

    Purpose: To develop models of compressed breasts undergoing mammography based on objective analysis, that are capable of accurately representing breast shapes in acquired clinical images and generating new, clinically realistic shapes. Methods: An automated edge detection algorithm was used to catalogue the breast shapes of clinically acquired cranio-caudal (CC) and medio-lateral oblique (MLO) view mammograms from a large database of digital mammography images. Principal component analysis (PCA) was performed on these shapes to reduce the information contained within the shapes to a small number of linearly independent variables. The breast shape models, one of each view, were developed from the identified principal components, and their ability to reproduce the shape of breasts from an independent set of mammograms not used in the PCA, was assessed both visually and quantitatively by calculating the average distance error (ADE). Results: The PCA breast shape models of the CC and MLO mammographic views based on six principal components, in which 99.2% and 98.0%, respectively, of the total variance of the dataset is contained, were found to be able to reproduce breast shapes with strong fidelity (CC view mean ADE = 0.90 mm, MLO view mean ADE = 1.43 mm) and to generate new clinically realistic shapes. The PCA models based on fewer principal components were also successful, but to a lesser degree, as the two-component model exhibited a mean ADE = 2.99 mm for the CC view, and a mean ADE = 4.63 mm for the MLO view. The four-component models exhibited a mean ADE = 1.47 mm for the CC view and a mean ADE = 2.14 mm for the MLO view. Paired t-tests of the ADE values of each image between models showed that these differences were statistically significant (max p-value = 0.0247). Visual examination of modeled breast shapes confirmed these results. Histograms of the PCA parameters associated with the six principal components were fitted with Gaussian distributions. The six

  5. Multi-tapered x-ray capillary optics for mammography

    NASA Astrophysics Data System (ADS)

    Bradford, Carla Duquesne

    X-ray mammography is currently the primary tool used for breast cancer detection. However mammography has limitations. Studies have shown that 5%-15% of breast cancers are not visualized mammographically and of the number of cases sent to biopsy, only 15% are actually cancerous (high false positive percentage). The long term goal of this project is to improve the x- ray mammographic imaging system using capillary optics. A post-patient capillary optic lens has the potential to increase spatial resolution and eliminate the detection of scattered x-rays, thereby improving image contrast and SNR. These improvements can be exploited with any detector but may have the greatest potential when implemented with digital detectors. An image analysis study has been performed using a prototype multi-tapered optic to determine the feasibility of a full-field multi-tapered optic. Scatter fraction, contrast, transmission, uniformity, MTF, NPS and DQE were measured for a CR imaging system when the prototype multi-tapered optic lens was applied. The results were compared with standard grid and air gap techniques. The measurements demonstrate that the multi-tapered optic lens removes 85% of the scattered photons, while air gap and grid methods remove 66% and 39%, respectively. This results in an improvement of contrast by approximately 80% for the optics, compared to 51% for the air gap and 30% for the grid methods. The single capillary optic lenses can improve the limiting resolution (5% MTF level) of the CR detector by 78% due to magnification with very little focal spot blurring, while the multi-tapered prototype improved resolution significantly but not as much as the single optic. This was due to relative misalignment of the individual lenses in the multi- tapered optic. Acceptable levels of misalignment have been established that appear to be readily achievable. Once this relative misalignment issue is resolved, the multi-tapered lens will produce results similar to single

  6. Which Phantom Is Better for Assessing the Image Quality in Full-Field Digital Mammography?: American College of Radiology Accreditation Phantom versus Digital Mammography Accreditation Phantom

    PubMed Central

    Song, Sung Eun; Yie, An; Ku, Bon Kyung; Kim, Hee-Young; Cho, Kyu Ran; Chung, Hwan Hoon; Lee, Seung Hwa; Hwang, Kyu-Won

    2012-01-01

    Objective To compare between the American College of Radiology (ACR) accreditation phantom and digital mammography accreditation phantom in assessing the image quality in full-field digital mammography (FFDM). Materials and Methods In each week throughout the 42-week study, we obtained phantom images using both the ACR accreditation phantom and the digital mammography accreditation phantom, and a total of 42 pairs of images were included in this study. We assessed the signal-to-noise ratio (SNR) in each phantom image. A radiologist drew a square-shaped region of interest on the phantom and then the mean value of the SNR and the standard deviation were automatically provided on a monitor. SNR was calculated by an equation, measured mean value of SNR-constant coefficient of FFDM/standard deviation. Two breast radiologists scored visible objects (fibers, specks, and masses) with soft-copy images and calculated the visible rate (number of visible objects/total number of objects). We compared SNR and the visible rate of objects between the two phantoms and calculated the k-coefficient for interobserver agreement. Results The SNR of the ACR accreditation phantom ranged from 42.0 to 52.9 (Mean, 47.3 ± 2.79) and that of Digital Phantom ranged from 24.8 to 54.0 (Mean, 44.1 ± 9.93) (p = 0.028). The visible rates of all three types of objects were much higher in the ACR accreditation phantom than those in the digital mammography accreditation phantom (p < 0.05). Interobserver agreement for visible rates of objects on phantom images was fair to moderate agreement (k-coefficients: 0.34-0.57). Conclusion The ACR accreditation phantom is superior to the digital mammography accreditation phantom in terms of SNR and visibility of phantom objects. Thus, ACR accreditation phantom appears to be satisfactory for assessing the image quality in FFDM. PMID:23118577

  7. Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women

    PubMed Central

    Haghighat, Shahpar; Akbari, Mohammad Esmaeil; Yavari, Parvin; Javanbakht, Mehdi; Ghaffari, Shahram

    2016-01-01

    Background Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease. Objectives We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer. Patients and Methods This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years (QALY) and lifetime costs. Results The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int. $ 37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int. $ 141,641 and Int. $ 389,148 respectively. Conclusions Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making. PMID:27366315

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

    SciTech Connect

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

    2006-03-15

    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.

  9. Research in digital mammography and tomosynthesis at the University of Toronto.

    PubMed

    Yaffe, Martin J

    2014-07-01

    There have been major advances in the field of breast cancer imaging since the early 1970s, both in technological improvements and in the use of the methods of medical physics and image analysis to optimize image quality. The introduction of digital mammography in 2000 provided a marked improvement in imaging of dense breasts. In addition, it became possible to produce tomographic and functional images on modified digital mammography systems. Digital imaging also greatly facilitated the extraction of quantitative information from images. My laboratory has been fortunate in being able to participate in some of these exciting developments. I will highlight some of the areas of our research interest which include modeling of the image formation process, development of high-resolution X-ray detectors for digital mammography and investigating new methods for analyzing image quality. I will also describe our more recent work on developing new applications of digital mammography including tomosynthesis, contrast-enhanced mammography, and measurement of breast density. Finally, I will point to a new area for our research--the application of the techniques of medical imaging to making pathology more quantitative to contribute to use of biomarkers for better characterizing breast cancer and directing therapeutic decisions. PMID:24961727

  10. Incorporating mobile mammography units into primary care: focus group interviews among inner-city health center patients.

    PubMed

    Skinner, C S; Zerr, A D; Damson, R L

    1995-06-01

    Mammography screening is underutilized, especially among women of lower socioeconomic status (SES). Mobile mammography units reduce cost and patient burden of mammography, and therefore might enhance screening rates among underserved populations. Few studies have explored factors associated with the acceptability of mobile mammography; none have targeted low-SES women. To explore these issues, we conducted focus group interviews in five university-affiliated urban primary-care clinics. The forty-three participants were 74% African-American, ranged in age from 40 to 70 years and most (67%) had household incomes below $15,000. A trained moderator led the groups of eight to 12 women through standardized, open-end interview questions exploring perceptions of mobile mammography. Findings suggest mammography vans are acceptable under only certain circumstances, including advance notice and assurance of privacy and quality. Convenience was important; 53% related being more likely to have mammograms if scheduled in conjunction with primary-care visits. Participants felt strongly that vans were inappropriate for public forums such as shopping centers. Association with primary-care health centers seemed to legitimize mammography vans and to allay concerns. If mammography screening is to become more widespread among low-income populations, these exploratory findings must be addressed in research and intervention development. PMID:10160229

  11. Predictive features of breast cancer on Mexican screening mammography patients

    NASA Astrophysics Data System (ADS)

    Rodriguez-Rojas, Juan; Garza-Montemayor, Margarita; Trevino-Alvarado, Victor; Tamez-Pena, José Gerardo

    2013-02-01

    Breast cancer is the most common type of cancer worldwide. In response, breast cancer screening programs are becoming common around the world and public programs now serve millions of women worldwide. These programs are expensive, requiring many specialized radiologists to examine all images. Nevertheless, there is a lack of trained radiologists in many countries as in Mexico, which is a barrier towards decreasing breast cancer mortality, pointing at the need of a triaging system that prioritizes high risk cases for prompt interpretation. Therefore we explored in an image database of Mexican patients whether high risk cases can be distinguished using image features. We collected a set of 200 digital screening mammography cases from a hospital in Mexico, and assigned low or high risk labels according to its BIRADS score. Breast tissue segmentation was performed using an automatic procedure. Image features were obtained considering only the segmented region on each view and comparing the bilateral di erences of the obtained features. Predictive combinations of features were chosen using a genetic algorithms based feature selection procedure. The best model found was able to classify low-risk and high-risk cases with an area under the ROC curve of 0.88 on a 150-fold cross-validation test. The features selected were associated to the differences of signal distribution and tissue shape on bilateral views. The model found can be used to automatically identify high risk cases and trigger the necessary measures to provide prompt treatment.

  12. Mammography imaging studies using a Laue crystal analyzer

    SciTech Connect

    Chapman, D.; Thomlinson, W.; Arfelli, F.; Gmuer, N.; Zhong, Z.; Menk, R.; Johnson, R.E.; Washburn, D.; Pisano, E.; Sayers, D. ||||

    1996-09-01

    Synchrotron-based mammography imaging experiments have been performed with monochromatic x-rays in which a Laue crystal placed after the object being imaged has been used to split the beam transmitted through the object. The X27C R&D beamline at the National Synchrotron Light Source was used with the white beam monochromatized by a double crystal Si(111) monochromator tuned to 18 keV. The imaging beam was a thin horizontal line approximately 0.5 mm high by 100 mm wide. Images were acquired in line scan mode with the phantom and detector both scanned together. The detector for these experiments was an image plate. A thin Si(111) Laue analyzer was used to diffract a portion of the beam transmitted through the phantom before the image plate detector. This {open_quote}{open_quote}scatter free{close_quote}{close_quote} diffracted beam was then recorded on the image plate during the phantom scan. Since the thin Laue crystal also transmitted a fraction of the incident beam, this beam was also simultaneously recorded on the image plate. The imaging results are interpreted in terms of an x-ray schliere or refractive index inhomogeneities. The analyzer images taken at various points in the rocking curve will be presented. {copyright} {ital 1996 American Institute of Physics.}

  13. Fractal analysis of radiologists' visual scanning pattern in screening mammography

    NASA Astrophysics Data System (ADS)

    Alamudun, Folami T.; Yoon, Hong-Jun; Hudson, Kathy; Morin-Ducote, Garnetta; Tourassi, Georgia

    2015-03-01

    Several researchers have investigated radiologists' visual scanning patterns with respect to features such as total time examining a case, time to initially hit true lesions, number of hits, etc. The purpose of this study was to examine the complexity of the radiologists' visual scanning pattern when viewing 4-view mammographic cases, as they typically do in clinical practice. Gaze data were collected from 10 readers (3 breast imaging experts and 7 radiology residents) while reviewing 100 screening mammograms (24 normal, 26 benign, 50 malignant). The radiologists' scanpaths across the 4 mammographic views were mapped to a single 2-D image plane. Then, fractal analysis was applied on the composite 4- view scanpaths. For each case, the complexity of each radiologist's scanpath was measured using fractal dimension estimated with the box counting method. The association between the fractal dimension of the radiologists' visual scanpath, case pathology, case density, and radiologist experience was evaluated using fixed effects ANOVA. ANOVA showed that the complexity of the radiologists' visual search pattern in screening mammography is dependent on case specific attributes (breast parenchyma density and case pathology) as well as on reader attributes, namely experience level. Visual scanning patterns are significantly different for benign and malignant cases than for normal cases. There is also substantial inter-observer variability which cannot be explained only by experience level.

  14. Preoperative digital mammography imaging in conservative mastectomy and immediate reconstruction

    PubMed Central

    Angrigiani, Claudio; Hammond, Dennis; Nava, Maurizio; Gonzalez, Eduardo; Rostagno, Roman; Gercovich, Gustavo

    2016-01-01

    Background Digital mammography clearly distinguishes gland tissue density from the overlying non-glandular breast tissue coverage, which corresponds to the existing tissue between the skin and the Cooper’s ligaments surrounding the gland (i.e., dermis and subcutaneous fat). Preoperative digital imaging can determine the thickness of this breast tissue coverage, thus facilitating planning of the most adequate surgical techniques and reconstructive procedures for each case. Methods This study aimed to describe the results of a retrospective study of 352 digital mammograms in 176 patients with different breast volumes who underwent preoperative conservative mastectomies. The breast tissue coverage thickness and its relationship with the breast volume were evaluated. Results The breast tissue coverage thickness ranged from 0.233 to 4.423 cm, with a mean value of 1.952 cm. A comparison of tissue coverage and breast volume revealed a non-direct relationship between these factors. Conclusions Preoperative planning should not depend only on breast volume. Flap evaluations based on preoperative imaging measurements might be helpful when planning a conservative mastectomy. Accordingly, we propose a breast tissue coverage classification (BTCC). PMID:26855903

  15. Fusion of digital mammography with breast ultrasound: a phantom study

    NASA Astrophysics Data System (ADS)

    Kapur, Ajay; Krucker, Jochen; Astley, Oliver; Buckley, Donald; Eberhard, Jeffrey W.; Alyassin, Abdal M.; Claus, Bernhard E. H.; Thomenius, Kai E.; Myers, Heather; Rumsey, Michael; Johnson, Roger N.; Karr, Steve

    2002-05-01

    The objective of this work was to acquire co-registered digital tomosynthesis mammograms and 3-D breast ultrasound images of breast phantoms. A prototype mammography compression paddle was built for this application and installed on an x-ray tomosynthesis prototype system (GE). Following x-ray exposure, an automated two-dimensional ultrasound probe mover assembly is precisely positioned above the compression plate, and an attached high-frequency ultrasound transducer is scanned over the acoustically coupled phantom or localized region of interest within the phantom through computerized control. The co-ordinate system of one of the two data sets is then transformed into that of the other, and matching regions of interest on either image set can be simultaneously viewed on the x-ray and ultrasound images thus enhancing qualitative visualization, localization and characterization of regions of interest. The potentials of structured noise reduction, cyst versus solid mass differentiation and full 3-D visualization of multi-modality registered data sets in a single automated combined examination are realized for the first time. Elements of system design and required image correction algorithms will be described and phantom studies with this prototype, automated system on an anthropomorphic breast phantom will be presented.

  16. On imaging with or without grid in digital mammography

    NASA Astrophysics Data System (ADS)

    Chen, Han; Danielsson, Mats; Cederström, Björn

    2014-03-01

    The grids used in digital mammography to reduce scattered radiation from the breast are not perfect and lead to partial absorption of primary radiation at the same time as not all of the scattered radiation is absorbed. It has therefore lately been suggested to remove the grids and correct for effects of scattered radiation by post- processing the images. In this paper, we investigated the dose reduction that might be achieved if the gird were to be removed. Dose reduction is determined as a function of PMMA thickness by comparing the contrast-to-noise ratios (CNRs) of images acquired with and without grid at a constant exposure. We used a theoretical model validated with Monte Carlo simulations and phantom studies. To evaluate the CNR, we applied aluminum filters of two different sizes, 4x8 cm2 and 1x1 cm2. When the large Al filter was used, the resulting CNR value for the grid-less images was overestimated as a result of a difference in amount of scattered radiation in the background region and of the region covered by the filter, a difference that could be eliminated by selecting a region of interest close to the edge of the filter. The optimal CNR when the PMMA thickness was above about 4 cm was obtained with a grid, whereas removing the grid leaded to a dose saving in thinner PMMAs. The results suggest not removing grids in breast cancer screening.

  17. Parallel hardware architecture for CCD-mosaic digital mammography

    NASA Astrophysics Data System (ADS)

    Smith, Scott T.; Kim, Hyunkeun; Swarnakar, Vivek; Jeong, Myoungki; Wobschall, Darold C.

    1998-06-01

    The development of an efficient parallel hardware architecture suitable for CCD-mosaic digital mammography has been accomplished. This paper presents this architecture including both the analog and digital portions of the imaging hardware. A two dimensional array of CCD sensors are used to capture the mammographic image synchronously and simultaneously. Each CCD's analog signal is converted to a 12 bits/pixel digital value through an array of high speed analog-to-digital converters. A parallel array of mesh connected TMS320C40 DSP processors then takes in the digital image data simultaneously. The DSP's are used to precisely register the mosaic of individual images to form the final large format digital mammogram. Also, they are used to control CCD characteristics and parallel data transport to the viewing workstation. One master DSP is located on the workstation's PCI bus which controls the parallel DSP array and collects compressed image data through a 60MB/s port. Since all computations are performed in parallel using local memory on each DSP, the overall acquisition, image registration, and transmission to display of the final mammogram is performed in less than 30 seconds. This allows the physician to perform a preliminary observation of the patient's mammogram.

  18. Optical mammography: bilateral breast symmetry in hemoglobin saturation maps.

    PubMed

    Anderson, Pamela G; Sassaroli, Angelo; Kainerstorfer, Jana M; Krishnamurthy, Nishanth; Kalli, Sirishma; Makim, Shital S; Graham, Roger A; Fantini, Sergio

    2016-10-01

    We present a study of the bilateral symmetry of human breast hemoglobin saturation maps measured with a broadband optical mammography instrument. We have imaged 21 patients with unilateral breast cancer, 32 patients with unilateral benign lesions, and 27 healthy patients. An image registration process was applied to the bilateral hemoglobin saturation (SO 2 SO2 ) images by assigning each pixel to the low, middle, or high range of SO 2 SO2 values, where the thresholds for the categories were the 15th and 85th percentiles of the individual saturation range. The Dice coefficient, which is a measure of similarity, was calculated for each patient’s pair of right and left breast SO 2 SO2 images. The invasive cancer patients were found to have an average Dice coefficient value of 0.55±0.07 0.55±0.07 , which was significantly lower than the benign and healthy groups (0.61±0.11 0.61±0.11 and 0.62±0.12 0.62±0.12 , respectively). Although differences were seen in a group analysis, the healthy patient Dice coefficients spanned a wide range, limiting the diagnostic capabilities of this SO 2 SO2 symmetry analysis on an individual basis. Our results suggest that for assessing the SO 2 SO2 contrast of breast lesions, it may be better to select a reference tissue in the ipsilateral rather than the contralateral breast. PMID:26849841

  19. Dosimetric implications of age related glandular changes in screening mammography

    NASA Astrophysics Data System (ADS)

    Beckett, J. R.; Kotre, C. J.

    2000-03-01

    The UK National Health Service Breast Screening Programme is currently organized to routinely screen women between the ages of 50 and 64, with screening for older women available on request. The lower end of this age range closely matches the median age for the menopause (51 years), during which significant changes in the composition of the breast are known to occur. In order to quantify the dosimetric effect of these changes, radiographic factors and compressed breast thickness data for a cohort of 1258 women aged between 35 and 79 undergoing breast screening mammography have been used to derive estimates of breast glandularity and mean glandular dose (MGD), and examine their variation with age. The variation of mean radiographic exposure factors with age is also investigated. The presence of a significant number of age trial women within the cohort allowed an extended age range to be studied. Estimates of MGD including corrections for breast glandularity based on compressed breast thickness only, compressed breast thickness and age and for each individual woman are compared with the MGD based on the conventional assumption of a 50:50 adipose/glandular composition. It has been found that the use of the conventional 50:50 assumption leads to overestimates of MGD of up to 13% over the age range considered. By using compressed breast thickness to estimate breast glandularity, this error range can be reduced to 8%, whilst age and compressed breast thickness based glandularity estimates result in an error range of 1%.

  20. Mammography imaging studies using a laue crystal analyzer

    SciTech Connect

    Chapman, D.; Thomlinson, W.; Arfelli, F. |

    1995-12-31

    Synchrotron based mammography imaging experiments have been performed with monochromatic x-rays in which a laue crystal placed after the object being imaged has been used to split the beam transmitted through the object. The X27C R&D beamline at the National Synchrotron Light Source was used with the white beam monochromatized by a double crystal Si(111) monochromator tuned to 18 keV. The imaging beam was a thin horizontal line approximately 0.5 mm high by 100 mm wide. Images were acquired in line scan mode with the phantom and detector both scanned together. The detector for these experiments was an image plate. A thin Si(l11) laue analyzer was used to diffract a portion of the beam transmitted through the phantom before the image plate detector. This ``scatter free`` diffracted beam was then recorded on the image plate during the phantom scan. Since the thin laue crystal also transmitted a fraction of the incident beam, this beam was also simultaneously recorded on the image plate. The imaging results are interpreted in terms of an x-ray schliere or refractive index inhomogeneities. The analyzer images taken at various points in the rocking curve will be presented.

  1. Comparison of scintillators for positron emission mammography (PEM) systems

    SciTech Connect

    Raymond Raylman; Stanislaw Majewski; Mark Smith; Randolph Wojcik; Andrew Weisenberger; Brian Kross; Vladimir Popov; Jamal J. Derakhshan

    2003-02-01

    Positron emission mammography (PEM) has promise as an effective method for the detection of breast lesions. Perhaps the most significant design feature of a PEM system is the choice of scintillator material. In this investigation we compared three scintillators for use in PEM: NaI(Tl), gadolinium oxyorthosilicate (GSO), and lutetium-gadolinium oxyorthosilicate (LGSO). The PEM systems consisted of two 30/spl times/30 arrays of pixelated scintillators (3/spl times/3/spl times/10 mm/sup 3/ for GSO and LGSO and 3/spl times/3/spl times/19 mm/sup 3/ for NaI(Tl)) coupled to arrays of square position-sensitive photomultiplier tubes. The Compton scatter fraction, system energy resolution, spatial resolution, spatial resolution uniformity, and detection sensitivity were compared. Compton scatter fractions for the systems were comparable, between 8% and 9%. The NaI(Tl) system produced the best system energy resolution (18.2%), the GSO system had the worst system energy resolution (28.7%).

  2. Testing the feasibility of a DVD-based intervention to promote preparedness for mammography in women with intellectual disabilities.

    PubMed

    Greenwood, Nechama W; Wang, Claire Tienwey; Bowen, Deborah; Wilkinson, Joanne

    2014-03-01

    Women with intellectual disabilities (ID, formerly mental retardation) have a similar breast cancer incidence as the general population, but they have higher breast cancer mortality and lower rates of regular screening mammography. We conducted a feasibility study evaluating acceptability, demand, and limited efficacy of a health education DVD about mammography for women with ID. The DVD was developed in order to address disability-specific barriers to mammography identified in prior studies, such as anxiety related to navigating the logistics of obtaining a mammogram. The DVD was found to be acceptable and feasible, and led to a moderate increase in mammography preparedness in this population. Study results suggest that this DVD-based intervention is an appropriate candidate for further study measuring efficacy and effectiveness in increasing regular mammography in women with ID, a disparity population. PMID:24197688

  3. Level of awareness of mammography among women attending outpatient clinics in a teaching hospital in Ibadan, South-West Nigeria

    PubMed Central

    2013-01-01

    Background Mammography has been used in developed countries with considerable success but very little is known about this imaging modality in low resource settings. This study examined the level of awareness of mammography and determined factors influencing the level of awareness. Methods We conducted a hospital based cross sectional study to investigate the level of awareness of mammography among 818 randomly selected women attending the General Outpatient clinics (GOP) of the University College Hospital (UCH), Ibadan, Nigeria. Independent predictors of level of awareness of mammography were identified using multiple logistic regression analysis. Results The proportion of women who ever heard of mammography was 5%, and they demonstrated poor knowledge of the procedure. Those with primary or secondary levels of education were about three times less likely to be aware of mammography when compared with those with tertiary level of education (OR = 0.3, 95% CI, 0.12 – 0.73). Also, participation in community breast cancer prevention activities (OR = 3.4, 95% CI, 1.39 – 8.36), and previous clinical breast examination (OR = 2.34, 95% CI, 1.10 – 4.96) independently predicted mammography awareness. Newspapers and magazines appeared to be the most important sources of information about mammography screening. Conclusion The level of awareness of mammography is poor among women attending outpatient clinics in the studied population. Interventions promoting awareness of this screening procedure should give particular attention to the illiterate and older women while clinicians performing breast examinations should utilize the opportunity to inform women about the mammography procedure. Promotion of educational articles on breast cancer and its screening methods via media remains vital for the literate. PMID:23324312

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  5. Automatic exposure control for a slot scanning full field digital mammography system

    SciTech Connect

    Elbakri, Idris A.; Lakshminarayanan, A.V.; Tesic, Mike M.

    2005-09-15

    Automatic exposure control (AEC) is an important feature in mammography. It enables consistently optimal image exposure despite variations in tissue density and thickness, and user skill level. Full field digital mammography systems cannot employ conventional AEC methods because digital receptors fully absorb the x-ray beam. In this paper we describe an AEC procedure for slot scanning mammography. With slot scanning detectors, our approach uses a fast low-resolution and low-exposure prescan to acquire an image of the breast. Tube potential depends on breast thickness, and the prescan histogram provides the necessary information to calculate the required tube current. We validate our approach with simulated prescan images and phantom measurements. We achieve accurate exposure tracking with thickness and density, and expect this method of AEC to reduce retakes and improve workflow.

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

    PubMed

    Strech, Daniel

    2014-03-01

    Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the "European guideline for quality assurance in breast cancer screening and diagnosis" specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates. PMID:24332817

  7. Factors That Influence Mammography Use among Older American Indian and Alaska Native Women

    PubMed Central

    James, Rosalina D.; Gold, Dana E.; St John BlackBird, Arlene; Trinidad, Susan Brown

    2014-01-01

    American Indian and Alaska Native (AIAN) women have relatively high breast-cancer mortality rates despite the availability of free or low-cost screening. Purpose This qualitative study explored issues that influence the participation of older AIAN women in mammography screening through tribally directed National Breast and Cervical Cancer Early Detection Programs (NBCCEDP). Methods We interviewed staff (n=12) representing five tribal NBCCEDP and conducted four focus groups with AIAN women ages 50 to 80 years (n = 33). Results Our analysis identified four main areas of factors that predispose, enable, or reinforce decisions around mammography: financial issues and personal investments, program characteristics including direct services and education, access issues such as transportation, and comfort zone topics that include cultural or community-wide norms regarding cancer prevention. Conclusion This study has implications for nurse education and training on delivering effective mammography services and preventive cancer outreach and education programs in AIAN communities. PMID:24626283

  8. Randomized Trial of an Intervention to Improve Mammography Utilization Among a Triracial Rural Population of Women

    PubMed Central

    Paskett, Electra; Tatum, Cathy; Rushing, Julia; Michielutte, Robert; Bell, Ronny; Foley, Kristie Long; Bittoni, Marisa; Dickinson, Stephanie L.; McAlearney, Ann Scheck; Reeves, Katherine

    2015-01-01

    Introduction Mammography is underused by certain groups of women, in particular poor and minority women. We developed a lay health advisor (LHA) intervention based on behavioral theories and tested whether it improved mammography attendance in Robeson County, NC, a rural, low-income, triracial (white, Native American, African American) population. Methods A total of 851 women who had not had a mammogram within the past year were randomly assigned to the LHA intervention (n = 433) or to a comparison arm (n = 418) during 1998–2002. Rates of mammography use after 12–14 months (as verified by medical record review) were compared using a chi-square test. Baseline and follow-up (at 12–14 months) surveys were used to obtain information on demographics, risk factors, and barriers, beliefs, and knowledge about mammography. Linear regression, Mantel–Haenszel statistics, and logistic regression were used to compare barriers, beliefs, and knowledge from baseline to follow-up and to identify baseline factors associated with mammography. Results At follow-up, 42.5% of the women in the LHA group and 27.3% of those in the comparison group had had a mammogram in the previous 12 months (relative risk = 1.56, 95% confidence interval [CI] = 1.29 to 1.87). Compared with those in the comparison group, women in the LHA group displayed statistically significantly better belief scores (difference = 0.46 points on a 0–10 scale, 95% CI = 0.15 to 0.77) and reduced barriers at follow-up (difference = −0.77 points, 95% CI = −1.02 to −0.53), after adjusting for baseline scores. Conclusions LHA interventions can improve mammography utilization. Future studies are needed to assess strategies to disseminate effective LHA interventions to under-served populations. PMID:16954475

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

    PubMed Central

    Chang-Halpenny, Christine; Kumarasamy, Narmadan A; Venegas, Angela; Braddock III, Clarence H

    2016-01-01

    Objective: Our aim was to examine underserved women’s perceptions on mobile versus fixed mammography in Santa Clara, California through a focus group study. Background: 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.  Methods: 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. Results: 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.  Conclusions: 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

  10. Effects of a Randomized Controlled Trial to Increase Repeat Mammography Screening in Iranian Women

    PubMed Central

    Taymoori, Parvaneh; Molina, Yamile; Roshani, Daem

    2014-01-01

    Background Although mammography use has increased in developed countries, regular screening in developing countries including Iran remains low. Multiple frameworks, including the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), have been used to understand screening practices among Iranians. The HBM includes intrapersonal constructs such as perceptions of breast cancer and mammography. The TPB includes interpersonal and environmental constructs, such as perceived control and subjective norms. Objectives The current study had 2 objectives: (1) to examine changes in the HBM and TPB constructs and repeat mammography screening in women receiving either intervention and women in the control group and (2) to compare changes in the HBM and TPB constructs and repeat mammography screening across the 2 interventions. Methods One hundred eight-four women from 3 randomly selected health centers in Sanandaj, Iran, participated. Eligibility criteria were being 50 years or older, having received a mammogram in the past 2 to 3 years, and no intention to obtain a mammogram within the next year. Results The TPB and HBM participants exhibited greater changes in the HBM and TPB constructs and were more likely to have a mammogram relative to control participants. The TPB and HBM participants exhibited comparable changes in constructs and repeat mammography. Conclusion Findings suggest both interventions equally improved mammography screening. Additional studies are furthermore warranted to address nonadherent Iranian women’s needs in line with these conceptual models. Implications for Practice Use of the HBM and TPB constructs in clinical practice may be helpful to promote continued screening among this population. PMID:25122130

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

    PubMed Central

    Yang, Shih-Neng; Li, Fang-Jing; Liao, Yen-Hsiu; Chen, Yueh-Sheng; Shen, Wu-Chung; Huang, Tzung-Chi

    2015-01-01

    Objectives 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. Materials and Methods 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. Results 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). Conclusion 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. PMID:26056841

  12. The Role of Social Capital in African-American Women's Use of Mammography

    PubMed Central

    Dean, Lorraine; Subramanian, SV; Williams, David R.; Armstrong, Katrina; Charles, Camille Zubrinsky; Kawachi, Ichiro

    2014-01-01

    Black/African-American women are more likely to get breast cancer at a young age and/or be diagnosed at a late disease stage, pointing to a greater need to promote mammography for Black women at earlier ages than are currently recommended. This study explores how perceived neighborhood social capital, that is, perceptions of how tight-knit a neighborhood is and what power that confers to neighborhood members, relates to use of mammography for Black women in Philadelphia. Living in a community with tight social ties (social cohesion) or that have a collective motivation for community change (collective efficacy) may increase the likelihood that an individual woman in that community will hear health messages from other community members and neighbors (diffusion of information) and will have access to health-related resources that allow them to engage in healthy behaviors. No prior studies have explored the role of social capital in decisions for mammography use. Using multilevel logistic regression, we analyzed self-report of mammography in the past year for 2,586, Black women over age 40 across 381 Philadelphia, Pennsylvania USA census tracts. Our study included individual demographic and aggregates of individual-level social capital data from the Public Health Management Corporation's 2004, 2006, and 2008 Community Health Database waves, and 2000 US Census sociodemographic characteristics. Individual perceptions that a Black woman's neighborhood had high social capital, specifically collective efficacy, had a positive and statistically significant association with mammography use (OR=1.40, CI: 1.05, 1.85). Our findings suggest that an individual woman's perception of greater neighborhood social capital may be related to increased mammography use. Although this analysis could not determine the direction of causality, it suggests that social capital may play a role in cancer preventive screening for African-American women in Philadelphia, which warrants further study

  13. Design for a coherent-scatter imaging system compatible with screening mammography.

    PubMed

    Kern, Katie; Peerzada, Lubna; Hassan, Laila; MacDonald, Carolyn

    2016-07-01

    A system using a wide-slot beam and simple antiscatter grids or slots has been designed to provide a localized map of tissue type that could be overlaid on the simultaneous conventional transmission image to provide an inexpensive, low dose adjunct to conventional screening mammography. Depth information is obtainable from the stereoscopic viewing angles. The system was demonstrated to produce observable contrast between adipose tissue and a phantom chosen to mimic carcinoma at an exposure comparable with screening mammography. Imaging data was collected over a range of system parameters to optimize contrast and to allow verification of simulation modeling. PMID:27610395

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

    PubMed

    2000-01-01

    Mammography is the only major imaging technique still unavailable in the United States in digital form. This is because the Food and Drug Administration (FDA) has been unable to devise an effective method for manufacturers to demonstrate the safety and efficacy of digital mammography systems. As a result, the agency has been unable to approve any of those systems for marketing in the United States. In this Regulatory Update, we describe FDA's recent efforts to help manufacturers obtain approval and the reasons those efforts have so far proved ineffective. PMID:10631559

  15. Health Behaviors Among Cancer Survivors Receiving Screening Mammography

    PubMed Central

    Rausch, Sarah M.; Millay, Shannon; Scott, Chris; Pruthi, Sandhya; Clark, Matthew M.; Patten, Christi; Stan, Daniela; Sellers, Thomas; Vachon, Celine

    2010-01-01

    Objectives The purpose of this study was to evaluate the prevalence of cancer-related behavioral risk factors among female cancer survivors, relative to women without a previous diagnosis of cancer. Methods In a large cohort of 19,948 women presenting for screening mammography, questionnaires on health behaviors were administered. Results 18,510 had detailed history on health behaviors and previous cancer history. Overall 2,713 (14.7%) reported a previous cancer history. We found statistically significant results indicating cancer survivors were less likely than those with no cancer history to: report their overall health as “excellent” (13.6% vs. 21.5%), to engage in moderate or strenuous exercise (56.5% vs. 63.3%), and to use complementary and alternative medicine (CAM) (57.4% vs. 60.2%). Conversely, cancer survivors were more likely to be current smokers (6.3% vs. 5.5%) rate their overall health as “poor” (15.8% vs. 9.1%), and to report more weight gain over time. Among cancer survivors, differences also emerged by type of primary cancer. For example, cervical cancer survivors (n=370) were most likely to report being current smokers (15.7%) and regular alcohol users (71.7%) compared to other survivors. Ovarian (n=185) and uterine (n=262) cancer survivors most frequently reported being obese (41% and 34.4% respectively). Cervical cancer survivors reported the largest weight gain (4.9 lbs at 5 yrs and 13.4 lbs at 10 yrs). Conclusions These results suggest opportunities for tailored behavioral health risk factor interventions for specific populations of cancer survivors. PMID:21293247

  16. Assessment of mass detection performance in contrast enhanced digital mammography

    NASA Astrophysics Data System (ADS)

    Carton, Ann-Katherine; de Carvalho, Pablo M.; Li, Zhijin; Dromain, Clarisse; Muller, Serge

    2015-03-01

    We address the detectability of contrast-agent enhancing masses for contrast-agent enhanced spectral mammography (CESM), a dual-energy technique providing functional projection images of breast tissue perfusion and vascularity using simulated CESM images. First, the realism of simulated CESM images from anthropomorphic breast software phantoms generated with a software X-ray imaging platform was validated. Breast texture was characterized by power-law coefficients calculated in data sets of real clinical and simulated images. We also performed a 2-alternative forced choice (2-AFC) psychophysical experiment whereby simulated and real images were presented side-by-side to an experienced radiologist to test if real images could be distinguished from the simulated images. It was found that texture in our simulated CESM images has a fairly realistic appearance. Next, the relative performance of human readers and previously developed mathematical observers was assessed for the detection of iodine-enhancing mass lesions containing different contrast agent concentrations. A four alternative-forced-choice (4 AFC) task was designed; the task for the model and human observer was to detect which one of the four simulated DE recombined images contained an iodineenhancing mass. Our results showed that the NPW and NPWE models largely outperform human performance. After introduction of an internal noise component, both observers approached human performance. The CHO observer performs slightly worse than the average human observer. There is still work to be done in improving model observers as predictors of human-observer performance. Larger trials could also improve our test statistics. We hope that in the future, this framework of software breast phantoms, virtual image acquisition and processing, and mathematical observers can be beneficial to optimize CESM imaging techniques.

  17. Quantitative volumetric breast density estimation using phase contrast mammography

    NASA Astrophysics Data System (ADS)

    Wang, Zhentian; Hauser, Nik; Kubik-Huch, Rahel A.; D'Isidoro, Fabio; Stampanoni, Marco

    2015-05-01

    Phase contrast mammography using a grating interferometer is an emerging technology for breast imaging. It provides complementary information to the conventional absorption-based methods. Additional diagnostic values could be further obtained by retrieving quantitative information from the three physical signals (absorption, differential phase and small-angle scattering) yielded simultaneously. We report a non-parametric quantitative volumetric breast density estimation method by exploiting the ratio (dubbed the R value) of the absorption signal to the small-angle scattering signal. The R value is used to determine breast composition and the volumetric breast density (VBD) of the whole breast is obtained analytically by deducing the relationship between the R value and the pixel-wise breast density. The proposed method is tested by a phantom study and a group of 27 mastectomy samples. In the clinical evaluation, the estimated VBD values from both cranio-caudal (CC) and anterior-posterior (AP) views are compared with the ACR scores given by radiologists to the pre-surgical mammograms. The results show that the estimated VBD results using the proposed method are consistent with the pre-surgical ACR scores, indicating the effectiveness of this method in breast density estimation. A positive correlation is found between the estimated VBD and the diagnostic ACR score for both the CC view (p=0.033 ) and AP view (p=0.001 ). A linear regression between the results of the CC view and AP view showed a correlation coefficient γ = 0.77, which indicates the robustness of the proposed method and the quantitative character of the additional information obtained with our approach.

  18. Multitapered x-ray capillary optics for mammography.

    PubMed

    Bradford, Carla D; Peppler, Walter W; Ross, Richard E

    2002-06-01

    X-ray mammography is currently the primary tool used for breast cancer detection. However, studies have shown that 5%-15% of breast cancers are not visualized mammographically. The long term goal of this project is to improve the x-ray mammographic imaging system using capillary optics. A post-patient capillary optic lens has the potential to increase spatial resolution and eliminate the detection of scattered x rays, thereby improving image contrast and the signal-to-noise ratio (SNR). Several individual and two prototype multitapered optics were studied to determine the feasibility of a full-field multitapered optic. Scatter fraction, contrast, transmission, uniformity, and the modulation transfer function (MTF) were measured for a Mo target tube/computed radiography (CR) imaging system when this prototype was applied. The results were compared with standard grid and airgap techniques. The multitapered optic lens removed 85% of the scattered photons as compared to 66% and 39% for the air gap and grid methods, respectively. This resulted in an improvement of contrast by approximately 80% for the optics, 51% for the air gap, and 30% for grid methods. The single optic lens improved the limiting resolution (5% MTF level) of the CR detector by 78% due to magnification with very little focal spot blurring, while the multitapered prototype improved resolution significantly, but not as much as the single optic. These measurements have shown that it is feasible to create a multitapered optic lens that significantly improves system MTF and virtually eliminates scatter. With continued improvements in fabrication techniques, a full-field multitapered lens will be feasible. PMID:12094979

  19. Motion correction via nonrigid coregistration of dynamic MR mammography series

    NASA Astrophysics Data System (ADS)

    Krol, Andrzej; Magri, Alphonso; Unlu, Mehmet; Feiglin, David; Lipson, Edward; Mandel, James; Tillapaugh-Fay, Gwen; Lee, Wei; Coman, Ioana; Szeverenyi, Nikolaus M.

