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Sample records for risiken der mammographie

  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 use.

    PubMed Central

    David, Michele M.; Ko, Linda; Prudent, Nicole; Green, Eric H.; Posner, Michael A.; Freund, Karen M.

    2005-01-01

    OBJECTIVES: The goal of this study was to compare mammography use in Haitian women versus that of other racial/ethnic groups in the same neighborhoods and to identify factors associated with mammography use in subpopulations that are seldom studied. METHODS: A community-based, cross-sectional survey sampled a multiethnic group of inner-city women from eastern Massachusetts. Bivariate analyses and logistic regression models were used to predict lifetime and recent (within two years) mammography screening. RESULTS: Self-reported lifetime mammography use was similar for Haitian (82%), African-American (78%), Caribbean (81%) and Latina women (86%) but higher for white women (94%, p = 0.008). Mammography use in the past two years was also similar in all groups (66-82%, p = 0.41). In multivariate models, African-American (adjusted odds ratio [AOR]; 0.3; 95% CI 0.1-0.9) and Haitian women (AOR 0.3; 95% CI 0.1-0.9) had lower odds of lifetime mammography compared to white women. Factors independently related to lifetime and recent mammography included having a regular healthcare provider, greater knowledge of breast cancer screening; higher education, and private health insurance. CONCLUSIONS: Haitian women with a regular provider and knowledge of breast cancer screening reported recent mammography use similar to women from other racial/ethnic groups