    2006-03-01

    The objectives of this investigation are to improve quality of subtraction MR breast images and improve accuracy of time-signal intensity curves (TSIC) related to local contrast-agent concentration in dynamic MR mammography. The patients, with up to nine fiducial skin markers (FSMs) taped to each breast, were prone with both breasts suspended into a single well that housed the receiver coil. After a preliminary scan, paramagnetic contrast agent gadopentate digmeglumine (Gd) was delivered intravenously, followed by physiological saline. The field of view was centered over the breasts. We used a gradient recalled echo (GRE) technique for pre-Gd baseline, and five more measurements at 60s intervals. Centroids were determined for corresponding FSMs visible on pre-Gd and any post-Gd images. This was followed by segmentation of breast surfaces in all dynamic-series images, and meshing of all post-Gd breast images. Tetrahedral volume and triangular surface elements were used to construct a finite element method (FEM) model. We used ANSYS TM software and an analogy between orthogonal components of the displacement field and the temperature differences in steady-state heat transfer (SSHT) in solids. The floating images were warped to a fixed image using an appropriate shape function for interpolation from mesh nodes to voxels. To reduce any residual misregistration, we performed surface matching between the previously warped floating image and the target image. Our method of motion correction via nonrigid coregistration yielded excellent differential-image series that clearly revealed lesions not visible in unregistered differential-image series. Further, it produced clinically useful maximum intensity projection (MIP) 3D images.

  20. Comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density.

    PubMed

    Devolli-Disha, Emine; Manxhuka-Kërliu, Suzana; Ymeri, Halit; Kutllovci, Arben

    2009-05-01

    Breast cancer is the most common cancer and the second most common cause of death from cancer in women.The aim of this studywas to determine which is more accurate imaging test mammography or ultrasound for diagnosis of breast cancer based on the women's age and breast density. We examined 546 patients with breast symptoms, by clinical breast examination, mammography and ultrasound. A total of 546 breast lesions were examined by histopathology analyses. Histopathology results revealed the presence of 259 invasive cancers, and 287 benign lesions. Sensitivity varied significantly with age and breast density. In the 259 women who had both tests, ultrasound had a higher sensitivity than mammography in women younger than 45 years, whereas mammography had a higher sensitivity than ultrasound in women older than 60 years. The sensitivity according to age was 52,1% for mammography and 72,6% for ultrasound. The specificity according to age was 88, 5% for ultrasound and 73, 9% for mammography. Comparing the sensitivity of mammography and ultrasound according to the breast density indicates that mammographic sensitivity was 82,2% among women with predominantly fatty breast, but 23.7% in women with heterogeneous dense breasts, with the increase of fibro glandular density the level of sensitivity with mammography decreases, while ultrasonographic sensitivity was 71,1% among women with predominantly fatty breast and 57,0% for heterogeneous dense breasts. Our data indicate that sensitivity and specificity of ultrasound was statistically significantly greater than mammography in patients with breast symptoms for the detection of breast cancer and benign lesions particularly in dense breast and in young women. PMID:19485945

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

    PubMed

    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 <25 % were more likely to be 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. PMID:26518019

  2. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... planar digital x-ray images of the entire breast. This generic type of device may include digital mammography acquisition software, full-field digital image receptor, acquisition workstation, automatic exposure control, image processing and reconstruction programs, patient and equipment supports,...

  3. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... planar digital x-ray images of the entire breast. This generic type of device may include digital mammography acquisition software, full-field digital image receptor, acquisition workstation, automatic exposure control, image processing and reconstruction programs, patient and equipment supports,...

  4. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... planar digital x-ray images of the entire breast. This generic type of device may include digital mammography acquisition software, full-field digital image receptor, acquisition workstation, automatic exposure control, image processing and reconstruction programs, patient and equipment supports,...

  5. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... planar digital x-ray images of the entire breast. This generic type of device may include digital mammography acquisition software, full-field digital image receptor, acquisition workstation, automatic exposure control, image processing and reconstruction programs, patient and equipment supports,...

  6. 75 FR 68200 - Medical Devices; Radiology Devices; Reclassification of Full-Field Digital Mammography System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-05

    ... FR 31040), FDA issued a proposed rule to reclassify the device, full-field digital mammography system... discussed in the preamble to the proposed rule (73 FR 31040) and comments on the proposed rule and draft... controls). The device type is intended to produce planar digital x-ray images of the entire breast;...

  7. Optical tomography as adjunct to x-ray mammography: methods and results

    NASA Astrophysics Data System (ADS)

    Khayat, Mario; Ichalalene, Zahia; Mincu, Niculae; Leblond, Fredéric; Guilman, Olga; Djeziri, Salim

    2007-02-01

    Recent years have seen significant efforts deployed to apply optical imaging techniques in clinical indications. Optical mammography as an adjunct to X-ray mammography is one such application. 3D optical mammography relies on the sensitivity of near-infrared light to endogenous breast chromophores in order to generate in vivo functional views of the breast. This work presents prospective tissue characterization results from a multi-site clinical study targeting optical tomography as an adjunct to conventional mammography. A 2 nd -generation multi-wavelength time-domain acquisition system was used to scan a wide population of women presenting normal or suspicious X-ray mammograms. Application specific algorithms based on a diffusive model of light transport were used to quantify the breast's optical properties and derive 3D images of physiological indices. Using histopathological findings as a gold standard, results confirm that optically derived parameters provide statistically significant discrimination between malignant and benign tissue in wide population of subjects. The methodology developed for case reviews, lesion delineation and characterization allows for better translation of the optical data to the more traditional x-ray paradigm while maintaining efficacy. They also point to the need for guidelines that facilitate correlation of optical data if those results are to be confirmed in a clinical setting.

  8. Costs and cost-effectiveness of a church-based intervention to promote mammography screening.

    PubMed Central

    Stockdale, S E; Keeler, E; Duan, N; Derose, K P; Fox, S A

    2000-01-01

    OBJECTIVES: To evaluate the costs of implementing a church-based, telephone-counseling program for increasing mammography use, and to identify the components of costs and the likely cost-effectiveness in hypothetical communities with varying characteristics. DATA SOURCES/STUDY SETTING: An ethnically and socioeconomically diverse sample of 1,443 women recruited from 45 churches participating in the Los Angeles Mammography Promotion (LAMP) program were followed from 1995 to 1997. STUDY DESIGN: Churches were stratified into blocks and randomized into three intervention arms-telephone counseling, mail counseling, and control. We surveyed participants before and after the intervention to collect data on mammography use and demographic characteristics. DATA COLLECTION/EXTRACTION METHODS: We used call records, activity reports, and interviews to collect data on the time and materials needed to organize and carry out the intervention. We constructed a standard model of costs and cost-effectiveness based on these data and the Year One results of the LAMP program. PRINCIPAL FINDINGS: The cost in materials and overhead to the church site was $10.89 per participant and $188 per additional screening. However, when the estimated cost for church volunteers' time was included, the cost of the intervention increased substantially. CONCLUSIONS: A church-based program to promote the use of mammography would be feasible for many churches with the use of volunteer labor and resources. PMID:11130802

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

    ERIC Educational Resources Information Center

    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…

  10. Identifying Churches for Community-Based Mammography Promotion: Lessons from the LAMP Study

    ERIC Educational Resources Information Center

    Duan, Naihua; Fox, Sarah; Derose, Kathryn Pitkin; Carson, Sally; Stockdale, Susan

    2005-01-01

    There is great potential in public health and faith communities partnering to promote health education and research. This article describes lessons learned from the design and implementation of such a partnership, the Los Angeles Mammography Promotion in Churches Program (LAMP). It is feasible, although challenging, to enumerate and survey…

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

    NASA Astrophysics Data System (ADS)

    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.

  12. 42 CFR 405.535 - Special rule for nonparticipating physicians and suppliers furnishing screening mammography...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002. 405.535 Section 405.535 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE...

  13. 76 FR 60848 - National Mammography Quality Assurance Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration National Mammography Quality Assurance Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public...

  14. Bayesian spatiotemporal modelling for identifying unusual and unstable trends in mammography utilisation

    PubMed Central

    Mengersen, Kerrie

    2016-01-01

    Objectives To compare two Bayesian models capable of identifying unusual and unstable temporal patterns in spatiotemporal data. Setting Annual counts of mammography screening users from each statistical local area (SLA) in Brisbane, Australia, recorded between 1997 and 2008 inclusive. Primary outcome measures Mammography screening counts. Results The temporal trends of 91 SLAs (58%) were dissimilar from the overall common temporal trend. SLAs that followed the common temporal trend also tended to have stable temporal trends. SLAs with unstable temporal trends tended to be situated farther from the city and farther from mammography screening facilities. Conclusions This paper demonstrates the usefulness of the two models in identifying unusual and unstable temporal trends, and the synergy obtained when both models are applied to the same data set. An analysis of these models has provided interesting insights into the temporal trends of mammography screening counts and has shown several possible avenues for further research, such as extending the models to allow for multiple common temporal trends and accounting for additional spatiotemporal heterogeneity. PMID:27230999

  15. 42 CFR 405.534 - Limitation on payment for screening mammography services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Limitation on payment for screening mammography services. 405.534 Section 405.534 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Criteria for Determining Reasonable Charges §...

  16. 42 CFR 413.123 - Payment for screening mammography performed by hospitals on an outpatient basis.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for screening mammography performed by hospitals on an outpatient basis. 413.123 Section 413.123 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL...

  17. Community Partnerships, Food Pantries, and an Evidence-Based Intervention to Increase Mammography among Rural Women

    ERIC Educational Resources Information Center

    Bencivenga, Marcyann; DeRubis, Susan; Leach, Patricia; Lotito, Lisa; Shoemaker, Charles; Lengerich, Eugene J.

    2008-01-01

    Context: Multiple national agencies and organizations recommend that women age 40 years and older have an annual screening mammogram. Women who are poor, less educated, lack a usual source of care, and reside in rural Appalachia are less likely to have had a recent mammogram. Purpose: To increase use of mammography among a rural Appalachian…

  18. Office Systems and Their Influence on Mammography Use in Rural and Urban Primary Care

    ERIC Educational Resources Information Center

    Engelman, Kimberly K.; Ellerbeck, Edward F.; Perpich, Denise; Nazir, Niaman; McCarter, Kevin; Ahluwalia, Jasjit S.

    2004-01-01

    Breast cancer screening rates are lower in rural communities. Although studies have addressed barriers to mammography for rural residents, physician practice barriers have received less attention. Purpose: Controlled clinical trials have shown that the use of office reminder systems in primary care practices is related to increased clinical care…

  19. Optimisation of X-ray examinations in Lithuania: start of implementation in mammography.

    PubMed

    Adliene, Diana; Adlys, Gediminas; Cerapaite, Reda; Jonaitiene, Egle; Cibulskaite, Inga

    2005-01-01

    Optimisation of medical X-ray examinations is very important for the enhancement of the reliability of the examination and for the reduction of the radiation dose to patients. Results of investigations of doses to patients during mammography using thermoluminescence dosemeters at different hospitals are presented together with a brief overview of the situation for mammography in Lithuania. It is shown that the entrance surface air kerma varies in a broad range and differed from hospital to hospital. Nevertheless the calculated values of average glandular dose (AGD) for a 'standard' breast being relatively high were comparable with those (3.2 mGy per exposure at net optical density 1.4) currently accepted by international authorities. Differences in AGD values evaluated at different hospitals demonstrate the existing potential for optimisation of the mammography screening procedures. The results of this investigation will be included in a database for patient doses in Lithuania and used for establishing a national reference dose level for mammography. Currently, reference levels recommended by international authorities are used in Lithuania. PMID:15933145

  20. Three-dimensional Breast Imaging with Full Field Digital Mammography Tomosynthesis

    NASA Astrophysics Data System (ADS)

    Eberhard, Jeffrey W.

    2003-03-01

    Although conventional film-screen mammography is the clinical modality of choice for early detection of breast cancer, many cancers are missed because they are masked by radiographically dense fibroglandular breast tissue which may be overlying or surrounding the tumor. The superposition of 3D breast anatomy in a standard 2D x-ray projection is perhaps the most significant problem in mammography today. GE Global Research has developed a new 3D full field digital mammography tomosynthesis prototype system that directly addresses the superimposed tissue problem by enabling volumetric imaging of the breast. High performance digital detectors with low electronic noise and fast read-out times, new reconstruction algorithms customized for tomosynthesis acquisitions, and application of volume rendering methods to enable rapid, effective review of 3D data are among the key enabling technologies for tomosynthesis. Phantom studies have demonstrated significantly enhanced performance of tomosynthesis compared to standard digital mammography exams. Over 200 patients have been imaged with a prototype system. Typical patient images will be shown.

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

    PubMed Central

    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

    Objective To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Method 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). Results 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). Conclusions The absence of rural–urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography. PMID:26844118

  2. Stages of change: Korean women's attitudes and barriers toward mammography screening.

    PubMed

    Kang, Hee Sun; Thomas, Eileen; Kwon, Bo Eun; Hyun, Myung-Sun; Jun, Eun Mi

    2008-02-01

    The positive and negative aspects of breast cancer screening were measured to gain insight into the barriers that prevent Korean women from participating in mammography screening. Breast cancer screening behaviors, attitudes, and barriers were identified from a convenience sample of 328 Korean women recruited in Seoul, Gyeonggi, and Jeju, South Korea. Pros, cons, and decisional balance constructs of the transtheoretical model of behavior change were used to identify stages of change in attitude related to mammography screening. There were significant differences in pros (F = 5.175, p = .001) and cons (F = 3.357, p = .012) across the five stages of change for mammography. Participants indicated that the major barriers to mammography screening were, in order of frequency, the belief that an absence of symptoms meant there was no need for a breast examination, the high cost of breast cancer screening, lack of time, lack of information, embarrassment, fear about x-rays and test results, reliance on breast self-examination (BSE), and discomfort or pain. The benefits of breast cancer screening should be emphasized among Korean women. PMID:18350421

  3. Mammography stage of adoption and decision balance among Asian Indian and Filipino American women.

    PubMed

    Wu, Tsu-Yin; West, Brady T

    2007-01-01

    Cancer is the leading cause of death among Asian American women, and the death rate has increased almost 200% since 1990. Previous research has applied the transtheoretical model constructs to examine cancer screening behavior; however, to our knowledge, this is the first such investigation to examine relationships between stages of mammography adoption and decision balance among Asian American women. This article presents study findings from a convenience sample of 228 women aged 40 to 81 years (mean = 55.0, SD = 9.6) residing in southeastern Michigan. The current study demonstrates excellent support for the psychometric properties of a pros and cons measure, with promising Cronbach alphas above .70. Results from confirmatory factor analysis also support the factor structure derived from exploratory factor analysis with good model fit indices. This study also provides some support on transtheoretical model-hypothesized relationships in this sample of Asian American women that, as the stages of adoption of mammography proceeded from earlier to later ones, the decisional balance would become more favorable. The specific beliefs (both positive and negative) associated with the various stages of mammography adoption have implications for health professionals in developing stage-matched interventions to motivate women in adopting regular mammography. PMID:17876185

  4. Dual-energy contrast-enhanced digital mammography in routine clinical practice in 2013.

    PubMed

    Badr, S; Laurent, N; Régis, C; Boulanger, L; Lemaille, S; Poncelet, E

    2014-03-01

    To date, analysis of the vascularisation of breast lesions mainly relies on MR imaging. However, the accessibility of MRI is sometimes limited and has led to the development of new means of imaging, such as dual-energy contrast-enhanced mammography, which provides data on the vascularisation of the breast along with the usual morphological information. The purpose of this paper is to present this new imaging technique as well as the recent references, illustrated by clinical reports derived from our everyday practice to focus on the advantages and disadvantages of this new breast exploration. Dual-energy contrast-enhanced mammography is a recent, seemingly promising technique, in the management of breast cancer. The main advantages consist of its easy installation, the good tolerance and the comfort in the interpretation of difficult to read mammograms. However, the indications and the role of dual-energy contrast-enhanced mammography still have to be determined within the diagnostic strategy of breast tumours. New studies are expected, especially to compare dual-energy contrast-enhanced mammography with breast MRI. PMID:24238816

  5. Signal uniformity of mammography systems and its impact on test results from contrast detail phantoms

    NASA Astrophysics Data System (ADS)

    Kaar, M.; Semturs, F.; Hummel, J.; Hoffmann, R.; Figl, M.

    2015-03-01

    Technical quality assurance (TQA) procedures for mammography systems usually include tests with a contrast-detail phantom. These phantoms contain multiple objects of varying dimensions arranged on a flat body. Exposures of the phantom are then evaluated by an observer, either human or software. One well-known issue of this method is that dose distribution is not uniform across the image area of any mammography system, mainly due to the heel effect. The purpose of this work is to investigate to what extent image quality differs across the detector plane. We analyze a total of 320 homogeneous mammography exposures from 32 radiology institutes. Systems of different models and manufacturers, both computed radiography (CR) and direct radiography (DR) are included. All images were taken from field installations operated within the nationwide Austrian mammography screening program, which includes mandatory continuous TQA. We calculate signal-to-noise ratios (SNR) for 15 regions of interest arranged to cover the area of the phantom. We define the 'signal range' of an image and compare this value categorized by technologies. We found the deviations of SNR greater in anterior-posterior than in lateral direction. SNR ranges are significantly higher for CR systems than for DR systems.

  6. A Systematic Review of Mammography Educational Interventions for Low-income Women

    PubMed Central

    Bailey, Tatiana M.; Delva, Jorge; Gretebeck, Kimberlee; Siefert, Kristine; Ismail, Amid

    2006-01-01

    Objective We conducted a systematic review to examine the effectiveness of educational interventions in increasing mammography screening among low-income women. Data Sources Bibliographic databases, including MEDLINE, The Cochrane Central Register of Controlled Trials, The Cochrane Database of Systematic Reviews, and the ISI Web of Science, were searched for relevant articles. Study Inclusion and Exclusion Criteria Randomized, community-based trials targeting low-income women and published between January 1980 and March 2003 were included. Data Extraction The search yielded 242 studies; 24 met all inclusion criteria. Data Synthesis Three studies used mammography vans, three used low-cost vouchers or provided free mammograms, three used home visits, one used community education alone, one provided referrals, five incorporated multiple intervention strategies, two used phone calls, one used videos and print material, and five used primarily print material. Results Of nine studies that reduced barriers to care via mammography vans, cost vouchers, or home visits, eight showed statistically significant increases in mammography screening. Seven of the eight studies that used peer educators had significant increases in screening, as did four of the five studies that used multiple (intervention) components. Conclusions Interventions that used peer educators, incorporated multiple intervention strategies, or provided easy access via vans, cost vouchers, or home visits were effective in increasing screenings. Mailed letter or telephone reminders were not effective in trials involving low-income women, which is contrary to findings from middle/upper-income studies. PMID:16295701

  7. Radiation-Induced Breast Cancer Incidence and Mortality from Digital Mammography Screening: A Modeling Study

    PubMed Central

    Miglioretti, Diana L.; Lange, Jane; van den Broek, Jeroen J.; Lee, Christoph I.; van Ravesteyn, Nicolien T.; Ritley, Dominique; Kerlikowske, Karla; Fenton, Joshua J.; Melnikow, Joy; de Koning, Harry J.; Hubbard, Rebecca A.

    2016-01-01

    Background Estimates of radiation-induced breast cancer risk from mammography screening have not previously considered dose exposure variation or diagnostic work-up after abnormal screening. Objective To estimate distributions of radiation-induced breast cancer incidence and mortality from digital mammography screening, considering exposure from screening and diagnostic mammography and dose variation across women. Design Two simulation-modeling approaches using common data on screening mammography from the Breast Cancer Surveillance Consortium and radiation dose from mammography from the Digital Mammographic Imaging Screening Trial. Setting U.S. population. Patients Women aged 40–74 years. Interventions Annual or biennial digital mammography screening from age 40, 45, or 50 until 74. Measurements Lifetime breast cancer deaths averted (benefits) and radiation-induced breast cancer incidence and mortality per 100,000 women screened (harms). Results On average, annual screening of 100,000 women aged 40 to 74 years was projected to induce 125 breast cancers (95% confidence interval [CI]=88–178) leading to 16 deaths (95% CI=11–23) relative to 968 breast cancer deaths averted by early detection from screening. Women exposed at the 95th percentile were projected to develop 246 radiation-induced breast cancers leading to 32 deaths per 100,000 women. Women with large breasts requiring extra views for complete breast examination (8% of population) were projected to have higher radiation-induced breast cancer incidence and mortality (266 cancers, 35 deaths per 100,000 women), compared to women with small or average breasts (113 cancers, 15 deaths per 100,000 women). Biennial screening starting at age 50 reduced risk of radiation-induced cancers 5-fold. Limitations We were unable to estimate years of life lost from radiation-induced breast cancer. Conclusions Radiation-induced breast cancer incidence and mortality from digital mammography screening are impacted by dose

  8. Asymmetric scatter kernels for software-based scatter correction of gridless mammography

    NASA Astrophysics Data System (ADS)

    Wang, Adam; Shapiro, Edward; Yoon, Sungwon; Ganguly, Arundhuti; Proano, Cesar; Colbeth, Rick; Lehto, Erkki; Star-Lack, Josh

    2015-03-01

    Scattered radiation remains one of the primary challenges for digital mammography, resulting in decreased image contrast and visualization of key features. While anti-scatter grids are commonly used to reduce scattered radiation in digital mammography, they are an incomplete solution that can add radiation dose, cost, and complexity. Instead, a software-based scatter correction method utilizing asymmetric scatter kernels is developed and evaluated in this work, which improves upon conventional symmetric kernels by adapting to local variations in object thickness and attenuation that result from the heterogeneous nature of breast tissue. This fast adaptive scatter kernel superposition (fASKS) method was applied to mammography by generating scatter kernels specific to the object size, x-ray energy, and system geometry of the projection data. The method was first validated with Monte Carlo simulation of a statistically-defined digital breast phantom, which was followed by initial validation on phantom studies conducted on a clinical mammography system. Results from the Monte Carlo simulation demonstrate excellent agreement between the estimated and true scatter signal, resulting in accurate scatter correction and recovery of 87% of the image contrast originally lost to scatter. Additionally, the asymmetric kernel provided more accurate scatter correction than the conventional symmetric kernel, especially at the edge of the breast. Results from the phantom studies on a clinical system further validate the ability of the asymmetric kernel correction method to accurately subtract the scatter signal and improve image quality. In conclusion, software-based scatter correction for mammography is a promising alternative to hardware-based approaches such as anti-scatter grids.

  9. Comparative performance of modern digital mammography systems in a large breast screening program

    SciTech Connect

    Yaffe, Martin J. Bloomquist, Aili K.; Hunter, David M.; Mawdsley, Gordon E.; Chiarelli, Anna M.; Muradali, Derek; Mainprize, James G.

    2013-12-15

    Purpose: To compare physical measures pertaining to image quality among digital mammography systems utilized in a large breast screening program. To examine qualitatively differences in these measures and differences in clinical cancer detection rates between CR and DR among sites within that program. Methods: As part of the routine quality assurance program for screening, field measurements are made of several variables considered to correlate with the diagnostic quality of medical images including: modulation transfer function, noise equivalent quanta, d′ (an index of lesion detectability) and air kerma to allow estimation of mean glandular dose. In addition, images of the mammography accreditation phantom are evaluated. Results: It was found that overall there were marked differences between the performance measures of DR and CR mammography systems. In particular, the modulation transfer functions obtained with the DR systems were found to be higher, even for larger detector element sizes. Similarly, the noise equivalent quanta, d′, and the phantom scores were higher, while the failure rates associated with low signal-to-noise ratio and high dose were lower with DR. These results were consistent with previous findings in the authors’ program that the breast cancer detection rates at sites employing CR technology were, on average, 30.6% lower than those that used DR mammography. Conclusions: While the clinical study was not large enough to allow a statistically powered system-by-system assessment of cancer detection accuracy, the physical measures expressing spatial resolution, and signal-to-noise ratio are consistent with the published finding that sites employing CR systems had lower cancer detection rates than those using DR systems for screening mammography.

  10. Utilization of Screening Mammography Among Middle-Aged and Older Women

    PubMed Central

    Hochhalter, Angela K.; Ahn, SangNam; Wernicke, Meghan M.; Ory, Marcia G.

    2011-01-01

    Abstract Aims This study examines patterns of screening mammogram use, investigating the relationship of screening with demographic, health status, and healthcare factors. Methods Data from 1242 women aged ≥41 were obtained from a random sample of mailed surveys to community households in an eight-county region in Central Texas in 2010. The dependent variable was the timing of the participants' most recent screening mammography (in the past 12 months, between 1 and 2 years, or >2 years). Predictor variables included demographic, health status, and healthcare access factors. Multinomial logistic regression identified variables associated with screening mammography practices. Results The majority of women reported having at least one mammogram during their lifetime (93.0%) and having a mammography within the past 2 years (76.2%). Participants who reported not having a routine checkup in the past 12 months (odds ratio [OR] 0.12, p<0.001), having a lapse of insurance in the past 3 years (OR 2.95, p<0.05), and living in a health provider shortage area (OR 1.42, p<0.05) were less likely to be screened within the past 2 years. Conclusions Routine healthcare plays a major role in preventive screening, which indicates screening mammography practices can be enhanced by improving participation in routine checkups with medical providers, continuity of insurance coverage, and women's access to healthcare. Interventions to encourage screening mammography may be particularly needed for women who have experienced a lapse in insurance or have not had a checkup in the past year. PMID:21780914

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

    PubMed

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

    2009-03-01

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

  12. B-spline active rays segmentation of microcalcifications in mammography

    SciTech Connect

    Arikidis, Nikolaos S.; Skiadopoulos, Spyros; Karahaliou, Anna; Likaki, Eleni; Panayiotakis, George; Costaridou, Lena

    2008-11-15

    Accurate segmentation of microcalcifications in mammography is crucial for the quantification of morphologic properties by features incorporated in computer-aided diagnosis schemes. A novel segmentation method is proposed implementing active rays (polar-transformed active contours) on B-spline wavelet representation to identify microcalcification contour point estimates in a coarse-to-fine strategy at two levels of analysis. An iterative region growing method is used to delineate the final microcalcification contour curve, with pixel aggregation constrained by the microcalcification contour point estimates. A radial gradient-based method was also implemented for comparative purposes. The methods were tested on a dataset consisting of 149 mainly pleomorphic microcalcification clusters originating from 130 mammograms of the DDSM database. Segmentation accuracy of both methods was evaluated by three radiologists, based on a five-point rating scale. The radiologists' average accuracy ratings were 3.96{+-}0.77, 3.97{+-}0.80, and 3.83{+-}0.89 for the proposed method, and 2.91{+-}0.86, 2.10{+-}0.94, and 2.56{+-}0.76 for the radial gradient-based method, respectively, while the differences in accuracy ratings between the two segmentation methods were statistically significant (Wilcoxon signed-ranks test, p<0.05). The effect of the two segmentation methods in the classification of benign from malignant microcalcification clusters was also investigated. A least square minimum distance classifier was employed based on cluster features reflecting three morphological properties of individual microcalcifications (area, length, and relative contrast). Classification performance was evaluated by means of the area under ROC curve (A{sub z}). The area and length morphologic features demonstrated a statistically significant (Mann-Whitney U-test, p<0.05) higher patient-based classification performance when extracted from microcalcifications segmented by the proposed method (0

  13. The Utility of MicroPure™ Ultrasound Technique in Assessing Grouped Microcalcifications without a Mass on Mammography

    PubMed Central

    Park, Ah Young; Cho, Kyu Ran; Woo, Ok Hee

    2016-01-01

    The term "grouped microcalcifications" refers to the smallest arrangement of a relatively few calcifications noted on mammography, and has a wide range of clinical associations. For the pathologic diagnosis of suspicious-looking grouped microcalcifications without an associated mass, a mammography-guided procedure should be considered, because visualization of microcalcifications by conventional ultrasound (US) is limited. A mammography-guided procedure requires radiation exposure, is associated with pain, and is more time-consuming to perform than an US-guided procedure. However, an innovative US technology called MicroPure™ (Toshiba Medical Systems Corp., Tokyo, Japan) imaging improves detection and visualization of microcalcifications. We demonstrate the early clinical experience with and utility of MicroPure US examination of 10 breast lesions involving grouped microcalcifications without a mass on mammography screening. PMID:27066098

  14. Competitive testing of health behavior theories: how do benefits, barriers, subjective norm, and intention influence mammography behavior?

    PubMed Central

    Murphy, Caitlin C.; Vernon, Sally W.; Diamond, Pamela M.; Tiro, Jasmin A.

    2013-01-01

    Background Competitive hypothesis testing may explain differences in predictive power across multiple health behavior theories. Purpose We tested competing hypotheses of the Health Belief Model (HBM) and Theory of Reasoned Action (TRA) to quantify pathways linking subjective norm, benefits, barriers, intention, and mammography behavior. Methods We analyzed longitudinal surveys of women veterans randomized to the control group of a mammography intervention trial (n=704). We compared direct, partial mediation, and full mediation models with Satorra-Bentler χ2 difference testing. Results Barriers had a direct and indirect negative effect on mammography behavior; intention only partially mediated barriers. Benefits had little to no effect on behavior and intention; however, it was negatively correlated with barriers. Subjective norm directly affected behavior and indirectly affected intention through barriers. Conclusions Our results provide empiric support for different assertions of HBM and TRA. Future interventions should test whether building subjective norm and reducing negative attitudes increases regular mammography. PMID:23868613

  15. Mammography use for breast cancer screening in Portugal: results from the 2005/2006 National Health Survey

    PubMed Central

    Dourado, Fernanda; Carreira, Helena

    2013-01-01

    Background: Understanding the patterns of mammography use is essential to promote the participation in breast cancer screening. Objectives: To describe the patterns of screening mammography use in Portugal. Methods: As part of the fourth National Health Survey (2005/2006), 3045 women were evaluated in face-to-face interviews. The previous use of mammography for screening was classified as never or ever, and the latter was further grouped according to the time elapsed since the latest mammography. Having undergone the latest mammography >2 years before was considered underuse. We assessed the determinants of never having been screened by mammography and, among those who had been tested, the determinants of mammography underuse, through age- and education-adjusted odds ratios (ORs), with 95% confidence intervals (95% CIs). Results: Among women aged 45–49 and 50–69 years, 86.3% and 88.0%, respectively, underwent a screening mammography before, and most of them were tested in the previous 2 years. The lowest risk of never having been screened was in Norte (OR = 0.41, 95% CI: 0.21–0.80) and the highest in Açores (OR = 4.04, 95% CI: 2.37–6.92), in comparison with Centro (the region with organized screening for a longer time). Participants with <4 years of formal education were more likely to have never been screened than the more educated (OR = 4.27, 95% CI: 1.67–10.89). Women with private health insurance (OR = 0.16, 95% CI: 0.04–0.65), as well as those who had undergone cervical cytology screening before (OR = 0.50, 95% CI: 0.30–0.85), had a lower risk of underuse. Conclusions: This study provides useful information to improve the allocation of resources to breast cancer screening. PMID:22874736

  16. Accuracy of Physical Examination, Ultrasonography, and Mammography in Predicting Residual Pathologic Tumor Size in Patients Treated With Neoadjuvant Chemotherapy

    PubMed Central

    Chagpar, Anees B.; Middleton, Lavinia P.; Sahin, Aysegul A.; Dempsey, Peter; Buzdar, Aman U.; Mirza, Attiqa N.; Ames, Fredrick C.; Babiera, Gildy V.; Feig, Barry W.; Hunt, Kelly K.; Kuerer, Henry M.; Meric-Bernstam, Funda; Ross, Merrick I.; Singletary, S Eva

    2006-01-01

    Objective: To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. Background: Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathologic tumor size after neoadjuvant chemotherapy is critical in guiding surgical therapy. Although physical examination, ultrasonography, and mammography have all been used to predict residual tumor size, there have been conflicting reports about the accuracy of these methods in the neoadjuvant setting. Methods: We reviewed the records of 189 patients who participated in 1 of 2 protocols using doxorubicin-containing neoadjuvant chemotherapy, and who had assessment by physical examination, ultrasonography, and/or mammography no more than 60 days before their surgical resection. Size correlations were performed using Spearman rho analysis. Clinical and pathologic measurements were also compared categorically using the weighted kappa statistic. Results: Size estimates by physical examination, ultrasonography, and mammography were only moderately correlated with residual pathologic tumor size after neoadjuvant chemotherapy (correlation coefficients: 0.42, 0.42, and 0.41, respectively), with an accuracy of ±1 cm in 66% of patients by physical examination, 75% by ultrasonography, and 70% by mammography. Kappa values (0.24–0.35) indicated poor agreement between clinical and pathologic measurements. Conclusion: Physical examination, ultrasonography, and mammography were only moderately useful for predicting residual pathologic tumor size after neoadjuvant chemotherapy. PMID:16432360

  17. Geographic access to mammography and its relationship to breast cancer screening and stage at diagnosis: a systematic review

    PubMed Central

    Khan-Gates, Jenna A.; Ersek, Jennifer L.; Eberth, Jan M.; Adams, Swann A.; Pruitt, Sandi

    2016-01-01

    Introduction A review was conducted to summarize the current evidence and gaps in the literature on geographic access to mammography and its relationship to breast cancer-related outcomes. Methods Ovid Medline and PubMed were searched for articles published between January 1, 2000 and April 1, 2013 using Medical Subject Headings and key terms representing geographic accessibility and breast cancer-related outcomes. Due to a paucity of breast cancer treatment and mortality outcomes meeting the criteria (N=6), outcomes were restricted to breast cancer screening and stage at diagnosis. Studies included one or more of the following types of geographic accessibility measures: capacity, density, distance and travel time. Study findings were grouped by outcome and type of geographic measure. Results Twenty-one articles met inclusion criteria. Fourteen articles included stage at diagnosis as an outcome, five included mammography utilization, and two included both. Geographic measures of mammography accessibility varied widely across studies. Findings also varied, but most articles found either increased geographic access to mammography associated with increased utilization and decreased late-stage at diagnosis or no statistically significant association. Conclusion The gaps and methodologic heterogeneity in the literature to date limit definitive conclusions about an underlying association between geographic mammography access and breast cancer-related outcomes. Future studies should focus on the development and application of more precise and consistent measures of geographic access to mammography. PMID:26219677

  18. Report: Evaluation on diagnosis significance of single high frequency Ultrasonography and mammography and combination on Breast Cancer.

    PubMed

    Sun, Huifang; Wang, Bo; Ding, Changmao; Yu, Zhan; Gao, Jianbo

    2016-07-01

    To evaluate the diagnosis significance of single high-frequency ultrasonography and mammography and combination therapy of both on breast cancer. 352 cases of female breast cancer patients were selected from The First Affiliated Hospital of Zhengzhou University from January 2012 to December 2014. Among the 352 patients, 124 patients had only performed high-frequency ultrasonography detection, 102 cases of patients were only conducted mammography, and 126 patients had applied the combination detection of high-frequency ultrasonography and mammography. The coincidence rate of single mammography detection was 79.4%, the misdiagnosis rate was 10.8%, and the missed diagnosis rate was 9.8%; the coincidence rate of single high frequency ultrasonography detection was 83.9%, the misdiagnosis rate was 11.5%, the missed diagnosis rate was 4.6%; the coincidence rate of combination of high frequency ultrasonography detection was 89.7%, the misdiagnosis rate was 6.3%, the missed diagnosis rate was 4.0%. The detection rate and missed diagnosis rate of combination diagnosis had statistical difference with single high frequency ultrasonography and single mammography. There was no statistical difference on misdiagnosis rate. mammography and high frequency ultrasonography respectively had their own advantages. The combination application of both had better diagnosis complementary, and could significantly improved the detection rate and accuracy rate on breast cancer, and decreased the misdiagnosis rate and missed diagnosis rate. PMID:27592481

  19. A virtual repository approach to clinical and utilization studies: application in mammography as alternative to a national database.

    PubMed

    Ohno-Machado, L; Boxwala, A A; Ehresman, J; Smith, D N; Greenes, R A

    1997-01-01

    A national mammography database was proposed, based on a centralized architecture for collecting, monitoring, and auditing mammography data. We have developed an alternative architecture relying on Internet-based distributed queries to heterogeneous databases. This architecture creates a "virtual repository", or a federated database which is constructed dynamically, for each query and makes use of data available in legacy systems. It allows the construction of custom-tailored databases at individual sites that can serve the dual purposes of providing data (a) to researchers through a common mammography repository and (b) to clinicians and administrators at participating institutions. We implemented this architecture in a prototype system at the Brigham and Women's Hospital to show its feasibility. Common queries are translated dynamically into database-specific queries, and the results are aggregated for immediate display or download by the user. Data reside in two different databases and consist of structured mammography reports, coded per BIRADS Standardized Mammography Lexicon, as well as pathology results. We prospectively collected data on 213 patients, and showed that our system can perform distributed queries effectively. We also implemented graphical exploratory analysis tools to allow visualization of results. Our findings indicate that the architecture is not only feasible, but also flexible and scaleable, constituting a good alternative to a national mammography database. PMID:9357650

  20. Short-Term Outcomes of Screening Mammography Using Computer-Aided Detection

    PubMed Central

    Fenton, Joshua J.; Xing, Guibo; Elmore, Joann G.; Bang, Heejung; Chen, Steven L.; Lindfors, Karen K.; Baldwin, Laura-Mae

    2013-01-01

    Background Computer-aided detection (CAD) has rapidly diffused into screening mammography practice despite limited and conflicting data on its clinical effect. Objective To determine associations between CAD use during screening mammography and the incidence of ductal carcinoma in situ (DCIS) and invasive breast cancer, invasive cancer stage, and diagnostic testing. Design Retrospective cohort study. Setting Medicare program. Participants Women aged 67 to 89 years having screening mammography between 2001 and 2006 in U.S. SEER (Surveillance, Epidemiology and End Results) regions (409 459 mammograms from 163 099 women). Measurements Incident DCIS and invasive breast cancer within 1 year after mammography, invasive cancer stage, and diagnostic testing within 90 days after screening among women without breast cancer. Results From 2001 to 2006, CAD prevalence increased from 3.6% to 60.5%. Use of CAD was associated with greater DCIS incidence (adjusted odds ratio [OR], 1.17 [95% CI, 1.11 to 1.23]) but no difference in invasive breast cancer incidence (adjusted OR, 1.00 [CI, 0.97 to 1.03]). Among women with invasive cancer, CAD was associated with greater likelihood of stage I to II versus III to IV cancer (adjusted OR, 1.27 [CI, 1.14 to 1.41]). In women without breast cancer, CAD was associated with increased odds of diagnostic mammography (adjusted OR, 1.28 [CI, 1.27 to 1.29]), breast ultrasonography (adjusted OR, 1.07 [CI, 1.06 to 1.09]), and breast biopsy (adjusted OR, 1.10 [CI, 1.08 to 1.12]). Limitation Short follow-up for cancer stage, potential unmeasured confounding, and uncertain generalizability to younger women. Conclusion Use of CAD during screening mammography among Medicare enrollees is associated with increased DCIS incidence, the diagnosis of invasive breast cancer at earlier stages, and increased diagnostic testing among women without breast cancer. Primary Funding Source Center for Healthcare Policy and Research, University of California, Davis. PMID

  1. Power spectrum analysis of the x-ray scatter signal in mammography and breast tomosynthesis projections

    PubMed Central

    Sechopoulos, Ioannis; Bliznakova, Kristina; Fei, Baowei

    2013-01-01

    Purpose: To analyze the frequency domain characteristics of the signal in mammography images and breast tomosynthesis projections with patient tissue texture due to detected scattered x-rays. Methods: Acquisitions of x-ray projection images of 19 different patient breasts were simulated using previously acquired volumetric patient images. Acquisition of these images was performed with a dedicated breast CT prototype system, and the images were classified into voxels representing skin, adipose, and glandular tissue with a previously validated automated algorithm. The classified three dimensional images then underwent simulated mechanical compression representing that which is performed during acquisition of mammography and breast tomosynthesis images. The acquisition of projection images of each patient breast was simulated using Monte Carlo methods with each simulation resulting in two images: one of the primary (non-scattered) signal and one of the scatter signal. To analyze the scatter signal for both mammography and breast tomosynthesis, two projections images of each patient breast were simulated, one with the x-ray source positioned at 0° (mammography and central tomosynthesis projection) and at 30° (wide tomosynthesis projection). The noise power spectra (NPS) for both the scatter signal alone and the total signal (primary + scatter) for all images were obtained and the combined results of all patients analyzed. The total NPS was fit to the expected power-law relationship NPS(f) = k/f^β and the results were compared with those previously published on the power spectrum characteristics of mammographic texture. The scatter signal alone was analyzed qualitatively and a power-law fit was also performed. Results: The mammography and tomosynthesis projections of three patient breasts were too small to analyze, so a total of 16 patient breasts were analyzed. The values of β for the total signal of the 0° projections agreed well with previously published results

  2. Tailoring automatic exposure control toward constant detectability in digital mammography

    SciTech Connect

    Salvagnini, Elena; Bosmans, Hilde; Struelens, Lara; Marshall, Nicholas W.

    2015-07-15

    Purpose: The automatic exposure control (AEC) modes of most full field digital mammography (FFDM) systems are set up to hold pixel value (PV) constant as breast thickness changes. This paper proposes an alternative AEC mode, set up to maintain some minimum detectability level, with the ultimate goal of improving object detectability at larger breast thicknesses. Methods: The default “OPDOSE” AEC mode of a Siemens MAMMOMAT Inspiration FFDM system was assessed using poly(methyl methacrylate) (PMMA) of thickness 20, 30, 40, 50, 60, and 70 mm to find the tube voltage and anode/filter combination programmed for each thickness; these beam quality settings were used for the modified AEC mode. Detectability index (d′), in terms of a non-prewhitened model observer with eye filter, was then calculated as a function of tube current-time product (mAs) for each thickness. A modified AEC could then be designed in which detectability never fell below some minimum setting for any thickness in the operating range. In this study, the value was chosen such that the system met the achievable threshold gold thickness (T{sub t}) in the European guidelines for the 0.1 mm diameter disc (i.e., T{sub t} ≤ 1.10 μm gold). The default and modified AEC modes were compared in terms of contrast-detail performance (T{sub t}), calculated detectability (d′), signal-difference-to-noise ratio (SDNR), and mean glandular dose (MGD). The influence of a structured background on object detectability for both AEC modes was examined using a CIRS BR3D phantom. Computer-based CDMAM reading was used for the homogeneous case, while the images with the BR3D background were scored by human observers. Results: The default OPDOSE AEC mode maintained PV constant as PMMA thickness increased, leading to a reduction in SDNR for the homogeneous background 39% and d′ 37% in going from 20 to 70 mm; introduction of the structured BR3D plate changed these figures to 22% (SDNR) and 6% (d′), respectively

  3. Problems, solutions, and perspectives in the evaluation of interval cancers in Italian mammography screening programmes: a position paper from the Italian group for mammography screening (GISMa).

    PubMed

    Bucchi, Lauro; Frigerio, Alfonso; Zorzi, Manuel; Fedato, Chiara; Angiolucci, Giovanni; Bernardi, Daniela; Campari, Cinzia; Crocetti, Emanuele; Ferretti, Stefano; Giorgi, Daniela; Marchisio, Francesca; Morrone, Doralba; Naldoni, Carlo; Petrella, Marco; Ponti, Antonio; Ravaioli, Alessandra; Saguatti, Gianni; Santini, Dolores; Sassoli de Bianchi, Priscilla; Serafini, Monica; Vergini, Viviana; Giordano, Livia

    2015-01-01

    In this position paper, a self-convened team of experts from the Italian Group for Mammography Screening (Gruppo italiano screening mammografico, GISMa) pointed out the problems that increasingly hamper the feasibility and validity of the estimate of the proportional incidence of interval breast cancer (IBC) in Italy, suggested potential solutions and an agenda for research, and proposed that the question of the sensitivity of mammography be viewed in a larger perspective, with a greater attention to radiological review activities and breast radiology quality assurance programmes. The main problems are as follows: the coverage of cancer registration is incomplete; the robustness of using the pre-screening incidence rates as underlying rates decreases with time since the start of screening; the intermediate mammograms performed for early detection purposes may cause an overrepresentation of IBCs; the classification of many borderline screening histories is prone to subjectivity; and, finally, the composition of cohorts of women with negative screening results is uncertain, because several mammography reports are neither clearly negative nor clearly positive, and because of the limitations and instability of the electronic mammography records. Several possibilities can be considered to cope with these issues: standard methods for using the hospital discharge records in the identification of IBCs should be established; for the calculation of regional estimates of the underlying incidence, a suitable mathematical model should be identified; the definition of IBC according to the 2008 GISMa guidelines needs to be updated, especially with respect to in situ cancers and to invasive cancers with borderline screening histories; a closer adherence to standard screening protocols, with a simplified patient management, would make it easier to objectively identify IBCs; alternative methods for estimating the sensitivity of mammography should be taken into consideration; and

  4. Breast cancer beliefs of women participating in a television-promoted mammography screening project.

    PubMed Central

    Fuller, S M; McDermott, R J; Roetzheim, R G; Marty, P J

    1992-01-01

    A survey of breast cancer and breast cancer screening beliefs was mailed to a random sample of 1,000 women who contacted a telephone bank in response to a television-promoted, reduced-cost mammography project. Beliefs and demographics of women in the sample who subsequently completed a mammogram were compared with those who did not. No statistically significant differences were found between participants (persons who completed a mammogram) and nonparticipants with respect to age, race, marital status, income, or educational preparation. Groups also did not differ significantly in the series of beliefs examined. Factor analysis revealed respondents' most salient beliefs about breast cancer and early detection of breast cancer. Evidence is presented to suggest a need for enhanced efforts to recruit minority group women to participate in mammography screening. PMID:1454981

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

    NASA Astrophysics Data System (ADS)

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

    2015-09-01

    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.

  6. Assessment of Content-Based Image Retrieval Approaches for Mammography Based on Breast Density Patterns.

    PubMed

    Purwadi, Nabila Sabatini; Atay, Hüseyin Tanzer; Kurt, Kenan Kaan; Turkeli, Serkan

    2016-01-01

    This study is trying to assess methods commonly used in content-based image retrieval (CBIR) for screening mammography analysis. A database consists of 12 different BI-RADS classes related to breast density patterns of mammogram patches which are taken from IRMA database is used in this study. Three feature extraction methods, namely grey-level co-occurrence matrix (GLCM), principal component analysis (PCA), and scale-invariant feature transform (SIFT) are being investigated and compared with prior studies. Two retrieval methods are also used in this study, namely k-nearest neighbor (KNN) and mutual information (MI) to measure the similarity between query image and images in database. The result will be evaluated using positive count rate in each query for each class. The result of this study is expected to contribute more towards better Computed-Aided Diagnosis (CADx) and specifically screening mammography analysis in clinical cases. PMID:27577481

  7. Contrast-Medium-Enhanced Digital Mammography: Contrast vs. Iodine Concentration Phantom Calibration

    SciTech Connect

    Rosado-Mendez, I.; Brandan, M. E.; Villasenor, Y.; Benitez-Bribiesca, L.

    2008-08-11

    This work deals with the application of the contrast-medium-enhanced digital subtraction mammography technique in order to calibrate the contrast level in subtracted phantom images as function of iodine concentration to perform dynamic studies of the contrast-medium uptake in the breast. Previously optimized dual-energy temporal subtraction modalities were used (a) to determine radiological parameters for a dynamic clinical study composed of 1 mask+3 post-contrast images limiting the total mean glandular dose to 2.5 mGy, and (b) to perform a contrast vs iodine concentration calibration using a custom-made phantom. Calculated exposure values were applied using a commercial full-field digital mammography unit. Contrast in subtracted phantom images (one mask and one post-CM) is linear as function of iodine concentration, although the sensitivity (contrast per iodine concentration) decreases beyond 8 mg/mL. This calibration seems to apply only to thin and normal thickness breasts.

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

    SciTech Connect

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

    2006-08-15

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

  9. Design of a novel phase contrast x-ray imaging system for mammography.

    PubMed

    Munro, Peter R T; Ignatyev, Konstantin; Speller, Robert D; Olivo, Alessandro

    2010-07-21

    It is hoped that x-ray phase contrast imaging (XPCi) will provide a generational improvement in the effectiveness of mammography. XPCi is sensitive to the refraction which x-rays undergo as a result of the variation in x-ray propagation speeds within an object. XPCi is, however, seldom used in clinical applications owing mainly to a lack of suitable systems. The radiation physics group at UCL has previously designed and built an XPCi system sensitive to phase gradients in one dimension for application in security inspection. We present here the design methodology and final design of a prototype XPCi system sensitive to phase gradients in two directions for use in mammography. The technique makes efficient use of the flux available from a laboratory x-ray source, thus making it suitable for clinical use. PMID:20601778

  10. [Reduction of radiation dosage in mammography by using film intensifying foil systems in Poland].

    PubMed

    Iwaszkiewicz, K; Bończyk, J

    In order to assess possibility of radiation dose reduction during mammography at direct film radiation, a comparative studies have been carried out. The studies involved Roentgen XT-2 film without intensifying foil compared with Mammoray MR-3 (Agfa Gevaert), Ortho M-MO-1 (Kodak) in the original cassettes, and Fluorfilm TK-1 (WZF Foton) with foils Min.-R. Film-intensifying foil systems are four and six times more sensitive than Rentgen XT-2 film. Sensitometric and diagnostic properties of Fluorofilm TK-1 are comparable with Mammoray MR-3 film. Therefore, films Rentgen XT-2 which are presently used in mammography should be replaced with Fluorofilm TK-1 with the intensifying foils. PMID:1669071

  11. Validation of scales measuring attitudes and norms related to mammography screening in women veterans.

    PubMed

    Tiro, Jasmin A; Diamond, Pamela M; Perz, Catherine A; Fernandez, Maria; Rakowski, William; DiClemente, Carlo C; Vernon, Sally W

    2005-11-01

    Validation of psychosocial measures for use in mammography screening research has been given inadequate attention in the literature. The authors report on the validation of 5 measures examining 4 attitudinal constructs (i.e., pros, cons, outcome expectations, and cancer worries) and 1 social influence construct (i.e., subjective norms) in a 22-item inventory. The study participants consisted of a national, randomly sampled population of women veterans (n = 2,910). After minor revision of scales, the authors found independent measures for 4 constructs: pros, cons, cancer worries, and subjective norms. The authors concluded that these scales have acceptable psychometric properties; support construct validity; and provide brief, reliable, and valid measures of attitudes toward and norms regarding mammography screening. These scales may be useful for intervention research. PMID:16287401

  12. Selective pattern enhancement processing for digital mammography, algorithms, and the visual evaluation

    NASA Astrophysics Data System (ADS)

    Yamada, Masahiko; Shimura, Kazuo; Nagata, Takefumi

    2003-05-01

    In order to enhance the micro calcifications selectively without enhancing noises, PEM (Pattern Enhancement Processing for Mammography) has been developed by utilizing not only the frequency information but also the structural information of the specified objects. PEM processing uses two structural characteristics i.e. steep edge structure and low-density isolated-point structure. The visual evaluation of PEM processing was done using two different resolution CR mammography images. The enhanced image by PEM processing was compared with the image without enhancement, and the conventional usharp-mask processed image. In the PEM processed image, an increase of noises due to enhancement was suppressed as compared with that in the conventional unsharp-mask processed image. The evaluation using CDMAM phantom showed that PEM processing improved the detection performance of a minute circular pattern. By combining PEM processing with the low and medium frequency enhancement processing, both mammary glands and micro calcifications are clearly enhanced.

  13. Technology assessment: observer study directly compares screen/film to CR mammography

    NASA Astrophysics Data System (ADS)

    Fletcher-Heath, Lynn; Richards, Anne; Ryan-Kron, Susan

    2007-03-01

    A new study supports and expands upon a previous reporting that computed radiography (CR) mammography offers as good, or better, image quality than state-of-the-art screen/film mammography. The suitability of CR mammography is explored through qualitative and quantitative study components: feature comparison and cancer detection rates of each modality. Images were collected from 150 normal and 50 biopsy-confirmed subjects representing a range of breast and pathology types. Comparison views were collected without releasing compression, using automatic exposure control on Kodak MIN-R films, followed by CR. Digital images were displayed as both softcopy (S/C) and hardcopy (H/C) for the feature comparison, and S/C for the cancer detection task. The qualitative assessment used preference scores from five board-certified radiologists obtained while viewing 100 screen/film-CR pairs from the cancer subjects for S/C and H/C CR output. Fifteen general image-quality features were rated, and up to 12 additional features were rated for each pair, based on the pathology present. Results demonstrate that CR is equivalent or preferred to conventional mammography for overall image quality (89% S/C, 95% H/C), image contrast (95% S/C, 98% H/C), sharpness (86% S/C, 93% H/C), and noise (94% S/C, 91% H/C). The quantitative objective was satisfied by asking 10 board-certified radiologists to provide a BI-RADS TM score and probability of malignancy per breast for each modality of the 200 cases. At least 28 days passed between observations of the same case. Average sensitivity and specificity was 0.89 and 0.82 for CR and 0.91 and 0.82 for screen/film, respectively.

  14. SU-E-I-04: A Mammography Phantom to Measure Mean Glandular Dose and Image Quality

    SciTech Connect

    Lopez-Pineda, E; Ruiz-Trejo, C; E, Brandan M

    2014-06-01

    Purpose: To evaluate mean glandular dose (MGD) and image quality in a selection of mammography systems using a novel phantom based on thermoluminescent dosemeters and the ACR wax insert. Methods: The phantom consists of two acrylic, 19 cm diameter, 4.5 cm thick, semicircular modules, used in sequence. The image quality module contains the ACR insert and is used to obtain a quality control image under automatic exposure conditions. The dosimetric module carries 15 TLD-100 chips, some under Al foils, to determine air kerma and half-value-layer. TL readings take place at our laboratory under controlled conditions. Calibration was performed using an ionization chamber and a Senographe 2000D unit for a variety of beam qualities, from 24 to 40 kV, Mo and Rh anodes and filters. Phantom MGD values agree, on the average, within 3% with ionization chamber data, and their precision is better than 10% (k=1). Results: MGD and image quality have been evaluated in a selection of mammography units currently used in Mexican health services. The sample includes analogic (screen/film), flexible digital (CR), and full-field digital image receptors. The highest MDG are associated to the CR technology. The most common image quality failure is due to artifacts (dust, intensifying screen scratches, and processor marks for film/screen, laser reader defects for CR). Conclusion: The developed phantom permits the MGD measurement without the need of a calibrated ionization chamber at the mammography site and can be used by a technician without the presence of a medical physicist. The results indicate the urgent need to establish quality control programs for mammography.

  15. Reproducing 2D breast mammography images with 3D printed phantoms

    NASA Astrophysics Data System (ADS)

    Clark, Matthew; Ghammraoui, Bahaa; Badal, Andreu

    2016-03-01

    Mammography is currently the standard imaging modality used to screen women for breast abnormalities and, as a result, it is a tool of great importance for the early detection of breast cancer. Physical phantoms are commonly used as surrogates of breast tissue to evaluate some aspects of the performance of mammography systems. However, most phantoms do not reproduce the anatomic heterogeneity of real breasts. New fabrication technologies, such as 3D printing, have created the opportunity to build more complex, anatomically realistic breast phantoms that could potentially assist in the evaluation of mammography systems. The primary objective of this work is to present a simple, easily reproducible methodology to design and print 3D objects that replicate the attenuation profile observed in real 2D mammograms. The secondary objective is to evaluate the capabilities and limitations of the competing 3D printing technologies, and characterize the x-ray properties of the different materials they use. Printable phantoms can be created using the open-source code introduced in this work, which processes a raw mammography image to estimate the amount of x-ray attenuation at each pixel, and outputs a triangle mesh object that encodes the observed attenuation map. The conversion from the observed pixel gray value to a column of printed material with equivalent attenuation requires certain assumptions and knowledge of multiple imaging system parameters, such as x-ray energy spectrum, source-to-object distance, compressed breast thickness, and average breast material attenuation. A detailed description of the new software, a characterization of the printed materials using x-ray spectroscopy, and an evaluation of the realism of the sample printed phantoms are presented.

  16. MRI in the differential diagnosis of primary architectural distortion detected by mammography

    PubMed Central

    Si, Lifang; Zhai, Renyou; Liu, Xiaojuan; Yang, Kaiyan; Wang, Li; Jiang, Tao

    2016-01-01

    PURPOSE We aimed to evaluate the diagnostic accuracy of a combination of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and apparent diffusion coefficient (ADC) values in lesions that manifest with architectural distortion (AD) on mammography. METHODS All full-field digital mammography (FFDM) images obtained between August 2010 and January 2013 were reviewed retrospectively, and 57 lesions showing AD were included in the study. Two independent radiologists reviewed all mammograms and MRI data and recorded lesion characteristics according to the BI-RADS lexicon. The gold standard was histopathologic results from biopsies or surgical excisions and results of the two-year follow-up. Receiver operating characteristic curve analysis was carried out to define the most effective threshold ADC value to differentiate malignant from benign breast lesions. We investigated the sensitivity and specificity of FFDM, DCE-MRI, FFDM+DCE-MRI, and DCE-MRI+ADC. RESULTS Of the 57 lesions analyzed, 28 were malignant and 29 were benign. The most effective threshold for the normalized ADC (nADC) was 0.61 with 93.1% sensitivity and 75.0% specificity. The sensitivity and specificity of DCE-MRI combined with nADC was 92.9% and 79.3%, respectively. DCE-MRI combined with nADC showed the highest specificity and equal sensitivity compared with other modalities, independent of the presentation of calcification. CONCLUSION DCE-MRI combined with nADC values was more reliable than mammography in differentiating the nature of disease manifesting as primary AD on mammography. PMID:26899149

  17. High dynamic range CMOS-based mammography detector for FFDM and DBT

    NASA Astrophysics Data System (ADS)

    Peters, Inge M.; Smit, Chiel; Miller, James J.; Lomako, Andrey

    2016-03-01

    Digital Breast Tomosynthesis (DBT) requires excellent image quality in a dynamic mode at very low dose levels while Full Field Digital Mammography (FFDM) is a static imaging modality that requires high saturation dose levels. These opposing requirements can only be met by a dynamic detector with a high dynamic range. This paper will discuss a wafer-scale CMOS-based mammography detector with 49.5 μm pixels and a CsI scintillator. Excellent image quality is obtained for FFDM as well as DBT applications, comparing favorably with a-Se detectors that dominate the X-ray mammography market today. The typical dynamic range of a mammography detector is not high enough to accommodate both the low noise and the high saturation dose requirements for DBT and FFDM applications, respectively. An approach based on gain switching does not provide the signal-to-noise benefits in the low-dose DBT conditions. The solution to this is to add frame summing functionality to the detector. In one X-ray pulse several image frames will be acquired and summed. The requirements to implement this into a detector are low noise levels, high frame rates and low lag performance, all of which are unique characteristics of CMOS detectors. Results are presented to prove that excellent image quality is achieved, using a single detector for both DBT as well as FFDM dose conditions. This method of frame summing gave the opportunity to optimize the detector noise and saturation level for DBT applications, to achieve high DQE level at low dose, without compromising the FFDM performance.

  18. Are Obese Women More Likely to Participate in a Mobile Mammography Program?

    PubMed Central

    Atkins, Elvonna; Madhavan, Suresh; LeMasters, Traci; Vyas, Ami; Gainor, Sara Jane; Remick, Scot

    2016-01-01

    Mobile mammography services are typically offered as a means to increase access and adherence to mammography screenings. As mobile mammography becomes a viable strategy to increase screening, a 3 year study of such a state-wide program in WV found surprisingly high rates of obesity within the study population. Thus, the objectives were to: (1) describe the demographic characteristics and comorbidities of women who utilized the WV program, and (2) determine the association between body mass index (BMI) and personal health and screening history, preventive care and wellness behaviors, nutrition and exercise behaviors, and demographics. Data collected from 1,099 women, age 40 and above, were analyzed using descriptive statistics, bivariate analyses, and a multivariate regression model. The majority (60.4 %) were married, had an income <$25,000 (59.2 %), and had health insurance (53.5 %). Major comorbidities were hypertension (49 %) and high cholesterol (43.9 %). Based on BMI scores, 884 participants were either overweight (26.6 %), mildly obese (27.7 %), moderately obese (15.1 %), or severely obese (11.1 %). Bivariate analyses indicated that increasing BMI was significantly associated with factors such as having hypertension or diabetes, limited daily activities, perceived health, and not smoking or drinking. The regression model was significant (p < 0.001; R2 = 0.425) indicating that women who engaged in preventive care behaviors were less likely to be obese than those who did not. The WV mobile mammography program appeared to attract women who were disproportionately obese and had multiple comorbidities, thus providing a great opportunity for targeted interventions related to improving preventive care and screening behaviors. PMID:23054419

  19. Light sensitometry of mammography films at varying development temperatures and times

    PubMed Central

    Sharma, Reena; Sharma, Sunil Dutt; Mayya, Y. S.

    2012-01-01

    Kodak MinR-2000 mammography film is widely used for mammography imaging. The sensitometric indices like base plus fog level (B + F), maximum optical density (ODmax), average gradient (AG) and speed of this film at varying development temperatures and times were evaluated using a light sensitometer. Totally 33 film strips were cut from a single Kodak MinR-2000 mammography film box and exposed in a light sensitometer operated in the green light spectrum to produce a 21-step sensitometric strip. These exposed film strips were processed at temperatures in the range of 32°C–37°C in the step of 1°C and at processing times in the range of 1–6 minutes in the step of 1 minute. The results of the present study show that the measured base plus fog level of the mammography film was not affected much, whereas significant changes were seen in the ODmax, AG and speed with varying development temperatures and times. The ODmax values of the film were found in the range of 3.67–3.76, AG values were in the range of 2.48–3.4 and speed values were in the range of 0.015–0.0236 when the processing temperature was varied from 32°C to 37°C. With processing time variation from 1 to 6 minutes, the observed changes in ODmax values were in the range of 3.54-3.71, changes in AG were in the range of 2.66–3.27 and changes in speed were in the range of 0.011–0.025. Based on these observations, recommendations for optimum processing parameters to be used for this film are made. PMID:22363111

  20. The Impact of Medicaid Coverage and Reimbursement on Access to Diagnostic Mammography

    PubMed Central

    Schuur, Jeremiah D.; Shah, Akash; Wu, Zheyang; Forman, Howard P.; Gross, Cary P.

    2013-01-01

    BACKGROUND Women of low socioeconomic status are at risk for delayed evaluation of abnormal mammograms and later stage presentations of breast cancer. Medicaid reimbursement for clinical services is lower than Medicare reimbursement, yet it is unclear whether low Medicaid reimbursement is a barrier to accessing mammography. The objective of the current study was to determine the association between reported insurance type (Medicaid vs Medicare), Medicaid reimbursement rate, and access to diagnostic mammography (DM). METHODS Standardized patients (SPs) called 521 mammography facilities in defined geographic regions of 11 states in 2005. Facilities were divided between high, middle, and low reimbursing states based on the state’s relative Medicaid-to-Medicare reimbursement rate for DM. SPs contacted each facility twice to schedule a DM using the same clinical vignette but switching insurance status (Medicaid vs Medicare). The authors measured the proportion of SPs who were offered 1) any appointment and 2) a timely appointment, defined as a third available appointment within 20 business days. RESULTS SPs with Medicaid were less likely to receive an appointment than SPs with Medicare (91% vs 99.1%; difference, 8.1%; 95% confidence interval, 5.3%–10.9% [P < .001]). Among facilities that offered appointments to both callers, the proportion of timely appointments did not differ between Medicaid (93.7%) and Medicare (92.9%; P = .51). States’ Medicaid reimbursement rates for DM were not associated with the percentage of SPs with Medicaid who were offered any appointment (P = .50) or a timely appointment (P = .69). CONCLUSIONS Callers with Medicaid were offered appointments for DM less frequently than callers with Medicare, although both were widely accepted. State Medicaid reimbursement rates did not affect access to mammography. PMID:19728371

  1. Association of primary care physician sex with cervical cancer and mammography screening

    PubMed Central

    Ince-Cushman, Daniel; Correa, José A.; Shuldiner, Jennifer; Segouin, Judith

    2013-01-01

    Objective To assess whether the sex of primary care physicians is associated with differing rates of cervical cancer and mammography screening in a contemporary multicultural context. Design Structured medical record review of a retrospectively defined cohort. Setting Academic urban primary care clinic in Montreal, Que. Participants Seven male physicians and 9 female physicians, and all female patients aged 14 to 69 years registered to one of the physicians (N = 1948). Main outcome measures Screening compliance rates as measured by the elapsed time between the last visit and cervical cancer screening for all women in the study. In addition, in women aged 50 to 69 years, elapsed time between the last visit and mammography screening. Results Crude rates of Papanicolaou tests for patients of female primary care physicians were higher than for patients of male primary care physicians in all patient age groups. The lowest rates of Pap testing were among the youngest and oldest patients. After adjustment for patient age, first language, and region of birth, as well as physician age, the odds ratio of having a Pap test was 2.24 (95% CI 1.18 to 4.28) for the patients of female physicians, relative to those of male physicians. The adjusted odds ratio for mammography screening was 1.25 (95% CI 0.97 to 1.61) for patients of female physicians. Conclusion Male primary care physician sex is associated with lower rates of cervical cancer screening in an urban multicultural context. The study did not detect a physician sex effect in the mammography cohort. PMID:23341674

  2. Sustaining Mammography Screening Among the Medically Underserved: A Follow-Up Evaluation

    PubMed Central

    Arnold, Connie L.; Bennett, Charles L.; Wolf, Michael S.; Liu, Dachao; Rademaker, Alfred

    2015-01-01

    Abstract Background: Our previous three-arm comparative effectiveness intervention in community clinic patients who were not up-to-date with screening resulted in mammography rates over 50% in all arms. Objective: Our aim was to evaluate the effectiveness and cost-effectiveness of the three interventions on improving biennial screening rates among eligible patients. Methods: A three-arm quasi-experimental evaluation was conducted in eight community clinics from 2008 to 2011. Screening efforts included (1) enhanced care: Participants received an in-person recommendation from a research assistant (RA) in year 1, and clinics followed usual clinic protocol for scheduling screening mammograms; (2) education intervention: Participants received education and in-person recommendation from an RA in year 1, and clinics followed usual clinic protocol for scheduling mammograms; or (3) nurse support: A nurse manager provided in-person education and recommendation, scheduled mammograms, and followed up with phone support. In all arms, mammography was offered at no cost to uninsured patients. Results: Of 624 eligible women, biennial mammography within 24–30 months of their previous test was performed for 11.0% of women in the enhanced-care arm, 7.1% in the education- intervention arm, and 48.0% in the nurse-support arm (p<0.0001). The incremental cost was $1,232 per additional woman undergoing screening with nurse support vs. enhanced care and $1,092 with nurse support vs. education. Conclusions: Biennial mammography screening rates were improved by providing nurse support but not with enhanced care or education. However, this approach was not cost-effective. PMID:25692910

  3. Breast Cancer Risk and Provider Recommendation for Mammography Among Recently Unscreened Women in the United States

    PubMed Central

    Sabatino, Susan A; Burns, Risa B; Davis, Roger B; Phillips, Russell S; McCarthy, Ellen P

    2006-01-01

    BACKGROUND AND OBJECTIVE Many women with increased breast cancer risk have not been screened recently. Provider recommendation for mammography is an important reason many women undergo screening. We examined the association between breast cancer risk and reported provider recommendation for mammography in recently unscreened women. DESIGN Cross-sectional study using 2000 National Health Interview Survey. PARTICIPANTS In all, 1673 women ages 40 to 75 years without cancer who saw a health care provider in the prior year and had no mammogram within 2 years. MEASUREMENTS AND ANALYSIS We assessed breast cancer risk by Gail score and risk factors. We used multivariable logistic regression models in SUDAAN adjusted for age, race and illness burden, to examine the association between risk and reported recommendation for mammography within 1 year for all women and women ages 50 to 75 years. RESULTS Of 1673 recently unscreened women, 29% reported a recommendation. Twelve percent of women had increased Gail risk and of these recently unscreened, high-risk women, 25% reported a recommendation. After adjustment, high-risk women were not more likely to report a recommendation than average-risk women. Results were similar for women 50 to 75 years old. No individual breast cancer factors other than age were associated with reporting a recommendation. CONCLUSIONS Approximately 70% of recently unscreened women seen by a health care provider in the prior year reported no recommendation for mammography, regardless of breast cancer risk. This did not include women who received a recommendation and were screened. Increasing reported recommendation rates may represent an opportunity to increase screening participation among recently unscreened women, particularly for women with increased breast cancer risk. PMID:16686802

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

    PubMed

    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. PMID:24787378

  5. Is the false-positive rate in mammography in North America too high?

    PubMed

    Le, Michelle T; Mothersill, Carmel E; Seymour, Colin B; McNeill, Fiona E

    2016-09-01

    The practice of investigating pathological abnormalities in the breasts of females who are asymptomatic is primarily employed using X-ray mammography. The importance of breast screening is reflected in the mortality-based benefits observed among females who are found to possess invasive breast carcinoma prior to the manifestation of clinical symptoms. It is estimated that population-based screening constitutes a 17% reduction in the breast cancer mortality rate among females affected by invasive breast carcinoma. In spite of the significant utility that screening confers in those affected by invasive cancer, limitations associated with screening manifest as potential harms affecting individuals who are free of invasive disease. Disease-free and benign tumour-bearing individuals who are subjected to diagnostic work-up following a screening examination constitute a population of cases referred to as false positives (FPs). This article discusses factors contributing to the FP rate in mammography and extends the discussion to an assessment of the consequences associated with FP reporting. We conclude that the mammography FP rate in North America is in excess based upon the observation of overtreatment of in situ lesions and the disproportionate distribution of detriment and benefit among the population of individuals recalled for diagnostic work-up subsequent to screening. To address the excessive incidence of FPs in mammography, we investigate solutions that may be employed to remediate the current status of the FP rate. Subsequently, it can be suggested that improvements in the breast-screening protocol, medical litigation risk, image interpretation software and the implementation of image acquisition modalities that overcome superimposition effects are promising solutions. PMID:27187600

  6. Self administered screening for hereditary cancers in conjunction with mammography and ultrasound.

    PubMed

    McDonnell, Charles H; Seidenwurm, David J; McDonnell, Diana E; Bobolis, Kristie A

    2013-12-01

    We evaluated the feasibility of an automated tablet computer application providing a family and personal history based cancer risk assessment for hereditary breast, ovarian, endometrial and colorectal cancers. 1,002 women presenting for screening mammography and 1,000 presenting for ultrasound were offered screening. The application calculated the risk of BRCA mutations using BRCAPRO, Myriad and Tyrer-Cuzick risk assessment models. Lifetime risk of breast and ovarian cancer was assessed with the BRCAPRO, Claus and Tyrer-Cuzick models. Colorectal and endometrial cancer risk was calculated via the MMRpro model. Patients were identified as high-risk based on thresholds 10% or greater risk for carrying genetic mutations or 20% or greater lifetime risk of breast or ovarian cancer. The percent of women found to be high-risk by a single risk assessment tool ranged from 0.5 to 5.3%. Combining assessment tools found 9.3% of women to be high-risk. The risk assessments performed similarly for the mammography and ultrasound cohorts with yields (combining assessment tools) of 9.2 and 9.4% respectively. The average ages of all the high-risk women were 45.8 and 39.6 years for the mammography and ultrasound cohorts respectively. Difficulties encountered included a need for software upgrade, wireless network unreliability and hardware theft. Automated family history screening can identify women probably at high-risk for hereditary cancers efficiently. The number of women identified is increased by employing multiple risk assessment models simultaneously. Surveying women in conjunction with ultrasound identified women at increased risk as effectively and at a younger age than with screening mammography. PMID:23584879

  7. A new CMOS-based digital imaging detector for applications in mammography

    NASA Astrophysics Data System (ADS)

    Baysal, Mehmet A.; Toker, Emre

    2005-09-01

    We have developed a CMOS-based x-ray imaging detector in the same form factor of a standard film cassette (18 cm × 24 cm) for Small Field-of-view Digital Mammography (SFDM) applications. This SFDM cassette is based on our three-side buttable, 25 mm × 50 mm, 48μm active-pixel CMOS sensor modules and utilizes a 150μm columnar CsI(Tl) scintillator. For imaging up to 100 mm × 100 mm field-of-view, a number of CMOS sensor modules need to be tiled and electronically synchronized together. By using fiber-optic communication, acquired images from the SFDM cassette can be transferred, processed and displayed on a review station within approximately 5 seconds of exposure, greatly enhancing patient flow. We present the physical performance of this CMOS-based SFDM cassette, using established objective criteria such as the Modulation Transfer Function (MTF), Detective Quantum Efficiency (DQE), and more subjective criteria, by evaluating images from a phantom study and the clinical studies of our collaborators. Driven by the strong demand from the computer industry, CMOS technology is one of the lowest cost, and the most readily accessible technologies available for digital mammography today. Recent popular use of CMOS imagers in high-end consumer cameras have also resulted in significant advances in the imaging performance of CMOS sensors against rivaling CCD sensors. The SFDM cassette can be employed in various mammography applications, including spot imaging, stereotactic biopsy imaging, core biopsy and surgical biopsy specimen radiography. This study demonstrates that all the image quality requirements for demanding mammography applications can be addressed with CMOS technology.

  8. Underutilizers of mammography screening today: characteristics of women planning, undecided about, and not planning a mammogram.

    PubMed

    Clemow, L; Costanza, M E; Haddad, W P; Luckmann, R; White, M J; Klaus, D; Stoddard, A M

    2000-01-01

    Using concepts from the Precaution Adoption Process Model, we identified behavioral factors, sociodemographic and psychosocial variables, and beliefs about breast cancer that discriminated among women at different stages with regard to their intention to obtain mammography screening. An independent survey company conducted telephone interviews with 2,507 women aged 50 to 80 who were identified as underutilizers of mammography screening. Each underutilizer was assigned to one of three stages with regard to intention to get a mammogram: (a) definitely planning, (b) thinking about, and (c) not planning. Estimated actual risk of breast cancer, perceived risk to breast cancer, worry about breast cancer, and fear of learning from a mammogram that one has breast cancer were variables found to be significantly associated with intention to obtain a mammogram for several subgroups of underutilizing women. There are significant behavioral and psychosocial variables, beliefs and feelings about breast cancer, and demographic characteristics that distinguish underutilizing women at various stages with regard to intention to obtain mammography screening. Our findings provide new information that could help the health care professional motivate women who are not planning to utilize this preventive health measure to become regular utilizers. PMID:10892532

  9. Complete internal audit of a mammography service in a reference institution for breast imaging*

    PubMed Central

    Badan, Gustavo Machado; Roveda Júnior, Décio; Ferreira, Carlos Alberto Pecci; de Noronha Junior, Ozeas Alves

    2014-01-01

    Objective Undertaking of a complete audit of the service of mammography, as recommended by BI-RADS®, in a private reference institution for breast cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of results with those recommended by the literature. Materials and Methods Retrospective, analytical and cross-sectional study including 8,000 patients submitted to mammography in the period between April 2010 and March 2011, whose results were subjected to an internal audit. The patients were followed-up until December 2012. Results The radiological classification of 7,249 screening mammograms, according to BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%), 4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8 cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases. Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%, respectively. In the present study, the sensitivity of the method was 97.1% and specificity, 97.4%. Conclusion The complete internal audit of a service of mammography is essential to evaluate the quality of such service, which reflects on an early breast cancer detection and reduction of mortality rates. PMID:25741052

  10. Dosimetry and image quality in digital mammography facilities in the State of Minas Gerais, Brazil

    NASA Astrophysics Data System (ADS)

    da Silva, Sabrina Donato; Joana, Geórgia Santos; Oliveira, Bruno Beraldo; de Oliveira, Marcio Alves; Leyton, Fernando; Nogueira, Maria do Socorro

    2015-11-01

    According to the National Register of Health Care Facilities (CNES), there are approximately 477 mammography systems operating in the state of Minas Gerais, Brazil, of which an estimated 200 are digital apparatus using mainly computerized radiography (CR) or direct radiography (DR) systems. Mammography is irreplaceable in the diagnosis and early detection of breast cancer, the leading cause of cancer death among women worldwide. A high standard of image quality alongside smaller doses and optimization of procedures are essential if early detection is to occur. This study aimed to determine dosimetry and image quality in 68 mammography services in Minas Gerais using CR or DR systems. The data of this study were collected between the years of 2011 and 2013. The contrast-to-noise ratio proved to be a critical point in the image production chain in digital systems, since 90% of services were not compliant in this regard, mainly for larger PMMA thicknesses (60 and 70 mm). Regarding the image noise, only 31% of these were compliant. The average glandular dose found is of concern, since more than half of the services presented doses above acceptable limits. Therefore, despite the potential benefits of using CR and DR systems, the employment of this technology has to be revised and optimized to achieve better quality image and reduce radiation dose as much as possible.

  11. Computational assessment of mammography accreditation phantom images and correlation with human observer analysis

    NASA Astrophysics Data System (ADS)

    Barufaldi, Bruno; Lau, Kristen C.; Schiabel, Homero; Maidment, D. A.

    2015-03-01

    Routine performance of basic test procedures and dose measurements are essential for assuring high quality of mammograms. International guidelines recommend that breast care providers ascertain that mammography systems produce a constant high quality image, using as low a radiation dose as is reasonably achievable. The main purpose of this research is to develop a framework to monitor radiation dose and image quality in a mixed breast screening and diagnostic imaging environment using an automated tracking system. This study presents a module of this framework, consisting of a computerized system to measure the image quality of the American College of Radiology mammography accreditation phantom. The methods developed combine correlation approaches, matched filters, and data mining techniques. These methods have been used to analyze radiological images of the accreditation phantom. The classification of structures of interest is based upon reports produced by four trained readers. As previously reported, human observers demonstrate great variation in their analysis due to the subjectivity of human visual inspection. The software tool was trained with three sets of 60 phantom images in order to generate decision trees using the software WEKA (Waikato Environment for Knowledge Analysis). When tested with 240 images during the classification step, the tool correctly classified 88%, 99%, and 98%, of fibers, speck groups and masses, respectively. The variation between the computer classification and human reading was comparable to the variation between human readers. This computerized system not only automates the quality control procedure in mammography, but also decreases the subjectivity in the expert evaluation of the phantom images.

  12. Measurements and simulations of scatter imaging as a simultaneous adjunct for screening mammography

    NASA Astrophysics Data System (ADS)

    Kern, Katie; Hassan, Laila; Peerzada, Lubna; Ur-Rehman, Mahboob; MacDonald, C. A.

    2015-03-01

    X-ray coherent scatter is dependent upon the molecular structure of the scattering material and hence allows differentiation between tissue types with potentially much higher contrast than conventional absorption-based radiography. Coherent-scatter computed tomography has been used to produce images based on the x-ray scattering properties of the tissue. However, the geometry for CT imaging requires a thin fan beam and multiple projections and is incommensurate with screening mammography. In this work we demonstrate progress in a developing a system using a wide slot beam and simple anti-scatter grid which is adequate to differentiate between scatter peaks to remove the fat background from the coherent scatter image. Adequate intensity in the coherent scatter image can be achieved at the dose commonly used for screening mammography to detect carcinoma surrogates as small as 2 mm in diameter. This technique would provide an inexpensive, low dose, simultaneous adjunct to conventional screening mammography to provide a localized map of tissue type that could be overlaid on the conventional transmission mammogram. Comparisons between phantom measurements and Monte Carlo simulations show good agreement, which allowed for detailed examination of the visibility of carcinoma under realistic conditions.

  13. Comparison of the clinical performance of three digital mammography systems in a breast cancer screening programme.

    PubMed

    Keavey, E; Phelan, N; O'Connell, A M; Flanagan, F; O'Doherty, A; Larke, A; Connors, A M

    2012-08-01

    This study compares the clinical performance of three digital mammography system types in a breast cancer screening programme. 28 digital mammography systems from three different vendors were included in the study. The retrospective analysis included 238 182 screening examinations of females aged between 50 and 64 years over a 3-year period. All images were double read and assigned a result according to a 5-point rating scale to indicate the probability of cancer. Females with a positive result were recalled for further assessment imaging and biopsy if necessary. Clinical performance in terms of cancer detection rate was analysed and the results presented. No statistically significant difference was found between the three different mammography systems in a population-based screening programme, in terms of the overall cancer detection rate or in the detection of invasive cancer and ductal carcinoma in situ. This was shown in both prevalent and subsequent screening examination categories. The results demonstrate comparable cancer detection performance for the three imaging system types operational in the screening programme. PMID:22096222

  14. A Longitudinal Examination of Stages of Change Model Applied to Mammography Screening.

    PubMed

    Lee-Lin, Frances; Nguyen, Thuan; Pedhiwala, Nisreen; Dieckmann, Nathan F; Menon, Usha

    2016-04-01

    Application of behavior change theories to ethnically diverse groups is limited. In a secondary analysis of intervention study data, we tested the validity of the transtheoretical model (TTM) of change among Chinese American immigrant women. Three hundred mammography non-adherent women were randomized to an intervention or control group. Compared with contemplators (60%), precontemplators reported higher perceived mammography barriers (p < .001) and lower breast cancer susceptibility (p < .01). Baseline contemplators were 1.5 times more likely to have a mammogram post intervention compared with precontemplators. Upward shift in stage of change was higher in the intervention than the control group at 3 months (odds ratio [OR] = 6.14), 6 months (OR = 4.82), and 12 months (OR = 2.85). Women with an upward shift at 3 months were more likely to complete mammography at 12 months (OR = 15.44). The results supported the TTM stages of change. Education targeted to Chinese women's stages of change has significant potential to decrease breast cancer screening disparities. PMID:26712817

  15. A consideration of the signal-to-noise ratio in phase contrast mammography

    NASA Astrophysics Data System (ADS)

    Kato, Yuri; Fujita, Naotoshi; Kodera, Yoshie

    2010-04-01

    Recently, with developments in medicine, digital systems such as computed radiography (CR) and flat-panel detector (FPD) systems are being employed for mammography instead of analog systems such as the screen-film system. Phase-contrast mammography (PCM) is a commercially available digital system that uses images with a magnification of 1.75x. To study the effect of the air gap in PCM, we measured the scatter fraction ratio (SFR) and calculated the signal-to-noise ratio (SNR) in PCM, and compared it to that in conventional mammography (CM). Then, to extend the SNR to the spatial frequency domain, we calculated the noise equivalent quanta (NEQ) and detective quantum efficiency (DQE) used by the modulation transfer function (MTF), noise power spectrum of the pixel value (NPSΔPV), gradient of the digital characteristic curve, and number of X-ray photons. The obtained results indicated that the SFR of the PCM was as low as that of the CM with a grid. When the exposure dose was constant, the SNR of the PCM was the highest in all systems. Moreover, the NEQ and DQE for the PCM were higher than those for the CM (G-) in the spatial frequency domain over 2.5 cycles/mm. These results showed that the number of scattered X-rays was reduced sufficiently by the air gap in the PCM and the NEQ and DQE for PCM were influenced by the presampled MTF in the high-spatial-frequency domain.

  16. The neoplastic transformation potential of mammography X rays and atomic bomb spectrum radiation.

    PubMed

    Heyes, G J; Mill, A J

    2004-08-01

    Considerable controversy currently exists regarding the biological effectiveness of 29 kVp X rays which are used for mammography screening. This issue must be resolved to enable proper evaluation of radiation risks from breast screening. Here a definitive assessment of the biological effectiveness of 29 kVp X rays compared to the quality of radiation to which the atomic bomb survivors were exposed is presented for the first time. The standard radiation sources used were (a) an atomic bomb simulation spectrum and (b) 2.2 MeV electrons from a strontium-90/yttrium-90 (90Sr/90Y) radioactive source. The biological end point used was neoplastic transformation in vitro in CGL1 (HeLa x human fibroblast hybrid) cells. No significant difference was observed for the biological effectiveness of the two high-energy sources for neoplastic transformation. A limiting relative biological effectiveness (RBE(M)) of 4.42 +/- 2.02 was observed for neoplastic transformation by 29 kVp X rays compared to these two sources. This compares with values of 4.67 +/- 3.93 calculated from previously published data and 3.58 +/- 1.77 when the reference radiation was 200 and 220 kVp X rays. This suggests that the risks associated with mammography screening may be approximately five times higher than previously assumed and that the risk-benefit relationship of mammography exposures may need to be re-examined. PMID:15387138

  17. Predictors of adherence to clinical breast examination and mammography screening among Malaysian women.

    PubMed

    Parsa, Parisa; Kandiah, Mirnalini

    2010-01-01

    Breast cancer is the most common cancer among Malaysian women and early detection can play an important role in reducing cancer morbidity and mortality. The aim of this cross-sectional study was to determine the rates and factors related to clinical breast examination (CBE) and mammography among 425 female teachers in Selangor, Malaysia. A self-administered questionnaire that included questions on socio-demography, cancer-related knowledge and practice and an adapted version of Champion's revised Health Belief Model Scale was employed. The mean age of participants was 37.2 ± 7.16 years. Only 25% of the women ever had a CBE. Of women over the age 40 (n=138), 13.6% reported having had a mammography. The results showed higher susceptibility to breast cancer, higher benefits of doing CBE and regular visits with a physician to be significant predictors for undergoing CBE (p < 0.05). In addition, higher a perceived susceptibility to breast cancer and regular undergoing CBE were significant predictors for having a mammography. The findings clearly suggest a need for improving women's awareness on breast cancer screening, its importance and recommended guidelines. PMID:21039036

  18. Exploratory survey of image quality on CR digital mammography imaging systems in Mexico.

    PubMed

    Gaona, E; Rivera, T; Arreola, M; Franco, J; Molina, N; Alvarez, B; Azorín, C G; Casian, G

    2014-01-01

    The purpose of this study was to assess the current status of image quality and dose in computed radiographic digital mammography (CRDM) systems. Studies included CRDM systems of various models and manufacturers which dose and image quality comparisons were performed. Due to the recent rise in the use of digital radiographic systems in Mexico, CRDM systems are rapidly replacing conventional film-screen systems without any regard to quality control or image quality standards. Study was conducted in 65 mammography facilities which use CRDM systems in the Mexico City and surrounding States. The systems were tested as used clinically. This means that the dose and beam qualities were selected using the automatic beam selection and photo-timed features. All systems surveyed generate laser film hardcopies for the radiologist to read on a scope or mammographic high luminance light box. It was found that 51 of CRDM systems presented a variety of image artefacts and non-uniformities arising from inadequate acquisition and processing, as well as from the laser printer itself. Undisciplined alteration of image processing settings by the technologist was found to be a serious prevalent problem in 42 facilities. Only four of them showed an image QC program which is periodically monitored by a medical physicist. The Average Glandular Dose (AGD) in the surveyed systems was estimated to have a mean value of 2.4 mGy. To improve image quality in mammography and make more efficient screening mammographic in early detection of breast cancer is required new legislation. PMID:23938078

  19. Diagnostic performance of radiologists with and without different CAD systems for mammography

    NASA Astrophysics Data System (ADS)

    Lauria, Adele; Fantacci, Maria E.; Bottigli, Ubaldo; Delogu, Pasquale; Fauci, Francesco; Golosio, Bruno; Indovina, Pietro L.; Masala, Giovanni L.; Oliva, Piernicola; Palmiero, Rosa; Raso, Giuseppe; Stumbo, Simone; Tangaro, Sabina

    2003-05-01

    The purpose of this study is the evaluation of the variation of performance in terms of sensitivity and specificity of two radiologists with different experience in mammography, with and without the assistance of two different CAD systems. The CAD considered are SecondLookTM (CADx Medical Systems, Canada), and CALMA (Computer Assisted Library in MAmmography). The first is a commercial system, the other is the result of a research project, supported by INFN (Istituto Nazionale di Fisica Nucleare, Italy); their characteristics have already been reported in literature. To compare the results with and without these tools, a dataset composed by 70 images of patients with cancer (biopsy proven) and 120 images of healthy breasts (with a three years follow up) has been collected. All the images have been digitized and analysed by two CAD, then two radiologists with respectively 6 and 2 years of experience in mammography indipendently made their diagnosis without and with, the support of the two CAD systems. In this work sensitivity and specificity variation, the Az area under the ROC curve, are reported. The results show that the use of a CAD allows for a substantial increment in sensitivity and a less pronounced decrement in specificity. The extent of these effects depends on the experience of the readers and is comparable for the two CAD considered.

  20. Mammography workstation design: effect on mammographer behaviour and the risk of musculoskeletal disorders

    NASA Astrophysics Data System (ADS)

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

    2008-03-01

    In the UK Breast Screening Programme there is a growing transition from film to digital mammography, and consequently a change in mammography workstation ergonomics. This paper investigates the effect of the change for radiologists including their comfort, likelihood of developing musculoskeletal disorders (MSD's), and work practices. Three workstations types were investigated: one with all film mammograms; one with digital mammograms alongside film mammograms from the previous screening round, and one with digital mammograms alongside digitised film mammograms from the previous screening round. Mammographers were video-taped whilst conducting work sessions at each of the workstations. Event based Rapid Upper Limb Assessment (RULA) postural analysis showed no overall increase in MSD risk level in the switch from the film to digital workstation. Average number of visual glances at the prior mammograms per case measured by analysis of recorded video footage showed an increase if the prior mammograms were digitised, rather than displayed on a multi-viewer (p<.05). This finding has potential implications for mammographer performance in the transition to digital mammography in the UK.

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

    NASA Astrophysics Data System (ADS)

    Gennaro, G.; Ferro, F.; Contento, G.; Fornasin, F.; di Maggio, C.

    2007-03-01

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

  2. Perception in screening mammography: Can insertion of obvious cases enhance detection?

    NASA Astrophysics Data System (ADS)

    Lewis, Sarah J.; Pietrzyk, Mariusz W.; Nurthen, Robert C. K.; McEntee, Mark F.; Evanoff, Michael; Lee, Warwick; Brennan, Patrick C.; Reed, Warren M.

    2013-03-01

    Purpose : To determine whether a strategy of inserting obvious cancers can improve the detection of subsequent abnormal cases in screening mammography sets. Method : Eight experienced breast imaging radiologists (mammographers) were asked to interpret 40 mammography cases in two sittings and localise any malignancies present. Two differing conditions were presented to participants. In Condition 1, there were 36 normal images interspersed with 4 abnormal cases determined to be of medium to high difficulty. Condition 2 differed in that two normal cases were replaced with two obvious malignant cases. These two obvious cases were placed shortly before two subtle malignancies. In both sittings, participants were told they were viewing a screening mammography set. Results: There was no statistical difference in the location sensitivity between the 2 conditions. There was decreased overall specificity in Condition 2 (p = 0.43). Conclusion: Preliminary findings suggest that the insertion of more easily observed abnormal cases into image sets does not improve performance and may in fact result in lower specificity. Further analysis of participants' eye-positions, and search strategies may offer some explanation of our findings

  3. Developing Asymmetries at Mammography: A Multimodality Approach to Assessment and Management.

    PubMed

    Chesebro, Allyson L; Winkler, Nicole S; Birdwell, Robin L; Giess, Catherine S

    2016-01-01

    A developing asymmetry is a focal asymmetry that is new or increased in conspicuity compared with the previous mammogram. It is challenging to evaluate, as it often looks similar to fibroglandular tissue at mammography. A developing asymmetry should be viewed with suspicion because it is an uncommon manifestation of breast cancer. Diagnostic mammography forms the foundation of diagnostic evaluation of a developing asymmetry and begins with additional spot compression, lateral, and/or rolled views to evaluate and localize it in three-dimensional space. Digital breast tomosynthesis can aid in evaluation by improving radiologists' sensitivity and specificity, as well as allowing localization of the lesion. Once the developing asymmetry has been fully characterized and localized with diagnostic mammography, targeted ultrasonography (US) should be performed to identify potentially benign causes of the developing asymmetry or identify a target for biopsy. However, lack of a US correlate should not preclude biopsy of a developing asymmetry. Diagnostic breast magnetic resonance imaging can be used in a minority of cases for problem solving or biopsy planning if no US correlate is identified and stereotactic biopsy is not feasible. The purpose of this article is to review the definition of developing asymmetry, describe the multimodality diagnostic tools available to the radiologist for evaluation of this challenging entity, and review the various causes, both benign and malignant. (©)RSNA, 2016. PMID:26963449

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

    NASA Astrophysics Data System (ADS)

    Beckerman, Barbara G.; Schnall, Mitchell D.

    2002-05-01

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

  5. The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme--a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone.

    PubMed Central

    Gilbert, Fiona J; Tucker, Lorraine; Gillan, Maureen Gc; Willsher, Paula; Cooke, Julie; Duncan, Karen A; Michell, Michael J; Dobson, Hilary M; Lim, Yit Yoong; Purushothaman, Hema; Strudley, Celia; Astley, Susan M; Morrish, Oliver; Young, Kenneth C; Duffy, Stephen W

    2015-01-01

    BACKGROUND Digital breast tomosynthesis (DBT) is a three-dimensional mammography technique with the potential to improve accuracy by improving differentiation between malignant and non-malignant lesions. OBJECTIVES The objectives of the study were to compare the diagnostic accuracy of DBT in conjunction with two-dimensional (2D) mammography or synthetic 2D mammography, against standard 2D mammography and to determine if DBT improves the accuracy of detection of different types of lesions. STUDY POPULATION Women (aged 47-73 years) recalled for further assessment after routine breast screening and women (aged 40-49 years) with moderate/high of risk of developing breast cancer attending annual mammography screening were recruited after giving written informed consent. INTERVENTION All participants underwent a two-view 2D mammography of both breasts and two-view DBT imaging. Image-processing software generated a synthetic 2D mammogram from the DBT data sets. RETROSPECTIVE READING STUDY In an independent blinded retrospective study, readers reviewed (1) 2D or (2) 2D + DBT or (3) synthetic 2D + DBT images for each case without access to original screening mammograms or prior examinations. Sensitivities and specificities were calculated for each reading arm and by subgroup analyses. RESULTS Data were available for 7060 subjects comprising 6020 (1158 cancers) assessment cases and 1040 (two cancers) family history screening cases. Overall sensitivity was 87% [95% confidence interval (CI) 85% to 89%] for 2D only, 89% (95% CI 87% to 91%) for 2D + DBT and 88% (95% CI 86% to 90%) for synthetic 2D + DBT. The difference in sensitivity between 2D and 2D + DBT was of borderline significance (p = 0.07) and for synthetic 2D + DBT there was no significant difference (p = 0.6). Specificity was 58% (95% CI 56% to 60%) for 2D, 69% (95% CI 67% to 71%) for 2D + DBT and 71% (95% CI 69% to 73%) for synthetic 2D + DBT. Specificity was significantly

  6. A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women

    PubMed Central

    Shen, S; Zhou, Y; Xu, Y; Zhang, B; Duan, X; Huang, R; Li, B; Shi, Y; Shao, Z; Liao, H; Jiang, J; Shen, N; Zhang, J; Yu, C; Jiang, H; Li, S; Han, S; Ma, J; Sun, Q

    2015-01-01

    Background: Chinese women tend to have small and dense breasts and ultrasound is a common method for breast cancer screening in China. However, its efficacy and cost comparing with mammography has not been evaluated in randomised trials. Methods: At 14 breast centres across China during 2008–2010, 13 339 high-risk women aged 30–65 years were randomised to be screened by mammography alone, ultrasound alone, or by both methods at enrolment and 1-year follow-up. Results: A total of 12 519 and 8692 women underwent the initial and second screenings, respectively. Among the 30 cancers (of which 15 were stage 0/I) detected, 5 (0.72/1000) were in the mammography group, 11 (1.51/1000) in the ultrasound group, and 14 (2.02/1000) in the combined group (P=0.12). In the combined group, ultrasound detected all the 14 cancers, whereas mammography detected 8, making ultrasound more sensitive (100 vs 57.1%, P=0.04) with a better diagnostic accuracy (0.999 vs 0.766, P=0.01). There was no difference between mammography and ultrasound in specificity (100 vs 99.9%, P=0.51) and positive predictive value (72.7 vs 70.0% P=0.87). To detect one cancer, the costs of ultrasound, mammography, and combined modality were $7876, $45 253, and $21 599, respectively. Conclusions: Ultrasound is superior to mammography for breast cancer screening in high-risk Chinese women. PMID:25668012

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

    SciTech Connect

    Contillo, Adriano Di Domenico, Giovanni; Cardarelli, Paolo; Gambaccini, Mauro; Taibi, Angelo

    2015-11-15

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

  8. Mammography dosimetry using an in-house developed polymethyl methacrylate phantom.

    PubMed

    Sharma, Reena; Sharma, Sunil Dutt; Mayya, Y S; Chourasiya, G

    2012-08-01

    Phantom-based measurements in mammography are well-established for quality assurance (QA) and quality control (QC) procedures involving equipment performance and comparisons of X-ray machines. Polymethyl methacrylate (PMMA) is among the best suitable materials for simulation of the breast. For carrying out QA/QC exercises in India, a mammographic PMMA phantom with engraved slots for keeping thermoluminescence dosemeters (TLD) has been developed. The radiation transmission property of the developed phantom was compared with the commercially available phantoms for verifying its suitability for mammography dosimetry. The breast entrance exposure (BEE), mean glandular dose (MGD), percentage depth dose (PDD), percentage surface dose distribution (PSDD), calibration testing of automatic exposure control (AEC) and density control function of a mammography machine were measured using this phantom. MGD was derived from the measured BEE following two different methodologies and the results were compared. The PDD and PSDD measurements were carried out using LiF: Mg, Cu, P chips. The in-house phantom was found comparable with the commercially available phantoms. The difference in the MGD values derived using two different methods were found in the range of 17.5-32.6 %. Measured depth ranges in the phantom lie between 0.32 and 0.40 cm for 75 % depth dose, 0.73 and 0.92 cm for 50 % depth dose, and 1.54 and 1.78 cm for 25 % depth dose. Higher PSDD value was observed towards chest wall edge side of the phantom, which is due to the orientation of cathode-anode axis along the chest wall to the nipple direction. Results obtained for AEC configuration testing shows that the observed mean optical density (O.D) of the phantom image was 1.59 and O.D difference for every successive increase in thickness of the phantom was within±0.15 O.D. Under density control function testing, at -2 and -1 density settings, the variation in film image O.D was within±0.15 O.D of the normal density

  9. Measurement of X-ray intensity in mammography by a ferroelectric dosimeter

    NASA Astrophysics Data System (ADS)

    Alter, Albert J.

    2005-07-01

    Each year in the US over 20 million women undergo mammography, a relatively high dose x-ray examination of the breast, which is relatively sensitive to the carcinogenic effect of ionizing radiation. The radiation risk from mammography is usually expressed in terms of mean glandular dose (MGD) which is calculated as the product of measured entrance exposure (ESE) and a dose conversion factor which is a function of anode material, peak tube voltage (23 to 35 kVp), half-value layer, filtration, compressed breast thickness and breast composition. Mammographic units may have anodes made of molybdenum, rhodium or tungsten and filters of molybdenum, rhodium, or aluminum. In order to accommodate all these parameters, multiple extensive tables of conversion factors are required to cover the range of possibilities. Energy fluence and energy imparted are alternative measures of radiation hazard, which have been used in situations where geometry or filtration is unconventional such as computed tomography or fluoroscopy. Unfortunately, at the present there is no way to directly measure these quantities clinically. In radiation therapy applications, calorimetry has been used to measure energy absorbed. A ferroelectric-based detector has been described that measures energy fluence rate (x-ray intensity) for diagnostic x-ray, 50 to 140 kVp, aluminum filtered tungsten spectrum [Carvalho & Alter: IEEE Transactions 44(6) 1997]. This work explores use of ferroelectric detectors to measure energy fluence, energy fluence rate and energy imparted in mammography. A detector interfaced with a laptop computer was developed to allow measurements on clinical units of five different manufactures having targets of molybdenum, rhodium and tungsten and filters of molybdenum, rhodium, and aluminum of various thicknesses. The measurements provide the first values of energy fluence and energy imparted in mammography. These measurements are compared with conventional parameters such as entrance

  10. X-ray spectroscopy applied to radiation shielding calculation in mammography

    SciTech Connect

    Kuenzel, Roseli; Levenhagen, Ronaldo Savarino; Herdade, Silvio Bruni; Terini, Ricardo Andrade; Costa, Paulo Roberto

    2008-08-15

    The protective shielding design of a mammography facility requires the knowledge of the scattered radiation by the patient and image receptor components. The shape and intensity of secondary x-ray beams depend on the kVp applied to the x-ray tube, target/filter combination, primary x-ray field size, and scattering angle. Currently, shielding calculations for mammography facilities are performed based on scatter fraction data for Mo/Mo target/filter, even though modern mammography equipment is designed with different anode/filter combinations. In this work we present scatter fraction data evaluated based on the x-ray spectra produced by a Mo/Mo, Mo/Rh and W/Rh target/filter, for 25, 30 and 35 kV tube voltages and scattering angles between 30 and 165 deg. Three mammography phantoms were irradiated and the scattered radiation was measured with a CdZnTe detector. The primary x-ray spectra were computed with a semiempirical model based on the air kerma and HVL measured with an ionization chamber. The results point out that the scatter fraction values are higher for W/Rh than for Mo/Mo and Mo/Rh, although the primary and scattered air kerma are lower for W/Rh than for Mo/Mo and Mo/Rh target/filter combinations. The scatter fractions computed in this work were applied in a shielding design calculation in order to evaluate shielding requirements for each of these target/filter combinations. Besides, shielding requirements have been evaluated converting the scattered air kerma from mGy/week to mSv/week adopting initially a conversion coefficient from air kerma to effective dose as 1 Sv/Gy and then a mean conversion coefficient specific for the x-ray beam considered. Results show that the thickest barrier should be provided for Mo/Mo target/filter combination. They also point out that the use of the conversion coefficient from air kerma to effective dose as 1 Sv/Gy is conservatively high in the mammography energy range and overestimate the barrier thickness.

  11. Effects of partial volume and phase shift between fat and water in gradient-echo magnetic resonance-mammography.

    PubMed

    Peller, M; Stehling, M K; Sittek, H; Kessler, M; Reiser, M

    1996-06-01

    The signal modulations caused by partial volume effect and phase shift between fat and water signal in gradient-echo magnetic resonance mammography (GRE MR-mammography) have been calculated. Based on this, the theoretical sensitivity and specificity of GRE MR-mammography has been investigated considering different evaluation methods for the gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA)-based signal enhancement. The results show that both in- and out-of-phase sequences suffer from partial volume effects in voxels that contain both fat and water. This can decrease sensitivity to Gd-DTPA uptake in small, fat-embedded lesions or in pathology that contains fat interspersed histologically. Additionally, out-of-phase sequences can suffer from phase cancellation effects that can further decrease their sensitivity to Gd-DTPA uptake. In the worst case signal can actually decrease during Gd-DTPA influx. Determination of enhancement relative to the baseline value can decrease the specificity of GRE MR-mammography in the out-of-phase condition and decrease the sensitivity in the in-phase condition. These effects are less pronounced when enhancement is calculated relative to fat. These effects need to be understood since Gd-DTPA uptake is the prime indicator of malignancy in MR-mammography. PMID:8875396

  12. Breast MRI, digital mammography and breast tomosynthesis: Comparison of three methods for early detection of breast cancer

    PubMed Central

    Roganovic, Dragana; Djilas, Dragana; Vujnovic, Sasa; Pavic, Dag; Stojanov, Dragan

    2015-01-01

    Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities. We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS) was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC) curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. with significant difference between breast tomosynthesis and digital mammography (p<0.001), while the difference between breast tomosynthesis and breast MRI was not significant (p = 0.20). PMID:26614855

  13. Using the Theory of Planned Behaviour and implementation intentions to predict and facilitate upward family communication about mammography.

    PubMed

    Browne, J L; Chan, A Y C

    2012-01-01

    Regular mammography facilitates early detection of breast cancer, and thus increases the chances of survival from this disease. Daughter-initiated (i.e. upward) communication about mammography within mother-daughter dyads may promote mammography to women of screening age. The current study examined this communication behaviour within the context of the Theory of Planned Behaviour (TPB), and aimed to bridge the intention-behaviour gap by trialling an implementation intention (II) intervention that aimed to facilitate upward family communication about mammography. Young women aged 18-39 (N=116) were assigned to either a control or experimental condition, and the latter group formed IIs about initiating a conversation with an older female family member about mammography. Overall, those who formed IIs were more likely to engage in the target communication behaviour, however the intervention was most effective for those who reported low levels of intention at baseline. Perceived behavioural control emerged as the most important variable in predicting the target behaviour. The altruistic nature of this behaviour, and the fact that it is not wholly under volitional control, may have contributed to this finding. Future studies that systematically explore the relative roles of intention and perceived behavioural control in behaviours of this nature are warranted. PMID:21981385

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

    NASA Astrophysics Data System (ADS)

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

    2004-12-01

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

  15. Barriers related to non-adherence in a mammography breast-screening program during the implementation period in the interior of São Paulo State, Brazil.

    PubMed

    Vieira, René Aloisio da Costa; Lourenço, Tânia Silveira; Mauad, Edmundo Carvalho; Moreira Filho, Valter Gonçalves; Peres, Stela Verzinhasse; Silva, Thiago Buosi; Lattore, Maria do Rosário Dias de Oliveira

    2015-09-01

    Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40-69 years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2 years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn't done de mammography in their lives and these women were principally from low socio-economic status (OR=2.99), low education (OR=3.00). The best strategies to include these women were mobile unit (OR=1.43) and Family Health Program (OR=1.79). The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education. PMID:26231397

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

    NASA Astrophysics Data System (ADS)

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

    2013-11-01

    This study retrospectively analyzed the mean glandular dose (MGD) to 133 breasts from 132 subjects, all women, who participated in a clinical trial evaluating dedicated breast CT in a diagnostic population. The clinical trial was conducted in adherence to a protocol approved by institutional review boards and the study participants provided written informed consent. Individual estimates of MGD to each breast from dedicated breast CT was obtained by combining x-ray beam characteristics with estimates of breast dimensions and fibroglandular fraction from volumetric breast CT images, and using normalized glandular dose coefficients. For each study participant and for the breast corresponding to that imaged with breast CT, an estimate of the MGD from diagnostic mammography (including supplemental views) was obtained from the DICOM image headers for comparison. This estimate uses normalized glandular dose coefficients corresponding to a breast with 50% fibroglandular weight fraction. The median fibroglandular weight fraction for the study cohort determined from volumetric breast CT images was 15%. Hence, the MGD from diagnostic mammography was corrected to be representative of the study cohort. Individualized estimates of MGD from breast CT ranged from 5.7 to 27.8 mGy. Corresponding to the breasts imaged with breast CT, the MGD from diagnostic mammography ranged from 2.6 to 31.6 mGy. The mean (± inter-breast SD) and the median MGD (mGy) from dedicated breast CT exam were 13.9 ± 4.6 and 12.6, respectively. For the corresponding breasts, the mean (± inter-breast SD) and the median MGD (mGy) from diagnostic mammography were 12.4 ± 6.3 and 11.1, respectively. Statistical analysis indicated that at the 0.05 level, the distributions of MGD from dedicated breast CT and diagnostic mammography were significantly different (Wilcoxon signed ranks test, p = 0.007). While the interquartile range and the range (maximum-minimum) of MGD from dedicated breast CT was lower than

  17. Development of a culturally specific instrument for mammography screening: an example with American Indian women in Vermont.

    PubMed

    Canales, Mary K; Rakowski, William

    2006-01-01

    This article presents the triangulation process for translating qualitative data about mammography screening from a grounded theory study with American Indian women in Vermont, into questionnaire items based on an existing model of behavior change, the Transtheoretical Model (TTM) Stages-of-Change. Qualitative data were used to derive a theory, Moving in Between Mammography, which suggested that traditionality influenced American Indian women's screening decisions. To examine the relationship between mammography and traditionality, new items were developed for each of three key TTM constructs: Pros, Cons, and Processes-of-Change. The process for developing the new TTM-based items, as well as traditionality items specific for American Indian women living off-reservation, are presented. This article provides one example of how an instrument can be developed within a culturally competent nursing framework. PMID:17086783

  18. Examination of the relevance of using radiochromic films in measuring entrance skin dose distribution in conventional digital mammography.

    PubMed

    Soliman, K; Bakkari, M

    2015-07-01

    Based on manufacturer specifications, radiochromic films are sensitive enough to be used for dosimetry in digital mammography (DM). The aim of this work was to study the feasibility of measuring entrance surface dose (ESD) distribution using Gafchromic XR-QA2 films. The films were irradiated following a standard clinical two-view screening mammography protocol using a full-field digital mammography (FFDM) imaging system. The films were then digitised using a flatbed scanner. The calibration curve relating the readings from a calibrated ionisation chamber and the films' net optical density (NOD) could not be obtained. The examination of the calibration data revealed non-sensitivity of the films to resolve dose differences below 20 mGy at 28 kVp. Therefore, radiochromic films were found not to be suitable for measuring ESD profiles in DM. A 2D map of the NOD of the irradiated films obtained using in-house developed MATLAB computer program is presented. PMID:25852183

  19. Randomized Trial of A Lay Health Advisor and Computer Intervention to Increase Mammography Screening in African American Women

    PubMed Central

    Russell, Kathleen M.; Champion, Victoria L.; Monahan, Patrick O.; Millon-Underwood, Sandra; Zhao, Qianqian; Spacey, Nicole; Rush, Nathan L.; Paskett, Electra D.

    2009-01-01

    Background Low-income African American women face numerous barriers to mammography screening. We tested the efficacy of a combined interactive computer program and lay health advisor (LHA) intervention to increase mammography screening. Methods In this randomized, single blind study, participants were 181 African American female health center patients ages 41-75, ≤250% of poverty level with no breast cancer history and no screening mammogram in the past 15 months. They were assigned to either (a) a low dose comparison group consisting of a culturally appropriate mammography screening pamphlet or (b) interactive, tailored computer instruction at baseline and 4 monthly LHA counseling sessions. Self-reported screening data were collected at baseline and 6 months and verified by medical record. Results For intent-to-treat analysis of primary outcome (medical-record-verified mammography screening, available on all but two participants), the intervention group had increased screening to 51% (45/89) compared to 18% (16/90) for the comparison group at 6 months. When adjusted for employment status, disability, first-degree relatives with breast cancer, health insurance, and previous breast biopsies, the intervention group was three times more likely (adjusted relative risk [RR]=2.7 [95% CI: 1.8, 3.7], p<.0001) to get screened than the low dose comparison group. Similar results were found for self-reported mammography stage of screening adoption. Conclusions The combined intervention was efficacious in improving mammography screening in low-income African American women, with an unadjusted effect size (RR = 2.84) significantly higher (p < .05) than previous studies of each intervention alone. PMID:20056639

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

    SciTech Connect

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

    2014-06-15

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

  1. Effect of radiotherapy on the interpretation of routine follow-up mammography after conservative breast surgery: a randomized study.

    PubMed Central

    Holli, K.; Saaristo, R.; Isola, J.; Hyöty, M.; Hakama, M.

    1998-01-01

    Radiotherapy after conservative surgery causes fat necrosis, fibrosis, skin thickening and other parenchymal distortion of the breast. The interpretation of a mammogram of the irradiated breast may therefore be difficult. We studied the effect of radiotherapy on the interpretation of the routine mammography used in the follow-up of breast cancer patients. A total of 144 low-risk breast cancer patients were randomized to radiotherapy or to no further treatment after conservative surgery. The first routine follow-up mammography was performed 18 months after surgery and every 18 months after that. The number of mammography examinations was estimated per patient and per follow-up year. The number of extra diagnostic tests and the occurrence of positive findings were assessed per mammography session and per follow-up year. Further diagnostic tests prompted by difficulties in interpreting the mammogram were performed to an extent of 0.19 per mammography examination in the radiotherapy group and of 0.15 in the non-radiotherapy group, i.e. 1.3 times more often. Findings that turned out to be negative at confirmation were 2.0 times (P< 0.05) more common in the radiotherapy group. These false-positive findings were more common in the radiotherapy group than in the surgery group and only shortly after treatment. Mammography is more difficult to interpret after radiotherapy than after conservative surgery alone, especially shortly after treatment, and more often involves extra diagnostic tests and findings that will be negative at confirmation. PMID:9716041

  2. Multiple-reader studies, digital mammography, computer-aided diagnosis, and the Holy Grail of imaging physics: I

    NASA Astrophysics Data System (ADS)

    Wagner, Robert F.; Beiden, Sergey V.; Campbell, Gregory

    2001-06-01

    There are multiple sources of variability in clinical studies of imaging systems. The variation of the reader `mindset' establishes the need for ROC analysis to control for that fundamental variable. The demonstration of the range of reader skills in mammography shows the need for a multivariate approach to ROC analysis. The multiple-reader, multiple-case (MRMC) ROC experimental paradigm addresses this need and several practical solutions to the problem of analysis of MRMC data have been developed. We review the application of these methods to an important clinical comparison of digital and conventional mammography.

  3. Comparison of radiation exposure and associated radiation-induced cancer risks from mammography and molecular imaging of the breast

    SciTech Connect

    O'Connor, Michael K.; Li Hua; Rhodes, Deborah J.; Hruska, Carrie B.; Clancy, Conor B.; Vetter, Richard J.

    2010-12-15

    Purpose: Recent studies have raised concerns about exposure to low-dose ionizing radiation from medical imaging procedures. Little has been published regarding the relative exposure and risks associated with breast imaging techniques such as breast specific gamma imaging (BSGI), molecular breast imaging (MBI), or positron emission mammography (PEM). The purpose of this article was to estimate and compare the risks of radiation-induced cancer from mammography and techniques such as PEM, BSGI, and MBI in a screening environment. Methods: The authors used a common scheme for all estimates of cancer incidence and mortality based on the excess absolute risk model from the BEIR VII report. The lifetime attributable risk model was used to estimate the lifetime risk of radiation-induced breast cancer incidence and mortality. All estimates of cancer incidence and mortality were based on a population of 100 000 females followed from birth to age 80 and adjusted for the fraction that survives to various ages between 0 and 80. Assuming annual screening from ages 40 to 80 and from ages 50 to 80, the cumulative cancer incidence and mortality attributed to digital mammography, screen-film mammography, MBI, BSGI, and PEM was calculated. The corresponding cancer incidence and mortality from natural background radiation was calculated as a useful reference. Assuming a 15%-32% reduction in mortality from screening, the benefit/risk ratio for the different imaging modalities was evaluated. Results: Using conventional doses of 925 MBq Tc-99m sestamibi for MBI and BSGI and 370 MBq F-18 FDG for PEM, the cumulative cancer incidence and mortality were found to be 15-30 times higher than digital mammography. The benefit/risk ratio for annual digital mammography was >50:1 for both the 40-80 and 50-80 screening groups, but dropped to 3:1 for the 40-49 age group. If the primary use of MBI, BSGI, and PEM is in women with dense breast tissue, then the administered doses need to be in the range

  4. SU-E-I-64: X-Ray Coherent Scatter Mammography Simulation

    SciTech Connect

    Hassan, L R; MacDonald, C A

    2014-06-01

    Purpose: Conventional mammography has poor contrast between healthy and cancerous tissues due to the small difference in attenuation properties. Coherent scatter potentially provides more information because interference of coherently scattered radiation depends on the average intermolecular spacing, and can be used to characterize tissue types. However, typical coherent scatter analysis techniques are not compatible with rapid low dose screening modalities. Coherent scatter slot scan imaging is a novel imaging technique which provides new information with higher contrast. In this work a simulation was performed of coherent scatter slot scan imaging to assess its performance and provide system optimization. Methods: In coherent scatter imaging, the coherent scatter is exploited using a conventional slot scan mammography system with anti-scatter grids tilted at the characteristic angle of cancerous tissues. A Monte Carlo simulation was used to simulate the coherent scatter imaging. System optimization was performed across several parameters, including source voltage and filtration, tilt angle, source and grid distances, grid ratio, and shielding geometry. Results: The contrast was high and increased as the grid tilt angle was increased beyond the characteristic angle for the modeled carcinoma, and as the source voltage increased. Source filtration did not have a significant effect on contrast. Increasing grid ratio improved contrast at the expense of decreasing the signal to noise ratio (SNR). As the tumor size is decreased, additional shields to block the fat signal are necessary in order to detect the cancer signal. Conclusion: Coherent scatter analysis using a wide slot setup is promising as an enhancement for screening mammography. This work was supported by National Institutes of Health, # 7 R01EB009715.

  5. Getting started with protocol for quality assurance of digital mammography in the clinical centre of Montenegro.

    PubMed

    Ivanovic, S; Bosmans, H; Mijovic, S

    2015-07-01

    The purpose of this work is (i) to work out a test procedure for quality assurance (QA) in digital mammography with newly released test equipment, including the MagicMax mam multimeter (IBA, Germany) and the anthropomorphic tissue equivalent phantom Mammo AT (IBA, Germany), and (ii) to determine whether a first digital computer radiography (CR) system in Montenegro meets the current European standards. Tested parameters were tube output (µGy mAs(-1)) and output rate (mGy s(-1)), reproducibility and accuracy of tube voltage, half value layer, reproducibility and accuracy of the AEC system, exposure control steps, image receptor's response function, image quality and printer stability test. The evaluated dosimetric quantity is the average glandular dose (AGD) as evaluated from PMMA slabs simulating breast tissue. The main findings are that QA can be organised in Montenegro. (1) All measured parameters are within the range described in European protocols except the tube voltage which deviated more than ± 1 kV. The automatic determination of the HVL was satisfactorily. AGD ranged from 0.66 to 7.02 mGy for PMMA thicknesses from 20 to 70 mm, and is in accordance with literature data. (2) The image quality score as obtained with the anthropomorphic tissue equivalent phantom Mammo AT for the CR system was similar to findings on the authors' conventional screen-film mammography. (3) In clinical practice the mammograms are printed. The CR reader produces images with a pixel size of 43.75 µm, which is compatible with the laser printer (39 µm laser spot spacing). The image processing algorithm embedded in the reader successfully processes mammograms with desirable image brightness and contrast in the printed image. The authors conclude that this first digital mammography system seems a good candidate for breast cancer screening applications. PMID:25862535

  6. Do Cervical Cancer Screening Rates Increase in Association with an Intervention Designed to Increase Mammography Usage?

    PubMed Central

    KATZ, MIRA L.; TATUM, CATHY M.; DEGRAFFINREID, CECILIA R.; DICKINSON, STEPHANIE; PASKETT, ELECTRA D.

    2015-01-01

    Objectives To assess cervical cancer screening behaviors among underserved women participating in an intervention designed to increase mammography use. Methods This was a randomized trial of 897 women from three racial groups (white, African American, Native American) living in a rural county in North Carolina. Baseline and follow-up surveys were completed by 815 women; 775 women provided data to be included in these analyses. The intervention group received an educational program focused on mammography delivered by a lay health advisor, and the control group received a physician letter/brochure focusing on Pap tests. Results Women in both the intervention (OR 1.70; 1.31, 2.21, p < 0.001) and control groups (OR 1.38; 1.04, 1.82, p = 0.025) significantly increased cervical cancer screening rates within risk appropriate guidelines. No differences by racial group were documented. Women categorized in the high-risk group for developing cervical cancer (>2 sexual partners, age <18 years at first sexual intercourse, smoker; treated for sexually transmitted disease [STD] or partner with treated STD) significantly (OR 1.88; 1.54, 2.28, p < 0.001) increased Pap test completion. However, a nonsignificant increase (OR 1.25; 0.87, 1.79, p = 0.221) in Pap test completion was demonstrated in women categorized as low risk for cervical cancer. Conclusions This study suggests that women in an intensive behavioral intervention designed to increase mammography use may also increase Pap test completion, similar to a minimal intervention focused only on increasing Pap test completion. These results have implications for the design and evaluation of behavioral intervention studies. PMID:17324094

  7. Comparison of mammography sensitivity after reduction mammoplasty targeting the glandular and fat tissue

    PubMed Central

    Çakır, Murat; Küçükkartallar, Tevfik; Tekin, Ahmet; Selimoğlu, Nebil; Poyraz, Necdet; Belviranlı, Mehmet Metin; Kartal, Adil

    2015-01-01

    Objective: Mammography may have some limitations in the diagnosis and screening of breast cancer for women who have previously undergone breast reduction surgery. This study aimed to investigate how the structural defects in the breast tissue formed by postoperative changes are reflected on mammography. Material and Methods: The records of patients who had previously undergone breast reduction surgery and who were requested to undergo mammography for breast cancer screening by the general surgery clinic were retrospectively studied. The patients’ ages, surgical procedures, postoperative follow-up periods, amount of removed material, and histopathological and mammographic results were studied. The patients were classified into 3 groups: those older than 40 years who underwent reduction mammoplasty targeting predominantly the glandular tissue (group 1), those younger than 40 years who underwent reduction mammoplasty targeting predominantly the fat tissue (group 2), and those older than 40 years who were diagnosed with breast hypertrophy and were not operated (group 3). Results: The mean follow-up period of the patients was 6 (2–10) years. The mean value of resected tissue was 1120 g (680–2070) in group 1 and 1220 g (720–1980) in group 2. The mean age at the time of surgery was 45 (40–70) years for group 1 and 35 (24–40) years for group 2. All patients in group 1 were classified in Breast Imaging-Reporting and Data System (BI-RADS) category 1–2; 28 patients in group 2 were classified in BI-RADS 1–2, 4 were classified in BI-RADS 3, and 8 were classified in BI-RADS 0. In group 3, 35 patients were classified in BI-RADS 1–2, 4 were classified in BI-RADS 3, and 1 was classified in BI-RADS 0. Conclusion: We believe that breast reduction surgery targeting predominantly the glandular tissue in patients older than 40 years increases mammographic sensitivity. PMID:26170752

  8. Quantification of breast density with dual energy mammography: An experimental feasibility study

    SciTech Connect

    Ducote, Justin L.; Molloi, Sabee

    2010-02-15

    Purpose: Breast density, the percentage of glandular breast tissue, has been shown to be a strong indicator of breast cancer risk. A quantitative method to measure breast density with dual energy mammography was investigated using physical phantoms. Methods: The dual energy mammography system used a tungsten anode x-ray tube with a 50 {mu}m rhodium beam filter for low energy images and a 300 {mu}m copper beam filter for high energy images. Glandular and adipose equivalent phantoms of uniform thickness were used to calibrate a dual energy basis decomposition algorithm. Four different phantom studies were used to evaluate the technique. The first study consisted of phantoms with thicknesses of 2.5-8.5 cm in 0.5 cm steps with variable densities centered at a mean of 28%. The second study consisted of phantoms at a fixed thickness of 4.0 cm, which ranged in densities from 0% to 100% in increments of 12.5%. The third study consisted of 4.0 cm thick phantoms at densities of 25%, 50% and 75% each imaged at three areal sizes, approximately 62.5, 125, and 250 cm{sup 2}, in order to assess the effect of breast size on density measurement. The fourth study consisted of step phantoms designed to more closely mimic the shape of a female breast with maximal thicknesses from 3.0 to 7.0 cm at a fixed density of 50%. All images were corrected for x-ray scatter. Results: The RMS errors in breast density measurements were 0.44% for the variable thickness phantoms, 0.64% for the variable density phantoms, 2.87% for the phantoms of different areal sizes, and 4.63% for step phantoms designed to closely resemble the shape of a breast. Conclusions: The results of the phantom studies indicate that dual energy mammography can be used to measure breast density with an RMS error of approximately 5%.

  9. Quality control for digital mammography in the ACRIN DMIST trial: Part I

    SciTech Connect

    Bloomquist, Aili K.; Yaffe, Martin J.; Pisano, Etta D.

    2006-03-15

    The Digital Mammography Imaging Screening Trial, conducted by the American College of Radiology Imaging Network, is a clinical trial designed to compare the accuracy of full-field digital mammography (FFDM) versus screen-film mammography in a screening population. Five FFDM systems from four manufacturers (Fischer, Fuji, General Electric, and Lorad) were employed in the study at 35 clinical sites. A core physics team devised and implemented tests to evaluate these systems. A detailed description of physics and quality control tests is presented, including estimates of: mean glandular dose, modulation transfer function (MTF), 2D noise power spectra, and signal-to-noise ratio (SNR). The mean glandular doses for the standard breast ranged from 0.79 to 2.98 mGy, with 1.62 mGy being the average across all units and machine types. For the five systems evaluated, the MTF dropped to 50% at markedly different percentages (22% to 87%) of the Nyquist limit, indicating that factors other than detector element (del) size have an important effect on spatial resolution. Noise power spectra and SNR were measured; however, we found that it was difficult to standardize and compare these between units. For each machine type, the performance as measured by the tests was very consistent, and no predictive benefit was seen for many of the tests during the 2-year period of the trial. It was found that, after verification of proper operation during acceptance testing, if systems failed they generally did so suddenly rather than through gradual deterioration of performance. Because of the relatively short duration of this study further, investigation of the long-term failure characteristics of these systems is advisable.

  10. The effect of breast compression on mass conspicuity in digital mammography

    SciTech Connect

    Saunders, Robert S. Jr; Samei, Ehsan

    2008-10-15

    This study analyzed how the inherent quality of diagnostic information in digital mammography could be affected by breast compression. A digital mammography system was modeled using a Monte Carlo algorithm based on the Penelope program, which has been successfully used to model several medical imaging systems. First, the Monte Carlo program was validated against previous measurements and simulations. Once validated, the Monte Carlo software modeled a digital mammography system by tracking photons through a voxelized software breast phantom, containing anatomical structures and breast masses, and following photons until they were absorbed by a selenium-based flat-panel detector. Simulations were performed for two compression conditions (standard compression and 12.5% reduced compression) and three photon flux conditions (constant flux, constant detector signal, and constant glandular dose). The results showed that reduced compression led to higher scatter fractions, as expected. For the constant photon flux condition, decreased compression also reduced glandular dose. For constant glandular dose, the SdNR for a 4 cm breast was 0.60{+-}0.11 and 0.62{+-}0.11 under standard and reduced compressions, respectively. For the 6 cm case with constant glandular dose, the SdNR was 0.50{+-}0.11 and 0.49{+-}0.10 under standard and reduced compressions, respectively. The results suggest that if a particular imaging system can handle an approximately 10% increase in total tube output and 10% decrease in detector signal, breast compression can be reduced by about 12% in terms of breast thickness with little impact on image quality or dose.

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

    SciTech Connect

    Kappadath, S. Cheenu; Shaw, Chris C.

    2005-11-15

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

  12. A technique optimization protocol and the potential for dose reduction in digital mammography

    SciTech Connect

    Ranger, Nicole T.; Lo, Joseph Y.; Samei, Ehsan

    2010-03-15

    Digital mammography requires revisiting techniques that have been optimized for prior screen/film mammography systems. The objective of the study was to determine optimized radiographic technique for a digital mammography system and demonstrate the potential for dose reduction in comparison to the clinically established techniques based on screen- film. An objective figure of merit (FOM) was employed to evaluate a direct-conversion amorphous selenium (a-Se) FFDM system (Siemens Mammomat Novation{sup DR}, Siemens AG Medical Solutions, Erlangen, Germany) and was derived from the quotient of the squared signal-difference-to-noise ratio to mean glandular dose, for various combinations of technique factors and breast phantom configurations including kilovoltage settings (23-35 kVp), target/filter combinations (Mo-Mo and W-Rh), breast-equivalent plastic in various thicknesses (2-8 cm) and densities (100% adipose, 50% adipose/50% glandular, and 100% glandular), and simulated mass and calcification lesions. When using a W-Rh spectrum, the optimized FOM results for the simulated mass and calcification lesions showed highly consistent trends with kVp for each combination of breast density and thickness. The optimized kVp ranged from 26 kVp for 2 cm 100% adipose breasts to 30 kVp for 8 cm 100% glandular breasts. The use of the optimized W-Rh technique compared to standard Mo-Mo techniques provided dose savings ranging from 9% for 2 cm thick, 100% adipose breasts, to 63% for 6 cm thick, 100% glandular breasts, and for breasts with a 50% adipose/50% glandular composition, from 12% for 2 cm thick breasts up to 57% for 8 cm thick breasts.

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

    PubMed

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

    2012-04-01

    In this work, a Monte Carlo code was used to investigate the performance of different x-ray spectra in digital mammography, through a figure of merit (FOM), defined as FOM = CNR²/(¯)D(g), with CNR being the contrast-to-noise ratio in image and [Formula: see text] being the average glandular dose. The FOM was studied for breasts with different thicknesses t (2 cm ≤ t ≤ 8 cm) and glandular contents (25%, 50% and 75% glandularity). The anode/filter combinations evaluated were those traditionally employed in mammography (Mo/Mo, Mo/Rh, Rh/Rh), and a W anode combined with Al or K-edge filters (Zr, Mo, Rh, Pd, Ag, Cd, Sn), for tube potentials between 22 and 34 kVp. Results show that the W anode combined with K-edge filters provides higher values of FOM for all breast thicknesses investigated. Nevertheless, the most suitable filter and tube potential depend on the breast thickness, and for t ≥ 6 cm, they also depend on breast glandularity. Particularly for thick and dense breasts, a W anode combined with K-edge filters can greatly improve the digital technique, with the values of FOM up to 200% greater than that obtained with the anode/filter combinations and tube potentials traditionally employed in mammography. For breasts with t < 4 cm, a general good performance was obtained with the W anode combined with 60 μm of the Mo filter at 24-25 kVp, while 60 μm of the Pd filter provided a general good performance at 24-26 kVp for t = 4 cm, and at 28-30 and 29-31 kVp for t = 6 and 8 cm, respectively. PMID:22421418

  14. Teleradiology and screening mammography: a telemammography system evaluation and comparison to clinical results

    NASA Astrophysics Data System (ADS)

    Leader, Joseph K.; Chough, Denise; Clearfield, Ronald J.; Ganott, Marie A.; Hakim, Christiane; Hardesty, Lara; Shindel, Betty; Sumkin, Jules H.; Drescher, John M.; Maitz, Glenn S.; Gur, David

    2005-04-01

    Radiologists' performance reviewing and rating breast cancer screening mammography exams using a telemammography system was evaluated and compared with the actual clinical interpretations of the same interpretations. Mammography technologists from three remote imaging sites transmitted 245 exams to a central site (radiologists), which they (the technologists) believed needed additional procedures (termed "recall"). Current exam image data and non-image data (i.e., technologist's text message, technologist's graphic marks, patient's prior report, and Computer Aided Detection (CAD) results) were transmitted to the central site and displayed on three high-resolution, portrait monitors. Seven radiologists interpreted ("recall" or "no recall") the exams using the telemammography workstation in three separate multi-mode studies. The mean telemammography recall rates ranged from 72.3% to 82.5% while the actual clinical recall rates ranged from 38.4% to 42.3% across the three studies. Mean Kappa of agreement ranged from 0.102 to 0.213 and mean percent agreement ranged from 48.7% to 57.4% across the three studies. Eighty-seven percent of the disagreement interpretations occurred when the telemammography interpretation resulted in a recommendation to recall and the clinical interpretation resulted in a recommendation not to recall. The poor agreement between the telemammography and clinical interpretations may indicate a critical dependence on images from prior screening exams rather than any text based information. The technologists were sensitive, if not specific, to the mammography features and changes that may lead to recall. Using the telemammography system the radiologists were able to reduce the recommended recalls by the technologist by approximately 25 percent.

  15. False-negative rate of combined mammography and ultrasound for women with palpable breast masses.

    PubMed

    Chan, Carlos H F; Coopey, Suzanne B; Freer, Phoebe E; Hughes, Kevin S

    2015-10-01

    Mammography and ultrasound are often used concurrently for patients with palpable breast masses. While mammography has a false-negative rate of approximately 15 %, the addition of breast ultrasound decreases this rate among patients with palpable breast masses. There are no recent outcome data regarding the use of combined reporting of ultrasound and mammography (CRUM) for palpable breast masses. In this study, female patients presenting with a palpable breast mass were retrospectively reviewed in a prospectively entered database at a single institution from June 2010 to July 2013. All cancer cases and false-negative cases using CRUM were identified. Cancer rates, false-negative rates, and negative predictive values were calculated based on CRUM breast imaging-reporting and data system (BI-RADS) categories. One thousand two hundreds and twelve female patients presenting with a palpable breast mass were identified; 77 % of patients had CRUM and 73 % (682/932) were BI-RADS 1-2. Despite negative or benign BI-RADS, 9.5 % of patients with BI-RADS 1-2 (65/682) underwent biopsy, compared to 96 % of patients with a BI-RADS 4-5 designation. Eighty-one patients were found to have cancers; 2 had BI-RADS 1-2 imaging. The false-negative rate of CRUM was 2.4 % (2/81). Since 69 % (428/617) of BI-RADS 1-2 patients without tissue diagnosis had follow-up imaging and/or clinical exam (median: 27 months, range: 2-62 months) and none developed cancers, the cancer rate and negative predictive value of a palpable breast mass of BI-RADS 1-2 were estimated to be 0.3 % (2/682) and 99.7 %, respectively. In the modern era of combined imaging for breast masses, a patient with a low suspicion exam can be reassured with a negative CRUM report. PMID:26341750

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

    NASA Astrophysics Data System (ADS)

    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.

  17. Detection of simulated microcalcifications in a phantom with digital mammography: effect of pixel size

    PubMed Central

    Suryanarayanan, Sankararaman; Karellas, Andrew; Vedantham, Srinivasan; Sechopoulos, Ioannis; D’Orsi, Carl J

    2008-01-01

    PURPOSE To evaluate the effect of pixel size on the detection of simulated microcalcifications in digital mammography using a phantom. MATERIALS AND METHODS A high-resolution prototype imager with variable pixel size of 39 and 78 μm, and a clinical full-field digital mammography (FFDM) system with pixel size of 100 μm were used. X-ray images of a contrast-detail (CD) phantom were obtained to perform alternative forced choice (AFC) observer experiments. Polymethyl-methacrylate (PMMA) was added to obtain phantom thickness of 45 and 58 mm which are typical breast thickness conditions encountered in mammography. Phantom images were acquired with both systems under nearly identical exposure conditions using an anti-scatter grid. Twelve images were acquired for each phantom thickness and pixel size (total of 72 images) and six observers participated in this study. Observer responses were used to compute the fraction of correctly detected disks. A signal detection model was used to fit the recorded data from which CD characteristics were obtained. Repeated-measures analyses using mixed effects linear models were performed for each of the 6 observers. All statistical tests were 2-sided and unadjusted for multiple comparisons. A P value of 0.05 or less was considered to indicate statistical significance. RESULTS Statistical analysis indicated significantly better CD characteristics with 39 and 78 μm pixel sizes compared to the 100 μm pixel for all disk diameters and phantom thickness conditions (p<0.001). Increase in phantom thickness degraded CD characteristics irrespective of pixel size (p<0.001). CONCLUSION Based on the conditions of this study, reducing pixel size below 100 μm with low imaging system noise enhances the visual perception of small objects that correspond to typical microcalcification size. PMID:17522348

  18. A technique optimization protocol and the potential for dose reduction in digital mammography

    PubMed Central

    Ranger, Nicole T.; Lo, Joseph Y.; Samei, Ehsan

    2010-01-01

    Digital mammography requires revisiting techniques that have been optimized for prior screen∕film mammography systems. The objective of the study was to determine optimized radiographic technique for a digital mammography system and demonstrate the potential for dose reduction in comparison to the clinically established techniques based on screen- film. An objective figure of merit (FOM) was employed to evaluate a direct-conversion amorphous selenium (a-Se) FFDM system (Siemens Mammomat NovationDR, Siemens AG Medical Solutions, Erlangen, Germany) and was derived from the quotient of the squared signal-difference-to-noise ratio to mean glandular dose, for various combinations of technique factors and breast phantom configurations including kilovoltage settings (23–35 kVp), target∕filter combinations (Mo–Mo and W–Rh), breast-equivalent plastic in various thicknesses (2–8 cm) and densities (100% adipose, 50% adipose∕50% glandular, and 100% glandular), and simulated mass and calcification lesions. When using a W–Rh spectrum, the optimized FOM results for the simulated mass and calcification lesions showed highly consistent trends with kVp for each combination of breast density and thickness. The optimized kVp ranged from 26 kVp for 2 cm 100% adipose breasts to 30 kVp for 8 cm 100% glandular breasts. The use of the optimized W–Rh technique compared to standard Mo–Mo techniques provided dose savings ranging from 9% for 2 cm thick, 100% adipose breasts, to 63% for 6 cm thick, 100% glandular breasts, and for breasts with a 50% adipose∕50% glandular composition, from 12% for 2 cm thick breasts up to 57% for 8 cm thick breasts. PMID:20384232

  19. Strategies for Increasing Mammography Screening in Primary Care in Chile: Results of a Randomized Clinical Trial

    PubMed Central

    Püschel, Klaus; Coronado, Gloria; Soto, Gabriela; Gonzalez, Karla; Martinez, Javiera; Holte, Sarah; Thompson, Beti

    2010-01-01

    Background Breast cancer is the cancer with the highest incidence among women in Chile and in many Latin American countries. Breast cancer screening has very low compliance among Chilean women. Methods We compare the effects on mammography screening rates of standard care, of a low intensity intervention based on mail contact, and of a high intensity intervention based on mail plus telephone or personal contact. A random sample of 500 women 50 to 70 years registered at a community clinic in Santiago who had not had a mammogram in the past two years were randomly assigned to one of the three intervention groups. Six months after randomization, participants were re-evaluated for their compliance with mammography screening. The outcome was measured by self report and by electronic clinical records. An intention to treat model was used to analyze the results. Results Between 92% and 93% of participants completed the study. Based on electronic records, mammography screening rates increased significantly from 6% in the control group to 51.8% in the low intensity group, and 70.1% in the high intensity group. About 14% of participants in each group received opportunistic advice, 100% of participants in the low and high intensity groups received the mail contact, and 50% in the high intensity group received a telephone or personal contact. Conclusion A primary care intervention based on mail or brief personal contact could significantly improve mammogram screening rates. Impact A relatively simple intervention could have a strong impact in breast cancer prevention in underserved communities. PMID:20826832

  20. Development of mammography system using CdTe photon counting detector for the exposure dose reduction

    NASA Astrophysics Data System (ADS)

    Maruyama, Sho; Niwa, Naoko; Yamazaki, Misaki; Yamakawa, Tsutomu; Nagano, Tatsuya; Kodera, Yoshie

    2014-03-01

    We propose a new mammography system using a cadmium telluride (CdTe) photon-counting detector for exposure dose reduction. In contrast to conventional mammography, this system uses high-energy X-rays. This study evaluates the usefulness of this system in terms of the absorbed dose distribution and contrast-to-noise ratio (CNR) at acrylic step using a Monte Carlo simulation. In addition, we created a prototype system that uses a CdTe detector and automatic movement stage. For various conditions, we measured the properties and evaluated the quality of images produced by the system. The simulation result for a tube voltage of 40 kV and tungsten/barium (W/Ba) as a target/filter shows that the surface dose was reduced more than 60% compared to that under conventional conditions. The CNR of our proposal system also became higher than that under conventional conditions. The point at which the CNRs coincide for 4 cm polymethyl methacrylate (PMMA) at the 2-mm-thick step corresponds to a dose reduction of 30%, and these differences increased with increasing phantom thickness. To improve the image quality, we determined the problematic aspects of the scanning system. The results of this study indicate that, by using a higher X-ray energy than in conventional mammography, it is possible to obtain a significant exposure dose reduction without loss of image quality. Further, the image quality of the prototype system can be improved by optimizing the balance between the shift-and-add operation and the output of the X-ray tube. In future work, we will further examine these improvement points.

  1. Cost-effectiveness of digital mammography screening before the age of 50 in The Netherlands.

    PubMed

    Sankatsing, Valérie D V; Heijnsdijk, Eveline A M; van Luijt, Paula A; van Ravesteyn, Nicolien T; Fracheboud, Jacques; de Koning, Harry J

    2015-10-15

    In the Netherlands, routine mammography screening starts at age 50. This starting age may have to be reconsidered because of the increasing breast cancer incidence among women aged 40 to 49 and the recent implementation of digital mammography. We assessed the cost-effectiveness of digital mammography screening that starts between age 40 and 49, using a microsimulation model. Women were screened before age 50, in addition to the current programme (biennial 50-74). Screening strategies varied in starting age (between 40 and 50) and frequency (annual or biennial). The numbers of breast cancers diagnosed, life-years gained (LYG) and breast cancer deaths averted were predicted and incremental cost-effectiveness ratios (ICERs) were calculated to compare screening scenarios. Biennial screening from age 50 to 74 (current strategy) was estimated to gain 157 life years per 1,000 women with lifelong follow-up, compared to a situation without screening, and cost €3,376/LYG (3.5% discounted). Additional screening increased the number of LYG, compared to no screening, ranging from 168 to 242. The costs to generate one additional LYG (i.e., ICER), comparing a screening strategy to the less intensive alternative, were estimated at €5,329 (biennial 48-74 vs. current strategy), €7,628 (biennial 45-74 vs. biennial 48-74), €10,826 (biennial 40-74 vs. biennial 45-74) and €18,759 (annual 40-49 + biennial 50-74 vs. biennial 40-74). Other strategies (49 + biennial 50-74 and annual 45-49 + biennial 50-74) resulted in less favourable ICERs. These findings show that extending the Dutch screening programme by screening between age 40 and 49 is cost-effective, particularly for biennial strategies. PMID:25895135

  2. Quantification of breast density using dual-energy mammography with liquid phantom calibration

    NASA Astrophysics Data System (ADS)

    Lam, Alfonso R.; Ding, Huanjun; Molloi, Sabee

    2014-07-01

    Breast density is a widely recognized potential risk factor for breast cancer. However, accurate quantification of breast density is a challenging task in mammography. The current use of plastic breast-equivalent phantoms for calibration provides limited accuracy in dual-energy mammography due to the chemical composition of the phantom. We implemented a breast-equivalent liquid phantom for dual-energy calibration in order to improve the accuracy of breast density measurement. To design these phantoms, three liquid compounds were chosen: water, isopropyl alcohol, and glycerol. Chemical compositions of glandular and adipose tissues, obtained from NIST database, were used as reference materials. Dual-energy signal of the liquid phantom at different breast densities (0% to 100%) and thicknesses (1 to 8 cm) were simulated. Glandular and adipose tissue thicknesses were estimated from a higher order polynomial of the signals. Our results indicated that the linear attenuation coefficients of the breast-equivalent liquid phantoms match those of the target material. Comparison between measured and known breast density data shows a linear correlation with a slope close to 1 and a non-zero intercept of 7%, while plastic phantoms showed a slope of 0.6 and a non-zero intercept of 8%. Breast density results derived from the liquid calibration phantoms showed higher accuracy than those derived from the plastic phantoms for different breast thicknesses and various tube voltages. We performed experimental phantom studies using liquid phantoms and then compared the computed breast density with those obtained using a bovine tissue model. The experimental data and the known values were in good correlation with a slope close to 1 (˜1.1). In conclusion, our results indicate that liquid phantoms are a reliable alternative for calibration in dual-energy mammography and better reproduce the chemical properties of the target material.

  3. Comparing narrative and informational videos to increase mammography in low-income African American women

    PubMed Central

    Kreuter, Matthew W.; Holmes, Kathleen; Alcaraz, Kassandra; Kalesan, Bindu; Rath, Suchitra; Richert, Melissa; McQueen, Amy; Caito, Nikki; Robinson, Lou; Clark, Eddie M.

    2011-01-01

    OBJECTIVE Compare effects of narrative and informational videos on use of mammography, cancer-related beliefs, recall of core content and a range of reactions to the videos. METHOD African American women (n=489) ages 40 and older were recruited from low-income neighborhoods in St. Louis, MO and randomly assigned to watch a narrative video comprised of stories from African American breast cancer survivors (Living Proof) or a content-equivalent informational video using a more expository and didactic approach (Facts for Life). Effects were measured immediately post-exposure and at 3- and 6-month follow-up. RESULTS The narrative video was better liked, enhanced recall, reduced counterarguing, increased breast cancer discussions with family members and was perceived as more novel. Women who watched the narrative video also reported fewer barriers to mammography, more confidence that mammograms work, and were more likely to perceive cancer as an important problem affecting African Americans. Use of mammography at 6-month follow-up did not differ for the narrative vs. informational groups overall (49% vs. 40%, p=.20), but did among women with less than a high school education (65% vs. 32%, p<.01), and trended in the same direction for those who had no close friends or family with breast cancer (49% vs. 31%, p=.06) and those who were less trusting of traditional cancer information sources (48% vs. 30%, p=.06). CONCLUSIONS Narrative forms of communication may increase the effectiveness of interventions to reduce cancer health disparities. PRACTICE IMPLICATIONS Narratives appear to have particular value in certain population sub-groups; identifying these groups and matching them to specific communication approaches may increase effectiveness. PMID:21071167

  4. Initial and repeat mammography screening in a low income multi-ethnic population in Los Angeles.

    PubMed

    Bastani, R; Kaplan, C P; Maxwell, A E; Nisenbaum, R; Pearce, J; Marcus, A C

    1995-03-01

    Low income, older, minority women are at high risk for underutilization of screening mammography. One strategy for increasing utilization is to conduct interventions targeting local and state health departments where a majority of these women seek health care. A prerequisite for conducting effective screening programs is to obtain current and accurate information on baseline screening rates to understand the nature and scope of the problem and to plan appropriate intervention strategies. The sample consisted of 3240 women who were 50+ years of age from 2 hospitals and 2 comprehensive health centers operated by the Los Angeles County Department of Health Services. Reviews of medical records indicated that only 21% of the sample had received a mammogram in the 12 months prior to the clinic visit on which they were sampled and 23% of the sample received a mammogram in the following 9 months. Approximately 5% of the total sample received a repeat mammogram in the 21-month period over which they were tracked. Prospective independent predictors of screening were age, number of visits to primary care clinics, number of visits to specialty care clinics, and history of breast abnormalities. The results underscore the importance of implementing programs to increase mammography implementing programs to increase mammography screening within public facilities serving low income multiethnic women. An important finding is that a large number of older women are seen in specialty clinics, which represents an untapped resource for increasing screening in this population. Innovative interventions targeting such specialty clinics could substantially contribute to increasing screening rates. A comprehensive approach targeting system, physician, and patient barriers is recommended. PMID:7742724

  5. Implementing PET-guided biopsy: integrating functional imaging data with digital x-ray mammography cameras

    NASA Astrophysics Data System (ADS)

    Weinberg, Irving N.; Zawarzin, Valera; Pani, Roberto; Williams, Rodney C.; Freimanis, Rita L.; Lesko, Nadia M.; Levine, E. A.; Perrier, N.; Berg, Wendie A.; Adler, Lee P.

    2001-05-01

    Purpose: Phantom trials using the PET data for localization of hot spots have demonstrated positional accuracies in the millimeter range. We wanted to perform biopsy based on information from both anatomic and functional imaging modalities, however we had a communication challenge. Despite the digital nature of DSM stereotactic X-ray mammography devices, and the large number of such devices in Radiology Departments (approximately 1600 in the US alone), we are not aware of any methods of connecting stereo units to other computers in the Radiology department. Methods: We implemented a local network between an external IBM PC (running Linux) and the Lorad Stereotactic Digital Spot Mammography PC (running DOS). The application used IP protocol on the parallel port, and could be run in the background on the LORAD PC without disrupting important clinical activities such as image acquisition or archiving. With this software application, users of the external PC could pull x-ray images on demand form the Load DSM computer. Results: X-ray images took about a minute to ship to the external PC for analysis or forwarding to other computers on the University's network. Using image fusion techniques we were able to designate locations of functional imaging features as the additional targets on the anatomic x-rays. These pseudo-features could then potentially be used to guide biopsy using the stereotactic gun stage on the Lorad camera. New Work to be Presented: A method of transferring and processing stereotactic x-ray mammography images to a functional PET workstation for implementing image-guided biopsy.

  6. Mammography screening: an incremental cost effectiveness analysis of two view versus one view procedures in London.

    PubMed Central

    Bryan, S; Brown, J; Warren, R

    1995-01-01

    STUDY OBJECTIVE--To compare the costs and effects of routine mammography screening by a single mediolateral-oblique view and two views (mediolateral-oblique plus craniocaudal) of each breast. DESIGN--A cost effectiveness analysis of a prospective non-randomised trial comparing one and two view mammography screening was carried out at St Margaret's Hospital, Epping. All women in the study had two view mammography. The mediolateral-oblique view was always the first image read by the radiologist. After reading the films for a clinic session, the same radiologist then went back and read both the mediolateral-oblique and craniocaudal views together. Each set of films was read by two radiologists. The main outcome measures were recall rates, number of cancers detected, screening and assessment costs, and cost effectiveness ratios. SUBJECTS--A total of 26,430 women who attended for breast screening using both one and two view mammography participated. A sample of 132 women attending for assessment provided data on the private costs incurred in attending for assessment. RESULTS--There was a reduction in the recall rate from 9.1% (2404 of 26,430) after one view screening to 6.7% (1760 of 26,430) after two view screening. The results also suggest that for every 10,000 women screened an additional five cancers would be detected earlier with two view screening. The additional health service screening cost associated with two view screening was estimated to be 3.63 pounds: the costs associated with one and two view screening policies were estimated to be 41.49 pounds and 32.99 pounds respectively. Private costs incurred were estimated to be 0.35 pounds per woman screened and 32.75 pounds per woman assessed. Two cost effectiveness ratios were calculated: an incremental health service cost per additional cancer detected of 4129 pounds and an incremental health service plus private cost per additional cancer detected of 2742 pounds. The sensitivity analysis suggested that the

  7. Four-wavelength time-resolved optical mammography in the 680-980-nm range

    NASA Astrophysics Data System (ADS)

    Pifferi, Antonio; Taroni, Paola; Torricelli, Alessandro; Messina, Fabrizio; Cubeddu, Rinaldo; Danesini, Gianmaria

    2003-07-01

    What is to our knowledge the first instrument for time-resolved optical mammography operating at wavelengths longer than 900 nm has been developed. It is a scanning system that relies on the acquisition of time-resolved transmittance curves at 683, 785, 912, and 975 nm, with a total measurement time of ~5 min for an entire image. Breast structures and lesions can be discriminated based on the different absorption and scattering properties at the four wavelengths, which reflect different contributions of oxyhemoglobin, deoxyhemoglobin, water, and lipids, as well as distinct structures. The system is currently used in a European clinical trial.

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

    SciTech Connect

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

    2011-12-15

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

  9. Second Opinion Assessment in Diagnostic Mammography at a Breast Cancer Centre

    PubMed Central

    Lorenzen, J.; Finck-Wedel, A. K.; Lisboa, B.; Adam, G.

    2012-01-01

    Purpose: The aim of this retrospective study was to evaluate the importance of second opinion assessment for diagnostic mammography and sonography in a breast cancer centre. Material and Method: We analysed a total of 374 diagnostic mammographies and sonographies. All patients had previously undergone mammography and sonography examination in different external clinics, and the findings had been classified according to the BI-RADS system. All patients underwent additional sonography investigation in the outpatient department of our university clinic with additional mammography where necessary. The final diagnosis (histological clarification in 316 cases, follow-up in 58 cases) was compared with the BI-RADS classification made by the external clinics and by the university clinic, and the correlation between their findings and the final diagnosis was analysed. Results: The final diagnosis yielded 146 benign lesions and 228 cancers. In 74 % of cases (277/374), the BI-RADS classification of the first assessment corresponded to that of the second assessment. 26/55 lesions (47 %) were upgraded at the second assessment from BI-RADS 3 to BI-RADS 4, and 71/186 findings (38 %) were downgraded at the second assessment from BI-RADS 4 to BI-RADS 3. The correlation between the initial diagnosis made in the external facilities and the final diagnosis was low (kappa: 0.263), but the correlation between the second opinion assessment and the final diagnosis was significantly (p < 0.001) higher (kappa: 0.765). The second assessment increased the sensitivity from 91 % (208/228) to 99 % (225/228) and the specificity from 32 % (46/146) to 74 % (108/146). 20 additional malignant lesions were only detected at the second assessment; however the second assessment also resulted in 3 additional false-negative findings. Surgical biopsy was prevented in 49 women after the second assessment. Conclusion: An independent second diagnostic evaluation can significantly

  10. Adherence to Mammography Screening Guidelines Among Transgender Persons and Sexual Minority Women.

    PubMed

    Bazzi, Angela Robertson; Whorms, Debra S; King, Dana S; Potter, Jennifer

    2015-11-01

    We used retrospective (2012-2013) chart review to examine breast cancer screening among transgender persons and sexual minority women (n = 1263) attending an urban community health center in Massachusetts. Transgender were less likely than cisgender patients and bisexuals were less likely than heterosexuals and lesbians to adhere to mammography screening guidelines (respectively, adjusted odds ratios = 0.53 and 0.56; 95% confidence intervals = 0.31, 0.91 and 0.34, 0.92) after adjustment for sociodemographics. Enhanced cancer prevention outreach is needed among gender and sexual minorities. PMID:26378843

  11. Discovering Potential Precursors of Mammography Abnormalities based on Textual Features, Frequencies, and Sequences

    SciTech Connect

    Patton, Robert M; Potok, Thomas E

    2010-01-01

    Diagnosing breast cancer from mammography reports is heavily dependant on the time sequences of the patient visits. In the work described, we take a longitudinal view of the text of a patient s mam- mogram reports to explore the existence of certain phrase patterns that indicate future abnormalities may exist for the patient. Our approach uses various text analysis techniques combined with Haar wavelets for the discovery and analysis of such precursor phrase patterns. We believe the results show significant promise for the early detection of breast can- cer and other breast abnormalities.

  12. Inconsistent mammography perceptions and practices among women at risk of breast cancer following a pediatric malignancy: a report from the Childhood Cancer Survivor Study.

    PubMed

    Smith, Stephanie M; Ford, Jennifer S; Rakowski, William; Moskowitz, Chaya S; Diller, Lisa; Hudson, Melissa M; Mertens, Ann C; Stanton, Annette L; Henderson, Tara O; Leisenring, Wendy M; Robison, Leslie L; Oeffinger, Kevin C

    2010-10-01

    Women treated with chest radiation for a pediatric cancer have low mammography screening rates despite their high risk for breast cancer. This study characterized the relationship between perceptions of mammography and screening practices. A cross-sectional survey was administered to 523 women in North America who were treated with chest radiation before 21 years of age. Women with inconsistent mammography perceptions and practices were identified using the Pros and Cons of Mammography for perceptions and Transtheoretical Model stages of adoption for prior and intended screening practices. Classification and regression tree (CART) analysis was used to identify barriers to and facilitators of screening among women with positive and negative perceptions. Nearly one-third of the cohort had inconsistent perceptions and practices: 37.4% had positive perceptions and were not having mammograms; 27.6% had negative/neutral perceptions and were having mammograms. Regardless of perceptions, a recent physician's recommendation for mammography, age ≥ 40, and interest in routine health care were universally associated with mammography practices. For women with positive perceptions and a physician's recommendation, barriers to screening included high acceptance coping, low active-planning coping, and high internal health locus of control. For women with negative perceptions, acknowledging the importance of asymptomatic screening was associated with mammography. PMID:20506037

  13. The Contribution of Mammography Screening to Breast Cancer Incidence Trends in the United States: An Updated Age-period-cohort Model

    PubMed Central

    Gangnon, Ronald E.; Sprague, Brian L.; Stout, Natasha K.; Alagoz, Oguz; Weedon-Fekjær, Harald; Holford, Theodore R.; Trentham-Dietz, Amy

    2015-01-01

    Background The impact of screening mammography on breast cancer incidence is difficult to disentangle from cohort- and age-related effects on incidence. Methods We developed an age-period-cohort model of ductal carcinoma in situ (DCIS) and invasive breast cancer incidence in U.S. females using cancer registry data. Five functions were included in the model to estimate stage-specific effects for age, premenopausal birth cohorts, postmenopausal birth cohorts, period (for all years of diagnosis), and a mammography period effect limited to women aged ≥40 years after 1982. Incidence with and without the mammography period effect was calculated. Results More recent birth cohorts have elevated underlying risk compared to earlier cohorts for both pre- and postmenopausal women. Comparing models with and without the mammography period effect showed that overall breast cancer incidence would have been 23.1% lower in the absence of mammography in 2010 (95% CI 18.8, 27.4), including 14.7% (9.5, 19.3) lower for invasive breast cancer and 54.5% (47.4, 59.6) lower for DCIS. Incidence of distant-staged breast cancer in 2010 would have been 29.0% (13.1, 48.1) greater in the absence of mammography screening. Conclusions Mammography contributes to markedly elevated rates of DCIS and early stage invasive cancers, but also contributes to substantial reductions in the incidence of metastatic breast cancer. Impact Mammography is an important tool for reducing the burden of breast cancer, but future work is needed to identify risk factors accounting for increasing underlying incidence and to distinguish between indolent and potentially lethal early stage breast cancers that are detected via mammography. PMID:25787716

  14. A critical comparison of three full field digital mammography systems using figure of merit.

    PubMed

    Kanaga, K C; Yap, H H; Laila, S E; Sulaiman, T; Zaharah, M; Shantini, A A

    2010-06-01

    Full field digital mammography (FFDM) has been progressively introduced in medical centers in recent years. However, it is questionable which exposure parameters are suitable in order to reduce the glandular breast doses as they are related to induced carcinogenesis. The goal of this study was to compare the average glandular doses (AGD) and image quality of three FFDM systems namely Siemens Mammomat NovationDR, Hologic Lorad Selenia and General Electric Senographe Essential using a Figure of Merit. A Computerized Imaging Reference Systems (CIRS) tissue equivalent breast phantom which consists of phototimer compensation plate with different thickness and glandularity was exposed in fully automatic exposure control mode in the cranio-caudal projection similar to clinical settings. Thermoluminescent dosimeter 100H (TLD- 100H) was used to measure the entrance surface air kerma (ESAK), the AGD was calculated using European protocol whilst the image quality was assessed quantitatively by measuring the contrast to noise ratio (CNR) value. The obtained values were used to calculate the Figure of Merit (FOM) to analyze the effectiveness of the system. Repeated Measures ANOVA analysis showed that there is a significant difference (p<0.05) in the mean value of AGD and CNR between the three FFDM systems. Hologic Lorad Selenia system contrbuted the highest AGD value while General Electric Senographe Essential had the highest CNR and FOM value. In conclusion, this study may provide an objective criterion during the selection of a mammography unit by using the figure of merit for screening or diagnostic purpose. PMID:23756795

  15. New design of a structured CsI(Tl) screen for digital mammography

    NASA Astrophysics Data System (ADS)

    Nagarkar, Vivek V.; Tipnis, Sameer V.; Gaysinskiy, Valeriy B.; Miller, Stuart R.; Karellas, Andrew; Vedantham, Srinivasan

    2003-06-01

    Columnar CsI(Tl) screens are now routinely used for digital x-ray imaging in a wide variety of applications such as mammography, dental radiography, and non-destructive testing. While commercially available CsI(Tl) screens exhibit excellent properties, it is possible to significantly improve their performance. Here, we report on a new design of a columnar CsI(Tl) screen. Specifically, columnar CsI(Tl) screens were subjected to mechanical pixelation for minimizing the long range spread of scintillation light within the film, thus enhancing spatial and contrast resolution, and increasing the detective quantum efficiency (DQE(f)) of the digital imaging detector. To date we have fabricated up to 200 μm thick pixelated CsI(Tl) screens for mammography, and characterized their performance using a CCD camera. This paper presents a comparison of the new pixelated CsI(Tl) screens, conventional columnar CsI(Tl) screens, and Gd2O2S(Tb) screens. The data show that pixelated screens substantially improve the DQE(f) of the digital imaging system.

  16. A method to measure paddle and detector pressures and footprints in mammography

    SciTech Connect

    Hogg, Peter; Szczepura, Katy; Darlington, Alison; Maxwell, Anthony

    2013-04-15

    Purpose: Compression is necessary in mammography to improve image quality and reduce radiation burden. Maximizing the amount of breast in contact with the image receptor (IR) is important. To achieve this, for the craniocaudal projection, there is no consensus within the literature regarding how the IR should be positioned relative to the inframammary fold (IMF). No information exists within the literature to describe how pressure balancing between IR and paddle, and IR breast footprint, might be optimized. This paper describes a novel method for measuring the respective pressures applied to the breast from the IR and the paddle and a method to simultaneously measure the breast footprints on the IR and the paddle. Methods: Using a deformable breast phantom and electronic pressure-sensitive mat, area and pressure readings were gathered from two mammography machines and four paddles at 60, 80, and 100 N with the IR positioned at -2, -1, 0, +1, and +2 cm relative to the IMF (60 combinations in total). Results: Paddle and IR footprints were calculated along with a uniformity index (UI). For all four paddle/machine/pressure combinations the greatest IR footprint was achieved at IMF +2 cm. The UI indicates that the best pressure/footprint balance is achieved at IMF +1 cm. Conclusions: The authors' method appears to be suited to measuring breast footprints and pressures on IR and paddle and a human female study is planned.

  17. Radiation protection program for early detection of breast cancer in a mammography facility

    NASA Astrophysics Data System (ADS)

    Villagomez Casimiro, Mariana; Ruiz Trejo, Cesar; Espejo Fonseca, Ruby

    2014-11-01

    Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1-4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systems (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (<3 mGy per projection). The image quality test showed that most images (70%)- presented artifacts. A brief summary of the results of quality control tests applied to the equipment and film processor are presented. To maintain an adequate level of quality and safety at FUCAM-AC is necessary that the proposed radiation protection program in this work is applied.

  18. The effects of music on pain and anxiety during screening mammography.

    PubMed

    Zavotsky, Kathleen Evanovich; Banavage, Adrienne; James, Patricia; Easter, Kathy; Pontieri-Lewis, Vicky; Lutwin, Lynn

    2014-06-01

    One in four women who are diagnosed with breast cancer die annually, and the single most important way to prevent this is early detection; therefore, women older than 40 years should have an annual screening mammography. Many barriers have been reported that prevent compliance with this recommendation, including lack of insurance, fear, anxiety, pain, worry, and mistrust of the medical community. Nurses are in a position to use creative interventions, such as music therapy, to help minimize barriers. Although this study did not show that music therapy during screening mammograms decreased the amount of pain that the participants experienced, it did suggest that music therapy has the potential to decrease the amount of anxiety. Assisting patients in decreasing anxiety reduces barriers for screening mammography. The literature does suggest that music is a distraction for many populations of patients; however, when patients are faced with the possible diagnosis of breast cancer, it may be difficult to find an intervention to distract a woman's mind, which was supported by the findings of this study. PMID:24867123

  19. The Influence of Spiritual Framing on African American Women's Mammography Intentions: A Randomized Trial.

    PubMed

    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 < .001) and more positive polarity (β = .237, SE = .04, p < .001) . Spiritual framing also had a significant indirect effect on mammography intentions through polarity (standardized indirect effect = .057, 95% confidence interval [.024, .106], p < .001). These results indicate that spiritual 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. PMID:27142231

  20. Added Value of Contrast-Enhanced Spectral Mammography in Postscreening Assessment.

    PubMed

    Tardivel, Anne-Marie; Balleyguier, Corinne; Dunant, Ariane; Delaloge, Suzette; Mazouni, Chafika; Mathieu, Marie-Christine; Dromain, Clarisse

    2016-09-01

    To assess the value on diagnostic and treatment management of contrast-enhanced spectral mammography (CESM), as adjunct to mammography (MG) and ultrasound (US) in postscreening in a breast cancer unit for patients with newly diagnosed breast cancer or with suspicious findings on conventional imaging. Retrospective review of routine use of bilateral CESM performed between September 2012 and September 2013 in 195 women with suspicious or undetermined findings on MG and/or US. CESM images were blindly reviewed by two radiologists for BI-RADS(®) assessment and probability of malignancy. Each lesion was definitely confirmed either with histopathology or follow-up. Two hundred and ninety-nine lesions were detected (221 malignant). CESM sensitivity, specificity, positive-predictive value and negative-predictive value were 94% (CI: 89-96%), 74% (CI: 63-83%), 91% (CI: 86-94%) and 81% (CI: 70-89%), respectively, with 18 false positive and 14 false negative. CESM changed diagnostic and treatment strategy in 41 (21%) patients either after detection of additional malignant lesions in 38 patients (19%)-with a more extensive surgery (n = 21) or neo-adjuvant chemotherapy (n = 1)-or avoiding further biopsy for 20 patients with negative CESM. CESM can be performed easily in a clinical assessment after positive breast cancer screening and may change significantly the diagnostic and treatment strategy through breast cancer staging. PMID:27345656

  1. The Influence of Spiritual Framing on African American Women’s Mammography Intentions: A Randomized Trial

    PubMed Central

    BEST, ALICIA L.; SPENCER, S. MELINDA; FRIEDMAN, DANIELA B.; HALL, INGRID J.; BILLINGS, DEBORAH

    2016-01-01

    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 < .001) and more positive polarity (β = .237, SE = .04, p < .001). Spiritual framing also had a significant indirect effect on mammography intentions through polarity (standardized indirect effect = .057, 95% confidence interval [.024, .106], p < .001). These results indicate that spiritual 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. PMID:27142231

  2. Predicting malignancy from mammography findings and image-guided core biopsies

    PubMed Central

    Ferreira, Pedro; Fonseca, Nuno A.; Dutra, Inês; Woods, Ryan; Burnside, Elizabeth

    2016-01-01

    The main goal of this work is to produce machine learning models that predict the outcome of a mammography from a reduced set of annotated mammography findings. In the study we used a dataset consisting of 348 consecutive breast masses that underwent image guided core biopsy performed between October 2005 and December 2007 on 328 female subjects. We applied various algorithms with parameter variation to learn from the data. The tasks were to predict mass density and to predict malignancy. The best classifier that predicts mass density is based on a support vector machine and has accuracy of 81.3%. The expert correctly annotated 70% of the mass densities. The best classifier that predicts malignancy is also based on a support vector machine and has accuracy of 85.6%, with a positive predictive value of 85%. One important contribution of this work is that our model can predict malignancy in the absence of the mass density attribute, since we can fill up this attribute using our mass density predictor. PMID:26333262

  3. Multi-scale image fusion for x-ray grating-based mammography

    NASA Astrophysics Data System (ADS)

    Jiang, Xiaolei; Zhang, Li; Wang, Zhentian; Stampanoni, Marco

    2012-10-01

    X-ray phase contrast imaging (PCI) can provide high sensitivity of weakly absorbing low-Z objects in medical and biological fields, especially in mammography. Grating-based differential phase contrast (DPC) method is the most potential PCI method for clinic applications because it can works well with conventional X-ray tube and it can retrieve attenuation, DPC and dark-field information of the samples in a single scanning. Three kinds of information have different details and contrast which represent different physical characteristics of X-rays with matters. Hence, image fusion can show the most desirable characteristics of each image. In this paper, we proposed a multi-scale image fusion for X-ray grating-based DPC mammography. Firstly, non-local means method is adopted for denoising due to the strong noise, especially for DPC and dark-field images. Then, Laplacian pyramid is used for multi-scale image fusion. The principal component analysis (PCA) method is used on the high frequency part and the spatial frequency method is used on the low frequency part. Finally, the fused image is obtained by inverse Laplacian pyramid transform. Our algorithm is validated by experiments. The experiments were performed on mammoDPC instrumentation at the Paul Scherrer Institut in Villigen, Switzerland. The results show that our algorithm can significantly show the advantages of three kinds of information in the fused image, which is very helpful for the breast cancer diagnosis.

  4. Clinical dose performance of full field digital mammography in a breast screening programme

    PubMed Central

    McCullagh, J B; Baldelli, P; Phelan, N

    2011-01-01

    Objective BreastCheck, the Irish Breast Screening Programme, has employed three different models of a full field digital mammography (FFDM) system since its transition to a digital service in 2007. The three models from GE Healthcare, Hologic and Sectra exhibit differences in their design and function, the most significant of which include anode target/filter choice, detector technology and the type of exposure automation. Methods The aim of this study was to use the results from a clinical breast dose survey to examine the differences between three different FFDM models in terms of exposure selection, breast mean glandular dose (MGD) and automatic exposure control (AEC) dose contribution. Results The accuracy of the dose estimation was improved by inclusion of the AEC pre-exposure dose contribution. The photon-counting system demonstrated the lowest average MGD. The GE Healthcare and Hologic flat-panel detector systems demonstrated a small but statistically significant dose difference. The pre-exposure dose contribution did not exceed 13% of the total exposure dose for any system in the survey. A comparison of the system calculated organ dose estimate from each machine with the corresponding MGD calculated from medical physics measurements indicated reasonably accurate organ dose estimates for most systems in the survey. Conclusion The results of this study provide a comprehensive assessment of the breast dose performance of current digital mammography systems in a clinical screening setting. PMID:21586506

  5. X-ray spectrum optimization of full-field digital mammography: Simulation and phantom study

    SciTech Connect

    Bernhardt, Philipp; Mertelmeier, Thomas; Hoheisel, Martin

    2006-11-15

    In contrast to conventional analog screen-film mammography new flat detectors have a high dynamic range and a linear characteristic curve. Hence, the radiographic technique can be optimized independently of the receptor exposure. It can be exclusively focused on the improvement of the image quality and the reduction of the patient dose. In this paper we measure the image quality by a physical quantity, the signal difference-to-noise ratio (SDNR), and the patient risk by the average glandular dose (AGD). Using these quantities, we compare the following different setups through simulations and phantom studies regarding the detection of microcalcifications and tumors for different breast thicknesses and breast compositions: Monochromatic radiation, three different anode/filter combinations: Molybdenum/molybdenum (Mo/Mo), molybdenum/rhodium (Mo/Rh), and tungsten/rhodium (W/Rh), different filter thicknesses, use of anti-scatter grids, and different tube voltages. For a digital mammography system based on an amorphous selenium detector it turned out that, first, the W/Rh combination is the best choice for all detection tasks studied. Second, monochromatic radiation can further reduce the AGD by a factor of up to 2.3, maintaining the image quality in comparison with a real polychromatic spectrum of an x-ray tube. And, third, the use of an anti-scatter grid is only advantageous for breast thicknesses larger than approximately 5 cm.

  6. Radiation protection program for early detection of breast cancer in a mammography facility

    SciTech Connect

    Mariana, Villagomez Casimiro E-mail: cesar@fisica.unam.mx; Cesar, Ruiz Trejo E-mail: cesar@fisica.unam.mx; Ruby, Espejo Fonseca

    2014-11-07

    Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1–4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systems (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (<3 mGy per projection). The image quality test showed that most images (70%)– presented artifacts. A brief summary of the results of quality control tests applied to the equipment and film processor are presented. To maintain an adequate level of quality and safety at FUCAM-AC is necessary that the proposed radiation protection program in this work is applied.

  7. A model-based framework for the detection of spiculated masses on mammography

    SciTech Connect

    Sampat, Mehul P.; Bovik, Alan C.; Whitman, Gary J.; Markey, Mia K.

    2008-05-15

    The detection of lesions on mammography is a repetitive and fatiguing task. Thus, computer-aided detection systems have been developed to aid radiologists. The detection accuracy of current systems is much higher for clusters of microcalcifications than for spiculated masses. In this article, the authors present a new model-based framework for the detection of spiculated masses. The authors have invented a new class of linear filters, spiculated lesion filters, for the detection of converging lines or spiculations. These filters are highly specific narrowband filters, which are designed to match the expected structures of spiculated masses. As a part of this algorithm, the authors have also invented a novel technique to enhance spicules on mammograms. This entails filtering in the radon domain. They have also developed models to reduce the false positives due to normal linear structures. A key contribution of this work is that the parameters of the detection algorithm are based on measurements of physical properties of spiculated masses. The results of the detection algorithm are presented in the form of free-response receiver operating characteristic curves on images from the Mammographic Image Analysis Society and Digital Database for Screening Mammography databases.

  8. BREAST: a novel method to improve the diagnostic efficacy of mammography

    NASA Astrophysics Data System (ADS)

    Brennan, P. C.; Tapia, K.; Ryan, J.; Lee, W.

    2013-03-01

    High quality breast imaging and accurate image assessment are critical to the early diagnoses, treatment and management of women with breast cancer. Breast Screen Reader Assessment Strategy (BREAST) provides a platform, accessible by researchers and clinicians world-wide, which will contain image data bases, algorithms to assess reader performance and on-line systems for image evaluation. The platform will contribute to the diagnostic efficacy of breast imaging in Australia and beyond on two fronts: reducing errors in mammography, and transforming our assessment of novel technologies and techniques. Mammography is the primary diagnostic tool for detecting breast cancer with over 800,000 women X-rayed each year in Australia, however, it fails to detect 30% of breast cancers with a number of missed cancers being visible on the image [1-6]. BREAST will monitor the mistakes, identify reasons for mammographic errors, and facilitate innovative solutions to reduce error rates. The BREAST platform has the potential to enable expert assessment of breast imaging innovations, anywhere in the world where experts or innovations are located. Currently, innovations are often being assessed by limited numbers of individuals who happen to be geographically located close to the innovation, resulting in equivocal studies with low statistical power. BREAST will transform this current paradigm by enabling large numbers of experts to assess any new method or technology using our embedded evaluation methods. We are confident that this world-first system will play an important part in the future efficacy of breast imaging.

  9. Probabilistic framework for reliability analysis of information-theoretic CAD systems in mammography.

    PubMed

    Habas, Piotr A; Zurada, Jacek M; Elmaghraby, Adel S; Tourassi, Georgia D

    2006-01-01

    The purpose of this study is to develop and evaluate a probabilistic framework for reliability analysis of information-theoretic computer-assisted detection (IT-CAD) systems in mammography. The study builds upon our previous work on a feature-based reliability analysis technique tailored to traditional CAD systems developed with a supervised learning scheme. The present study proposes a probabilistic framework to facilitate application of the reliability analysis technique for knowledge-based CAD systems that are not feature-based. The study was based on an information-theoretic CAD system developed for detection of masses in screening mammograms from the Digital Database for Screening Mammography (DDSM). The experimental results reveal that the query-specific reliability estimate provided by the proposed probabilistic framework is an accurate predictor of CAD performance for the query case. It can also be successfully applied as a base for stratification of CAD predictions into clinically meaningful reliability groups (i.e., HIGH, MEDIUM, and LOW). Based on a leave-one-out sampling scheme and ROC analysis, the study demonstrated that the diagnostic performance of the IT-CAD is significantly higher for cases with HIGH reliability (A(z) = 0.92 +/- 0.03) than for those stratified as MEDIUM (A(z) = 0.84 +/- 0.02) or LOW reliability predictions (A(z) = 0.78 +/- 0.02). PMID:17946741

  10. Comparison of full field digital (FFD) and computed radiography (CR) mammography systems in Greece.

    PubMed

    Kalathaki, M; Hourdakis, C J; Economides, S; Tritakis, P; Kalyvas, N; Simantirakis, G; Manousaridis, G; Kaisas, I; Kamenopoulou, V

    2011-09-01

    The purpose of this study is to evaluate and compare the performance of 52 full field digital (FFD) and computed radiography (CR) mammography systems checked by the Greek Atomic Energy Commission with respect to dose and image quality. Entrance surface air kerma (ESAK) was measured and average glandular dose (AGD) was calculated according to the European protocol on dosimetry in mammography. The exposures were performed using the clinical protocol of each laboratory. The image quality was assessed by the total score of resolved phantom structures incorporated in an American College of Radiology accreditation phantom. The mean ESAK values for FFD and CR systems were 4.59 ± 1.93 and 5.0 ± 1.78 mGy, respectively, whereas the AGD yielded a mean value of 1.06 ± 0.36 mGy for the FFD and 1.04 ± 0.35 mGy for the CR systems. Considering image quality, FFD systems indicated a mean total score of 13.04 ± 0.89, whereas CR systems a mean total score of 11.54 ± 1.06. PMID:21821614

  11. Laser-based microfocused x-ray source for mammography: feasibility study.

    PubMed

    Krol, A; Ikhlef, A; Kieffer, J C; Bassano, D A; Chamberlain, C C; Jiang, Z; Pépin, H; Prasad, S C

    1997-05-01

    A laser-produced plasma (LPP) x-ray source with possible application in mammography was created by focusing a laser beam on a Mo target. A Table-Top-Terawatt (TTT) laser operating at 1 J energy per pulse was employed. A dual pulse technique was used. Maximum energy transfer (approximately 10%) from laser light to hot electrons was reached at a 150 ps delay between pulses and the conversion efficiency (hard x-ray yield/laser energy input) was approximately 2 x 10(-4). The created LPP x-ray source is characterized by a very small focal spot size (tens of microns), Gaussian brightness distribution, and a very short pulse duration (a few ps). The spectral distribution of the generated x rays was measured. Images of the focal spot, using a pinhole camera, and images of a resolution pattern and a mammographic phantom were obtained. The LPP focal spot modulation transfer function for different magnification factors was calculated. We have shown that the LPP source in conjunction with a spherically bent, high throughput, crystal monochromator in a fixed-exit Rowland circle configuration can be used to created a narrow band tunable mammography system. Tunability to a specific patient breast tissue thickness and density would allow one to significantly improve contrast and resolution (exceeding 20 lp/mm) while lowering the exposure up to 50% for thicker breasts. The prospects for the LPP x-ray source for mammographic application are discussed. PMID:9167163

  12. A comparison of the performance of new screen-film and digital mammography systems

    NASA Astrophysics Data System (ADS)

    Monnin, P.; Gutierrez, D.; Castella, C.; Lepori, D.; Verdun, F. R.

    2006-03-01

    This work compares the detector performances of the recent Kodak Min-R EV 190/Min-R EV and current Kodak Min-R 2190/Min-R 2000 mammography screen-film combinations with the Kodak CR 850M system using the new EHR-M and standard HR plates. Basic image quality parameters (MTF, NNPS and DQE) were evaluated according to ISO 9236-3 conditions (i.e. 28 kV; Mo/Mo; HVL = 0.64 mm eq. Al) at an entrance air kerma level of 60 μGy. Compared with the Min-R 2000, the Kodak Min-R EV screen-film system has a higher contrast and an intrinsically lower noise level, leading to a better DQE. Due to a lower noise level, the new EHR-M plate improves the DQE of the CR system, in comparison with the use of the standard HR plate (30 % improvement) in a mammography cassette. Compared with the CR plates, screen-film systems still permit to resolve finer details and have a significantly higher DQE for all spatial frequencies.

  13. Radiologists’ ability to accurately estimate and compare their own interpretative mammography performance to their peers

    PubMed Central

    Cook, Andrea J.; Elmore, Joann G.; Zhu, Weiwei; Jackson, Sara L.; Carney, Patricia A.; Flowers, Chris; Onega, Tracy; Geller, Berta; Rosenberg, Robert D.; Miglioretti, Diana L.

    2013-01-01

    Objective To determine if U.S. radiologists accurately estimate their own interpretive performance of screening mammography and how they compare their performance to their peers’. Materials and Methods 174 radiologists from six Breast Cancer Surveillance Consortium (BCSC) registries completed a mailed survey between 2005 and 2006. Radiologists’ estimated and actual recall, false positive, and cancer detection rates and positive predictive value of biopsy recommendation (PPV2) for screening mammography were compared. Radiologists’ ratings of their performance as lower, similar, or higher than their peers were compared to their actual performance. Associations with radiologist characteristics were estimated using weighted generalized linear models. The study was approved by the institutional review boards of the participating sites, informed consent was obtained from radiologists, and procedures were HIPAA compliant. Results While most radiologists accurately estimated their cancer detection and recall rates (74% and 78% of radiologists), fewer accurately estimated their false positive rate and PPV2 (19% and 26%). Radiologists reported having similar (43%) or lower (31%) recall rates and similar (52%) or lower (33%) false positive rates compared to their peers, and similar (72%) or higher (23%) cancer detection rates and similar (72%) or higher (38%) PPV2. Estimation accuracy did not differ by radiologists’ characteristics except radiologists who interpret ≤1,000 mammograms annually were less accurate at estimating their recall rates. Conclusion Radiologists perceive their performance to be better than it actually is and at least as good as their peers. Radiologists have particular difficulty estimating their false positive rates and PPV2. PMID:22915414

  14. [Performance of record linkage for cancer registry data linked with mammography screening data].

    PubMed

    Giersiepen, K; Bachteler, T; Gramlich, T; Reiher, J; Schubert, B; Novopashenny, I; Schnell, R

    2010-07-01

    The evaluation of the German Mammography Screening Program requires record linkage with data from cancer registries in order to measure the number of false-negative mammograms and interval cancers. This study aims at evaluating the performance of the established linkage method based on identifiers encrypted by the standard procedure of the German cancer registries. In addition, the results are compared with an alternative method based on plain text identifiers. A total of 16,572 records from the Bremen Mammography Screening Pilot Study were linked with data from the Bremen Cancer Registry. Based on a gold standard set of matching record pairs, homonym and synonym errors were determined. Given the customary threshold value in cancer registries, the plain text method showed a lower rate of synonym errors (2.1-5.1%) and a lower rate of homonym errors (0.01-0.15%). As 10.4 million women are invited to take part biennially in screening, the corresponding figures would be 3,237 homonym errors for the standard procedure and 294 using the plain text method provided equivalent conditions. The 11-fold increase in the homonym error rate documents the trade-off for better data protection using encrypted data. PMID:20652484

  15. Survey of patient exposure from general radiography and mammography in Japan in 2014.

    PubMed

    Asada, Y; Suzuki, S; Minami, K; Shirakawa, S; Kobayashi, M

    2016-06-01

    With the objective of reducing patient exposure to radiation, we conducted a questionnaire survey regarding radiographic conditions in 2014. Here we report estimates of dose exposure in general radiography and mammography through an investigation and comparison of present patient exposure conditions. Questionnaires were sent to 3000 facilities nationwide in Japan. Surveys asked questions on a total of 16 items related to general radiography, including the chest, abdomen, and breast. Output data from x-ray tubes measured in the Chubu area of Japan were used as the mean in these estimates. The index of patient exposure was adopted as the entrance skin dose (ESD) for general radiography and as the mean glandular dose (MGD) for mammography. The response rate for this survey was 21.9%. Our results showed that doses received through the use of flat-panel detector (FPD) devices were lower than those received through computed radiography devices, except for the ankle joint (e.g. in chest examination, the dose from FPD and CR was 0.24 mGy, 0.31 mGy on the average, respectively). These results suggest that more widespread use of FPD devices could lead to decreases in the ESD and MGD, thereby reducing patient exposure. PMID:26975874

  16. Comparative evaluation of support vector machine classification for computer aided detection of breast masses in mammography

    NASA Astrophysics Data System (ADS)

    Lesniak, J. M.; Hupse, R.; Blanc, R.; Karssemeijer, N.; Székely, G.

    2012-08-01

    False positive (FP) marks represent an obstacle for effective use of computer-aided detection (CADe) of breast masses in mammography. Typically, the problem can be approached either by developing more discriminative features or by employing different classifier designs. In this paper, the usage of support vector machine (SVM) classification for FP reduction in CADe is investigated, presenting a systematic quantitative evaluation against neural networks, k-nearest neighbor classification, linear discriminant analysis and random forests. A large database of 2516 film mammography examinations and 73 input features was used to train the classifiers and evaluate for their performance on correctly diagnosed exams as well as false negatives. Further, classifier robustness was investigated using varying training data and feature sets as input. The evaluation was based on the mean exam sensitivity in 0.05-1 FPs on normals on the free-response receiver operating characteristic curve (FROC), incorporated into a tenfold cross validation framework. It was found that SVM classification using a Gaussian kernel offered significantly increased detection performance (P = 0.0002) compared to the reference methods. Varying training data and input features, SVMs showed improved exploitation of large feature sets. It is concluded that with the SVM-based CADe a significant reduction of FPs is possible outperforming other state-of-the-art approaches for breast mass CADe.

  17. Method for inserting noise in digital mammography to simulate reduction in radiation dose

    NASA Astrophysics Data System (ADS)

    Borges, Lucas R.; de Oliveira, Helder C. R.; Nunes, Polyana F.; Vieira, Marcelo A. C.

    2015-03-01

    The quality of clinical x-ray images is closely related to the radiation dose used in the imaging study. The general principle for selecting the radiation is ALARA ("as low as reasonably achievable"). The practical optimization, however, remains challenging. It is well known that reducing the radiation dose increases the quantum noise, which could compromise the image quality. In order to conduct studies about dose reduction in mammography, it would be necessary to acquire repeated clinical images, from the same patient, with different dose levels. However, such practice would be unethical due to radiation related risks. One solution is to simulate the effects of dose reduction in clinical images. This work proposes a new method, based on the Anscombe transformation, which simulates dose reduction in digital mammography by inserting quantum noise into clinical mammograms acquired with the standard radiation dose. Thus, it is possible to simulate different levels of radiation doses without exposing the patient to new levels of radiation. Results showed that the achieved quality of simulated images generated with our method is the same as when using other methods found in the literature, with the novelty of using the Anscombe transformation for converting signal-independent Gaussian noise into signal-dependent quantum noise.

  18. Bavarian mammography recertification program: experiences with a workstation prototype for softcopy reading

    NASA Astrophysics Data System (ADS)

    Riesmeier, Jorg; Eichelberg, Marco; Kieschke, Joachim; Hellemann, Hans-Peter; Gruschka-Hellemann, Birgit; Sokiranski, Roman; Munte, Axel; Thoben, Wilfried; Jensch, Peter F.

    2003-05-01

    In January 2002, the Bavarian Statutory Health Care Administration ("Kassenarztliche Vereinigung Bayerns", KVB) started a recertification programme for quality assurance and quality improvement in mammography reading. All accredited radiologists and gynaecologists are asked to prove their qualification every 1-2 years. The recertification programme requires the physicians to read 50 cases randomly selected from a larger collection of high-quality test cases. The portion of malignant and benign cases corresponds to the requirements of the German National Association of Statutory Health Insurance Physicians ("Kassenarztliche Bundesvereinigung", KBV). In order to read the mammograms on a softcopy device the images are digitised with a high-quality scanner and converted to DICOM Digital Mammography format. The workstation software has been implemented according to the particular requirements of this programme. To verify the applicability of digitised mammograms for recertification purposes, a comparative study with 32 trained radiologists and gynaecologists has been performed. As a result the study showed that there was no significant difference in the error rate of the reported findings between conventional film and softcopy reading. The first intermediate results of this quality initiative are promising. The introduction of a corresponding federal German recertification programme is intended.

  19. Dual-energy tissue cancellation in mammography with quasi-monochromatic x-rays

    NASA Astrophysics Data System (ADS)

    Marziani, M.; Taibi, A.; Tuffanelli, A.; Gambaccini, M.

    2002-01-01

    Dual-energy radiography has not evolved into a routine clinical examination yet due to intrinsic limitations of both dual-kVp imaging and single-exposure imaging with conventional x-ray sources. The recent introduction of novel quasi-monochromatic x-ray sources and detectors could lead to interesting improvements, especially in mammography where the complex structure of healthy tissues often masks the detectability of lesions. A dual-energy radiography technique based on a tissue cancellation algorithm has been developed for mammography, with the aim of maximizing the low intrinsic contrast of pathologic tissues while being able to minimize or cancel the contrast between glandular and fat tissues. Several images of a plastic test object containing various tissue equivalent inserts were acquired in the energy range 17-36 keV using a quasi-monochromatic x-ray source and a scintillator-coated CCD detector. Images acquired at high and low energies were non-linearly combined to generate two energy-independent basis images. Suitable linear combinations of these two basis images result in the elimination of the contrast of a given material with respect to another. This makes it possible to selectively cancel certain details in the processed image.

  20. X-ray spectrum optimization of full-field digital mammography: simulation and phantom study.

    PubMed

    Bernhardt, Philipp; Mertelmeier, Thomas; Hoheisel, Martin

    2006-11-01

    In contrast to conventional analog screen-film mammography new flat detectors have a high dynamic range and a linear characteristic curve. Hence, the radiographic technique can be optimized independently of the receptor exposure. It can be exclusively focused on the improvement of the image quality and the reduction of the patient dose. In this paper we measure the image quality by a physical quantity, the signal difference-to-noise ratio (SDNR), and the patient risk by the average glandular dose (AGD). Using these quantities, we compare the following different setups through simulations and phantom studies regarding the detection of microcalcifications and tumors for different breast thicknesses and breast compositions: Monochromatic radiation, three different anode/filter combinations: Molybdenum/molybdenum (Mo/Mo), molybdenum/rhodium (Mo/Rh), and tungsten/rhodium (W/Rh), different filter thicknesses, use of anti-scatter grids, and different tube voltages. For a digital mammography system based on an amorphous selenium detector it turned out that, first, the W/Rh combination is the best choice for all detection tasks studied. Second, monochromatic radiation can further reduce the AGD by a factor of up to 2.3, maintaining the image quality in comparison with a real polychromatic spectrum of an x-ray tube. And, third, the use of an anti-scatter grid is only advantageous for breast thicknesses larger than approximately 5 cm. PMID:17153413

  1. Improved scintimammography using a high-resolution camera mounted on an upright mammography gantry

    NASA Astrophysics Data System (ADS)

    Itti, Emmanuel; Patt, Bradley E.; Diggles, Linda E.; MacDonald, Lawrence; Iwanczyk, Jan S.; Mishkin, Fred S.; Khalkhali, Iraj

    2003-01-01

    99mTc-sestamibi scintimammography (SMM) is a useful adjunct to conventional X-ray mammography (XMM) for the assessment of breast cancer. An increasing number of studies has emphasized fair sensitivity values for the detection of tumors >1 cm, compared to XMM, particularly in situations where high glandular breast densities make mammographic interpretation difficult. In addition, SMM has demonstrated high specificity for cancer, compared to various functional and anatomic imaging modalities. However, large field-of-view (FOV) gamma cameras are difficult to position close to the breasts, which decreases spatial resolution and subsequently, the sensitivity of detection for tumors <1 cm. New dedicated detectors featuring small FOV and increased spatial resolution have recently been developed. In this setting, improvement in tumor detection sensitivity, particularly with regard to small cancers is expected. At Division of Nuclear Medicine, Harbor-UCLA Medical Center, we have performed over 2000 SMM within the last 9 years. We have recently used a dedicated breast camera (LumaGEM™) featuring a 12.8×12.8 cm 2 FOV and an array of 2×2×6 mm 3 discrete crystals coupled to a photon-sensitive photomultiplier tube readout. This camera is mounted on a mammography gantry allowing upright imaging, medial positioning and use of breast compression. Preliminary data indicates significant enhancement of spatial resolution by comparison with standard imaging in the first 10 patients. Larger series will be needed to conclude on sensitivity/specificity issues.

  2. Mammography display station and its application in a digital teaching file

    NASA Astrophysics Data System (ADS)

    Cao, Fei; Huang, H. K.; Sickles, Edward A.; Moskowitz, Michael J.

    1997-05-01

    We implemented a high resolution display system for viewing digitized mammograms at real-time speeds. This display system has been utilized at the UCSF to develop a digital breast imaging teaching file. The mammography display station is built on a Sun workstation and Pixar processing hardware. It is capable of real-time 2K image display and manipulation, and serves as a basic platform for our digital mammographic teaching file. The teaching file is designed on a sophisticated computer-aided instruction (CAI) model, which simulates the work-up sequences used in imaging interpretation. Our CAI model not only provides answers to questions, but also allows user's detection of imaging abnormalities by pointing at the image. We also developed a software tool with an easy-to-use interface to manage patient images and related information, and manipulate the large quantity of digital mammograms. The display station is found to be adequate for fast display of high resolution digital mammograms. Our sophisticated CAI model integrates the vast image and textual data with visualization software into an interactive mammographic teaching file. This teaching file can be used as a real teaching tool for training radiology residents in mammography.

  3. Breast Cancer Preoperative Staging: Does Contrast-Enhanced Magnetic Resonance Mammography Modify Surgery?

    PubMed Central

    Perono Biacchiardi, Chiara; Brizzi, Davide; Genta, Franco; Zanon, Eugenio; Camanni, Marco; Deltetto, Francesco

    2011-01-01

    Women with newly diagnosed breast cancer may have lesions undetected by conventional imaging. Recently contrast-enhanced magnetic resonance mammography (CE-MRM) showed higher sensitivity in breast lesions detection. The present analysis was aimed at evaluating the benefit of preoperative CE-MRM in the surgical planning. From 2005 to 2009, 525 consecutive women (25–75 years) with breast cancer, newly diagnosed by mammography, ultrasound, and needle-biopsy, underwent CE-MRM. The median invasive tumour size was 19 mm. In 144 patients, CE-MRM identified additional lesions. After secondlook, 119 patients underwent additional biopsy. CE-MRM altered surgery in 118 patients: 57 received double lumpectomy or wider excision (41 beneficial), 41 required mastectomy (40 beneficial), and 20 underwent contra lateral surgery (18 beneficial). The overall false-positive rate was 27.1% (39/144). CE-MRM contributed significantly to the management of breast cancer, suggesting more extensive disease in 144/525 (27.4%) patients and changing the surgical plan in 118/525 (22.5%) patients (99/525, 18.8% beneficial). PMID:22295233

  4. Evaluation of edge effect due to phase contrast imaging for mammography

    SciTech Connect

    Matsuo, Satoru; Katafuchi, Tetsuro; Tohyama, Keiko; Morishita, Junji; Yamada, Katsuhiko; Fujita, Hiroshi

    2005-08-15

    It is well-known that the edge effect produced by phase contrast imaging results in the edge enhancement of x-ray images and thereby sharpens those images. It has recently been reported that phase contrast imaging using practical x-ray tubes with small focal spots has improved image sharpness as observed in the phase contrast imaging with x-ray from synchrotron radiation or micro-focus x-ray tubes. In this study, we conducted the phase contrast imaging of a plastic fiber and plant seeds using a customized mammography equipment with a 0.1 mm focal spot, and the improvement of image sharpness was evaluated in terms of spatial frequency response of the images. We observed that the image contrast of the plastic fiber was increased by edge enhancement, and, as predicted elsewhere, spectral analysis revealed that as the spatial frequencies of the x-ray images increased, so did the sharpness gained through phase contrast imaging. Thus, phase contrast imaging using a practical molybdenum anode tube with a 0.1 mm-focal spot would benefit mammography, in which the morphological detectability of small species such as micro-calcifications is of great concern. And detectability of tumor-surrounded glandular tissues in dense breast would be also improved by the phase contrast imaging.

  5. Computer-aided detection (CAD) of breast masses in mammography: combined detection and ensemble classification

    NASA Astrophysics Data System (ADS)

    Choi, Jae Young; Kim, Dae Hoe; Plataniotis, Konstantinos N.; Ro, Yong Man

    2014-07-01

    We propose a novel computer-aided detection (CAD) framework of breast masses in mammography. To increase detection sensitivity for various types of mammographic masses, we propose the combined use of different detection algorithms. In particular, we develop a region-of-interest combination mechanism that integrates detection information gained from unsupervised and supervised detection algorithms. Also, to significantly reduce the number of false-positive (FP) detections, the new ensemble classification algorithm is developed. Extensive experiments have been conducted on a benchmark mammogram database. Results show that our combined detection approach can considerably improve the detection sensitivity with a small loss of FP rate, compared to representative detection algorithms previously developed for mammographic CAD systems. The proposed ensemble classification solution also has a dramatic impact on the reduction of FP detections; as much as 70% (from 15 to 4.5 per image) at only cost of 4.6% sensitivity loss (from 90.0% to 85.4%). Moreover, our proposed CAD method performs as well or better (70.7% and 80.0% per 1.5 and 3.5 FPs per image respectively) than the results of mammography CAD algorithms previously reported in the literature.

  6. Computer-aided detection (CAD) of breast masses in mammography: combined detection and ensemble classification.

    PubMed

    Choi, Jae Young; Kim, Dae Hoe; Plataniotis, Konstantinos N; Ro, Yong Man

    2014-07-21

    We propose a novel computer-aided detection (CAD) framework of breast masses in mammography. To increase detection sensitivity for various types of mammographic masses, we propose the combined use of different detection algorithms. In particular, we develop a region-of-interest combination mechanism that integrates detection information gained from unsupervised and supervised detection algorithms. Also, to significantly reduce the number of false-positive (FP) detections, the new ensemble classification algorithm is developed. Extensive experiments have been conducted on a benchmark mammogram database. Results show that our combined detection approach can considerably improve the detection sensitivity with a small loss of FP rate, compared to representative detection algorithms previously developed for mammographic CAD systems. The proposed ensemble classification solution also has a dramatic impact on the reduction of FP detections; as much as 70% (from 15 to 4.5 per image) at only cost of 4.6% sensitivity loss (from 90.0% to 85.4%). Moreover, our proposed CAD method performs as well or better (70.7% and 80.0% per 1.5 and 3.5 FPs per image respectively) than the results of mammography CAD algorithms previously reported in the literature. PMID:24923292

  7. CORRELATION BETWEEN MAMMOGRAPHY DETECTED BREAST ARTERIAL CALCIFICATIONS AND LIFESTYLE RISK FACTORS.

    PubMed

    Kosović, Vilma; Krolo, Ivan; Zadravec, Dijana; Drviš, Petar

    2015-06-01

    The aim of the study was to investigate the association between some lifestyle-attributable risk factors of atherosclerosis, such as body mass index (BMI), oral contraceptives, hormone replacement therapy, smoking and alcohol consumption with breast arterial calcification (BAC) and its intensity on mammograms, and to assess the impact of these lifestyle risk factors on mammography findings of BAC. This prospective study included 300 women aged 47-69, i.e. a group of 149 women with BAC on mammograms and control group of 151 women without BAC. Self-reported BMI, use of oral contraceptives, hormone replacement therapy, smoking and alcohol consumption were recorded by medical interview. The presence of BAC and its intensity on mammography was compared according to the presence of high BMI and use of hormone therapy, smoking and alcohol consumption. The results showed the highest proportion of smokers (28.9%) in the group with mild BAC as compared with the groups without calcification (14.6%) and with intense calcification (12.1%). Women taking oral contraceptives had a higher level of calcified breast arteries but no significant between-group difference was found for high BMI, hormone therapy and alcohol consumption. Thus, study results showed the mammographic finding of BAC to be inadequate to identify women with some lifestyle-attributable risk factors such as BMI, hormone replacement therapy, smoking and alcohol consumption. PMID:26415310

  8. Phylloides tumor: findings on mammography, sonography, and aspiration cytology in 10 cases.

    PubMed

    Buchberger, W; Strasser, K; Heim, K; Müller, E; Schröcksnadel, H

    1991-10-01

    Phylloides tumor is a rare fibroepithelial breast tumor that occasionally has unpredictable clinical behavior. In nine cases of histologically benign tumors and one case of malignant phylloides tumor, the findings on physical examination, mammography, sonography, and aspiration biopsy were correlated retrospectively with the histologic diagnosis of resected specimens. Mammograms showed a round or lobulated benign-appearing opacity in nine cases; one small tumor was missed mammographically. Sonography depicted all tumors as mostly solid masses. Sonographic features included low-level internal echoes, either uniform or scattered; smooth contours; and no significant posterior shadowing. Intramural cysts were shown in six cases. Neither mammography nor sonography allowed reliable differentiation between benign and malignant phylloides tumors. Aspiration biopsy permitted accurate diagnosis of seven benign tumors. The malignant phylloides tumor was classified as a malignant tumor, but the definite differentiation from a carcinoma could not be made. Two histologically benign phylloides tumors were misdiagnosed as carcinomas. Although uncommon, phylloides tumor should be considered in the differential diagnosis of mammographically benign-appearing breast masses, especially if sonography shows intramural cysts within a well-defined solid lesion. Aspiration cytology is unreliable because of the inhomogeneity of the tumor; both intraoperative frozen section and permanent sections are needed for correct histologic diagnosis. PMID:1654022

  9. The Efficacy of Mammography Boot Camp to Improve the Performance of Radiologists

    PubMed Central

    Lee, Eun Hye; Jung, Seung Eun; Kim, You Me; Choi, Nami

    2014-01-01

    Objective To evaluate the efficacy of a mammography boot camp (MBC) to improve radiologists' performance in interpreting mammograms in the National Cancer Screening Program (NCSP) in Korea. Materials and Methods Between January and July of 2013, 141 radiologists were invited to a 3-day educational program composed of lectures and group practice readings using 250 digital mammography cases. The radiologists' performance in interpreting mammograms were evaluated using a pre- and post-camp test set of 25 cases validated prior to the camp by experienced breast radiologists. Factors affecting the radiologists' performance, including age, type of attending institution, and type of test set cases, were analyzed. Results The average scores of the pre- and post-camp tests were 56.0 ± 12.2 and 78.3 ± 9.2, respectively (p < 0.001). The post-camp test scores were higher than the pre-camp test scores for all age groups and all types of attending institutions (p < 0.001). The rate of incorrect answers in the post-camp test decreased compared to the pre-camp test for all suspicious cases, but not for negative cases (p > 0.05). Conclusion The MBC improves radiologists' performance in interpreting mammograms irrespective of age and type of attending institution. Improved interpretation is observed for suspicious cases, but not for negative cases. PMID:25246818

  10. Dose assessment in contrast enhanced digital mammography using simple phantoms simulating standard model breasts

    NASA Astrophysics Data System (ADS)

    Bouwman, R. W.; van Engen, R. E.; Young, K. C.; Veldkamp, W. J. H.; Dance, D. R.

    2015-01-01

    Slabs of polymethyl methacrylate (PMMA) or a combination of PMMA and polyethylene (PE) slabs are used to simulate standard model breasts for the evaluation of the average glandular dose (AGD) in digital mammography (DM) and digital breast tomosynthesis (DBT). These phantoms are optimized for the energy spectra used in DM and DBT, which normally have a lower average energy than used in contrast enhanced digital mammography (CEDM). In this study we have investigated whether these phantoms can be used for the evaluation of AGD with the high energy x-ray spectra used in CEDM. For this purpose the calculated values of the incident air kerma for dosimetry phantoms and standard model breasts were compared in a zero degree projection with the use of an anti scatter grid. It was found that the difference in incident air kerma compared to standard model breasts ranges between -10% to +4% for PMMA slabs and between 6% and 15% for PMMA-PE slabs. The estimated systematic error in the measured AGD for both sets of phantoms were considered to be sufficiently small for the evaluation of AGD in quality control procedures for CEDM. However, the systematic error can be substantial if AGD values from different phantoms are compared.

  11. Broadband Optical Mammography: Chromophore Concentration and Hemoglobin Saturation Contrast in Breast Cancer

    PubMed Central

    Anderson, Pamela G.; Kainerstorfer, Jana M.; Sassaroli, Angelo; Krishnamurthy, Nishanth; Homer, Marc J.; Graham, Roger A.; Fantini, Sergio

    2015-01-01

    This study reports the optical characterization and quantitative oximetry of human breast cancer using spectrally-resolved images collected with a broadband, continuous-wave optical mammography instrument. On twenty-six cancer patients, we collected two-dimensional optical mammograms and created maps of the concentrations of hemoglobin, water, and lipids, as well as the oxygen saturation of hemoglobin. For each cancerous breast, we analyzed the difference between the tumor region (as identified by x-ray and optical mammography) and the remainder of breast tissue. With respect to the surrounding tissue, we found that cancer regions have significantly higher concentrations of total hemoglobin (+2.4±0.4 μM) and water (+7±1% v/v), and significantly lower lipid concentration (8±2% v/v) and oxygen saturation of hemoglobin (5±1%). We also found a significant correlation between the tumor optical contrast and the grade of breast cancer as quantified by the Nottingham histologic score; this demonstrates how optical signatures may be representative of metabolic and morphological features, as well as the aggressive potential of the tumor. PMID:25781469

  12. Eight years of quality control in Bulgaria: impact on mammography practice.

    PubMed

    Avramova-Cholakova, S; Lilkov, G; Kaneva, M; Terziev, K; Nakov, I; Mutkurov, N; Kovacheva, D; Ivanova, M; Vasilev, D

    2015-07-01

    The requirements for quality control (QC) in diagnostic radiology were introduced in Bulgarian legislation in 2005. Hospital medical physicists and several private medical physics groups provide QC services to radiology departments. The aim of this study was to analyse data from QC tests in mammography and to investigate the impact of QC introduction on mammography practice in the country. The study was coordinated by the National Centre of Radiobiology and Radiation Protection. All medical physics services were requested to fill in standardised forms with information about most important parameters routinely measured during QC. All QC service providers responded. Results demonstrated significant improvement of practice since the introduction of QC, with reduction of established deviations from 65 % during the first year to 7 % in the last year. The systems that do not meet the acceptability criteria were suspended from use. Performance of automatic exposure control and digital detectors are not regularly tested because of the absence of requirements in the legislation. The need of updated guidance and training of medical physicists to reflect the change in technology was demonstrated. PMID:25836697

  13. X-ray spectral optimization for mammography applications using signal-to-noise ratio

    NASA Astrophysics Data System (ADS)

    Tucker, Jonathan Ernest

    2000-07-01

    A hypotheses that optimum exposure technique factors for mammography can be computed using uncorrected x-ray spectra measured with an inexpensive semiconductor detector is proven. A parametric model is developed, based upon the minimum signal-to-noise ratio required to perceive an object against background, to predict optimum exposure technique factors. Using published molybdenum- and rhodium-target x-ray spectra, the model predicts that aluminum-filtered molybdenum and rhodium spectra are optimum. The model is subsequently used to predict optimum exposure technique factors using uncorrected x- ray spectra from a GE Senographe DMR mammography unit measured with a cadmium zinc telluride detector and multichannel analyzer. The computed optimum exposure technique factors using uncorrected measured spectra and published spectra are comparable. The model is validated using the uncorrected measured spectra and a phantom containing objects mimicking microcalcifications and fibrous tissue structures. Entrance skin exposure and breast dose for aluminum-filtered spectra are well below those produced using currently popular k-edge filtered spectra. Aluminum-filtered spectra should be considered useful because (1)structures associated with breast cancer can be successfully imaged, and (2)the patient receives a greatly reduced dose.

  14. Configuration of automatic exposure control on mammography units for computed radiography to match patient dose of screen film systems

    NASA Astrophysics Data System (ADS)

    Yang, Chang-Ying Joseph; Huang, Weidong

    2009-02-01

    Computed radiography (CR) is considered a drop-in addition or replacement for traditional screen-film (SF) systems in digital mammography. Unlike other technologies, CR has the advantage of being compatible with existing mammography units. One of the challenges, however, is to properly configure the automatic exposure control (AEC) on existing mammography units for CR use. Unlike analogue systems, the capture and display of digital CR images is decoupled. The function of AEC is changed from ensuring proper and consistent optical density of the captured image on film to balancing image quality with patient dose needed for CR. One of the preferences when acquiring CR images under AEC is to use the same patient dose as SF systems. The challenge is whether the existing AEC design and calibration process-most of them proprietary from the X-ray systems manufacturers and tailored specifically for SF response properties-can be adapted for CR cassettes, in order to compensate for their response and attenuation differences. This paper describes the methods for configuring the AEC of three different mammography units models to match the patient dose used for CR with those that are used for a KODAK MIN-R 2000 SF System. Based on phantom test results, these methods provide the dose level under AEC for the CR systems to match with the dose of SF systems. These methods can be used in clinical environments that require the acquisition of CR images under AEC at the same dose levels as those used for SF systems.

  15. Cone beam CT for determining breast cancer margin: an initial experience and its comparison with mammography and specimen radiograph

    PubMed Central

    Yao, Juan; Shaw, Chris; Lai, CJ; Rong, John; Wang, Jian; Liu, Wenya

    2015-01-01

    Purpose: To assess the ability of cone beam CT (CBCT) in determining the breast cancer margin using, to compare the results with mammography and specimen radiography, and to explore the clinical potential of CBCT for breast imaging. Methods: Specimens of 46 breast cancer patients were imaged by using a prototype CBCT system. Each patient underwent mammography, CBCT and X-ray of breast surgical specimen within 6 months. Images of mammography, breast surgical specimen radiography and CBCT were evaluated by an experienced radiologist. Indicators, such as: morphology, glitch, density, invasion, structural distortion and calcification, were observed. Result: There was no significant difference of the calcification, glitch and morphology among three methods. However, there was significant difference in indicators of breast tumor invasion among three methods. There was statistical significance in detecting invasions of breast cancer cells in peripheral tissues among three methods. Conclusion: CBCT shows no superiority over mammography and specimen radiography in determining tumor’s outline and detecting calcification. On the other hand, CBCT demonstrates its advantage in determining the 3 dimensional position of a lesion which could be a potential clinical application in future practices of breast imaging. PMID:26629005

  16. Stepped-Care, Community Clinic Interventions to Promote Mammography Use among Low-Income Rural African American Women

    ERIC Educational Resources Information Center

    West, Delia Smith; Greene, Paul; Pulley, LeaVonne; Kratt, Polly; Gore, Stacy; Weiss, Heidi; Siegfried, Nicole

    2004-01-01

    Few studies have investigated community clinic-based interventions to promote mammography screening among rural African American women. This study randomized older low-income rural African American women who had not participated in screening in the previous 2 years to a theory-based, personalized letter or usual care; no group differences in…

  17. Using a NPWE model observer to assess suitable image quality for a digital mammography quality assurance programme.

    PubMed

    Monnin, P; Bochud, F O; Verdun, F R

    2010-01-01

    A method of objectively determining imaging performance for a mammography quality assurance programme for digital systems was developed. The method is based on the assessment of the visibility of a spherical microcalcification of 0.2 mm using a quasi-ideal observer model. It requires the assessment of the spatial resolution (modulation transfer function) and the noise power spectra of the systems. The contrast is measured using a 0.2-mm thick Al sheet and Polymethylmethacrylate (PMMA) blocks. The minimal image quality was defined as that giving a target contrast-to-noise ratio (CNR) of 5.4. Several evaluations of this objective method for evaluating image quality in mammography quality assurance programmes have been considered on computed radiography (CR) and digital radiography (DR) mammography systems. The measurement gives a threshold CNR necessary to reach the minimum standard image quality required with regards to the visibility of a 0.2-mm microcalcification. This method may replace the CDMAM image evaluation and simplify the threshold contrast visibility test used in mammography quality. PMID:20395413

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

    SciTech Connect

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

    2008-08-11

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

  19. Optimizing the anode-filter combination in the sense of image quality and average glandular dose in digital mammography

    NASA Astrophysics Data System (ADS)

    Varjonen, Mari; Strömmer, Pekka

    2008-03-01

    This paper presents the optimized image quality and average glandular dose in digital mammography, and provides recommendations concerning anode-filter combinations in digital mammography, which is based on amorphous selenium (a-Se) detector technology. The full field digital mammography (FFDM) system based on a-Se technology, which is also a platform of tomosynthesis prototype, was used in this study. X-ray tube anode-filter combinations, which we studied, were tungsten (W) - rhodium (Rh) and tungsten (W) - silver (Ag). Anatomically adaptable fully automatic exposure control (AAEC) was used. The average glandular doses (AGD) were calculated using a specific program developed by Planmed, which automates the method described by Dance et al. Image quality was evaluated in two different ways: a subjective image quality evaluation, and contrast and noise analysis. By using W-Rh and W-Ag anode-filter combinations can be achieved a significantly lower average glandular dose compared with molybdenum (Mo) - molybdenum (Mo) or Mo-Rh. The average glandular dose reduction was achieved from 25 % to 60 %. In the future, the evaluation will concentrate to study more filter combinations and the effect of higher kV (>35 kV) values, which seems be useful while optimizing the dose in digital mammography.

  20. A conversion method of air kerma from the primary, scatter, and leakage radiations to effective dose for calculating x-ray shielding barriers in mammography

    SciTech Connect

    Kharrati, Hedi

    2005-05-01

    In this study, a new approach has been introduced for derivation of the effective dose from air kerma to calculate shielding requirements in mammography facilities. This new approach has been used to compute the conversion coefficients relating air kerma to the effective dose for the mammography reference beam series of the Netherlands Metrology Institute Van Swinden Laboratorium, National Institute of Standards and Technology, and International Atomic Energy Agency laboratories. The results show that, in all cases, the effective dose in mammography energy range is less than 25% of the incident air kerma for the primary and the scatter radiations and does not exceed 75% for the leakage radiation.

  1. Breast dose in mammography is about 30% lower when realistic heterogeneous glandular distributions are considered

    SciTech Connect

    Hernandez, Andrew M.; Seibert, J. Anthony; Boone, John M.

    2015-11-15

    Purpose: Current dosimetry methods in mammography assume that the breast is comprised of a homogeneous mixture of glandular and adipose tissues. Three-dimensional (3D) dedicated breast CT (bCT) data sets were used previously to assess the complex anatomical structure within the breast, characterizing the statistical distribution of glandular tissue in the breast. The purpose of this work was to investigate the effect of bCT-derived heterogeneous glandular distributions on dosimetry in mammography. Methods: bCT-derived breast diameters, volumes, and 3D fibroglandular distributions were used to design realistic compressed breast models comprised of heterogeneous distributions of glandular tissue. The bCT-derived glandular distributions were fit to biGaussian functions and used as probability density maps to assign the density distributions within compressed breast models. The MCNPX 2.6.0 Monte Carlo code was used to estimate monoenergetic normalized mean glandular dose “DgN(E)” values in mammography geometry. The DgN(E) values were then weighted by typical mammography x-ray spectra to determine polyenergetic DgN (pDgN) coefficients for heterogeneous (pDgN{sub hetero}) and homogeneous (pDgN{sub homo}) cases. The dependence of estimated pDgN values on phantom size, volumetric glandular fraction (VGF), x-ray technique factors, and location of the heterogeneous glandular distributions was investigated. Results: The pDgN{sub hetero} coefficients were on average 35.3% (SD, 4.1) and 24.2% (SD, 3.0) lower than the pDgN{sub homo} coefficients for the Mo–Mo and W–Rh x-ray spectra, respectively, across all phantom sizes and VGFs when the glandular distributions were centered within the breast phantom in the coronal plane. At constant breast size, increasing VGF from 7.3% to 19.1% lead to a reduction in pDgN{sub hetero} relative to pDgN{sub homo} of 23.6%–27.4% for a W–Rh spectrum. Displacement of the glandular distribution, at a distance equal to 10% of the

  2. GPCALMA: implementation in Italian hospitals of a computer aided detection system for breast lesions by mammography examination.

    PubMed

    Lauria, Adele

    2009-06-01

    We describe the implementation in several Italian hospitals of a computer aided detection (CAD) system, named GPCALMA (grid platform for a computer aided library in mammography), for the automatic search of lesions in X-ray mammographies. GPCALMA has been under development since 1999 by a community of physicists of the Italian National Institute for Nuclear Physics (INFN) in collaboration with radiologists. This CAD system was tested as a support to radiologists in reading mammographies. The main system components are: (i) the algorithms implemented for the analysis of digitized mammograms to recognize suspicious lesions, (ii) the database of digitized mammographic images, and (iii) the PC-based digitization and analysis workstation and its user interface. The distributed nature of data and resources and the prevalence of geographically remote users suggested the development of the system as a grid application: the design of this networked version is also reported. The paper describes the system architecture, the database of digitized mammographies, the clinical workstation and the medical applications carried out to characterize the system. A commercial CAD was evaluated in a comparison with GPCALMA by analysing the medical reports obtained with and without the two different CADs on the same dataset of images: with both CAD a statistically significant increase in sensitivity was obtained. The sensitivity in the detection of lesions obtained for microcalcification and masses was 96% and 80%, respectively. An analysis in terms of receiver operating characteristic (ROC) curve was performed for massive lesion searches, achieving an area under the ROC curve of A(z)=0.783+/-0.008. Results show that the GPCALMA CAD is ready to be used in the radiological practice, both for screening mammography and clinical studies. GPCALMA is a starting point for the development of other medical imaging applications such as the CAD for the search of pulmonary nodules, currently under

  3. Screening mammography use among current, former and never hormone therapy users may not explain recent declines in breast cancer incidence

    PubMed Central

    Buist, Diana S.M.; Walker, Rod; Bowles, Erin J. Aiello; Carney, Patricia A.; Taplin, Stephen H.; Onega, Tracy; Kerlikowske, Karla; Clinton, Walter; Miglioretti, Diana L.

    2012-01-01

    Background Screening mammography and invasive breast cancer and ductal carcinoma in situ (DCIS) rates recently declined in the United States; screening mammography declines among former hormone therapy (HT) users may be an important contributor. We longitudinally examined women and compared mammography use and cancer rates by HT use [current, former, and never users of estrogen+progestin (EPT) and estrogen-only (ET)]. Methods We studied 163,490 unique women aged 50–79 years enrolled in Group Health (Washington State) between 1994–2009. Electronic data identified HT dispensing, mammography use and incident breast cancer diagnosis. We calculated age-adjusted screening compliance as a time-varying variable (screened-within-the-past-26 months, yes/no). Results Before 2002, screening compliance differed significantly by HT with current EPT users having the highest rates (83%) followed by former EPT (77%), current ET (77%), former ET (72%) and never users (56%). After 2002, screening was high (~81%) among current and former EPT and ET users and significantly increased among never users (~62%). Invasive breast cancer rates significantly decreased over the whole study period (ptrend≤0.05) for all HT users, except EPT current users (ptrend=0.68); DCIS rates did not change in any group. Conclusions Differential screening mammography rates by HT use do not explain invasive breast cancer incidence declines. Our data suggest discontinuing HT has an immediate effect on breast cancer rates, lending support to the mechanism that cessation leads to tumor regression. Impact Studies examining the influence of a changing exposure in relation to outcomes should account for varying exposures, individuals’ characteristics, as well as screening methods and frequency. PMID:22301831

  4. Multilevel factors associated with long-term adherence to screening mammography in older women in the U.S.

    PubMed

    Hubbard, Rebecca A; O'Meara, Ellen S; Henderson, Louise M; Hill, Deirdre; Braithwaite, Dejana; Haas, Jennifer S; Lee, Christoph I; Sprague, Brian L; Alford-Teaster, Jennifer; Tosteson, Anna N A; Wernli, Karen J; Onega, Tracy

    2016-08-01

    In the U.S., guidelines recommend that women continue mammography screening until at least age 74, but recent evidence suggests declining screening rates in older women. We estimated adherence to screening mammography and multilevel factors associated with adherence in a longitudinal cohort of older women. Women aged 66-75years receiving screening mammography within the Breast Cancer Surveillance Consortium were linked to Medicare claims (2005-2010). Claims data identified baseline adherence, defined as receiving subsequent mammography within approximately 2years, and length of time adherent to guidelines. Characteristics associated with adherence were investigated using logistic and Cox proportional hazards regression models. Analyses were stratified by age to investigate variation in relationships between patient factors and adherence. Among 49,775 women, 89% were adherent at baseline. Among women 66-70years, those with less than a high school education were more likely to be non-adherent at baseline (odds ratio [OR] 1.96; 95% confidence interval [CI] 1.65-2.33) and remain adherent for less time (hazard ratio [HR] 1.41; 95% CI 1.11-1.80) compared to women with a college degree. Women with ≥1 versus no Charlson co-morbidities were more likely to be non-adherent at baseline (OR 1.46; 95% CI 1.31-1.62) and remain adherent for less time (HR 1.44; 95% CI 1.24-1.66). Women aged 71-75 had lower adherence overall, but factors associated with non-adherence were similar. In summary, adherence to guidelines is high among Medicare-enrolled women in the U.S. receiving screening mammography. Efforts are needed to ensure that vulnerable populations attain these same high levels of adherence. PMID:27261409

  5. Investigation of physical image characteristics and phenomenon of edge enhancement by phase contrast using equipment typical for mammography

    SciTech Connect

    Yamazaki, Asumi; Ichikawa, Katsuhiro; Kodera, Yoshie

    2008-11-15

    A technique called phase contrast mammography (PCM) has only recently been applied in clinical examination. In this application, PCM images are acquired at a 1.75x magnification using an x-ray tube for clinical use, and then reduced to the real size of the object by image processing. The images showed enhanced object edges; reportedly, this enhancement occurred because of the refraction of x rays through a cylindrical object. The authors measured the physical image characteristics of PCM to compare the image characteristics of PCM with those of conventional mammography. More specifically, they measured the object-edge-response characteristics and the noise characteristics in the spatial frequency domain. The results revealed that the edge-response characteristics of PCM outperformed those of conventional mammography. In addition, the characteristics changed with the object-placement conditions and the object shapes. The noise characteristics of PCM were better than those of conventional mammography. Subsequently, to verify why object edges were enhanced in PCM images, the authors simulated image profiles that would be obtained if the x rays were refracted and totally reflected by using not only a cylindrical substance but also a planar substance as the object. So, they confirmed that the object edges in PCM images were enhanced because x rays were refracted irrespective of the object shapes. Further, they found that the edge enhancements depended on the object shapes and positions. It was also proposed that the larger magnification than 1.75 in the commercialized system might be more suitable for PCM. Finally, the authors investigated phase-contrast effects to breast tissues by the simulation and demonstrated that PCM would be helpful in the diagnoses of mammography.

  6. Using LROC analysis to evaluate detection accuracy of microcalcification clusters imaged with flat-panel CT mammography

    NASA Astrophysics Data System (ADS)

    Gong, Xing; Glick, Stephen J.; Vedula, Aruna A.

    2004-05-01

    The purpose of this study is to investigate the detectability of microcalcification clusters (MCCs) using CT mammography with a flat-panel detector. Compared with conventional mammography, CT mammography can provide improved discrimination between malignant and benign cases as it can provide the radiologist with more accurate morphological information on MCCs. In this study, two aspects of MCC detection with flat-panel CT mammography were examined: (1) the minimal size of MCCs detectable with mean glandular dose (MGD) used in conventional mammography; (2) the effect of different detector pixel size on the detectability of MCCs. A realistic computer simulation modeling x-ray transport through the breast, as well as both signal and noise propagation through the flat-panel imager, was developed to investigate these questions. Microcalcifications were simulated as calcium carbonate spheres with diameters set at the levels of 125, 150 and 175 μm. Each cluster consisted of 10 spheres spread randomly in a 6×6 mm2 region of interest (ROI) and the detector pixel size was set to 100×100, 200×200, or 300×300μm2. After reconstructing 100 projection sets for each case (half with signal present) with the cone-beam Feldkamp (FDK) algorithm, a localization receiver operating characteristic (LROC) study was conducted to evaluate the detectability of MCCs. Five observers chose the locations of cluster centers with correspondent confidence ratings. The average area under the LROC curve suggested that the 175 μm MCCs can be detected at a high level of confidence. Results also indicate that flat-panel detectors with pixel size of 200×200 μm2 are appropriate for detecting small targets, such as MCCs.

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

    SciTech Connect

    Zhao Bo; Zhao Wei

    2008-05-15

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

  8. Stereotactic mammography imaging combined with 3D US imaging for image guided breast biopsy

    SciTech Connect

    Surry, K. J. M.; Mills, G. R.; Bevan, K.; Downey, D. B.; Fenster, A.

    2007-11-15

    Stereotactic X-ray mammography (SM) and ultrasound (US) guidance are both commonly used for breast biopsy. While SM provides three-dimensional (3D) targeting information and US provides real-time guidance, both have limitations. SM is a long and uncomfortable procedure and the US guided procedure is inherently two dimensional (2D), requiring a skilled physician for both safety and accuracy. The authors developed a 3D US-guided biopsy system to be integrated with, and to supplement SM imaging. Their goal is to be able to biopsy a larger percentage of suspicious masses using US, by clarifying ambiguous structures with SM imaging. Features from SM and US guided biopsy were combined, including breast stabilization, a confined needle trajectory, and dual modality imaging. The 3D US guided biopsy system uses a 7.5 MHz breast probe and is mounted on an upright SM machine for preprocedural imaging. Intraprocedural targeting and guidance was achieved with real-time 2D and near real-time 3D US imaging. Postbiopsy 3D US imaging allowed for confirmation that the needle was penetrating the target. The authors evaluated 3D US-guided biopsy accuracy of their system using test phantoms. To use mammographic imaging information, they registered the SM and 3D US coordinate systems. The 3D positions of targets identified in the SM images were determined with a target localization error (TLE) of 0.49 mm. The z component (x-ray tube to image) of the TLE dominated with a TLE{sub z} of 0.47 mm. The SM system was then registered to 3D US, with a fiducial registration error (FRE) and target registration error (TRE) of 0.82 and 0.92 mm, respectively. Analysis of the FRE and TRE components showed that these errors were dominated by inaccuracies in the z component with a FRE{sub z} of 0.76 mm and a TRE{sub z} of 0.85 mm. A stereotactic mammography and 3D US guided breast biopsy system should include breast compression for stability and safety and dual modality imaging for target localization

  9. Suitability of new anode materials in mammography: Dose and subject contrast considerations using Monte Carlo simulation

    SciTech Connect

    Delis, H.; Spyrou, G.; Costaridou, L.; Tzanakos, G.; Panayiotakis, G.

    2006-11-15

    Mammography is the technique with the highest sensitivity and specificity, for the early detection of nonpalpable lesions associated with breast cancer. As screening mammography refers to asymptomatic women, the task of optimization between the image quality and the radiation dose is critical. A way toward optimization could be the introduction of new anode materials. A method for producing the x-ray spectra of different anode/filter combinations is proposed. The performance of several mammographic spectra, produced by both existing and theoretical anode materials, is evaluated, with respect to their dose and subject contrast characteristics, using a Monte Carlo simulation.The mammographic performance is evaluated utilizing a properly designed mathematical phantom with embedded inhomogeneities, irradiated with different spectra, based on combinations of conventional and new (Ru, Ag) anode materials, with several filters (Mo, Rh, Ru, Ag, Nb, Al). An earlier developed and validated Monte Carlo model, for deriving both image and dose characteristics in mammography, was utilized and overall performance results were derived in terms of subject contrast to dose ratio and squared subject contrast to dose ratio. Results demonstrate that soft spectra, mainly produced from Mo, Rh, and Ru anodes and filtered with k-edge filters, provide increased subject contrast for inhomogeneities of both small size, simulating microcalcifications and low density, simulating masses. The harder spectra (W and Ag anode) come short in the discrimination task but demonstrate improved performance when considering the dose delivered to the breast tissue. As far as the overall performance is concerned, new theoretical spectra demonstrate a noticeable good performance that is similar, and in some cases better compared to commonly used systems, stressing the possibility of introducing new materials in mammographic practice as a possible contribution to its optimization task. In the overall

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

    PubMed Central

    2012-01-01

    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 = < .001). In ordinal regression analysis, OBG specialty was a significant predictor for perceived higher SM effectiveness and recommendations for younger and older women. In evaluating hypothetical scenarios, overall PCPs would recommend SM for the 80 year woman with CHF with a significant variation

  11. Image quality assessment in digital mammography: part I. Technical characterization of the systems.

    PubMed

    Marshall, N W; Monnin, P; Bosmans, H; Bochud, F O; Verdun, F R

    2011-07-21

    In many European countries, image quality for digital x-ray systems used in screening mammography is currently specified using a threshold-detail detectability method. This is a two-part study that proposes an alternative method based on calculated detectability for a model observer: the first part of the work presents a characterization of the systems. Eleven digital mammography systems were included in the study; four computed radiography (CR) systems, and a group of seven digital radiography (DR) detectors, composed of three amorphous selenium-based detectors, three caesium iodide scintillator systems and a silicon wafer-based photon counting system. The technical parameters assessed included the system response curve, detector uniformity error, pre-sampling modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE). Approximate quantum noise limited exposure range was examined using a separation of noise sources based upon standard deviation. Noise separation showed that electronic noise was the dominant noise at low detector air kerma for three systems; the remaining systems showed quantum noise limited behaviour between 12.5 and 380 µGy. Greater variation in detector MTF was found for the DR group compared to the CR systems; MTF at 5 mm(-1) varied from 0.08 to 0.23 for the CR detectors against a range of 0.16-0.64 for the DR units. The needle CR detector had a higher MTF, lower NNPS and higher DQE at 5 mm(-1) than the powder CR phosphors. DQE at 5 mm(-1) ranged from 0.02 to 0.20 for the CR systems, while DQE at 5 mm(-1) for the DR group ranged from 0.04 to 0.41, indicating higher DQE for the DR detectors and needle CR system than for the powder CR phosphor systems. The technical evaluation section of the study showed that the digital mammography systems were well set up and exhibiting typical performance for the detector technology employed in the respective systems. PMID:21701051

  12. Image quality assessment in digital mammography: part I. Technical characterization of the systems

    NASA Astrophysics Data System (ADS)

    Marshall, N. W.; Monnin, P.; Bosmans, H.; Bochud, F. O.; Verdun, F. R.

    2011-07-01

    In many European countries, image quality for digital x-ray systems used in screening mammography is currently specified using a threshold-detail detectability method. This is a two-part study that proposes an alternative method based on calculated detectability for a model observer: the first part of the work presents a characterization of the systems. Eleven digital mammography systems were included in the study; four computed radiography (CR) systems, and a group of seven digital radiography (DR) detectors, composed of three amorphous selenium-based detectors, three caesium iodide scintillator systems and a silicon wafer-based photon counting system. The technical parameters assessed included the system response curve, detector uniformity error, pre-sampling modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE). Approximate quantum noise limited exposure range was examined using a separation of noise sources based upon standard deviation. Noise separation showed that electronic noise was the dominant noise at low detector air kerma for three systems; the remaining systems showed quantum noise limited behaviour between 12.5 and 380 µGy. Greater variation in detector MTF was found for the DR group compared to the CR systems; MTF at 5 mm-1 varied from 0.08 to 0.23 for the CR detectors against a range of 0.16-0.64 for the DR units. The needle CR detector had a higher MTF, lower NNPS and higher DQE at 5 mm-1 than the powder CR phosphors. DQE at 5 mm-1 ranged from 0.02 to 0.20 for the CR systems, while DQE at 5 mm-1 for the DR group ranged from 0.04 to 0.41, indicating higher DQE for the DR detectors and needle CR system than for the powder CR phosphor systems. The technical evaluation section of the study showed that the digital mammography systems were well set up and exhibiting typical performance for the detector technology employed in the respective systems.

  13. Screening Mammography & Breast Cancer Mortality: Meta-Analysis of Quasi-Experimental Studies

    PubMed Central

    Irvin, Veronica L.; Kaplan, Robert M.

    2014-01-01

    Background The magnitude of the benefit associated with screening has been debated. We present a meta-analysis of quasi-experimental studies on the effects of mammography screening. Methods We searched MEDLINE/PubMed and Embase for articles published through January 31, 2013. Studies were included if they reported: 1) a population-wide breast cancer screening program using mammography with 5+ years of data post-implementation; 2) a comparison group with equal access to therapies; and 3) breast cancer mortality. Studies excluded were: RCTs, case-control, or simulation studies. We defined quasi-experimental as studies that compared either geographical, historical or birth cohorts with a screening program to an equivalent cohort without a screening program. Meta-analyses were conducted in Stata using the metan command, random effects. Meta-analyses were conducted separately for ages screened: under 50, 50 to 69 and over 70 and weighted by population and person-years. Results Among 4,903 published papers that were retrieved, 19 studies matched eligibility criteria. Birth cohort studies reported a significant benefit for women screened Mammography screening may have modest effects on cancer mortality between the ages of 50 and 69 and non-significant effects for women older than age 70. Results are consistent with meta-analyses of RCTs. Effects on total mortality

  14. Comparative effectiveness of breast MRI and mammography in screening young women with elevated risk of developing breast cancer: a retrospective cohort study.

    PubMed

    Narayan, Anand K; Visvanathan, Kala; Harvey, Susan C

    2016-08-01

    Screening guidelines recommend that women with 20 % or greater lifetime risk of breast cancer undergo annual breast MRI screening to supplement mammography, irrespective of age. In patients less than 40 years, mammography is often avoided due to concerns about radiation and decreased performance. However, prior studies have been limited by large percentages of women above 40 with decreased breast density. Our purpose was to test whether adding mammography to breast MRI screening compared to breast MRI screening alone in women below 40 increases cancer detection rates. After obtaining IRB approval, chart review identified patients aged 25-40 years undergoing breast MR screening (2005-2014). Demographics, risk factors, BI-RADS assessments, background parenchymal enhancement, and mammographic breast tissue density were recorded. Cancer detection rates, short-term follow-up (BIRADS 3), image-guided biopsy (BIRADS 4,5), and PPV1-3 were calculated. 342 breast MRI exams were identified (average age was 33, 37 % were nulliparous, and 64 % had prior benign biopsy), 226 (66 %) of which underwent concurrent mammography. Risk factors included 64 % with breast cancer in first-degree relative(s), 90 % had heterogeneous or extremely dense breast tissue on mammography, and 16 % were BRCA carriers. Four invasive cancers were detected by MRI (11.7 cancers/1000 examinations, 95 % CI 8.3, 15.1). None of these was detected by mammography, and no cancers were independently identified by mammography. Breast MRI screening in high-risk women under 40 yielded elevated cancer detection rates (11.7/1000). The cancer detection rate for mammography was 0 %, suggesting that MRI alone may be useful in screening high-risk women under 40. PMID:27444927

  15. Increased radiation dose at mammography due to prolonged exposure, delayed processing, and increased film darkening

    SciTech Connect

    Kimme-Smith, C.; Bassett, L.W.; Gold, R.H.; Chow, S. )

    1991-02-01

    Four single-emulsion films introduced over the past 2 years--Du Pont Microvision, Fuji MiMa, Konica CM, and Eastman Kodak OM--were compared with Eastman Kodak OM SO-177 (Min-RE) film to evaluate their varying effects on mean glandular dose of reciprocity law failure due to prolonged exposure, delayed processing, and increased film darkening as a result of increased radiation exposure to improve penetration of glandular tissue. Exposures over 1.3 seconds led to increased radiation doses of 20%-30%. Delays in processing of 6 hours decreased processing speed by 11%-32% for all films except Du Pont Microvision. Optical density increases of 0.40 required 20%-30% more skin exposure for all five films. Optimal viewing densities were also evaluated and found to be different for each of the five films. Mammographers need to be aware of these differences in mammographic films to achieve maximum contrast at mammography.

  16. Randomized trial of DVD, telephone, and usual care for increasing mammography adherence.

    PubMed

    Champion, Victoria L; Rawl, Susan M; Bourff, Sara A; Champion, Kristen M; Smith, Lisa G; Buchanan, Adam H; Fish, Laura J; Monahan, Patrick O; Stump, Timothy E; Springston, Jeffery K; Gathirua-Mwangi, Wambui G; Skinner, Celette Sugg

    2016-06-01

    The purpose of this study was to test an intervention to increase mammography screening in women 51-75 years of age who had not received a mammogram in the last 15 months. A total of 1681 women were randomized to (1) a mailed tailored interactive DVD, (2) a computer-tailored telephone counseling, or (3) usual care. Women with income below US$75,000 who were in the interactive DVD group had significantly more mammograms than women in usual care. Women with income above US$75,000 had significantly fewer mammograms than women with income less than US$75,000 regardless of group. Further investigation is needed to understand why women with income above US$75,000 did not show the same benefit of the intervention. PMID:25070967

  17. Computer-aided diagnosis of digital mammography images using unsupervised clustering and biclustering techniques

    NASA Astrophysics Data System (ADS)

    Al-Olfe, Mohamed A.; Al-Akwaa, Fadhl M.; Mohamed, Wael A.; Kadah, Yasser M.

    2010-03-01

    A new methodology for computer aided diagnosis in digital mammography using unsupervised classification and classdependent feature selection is presented. This technique considers unlabeled data and provides unsupervised classes that give a better insight into classes and their interrelationships, thus improving the overall effectiveness of the diagnosis. This technique is also extended to utilize biclustering methods, which allow for definition of unsupervised clusters of both pathologies and features. This has potential to provide more flexibility, and hence better diagnostic accuracy, than the commonly used feature selection strategies. The developed methods are applied to diagnose digital mammographic images from the Mammographic Image Analysis Society (MIAS) database and the results confirm the potential for improving the current diagnostic rates.

  18. SIMULATING LOCAL DENSE AREAS USING PMMA TO ASSESS AUTOMATIC EXPOSURE CONTROL IN DIGITAL MAMMOGRAPHY.

    PubMed

    Bouwman, R W; Binst, J; Dance, D R; Young, K C; Broeders, M J M; den Heeten, G J; Veldkamp, W J H; Bosmans, H; van Engen, R E

    2016-06-01

    Current digital mammography (DM) X-ray systems are equipped with advanced automatic exposure control (AEC) systems, which determine the exposure factors depending on breast composition. In the supplement of the European guidelines for quality assurance in breast cancer screening and diagnosis, a phantom-based test is included to evaluate the AEC response to local dense areas in terms of signal-to-noise ratio (SNR). This study evaluates the proposed test in terms of SNR and dose for four DM systems. The glandular fraction represented by the local dense area was assessed by analytic calculations. It was found that the proposed test simulates adipose to fully glandular breast compositions in attenuation. The doses associated with the phantoms were found to match well with the patient dose distribution. In conclusion, after some small adaptations, the test is valuable for the assessment of the AEC performance in terms of both SNR and dose. PMID:26977073

  19. Sensitometric analyses of screen-film systems for mammography exams in Brazil

    NASA Astrophysics Data System (ADS)

    Magalhães, L. A. G.; Drexler, G. G.; de Almeida, C. E.; Medeiros, L. L.; Ferreira, N. M. P. D.; Estrada, J. J. S.

    2015-12-01

    A determination of the sensitometric parameters of screen-film systems to evaluate their qualities was performed. The quality control of the automatic film processor was carried out to ensure a high level of efficiency. Based on ISO 9236-3, the following potentials were applied on the X-ray tubes: 25 kV, 28 kV, 30 kV and 35 kV. Four different mammography films from different manufacturers with and without screens were tested for curve shape, speed and average gradient. The results indicated that film 1 exhibited better contrast, film 3 demonstrated the highest energy dependence, and film 4 presented the largest base+fog density. None of the four mammographic films tested achieved satisfactory results in all parameters analyzed. Improvements in the manufacturing process for these films must be completed to avoid losses in the image quality.

  20. Shapelet analysis of pupil dilation for modeling visuo-cognitive behavior in screening mammography

    NASA Astrophysics Data System (ADS)

    Alamudun, Folami; Yoon, Hong-Jun; Hammond, Tracy; Hudson, Kathy; Morin-Ducote, Garnetta; Tourassi, Georgia

    2016-03-01

    Our objective is to improve understanding of visuo-cognitive behavior in screening mammography under clinically equivalent experimental conditions. To this end, we examined pupillometric data, acquired using a head-mounted eye-tracking device, from 10 image readers (three breast-imaging radiologists and seven Radiology residents), and their corresponding diagnostic decisions for 100 screening mammograms. The corpus of mammograms comprised cases of varied pathology and breast parenchymal density. We investigated the relationship between pupillometric fluctuations, experienced by an image reader during mammographic screening, indicative of changes in mental workload, the pathological characteristics of a mammographic case, and the image readers' diagnostic decision and overall task performance. To answer these questions, we extract features from pupillometric data, and additionally applied time series shapelet analysis to extract discriminative patterns in changes in pupil dilation. Our results show that pupillometric measures are adequate predictors of mammographic case pathology, and image readers' diagnostic decision and performance with an average accuracy of 80%.

  1. Analysis of the scatter effect on detective quantum efficiency of digital mammography

    NASA Astrophysics Data System (ADS)

    Park, Jiwoong; Yun, Seungman; Kim, Dong Woon; Baek, Cheol-Ha; Youn, Hanbean; Jeon, Hosang; Kim, Ho Kyung

    2016-03-01

    The scatter effect on detective quantum efficiency (DQE) of digital mammography is investigated using the cascaded-systems model. The cascaded-systems model includes a scatter-reduction device as a binomial selection stage. Quantum-noise-limited operation approximates the system DQE into the multiplication form of the scatter-reduction device DQE and the conventional detector DQE. The developed DQE model is validated in comparisons with the measured results using a CMOS flat-panel detector under scatter environments. For various scatter-reduction devices, the slot-scan method shows the best scatter-cleanup performance in terms of DQE, and the scatter-cleanup performance of the conventional one-dimensional grid is rather worse than the air gap. The developed model can also be applied to general radiography and will be very useful for a better design of imaging chain.

  2. Design and initial performance evaluation of a full field digital mammography upgrade cassette

    PubMed Central

    Nguyen, D; Baysal, MA; Toker, E; Wang, JM

    2008-01-01

    This paper discusses the criteria underlying the design of an innovative X-ray active pixel sensor in CMOS technology. This X-ray detector is used in a Full Field-of-view Digital Mammography (FFDM) camera. The CMOS imager is a three-side buttable 29mm × 119mm, 48 μm active pixel CMOS sensor in 0.18 μm technology. The 1st silicon FFDM devices were fabricated at the end of June, 2007. The device suffers a common failure mode of high current and currently is in failure analysis at Bioptics foundry. Current target for revision A1 tape out is at the end of August, 2007. PMID:18958298

  3. Design and initial performance evaluation of a full field digital mammography upgrade cassette.

    PubMed

    Nguyen, D; Baysal, Ma; Toker, E; Wang, Jm

    2007-09-01

    This paper discusses the criteria underlying the design of an innovative X-ray active pixel sensor in CMOS technology. This X-ray detector is used in a Full Field-of-view Digital Mammography (FFDM) camera. The CMOS imager is a three-side buttable 29mm x 119mm, 48 mum active pixel CMOS sensor in 0.18 mum technology. The 1(st) silicon FFDM devices were fabricated at the end of June, 2007. The device suffers a common failure mode of high current and currently is in failure analysis at Bioptics foundry. Current target for revision A1 tape out is at the end of August, 2007. PMID:18958298

  4. Investigating the visual inspection subjectivity on the contrast-detail evaluation in digital mammography images

    NASA Astrophysics Data System (ADS)

    Sousa, Maria A. Z.; Medeiros, Regina B.; Schiabel, Homero

    2014-03-01

    A major difficulty in the interpretation of mammographic images is the low contrast and, in the case of early detection of breast cancer, the reduced size of the features of malignancy on findings such as microcalcifications. Furthermore, image assessment is subject to significant reliance of the capacity of observation of the expert that will perform it, compromising the final diagnosis accuracy. Thinking about this aspect, this study evaluated the subjectivity of visual inspection to assess the contrast-detail in mammographic images. For this, we compared the human readings of images generated with the CDMAM phantom performed by four observers, enabling to determining a threshold of contrast visibility in each diameter disks present in the phantom. These thresholds were compared graphically and by statistical measures allowing us to build a strategy for use of contrast and detail (dimensions) as parameters of quality in mammography.

  5. The SYRMEP Beamline of Elettra: Clinical Mammography and Bio-medical Applications

    SciTech Connect

    Tromba, G.; Abrami, A.; Casarin, K.; Chenda, V.; Dreossi, D.; Mancini, L.; Menk, R. H.; Quai, E.; Sodini, N.; Vascotto, A.; Longo, R.; Arfelli, F.; Castelli, E.; Astolfo, A.; Bregant, P.; Brun, F.; Hola, M.; Kaiser, J.

    2010-07-23

    At the SYnchrotron Radiation for MEdical Physics (SYRMEP) beamline of Elettra Synchrotron Light Laboratory in Trieste (Italy), an extensive research program in bio-medical imaging has been developed since 1997. The core program carried out by the SYRMEP collaboration concerns the use of Synchrotron Radiation (SR) for clinical mammography with the aim of improving the diagnostic performance of the conventional technique. The first protocol with patients, started in 2006 has been completed at the end of 2009 and the data analysis is now in progress.Regarding applications different from clinical imaging, synchrotron X-ray computed microtomography (micro-CT) is the most used technique, both in absorption and phase contrast. A new software tool, Pore3D, has been developed to perform a quantitative morphological analysis on the reconstructed slices and to access textural information of the sample under study.

  6. Image properties of list mode likelihood reconstruction for a rectangular positron emission mammography with DOI measurements

    SciTech Connect

    Qi, Jinyi; Klein, Gregory J.; Huesman, Ronald H.

    2000-10-01

    A positron emission mammography scanner is under development at our Laboratory. The tomograph has a rectangular geometry consisting of four banks of detector modules. For each detector, the system can measure the depth of interaction information inside the crystal. The rectangular geometry leads to irregular radial and angular sampling and spatially variant sensitivity that are different from conventional PET systems. Therefore, it is of importance to study the image properties of the reconstructions. We adapted the theoretical analysis that we had developed for conventional PET systems to the list mode likelihood reconstruction for this tomograph. The local impulse response and covariance of the reconstruction can be easily computed using FFT. These theoretical results are also used with computer observer models to compute the signal-to-noise ratio for lesion detection. The analysis reveals the spatially variant resolution and noise properties of the list mode likelihood reconstruction. The theoretical predictions are in good agreement with Monte Carlo results.

  7. First organized screening mammography programme in Saudi Arabia: preliminary analysis of pilot round.

    PubMed

    Akhtar, S S; Nadrah, H M; Al-Habdan, M A; El Gabbani, S A; El Farouk, G M K; Abdelgadir, M H; Al-Saigul, A M

    2010-10-01

    The aim of this study was to analyse results of the pilot screening round for Al-Qassim Screening Mammography Programme and compare with international standards. Analysis was conducted in the central screening office in Prince Faisal Oncology Centre, which coordinates activities of various screening units. Data were collected during the period 1 January 2007 to 30 June 2008. Organizational and functional information was obtained from policy and procedure manuals of the programme. Out of 9812 eligible women, 1766 (18%) participated and data were available for 1628 (16.6%). The median age of participants was 47 (standard deviation 8.12) years. The low uptake rate (18%) and a high recall rate (31.6%) characterized the pilot screening round. Biopsy rate was 1.5% and cancer detection rate was 0.24%. Many performance indicators in this pilot screening round were not available. Many of the available indicators did not meet international standards. PMID:21222417

  8. Contrast-enhanced spectral mammography with a photon-counting detector

    SciTech Connect

    Fredenberg, Erik; Hemmendorff, Magnus; Cederstroem, Bjoern; Aaslund, Magnus; Danielsson, Mats

    2010-05-15

    Purpose: Spectral imaging is a method in medical x-ray imaging to extract information about the object constituents by the material-specific energy dependence of x-ray attenuation. The authors have investigated a photon-counting spectral imaging system with two energy bins for contrast-enhanced mammography. System optimization and the potential benefit compared to conventional non-energy-resolved absorption imaging was studied. Methods: A framework for system characterization was set up that included quantum and anatomical noise and a theoretical model of the system was benchmarked to phantom measurements. Results: Optimal combination of the energy-resolved images corresponded approximately to minimization of the anatomical noise, which is commonly referred to as energy subtraction. In that case, an ideal-observer detectability index could be improved close to 50% compared to absorption imaging in the phantom study. Optimization with respect to the signal-to-quantum-noise ratio, commonly referred to as energy weighting, yielded only a minute improvement. In a simulation of a clinically more realistic case, spectral imaging was predicted to perform approximately 30% better than absorption imaging for an average glandularity breast with an average level of anatomical noise. For dense breast tissue and a high level of anatomical noise, however, a rise in detectability by a factor of 6 was predicted. Another {approx}70%-90% improvement was found to be within reach for an optimized system. Conclusions: Contrast-enhanced spectral mammography is feasible and beneficial with the current system, and there is room for additional improvements. Inclusion of anatomical noise is essential for optimizing spectral imaging systems.

  9. Balancing harms and benefits of service mammography screening programs: a cohort study

    PubMed Central

    2012-01-01

    Introduction The use of screening mammography is still under debate within the medical community. The aim of this study is to define a balance sheet of benefits (breast cancer mortality reduction) and harms (overdiagnosis) for mammography screening programs. Methods We compared breast cancer incidence and mortality in two cohorts of women, defined as 'attenders' or 'non-attenders' on the basis of the individual attitudes towards screening, who were invited to the first round of the Florentine screening program. The effects of screening exposure on breast cancer incidence and mortality were evaluated by fitting Poisson regression models adjusted for age at entry, marital status and deprivation index. We performed a sensitivity analysis excluding 34 women not responding to the invitation with a breast cancer diagnosis in the following six months. Results In total, we included 51,096 women aged 50 to 69 years invited at the first screening round (1991 to 1993) and followed-up for breast cancer incidence and mortality until 31 December 2007 and 31 December 2008, respectively The estimate of mortality reduction varies from 45% among 50 to 59 year-old women up to 51% among 60 to 69 year-old women. The estimate of overdiagnosis, according to the cumulative-incidence method, is an additional 10% of all breast cancer cases among 60 to 69 year-old women screened. Conclusions Comparing the breast cancer mortality and breast cancer incidence between attenders and non-attenders, we have determined that the overall cost to save one life corresponds to no more than one over-diagnosed tumor (from 0.6 to 1 depending on the selection criteria of the cohort), even if a residual self-selection bias cannot be excluded. PMID:22230345

  10. Measurement of breast-tissue x-ray attenuation by spectral mammography: solid lesions.

    PubMed

    Fredenberg, Erik; Kilburn-Toppin, Fleur; Willsher, Paula; Moa, Elin; Danielsson, Mats; Dance, David R; Young, Kenneth C; Wallis, Matthew G

    2016-04-01

    Knowledge of x-ray attenuation is essential for developing and evaluating x-ray imaging technologies. For instance, techniques to distinguish between cysts and solid tumours at mammography screening would be highly desirable to reduce recalls, but the development requires knowledge of the x-ray attenuation for cysts and tumours. We have previously measured the attenuation of cyst fluid using photon-counting spectral mammography. Data on x-ray attenuation for solid breast lesions are available in the literature, but cover a relatively wide range, likely caused by natural spread between samples, random measurement errors, and different experimental conditions. In this study, we have adapted a previously developed spectral method to measure the linear attenuation of solid breast lesions. A total of 56 malignant and 5 benign lesions were included in the study. The samples were placed in a holder that allowed for thickness measurement. Spectral (energy-resolved) images of the samples were acquired and the image signal was mapped to equivalent thicknesses of two known reference materials, which can be used to derive the x-ray attenuation as a function of energy. The spread in equivalent material thicknesses was relatively large between samples, which is likely to be caused mainly by natural variation and only to a minor extent by random measurement errors and sample inhomogeneity. No significant difference in attenuation was found between benign and malignant solid lesions. The separation between cyst-fluid and tumour attenuation was, however, significant, which suggests it may be possible to distinguish cystic from solid breast lesions, and the results lay the groundwork for a clinical trial. In addition, the study adds a relatively large sample set to the published data and may contribute to a reduction in the overall uncertainty in the literature. PMID:26961507

  11. Experience in reading digital images may decrease observer accuracy in mammography

    NASA Astrophysics Data System (ADS)

    Rawashdeh, Mohammad A.; Lewis, Sarah J.; Lee, Warwick; Mello-Thoms, Claudia; Reed, Warren M.; McEntee, Mark; Tapia, Kriscia; Brennan, Patrick C.

    2015-03-01

    Rationale and Objectives: To identify parameters linked to higher levels of performance in screening mammography. In particular we explored whether experience in reading digital cases enhances radiologists' performance. Methods: A total of 60 cases were presented to the readers, of which 20 contained cancers and 40 showed no abnormality. Each case comprised of four images and 129 breast readers participated in the study. Each reader was asked to identify and locate any malignancies using a 1-5 confidence scale. All images were displayed using 5MP monitors, supported by radiology workstations with full image manipulation capabilities. A jack-knife free-response receiver operating characteristic, figure of merit (JAFROC, FOM) methodology was employed to assess reader performance. Details were obtained from each reader regarding their experience, qualifications and breast reading activities. Spearman and Mann Whitney U techniques were used for statistical analysis. Results: Higher performance was positively related to numbers of years professionally qualified (r= 0.18; P<0.05), number of years reading breast images (r= 0.24; P<0.01), number of mammography images read per year (r= 0.28; P<0.001) and number of hours reading mammographic images per week (r= 0.19; P<0.04). Unexpectedly, higher performance was inversely linked to previous experience with digital images (r= - 0.17; p<0.05) and further analysis, demonstrated that this finding was due to changes in specificity. Conclusion: This study suggests suggestion that readers with experience in digital images reporting may exhibit a reduced ability to correctly identify normal appearances requires further investigation. Higher performance is linked to number of cases read per year.

  12. B3-lesions of the breast and cancer risk - an analysis of mammography screening patients

    PubMed Central

    HOFFMANN, OLIVER; STAMATIS, GESINA ATHINA; BITTNER, ANN-KATHRIN; ARNOLD, GEORG; SCHNABEL, ROLF; KRÜGER, KARLGEORG; KIMMIG, RAINER; HEUBNER, MARTIN

    2016-01-01

    The use of mammography screening, followed by needle core biopsy (NCB), is associated with an increasing amount of invasive procedures. A considerable amount of specimens must be classified as lesions with uncertain malignant potential (B3-lesion). In these cases, an open biopsy is indicated for further diagnosis. We evaluated patients with B3-lesions to determine the risk of malignancy corresponding to the histopathological NCB results and the type of radiological lesion identified. A total of 95 patients participating in the German mammography screening program with a B3-lesion following NCB (104 B3-lesions in total) were included in our analysis. We analyzed the correlation between the initial histopathological findings from the NCB specimen and cancer risk. We further analyzed the correlations of malignant results with the type of mammographic lesion. In 23 cases (22%), histopathological examination following excision revealed a malignant lesion, including invasive and in situ carcinoma. The positive predictive value of the subgroups of B3-lesions ranged between 0.11 and 0.31; the B3-lesion associated with the highest cancer risk was the atypical ductal hyperplasia; however, no significant difference was observed between the B3-lesion subgroups (P=0.309) regarding the risk of malignancy. Comparing the different types of mammographic findings, such as radiological mass or microcalcifications, there was no significant difference in the risk for malignancy (P=0.379). The different types of B3-lesions did not exhibit differences in the risk for malignancy, and the morphological type of mammographic lesion does not appear to be correlated with cancer risk; therefore, our results underline the need for open biopsy in patients with B3-lesions following NCB. PMID:27123266

  13. Performance of Screening Mammography: A Report of the Alliance for Breast Cancer Screening in Korea

    PubMed Central

    Lee, Eun Hye; Kim, Keum Won; Kim, Young Joong; Shin, Dong-Rock; Park, Young Mi; Lim, Hyo Soon; Park, Jeong Seon; Kim, Hye-Won; Kim, You Me; Kim, Hye Jung

    2016-01-01

    Objective To analyze the diagnostic accuracy and trend in screening mammography in Korea. Materials and Methods We retrospectively linked the information from hospitals participating in the Alliance of Breast Cancer Screening in Korea (ABCS-K) and the database of the National Cancer Screening Program. We calculated performance indicators, including the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false-positive rate (FPR), and interval cancer rate (ICR). Changes in the performance indicators were calculated as the annual percent change with 95% confidence interval (CI). Results We enrolled 128756 cases from 10 hospitals from 2005 to 2010. The recall rate was 19.1% with a downward trend over time (-12.1% per year; 95% CI, -15.9 to -8.2). The CDR was 2.69 per 1000 examinations, without a significant trend. The PPV was 1.4% with an upward trend (20.8% per year; 95% CI, 15.2 to 26.7). The sensitivity was 86.5% without a significant trend, whereas the specificity was 81.1% with an upward trend (3.3% per year; 95% CI, 2.1 to 4.5). The FPR was 18.9% with a downward trend (-12.4% per year; 95% CI, -16.2 to -8.4). The ICR was 0.5 per 1000 negative examinations without a significant trend. There were institutional variations in the diagnostic accuracy and trend except for the CDR, sensitivity, and ICR. Conclusion The sensitivity and CDR of screening mammography in the ABCS-K from 2005 to 2010 were compatible with those for Western women. The recall rate, PPV and specificity, however, were suboptimal, although they showed significant improvements over this period. A further analysis is required to explain institutional variations. PMID:27390540

  14. Trends in Mammography Over Time for Women With and Without Chronic Disability

    PubMed Central

    Kurtz, Stephen G.; Rao, Sowmya R.

    2015-01-01

    Abstract Background: Women with disabilities often receive mammograms at lower rates than do nondisabled women, although this disparity varies by disability type and severity. Given the implementation of disability civil rights laws in the early 1990s, we examined whether disability disparities in mammogram use have diminished over time. Methods: We analyzed National Health Interview Survey responses of civilian, noninstitutionalized United States female residents 50 to 74 years old from selected years between 1998 and 2010. We identified seven chronic disability types using self-reported functional impairments, activity/participation limitations, and expected duration. We conducted bivariable and multivariable logistic regression analyses examining associations of self-reported mammogram use within the previous two years with sociodemographic factors and disability. Results: Most chronic disability rates rose over time. The most common disability was movement difficulties, with rates increasing from 35.6% (1998) to 39.8% (2010). Mammogram rates for all women remained relatively stable over time, ranging from 72% to 75%. Bivariable analyses generally found statistically significantly lower mammogram rates for women with disability versus nondisabled women. Over time, disparities grew significantly between women with any basic action difficulty or complex activity limitation and nondisabled women (p<0.01). In multivariable logistic analyses, having any difficulty with basic actions was significantly associated with lower adjusted odds of mammography; for example, adjusted odds [95% confidence interval]=0.5 [0.3–0.8], p=0.006, in the model involving movement disability. Conclusions: Little has changed since 1998 in mammogram rates for women with versus without disabilities. Women with certain disabilities continue to experience disparities in mammography testing. PMID:26083235

  15. Comparison of model and human observer performance in FFDM, DBT, and synthetic mammography

    NASA Astrophysics Data System (ADS)

    Ikejimba, Lynda; Glick, Stephen J.; Samei, Ehsan; Lo, Joseph Y.

    2016-03-01

    Reader studies are important in assessing breast imaging systems. The purpose of this work was to assess task-based performance of full field digital mammography (FFDM), digital breast tomosynthesis (DBT), and synthetic mammography (SM) using different phantom types, and to determine an accurate observer model for human readers. Images were acquired on a Hologic Selenia Dimensions system with a uniform and anthropomorphic phantom. A contrast detail insert of small, low-contrast disks was created using an inkjet printer with iodine-doped ink and inserted in the phantoms. The disks varied in diameter from 210 to 630 μm, and in contrast from 1.1% contrast to 2.2% in regular increments. Human and model observers performed a 4-alternative forced choice experiment. The models were a non-prewhitening matched filter with eye model (NPWE) and a channelized Hotelling observer with either Gabor channels (Gabor-CHO) or Laguerre-Gauss channels (LG-CHO). With the given phantoms, reader scores were higher in FFDM and DBT than SM. The structure in the phantom background had a bigger impact on outcome for DBT than for FFDM or SM. All three model observers showed good correlation with humans in the uniform background, with ρ between 0.89 and 0.93. However, in the structured background, only the CHOs had high correlation, with ρ=0.92 for Gabor-CHO, 0.90 for LG-CHO, and 0.77 for NPWE. Because results of any analysis can depend on the phantom structure, conclusions of modality performance may need to be taken in the context of an appropriate model observer and a realistic phantom.

  16. TU-A-18C-01: ACR Accreditation Updates in CT, Ultrasound, Mammography and MRI

    SciTech Connect

    Price, R; Berns, E; Hangiandreou, N; McNitt-Gray, M

    2014-06-15

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, the ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, mammography, ultrasound, and computed tomography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program. To understand the new requirements of the ACR ultrasound accreditation program, and roles the physicist can play in annual equipment surveys and setting up and supervising the routine QC program. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process.

  17. Physical characterization of a high-resolution CCD detector for mammography.

    PubMed

    Elbakri, I A; Tesic, M M; Xiong, Quanren

    2007-04-21

    The physical characteristics of charge-coupled device (CCD) mammography detector with 16-bit dynamic range and 27 microm detector element size were investigated. The detector, with an active area of 1 cm x 20 cm is suitable for slot-scanning systems. We evaluated the detector resolution by measuring the modulation transfer function (MTF) using a tilted edge. We also measured the noise power spectra (NPS) and detective quantum efficiency (DQE) using tungsten spectra filtered with 3 mm Al. We carried out measurements in two modes of operation: the frame mode where the detector is stationary and the scan mode where the detector operates in a slot-scanning configuration. The specific beam qualities and exposure ranges employed were 30 kVp, HVL 1.4 mm Al, 1.24 microC kg(-1) to 12.44 microC kg(-1), and 40 kVp, HVL 2.1 mm Al and 3.26 microC kg(-1) to 16.64 microC kg(-1). The product of the normalized noise power spectrum and exposure was also computed to evaluate the quantum limited characteristic of the detector. The detector MTF was 12% at 15 lp mm(-1). The product of the noise power spectra and exposure was independent of exposure level, indicating a quantum limited detector. The DQE in the scan and frame modes near zero frequency was 40% and 60%, respectively. Our results show that the slot-scanning configuration was less efficient than the performance capabilities of the detector. This detector is comparable to other digital mammography sensors evaluated in the literature. PMID:17404462

  18. Evaluation of the potential in radiation dose reduction for full-field digital mammography

    NASA Astrophysics Data System (ADS)

    Kasch, Kay-Uwe; Moftah, Belal A.

    2008-01-01

    This study evaluates the image quality for different radiation doses in full-field digital mammography (FFDM). The potential of dose reductions is evaluated for both, the transition from screen-film mammography (SFM) to FFDM as well as within FFDM due to the optimization of exposure parameters. Exposures of a 4.5 cm breast phantom rendering different contrasts as well as bar patterns were made using a FFDM system (GE Senographe 2000D). For different kVp and mAs settings as well as different target/filter combinations chosen for the above exposures, average glandular dose (AGD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and modulation transfer function (MTF) were determined. To benchmark the results, relative change of AGD was evaluated against SNR, CNR and MTF. Eventually, the results were normalized to AGD's rendered by settings typically used in today's clinical routine. For standard settings (automatic mode), both FFDM and SFM deliver approximately the same AGD of about 2.2 mGy. From that, AGD reduction can be substantial in FFDM if only SNR and high contrast CNR are considered. In this case, reduction of up to 40% can be achieved in a wide kVp range if switching from the standard target/filter combination Mo/Rh to Rh/Rh. However, if low contrast CNR is to remain unchanged, dose reduction is practically impossible. The change of peak voltage and target/filter material had no influence on MTF. Assuming current CNR requirements as standards, significant dose reduction in FFDM cannot be achieved. Only by compromising low contrast CNR levels AGD of up to 40% can be saved at current standards of SNR and high contrast CNR.

  19. Dose dependence of mass and microcalcification detection in digital mammography: Free response human observer studies

    SciTech Connect

    Ruschin, Mark; Timberg, Pontus; Ba ring th, Magnus; Hemdal, Bengt; Svahn, Tony; Saunders, Rob S.; Samei, Ehsan; Andersson, Ingvar; Mattsson, Soeren; Chakraborty, Dev P.; Tingberg, Anders

    2007-02-15

    The purpose of this study was to evaluate the effect of dose reduction in digital mammography on the detection of two lesion types--malignant masses and clusters of microcalcifications. Two free-response observer studies were performed--one for each lesion type. Ninety screening images were retrospectively selected; each image was originally acquired under automatic exposure conditions, corresponding to an average glandular dose of 1.3 mGy for a standard breast (50 mm compressed breast thickness with 50% glandularity). For each study, one to three simulated lesions were added to each of 40 images (abnormals) while 50 were kept without lesions (normals). Two levels of simulated system noise were added to the images yielding two new image sets, corresponding to simulated dose levels of 50% and 30% of the original images (100%). The manufacturer's standard display processing was subsequently applied to all images. Four radiologists experienced in mammography evaluated the images by searching for lesions and marking and assigning confidence levels to suspicious regions. The search data were analyzed using jackknife free-response (JAFROC) methodology. For the detection of masses, the mean figure-of-merit (FOM) averaged over all readers was 0.74, 0.71, and 0.68 corresponding to dose levels of 100%, 50%, and 30%, respectively. These values were not statistically different from each other (F=1.67, p=0.19) but showed a decreasing trend. In contrast, in the microcalcification study the mean FOM was 0.93, 0.67, and 0.38 for the same dose levels and these values were all significantly different from each other (F=109.84, p<0.0001). The results indicate that lowering the present dose level by a factor of two compromised the detection of microcalcifications but had a weaker effect on mass detection.

  20. miRNAs as potential biomarkers in early breast cancer detection following mammography.

    PubMed

    Fu, Sidney W; Lee, Woojin; Coffey, Caitrin; Lean, Alexa; Wu, Xiaoling; Tan, Xiaohui; Man, Yan-Gao; Brem, Rachel F

    2016-01-01

    Breast cancer is the most common cancer among American women, except for skin cancers. About 12 % women in the United States will develop invasive breast cancer during their lifetime. Currently one of the most accepted model/theories is that ductal breast cancer (most common type of breast cancer) follows a linear progression: from normal breast epithelial cells to ductal hyperplasia to atypical ductal hyperplasia (ADH) to ductal carcinoma in situ (DCIS), and finally to invasive ductal carcinoma (IDC). Distinguishing pure ADH diagnosis from DCIS and/or IDC on mammography, and even combined with follow-up core needle biopsy (CNB) is still a challenge. Therefore subsequent surgical excision cannot be avoided to make a definitive diagnosis. MicroRNAs (miRNAs) are a highly abundant class of endogenous non-coding RNAs, which contribute to cancer initiation and progression, and are differentially expressed between normal and cancer tissues. They can function as either tumor suppressors or oncogenes. With accumulating evidence of the role of miRNAs in breast cancer progression, including our own studies, we sought to summarize the nature of early breast lesions and the potential use of miRNA molecules as biomarkers in early breast cancer detection. In particular, miRNA biomarkers may potentially serve as a companion tool following mammography screening and CNB. In the long-term, a better understanding of the molecular mechanisms underlying the miRNA signatures associated with breast cancer development could potentially result in the development of novel strategies for disease prevention and therapy. PMID:26819702

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

    NASA Astrophysics Data System (ADS)

    Baysal, Mehmet A.; Toker, Emre

    2006-03-01

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

  2. Measurement of breast-tissue x-ray attenuation by spectral mammography: solid lesions

    NASA Astrophysics Data System (ADS)

    Fredenberg, Erik; Kilburn-Toppin, Fleur; Willsher, Paula; Moa, Elin; Danielsson, Mats; Dance, David R.; Young, Kenneth C.; Wallis, Matthew G.

    2016-04-01

    Knowledge of x-ray attenuation is essential for developing and evaluating x-ray imaging technologies. For instance, techniques to distinguish between cysts and solid tumours at mammography screening would be highly desirable to reduce recalls, but the development requires knowledge of the x-ray attenuation for cysts and tumours. We have previously measured the attenuation of cyst fluid using photon-counting spectral mammography. Data on x-ray attenuation for solid breast lesions are available in the literature, but cover a relatively wide range, likely caused by natural spread between samples, random measurement errors, and different experimental conditions. In this study, we have adapted a previously developed spectral method to measure the linear attenuation of solid breast lesions. A total of 56 malignant and 5 benign lesions were included in the study. The samples were placed in a holder that allowed for thickness measurement. Spectral (energy-resolved) images of the samples were acquired and the image signal was mapped to equivalent thicknesses of two known reference materials, which can be used to derive the x-ray attenuation as a function of energy. The spread in equivalent material thicknesses was relatively large between samples, which is likely to be caused mainly by natural variation and only to a minor extent by random measurement errors and sample inhomogeneity. No significant difference in attenuation was found between benign and malignant solid lesions. The separation between cyst-fluid and tumour attenuation was, however, significant, which suggests it may be possible to distinguish cystic from solid breast lesions, and the results lay the groundwork for a clinical trial. In addition, the study adds a relatively large sample set to the published data and may contribute to a reduction in the overall uncertainty in the literature.

  3. Comparison of the polynomial model against explicit measurements of noise components for different mammography systems

    NASA Astrophysics Data System (ADS)

    Monnin, P.; Bosmans, H.; Verdun, F. R.; Marshall, N. W.

    2014-10-01

    Given the adverse impact of image noise on the perception of important clinical details in digital mammography, routine quality control measurements should include an evaluation of noise. The European Guidelines, for example, employ a second-order polynomial fit of pixel variance as a function of detector air kerma (DAK) to decompose noise into quantum, electronic and fixed pattern (FP) components and assess the DAK range where quantum noise dominates. This work examines the robustness of the polynomial method against an explicit noise decomposition method. The two methods were applied to variance and noise power spectrum (NPS) data from six digital mammography units. Twenty homogeneously exposed images were acquired with PMMA blocks for target DAKs ranging from 6.25 to 1600 µGy. Both methods were explored for the effects of data weighting and squared fit coefficients during the curve fitting, the influence of the additional filter material (2 mm Al versus 40 mm PMMA) and noise de-trending. Finally, spatial stationarity of noise was assessed. Data weighting improved noise model fitting over large DAK ranges, especially at low detector exposures. The polynomial and explicit decompositions generally agreed for quantum and electronic noise but FP noise fraction was consistently underestimated by the polynomial method. Noise decomposition as a function of position in the image showed limited noise stationarity, especially for FP noise; thus the position of the region of interest (ROI) used for noise decomposition may influence fractional noise composition. The ROI area and position used in the Guidelines offer an acceptable estimation of noise components. While there are limitations to the polynomial model, when used with care and with appropriate data weighting, the method offers a simple and robust means of examining the detector noise components as a function of detector exposure.

  4. Predicting diagnostic error in Radiology via eye-tracking and image analytics: Application in mammography

    SciTech Connect

    Voisin, Sophie; Pinto, Frank M; Morin-Ducote, Garnetta; Hudson, Kathy; Tourassi, Georgia

    2013-01-01

    Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels. Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from 4 Radiology residents and 2 breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADs images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated. Results: Diagnostic error can be predicted reliably by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model (AUC=0.79). Personalized user modeling was far more accurate for the more experienced readers (average AUC of 0.837 0.029) than for the less experienced ones (average AUC of 0.667 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features. Conclusions: Diagnostic errors in mammography can be predicted reliably by leveraging the radiologists gaze behavior and image content.

  5. Creating a semantic lesion database for computer-aided MR mammography

    NASA Astrophysics Data System (ADS)

    Wang, Xiaogang; Martel, Anne

    2012-02-01

    This work presents the creation of a semantic lesion database which will support research into computer-aided lesion detection (CAD) in breast screening MRI. As an adjunct to conventional X-ray mammography, MR-mammography has become a popular screening tool for women with a high risk of breast cancer because of its high sensitivity in detecting malignancy. To address the needs of research and development into CAD for breast MRI an integrated tool has been designed to collect all lesion related information, conduct quantitative analysis, and then present crucial data to clinicians and researchers. A lesion database is an essential component of this system as it provides a link between the DICOM database of MR images and the meta-information contained in the Electronic Patient Record. The patient history, radiology reports from MRI screening visits and pathology reports are all collected, dissected, and stored in a hierarchical structure in the database. Moreover, internal links between pathology specimens and the location of the corresponding lesion in the image are established allowing diagnostic information to be displayed alongside the relevant images. If "ground truth" for an imaging visit can be established either by biopsy or by 2-year follow-up, then the case is labeled as suitable for use in training and testing CAD algorithms. At present a total of 1882 lesions (benign/malignant), 200 pathology specimens over 405 subjects and 1794 screening (455 CAD studies) are included in the database. As well as providing an excellent resource for CAD development this also has potential applications in resident radiologists' training and education.

  6. Comparison of Soft-copy and Hard-copy Reading for Full-Field Digital Mammography

    PubMed Central

    Nishikawa, Robert M.; Acharyya, Suddhasatta; Gatsonis, Constantine; Pisano, Etta D.; Cole, Elodia B.; Marques, Helga S.; D'Orsi, Carl J.; Farria, Dione M.; Kanal, Kalpana M.; Mahoney, Mary C.; Rebner, Murray; Staiger, Melinda J.

    2009-01-01

    Purpose: To compare radiologists' performance in detecting breast cancer when reading full-field digital mammographic (FFDM) images either displayed on monitors or printed on film. Materials and Methods: This study received investigational review board approval and was HIPAA compliant, with waiver of informed consent. A reader study was conducted in which 26 radiologists read screening FFDM images displayed on high-resolution monitors (soft-copy digital) and printed on film (hard-copy digital). Three hundred thirty-three cases were selected from the Digital Mammography Image Screening Trial screening study (n = 49 528). Of these, 117 were from patients who received a diagnosis of breast cancer within 15 months of undergoing screening mammography. The digital mammograms were displayed on mammographic workstations and printed on film according to the manufacturer's specifications. Readers read both hard-copy and soft-copy images 6 weeks apart. Each radiologist read a subset of the total images. Twenty-two readers were assigned to evaluate images from one of three FFDM systems, and four readers were assigned to evaluate images from two mammographic systems. Each radiologist assigned a malignancy score on the basis of overall impression by using a seven-point scale, where 1 = definitely not malignant and 7 = definitely malignant. Results: There were no significant differences in the areas under the receiver operating characteristic curves (AUCs) for the primary comparison. The AUCs for soft-copy and hard-copy were 0.75 and 0.76, respectively (95% confidence interval: −0.04, 0.01; P = .36). Secondary analyses showed no significant differences in AUCs on the basis of manufacturer type, lesion type, or breast density. Conclusion: Soft-copy reading does not provide an advantage in the interpretation of digital mammograms. However, the display formats were not optimized and display software remains an evolving process, particularly for soft-copy reading. © RSNA, 2009

  7. Predicting diagnostic error in radiology via eye-tracking and image analytics: Preliminary investigation in mammography

    SciTech Connect

    Voisin, Sophie; Tourassi, Georgia D.; Pinto, Frank; Morin-Ducote, Garnetta; Hudson, Kathleen B.

    2013-10-15

    Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists’ gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels.Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from four Radiology residents and two breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADS images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated.Results: Machine learning can be used to predict diagnostic error by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model [area under the ROC curve (AUC) = 0.792 ± 0.030]. Personalized user modeling was far more accurate for the more experienced readers (AUC = 0.837 ± 0.029) than for the less experienced ones (AUC = 0.667 ± 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features.Conclusions: Diagnostic errors in mammography can be predicted to a good extent by leveraging the radiologists’ gaze behavior and image content.

  8. Ultrasound mammography

    NASA Astrophysics Data System (ADS)

    Mensah, Serge; Franceschini, Emilie; Pauzin, Marie-Christine

    2007-02-01

    We introduce a near-field formulation of the acoustic field scattered by a soft tissue organ. This derivation is based on the Huygens-Fresnel principle that describes the scattered field as the result of the interferential scheme of all the secondary spherical waves. This leads us to define a new Fourier transform which yields a spectrum whose harmonic components have an elliptical spatial support. Based on these projections, we define an Elliptical Radon transform that enables us to reconstruct either the impedance or the celerity maps of an acoustical model characterized in terms of impedance and celerity fluctuations. The formulation is very similar to that developed in the far-field domain where the Radon transform pair is derived from an harmonic plane wave decomposition. This formulation allows us to introduce the Ductal Tomography, following the example of the Ductal Echography, that provides a systematic inspection of each mammary lobe, in order to reveal breast lesions at an early stage. In order to review the performances obtained with current echographs in view of specific experiment (numerical simulations), we develop a computer phantom that gains in realism. This 2-D anatomical phantom is an axial cut of the ductolobular structure corresponding to a daisy-like internal arrangement with petals (lobes) radiating around the nipple, for healthy and pathological situations. The different constitutive tissues and ducts are characterized in terms of density and celerity parameters whose spatial distributions are defined with specific random density laws. The use of a velocity-pressure formulation permits us to model time domain acoustic wave propagation. Broadband US pulses are transmitted and measured in diffraction around the breast with a ring antenna, the images are reconstructed using the elliptical back-projection-based procedure mentioned above.

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

    PubMed Central

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

    2015-01-01

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

  10. Modeling and simulation of Positron Emission Mammography (PEM) based on double-sided CdTe strip detectors

    NASA Astrophysics Data System (ADS)

    Ozsahin, I.; Unlu, M. Z.

    2014-03-01

    Breast cancer is the most common leading cause of cancer death among women. Positron Emission Tomography (PET) Mammography, also known as Positron Emission Mammography (PEM), is a method for imaging primary breast cancer. Over the past few years, PEMs based on scintillation crystals dramatically increased their importance in diagnosis and treatment of early stage breast cancer. However, these detectors have significant limitations like poor energy resolution resulting with false-negative result (missed cancer), and false-positive result which leads to suspecting cancer and suggests an unnecessary biopsy. In this work, a PEM scanner based on CdTe strip detectors is simulated via the Monte Carlo method and evaluated in terms of its spatial resolution, sensitivity, and image quality. The spatial resolution is found to be ~ 1 mm in all three directions. The results also show that CdTe strip detectors based PEM scanner can produce high resolution images for early diagnosis of breast cancer.

  11. [Guideline for the additional test positions according to the EPQC 4th Edition for Digital Mammography Systems].

    PubMed

    Sommer, A; Lenzen, H; Blaser, D; Ehlers, S-E; Schopphoven, S; John, C

    2009-09-01

    Within the physical-technical quality assurance of the German breast cancer screening program all digital mammography systems have to perform the contrast resolution test and the determination of the average glandular dose based on the European guidelines for quality assurance in breast cancer screening and diagnosis (4th Edition). Since 1.1.2009 this applies to digital systems outside the screening program too. To accomplish uniform measurements in all federal states of Germany, the physical board of the reference centers developed together a special guideline for these test position. This Guideline describes the determination of the average glandular dose for different types of mammography systems, the CDMAM image acquisition and the CDMAM image evaluation as well. This guideline was verified by the German task group "Röntgenverordnung". PMID:19676011

  12. The role of mammography in evaluating patients with early carcinoma of the breast for tylectomy and radiation therapy

    SciTech Connect

    Gefter, W.B.; Friedman, A.K.; Goodman, R.L.

    1982-01-01

    The value of mammography in treatment planning for early breast cancer following excisional biopsy was studied in 38 patients. One-third of the post-biopsy mammograms yielded information usefu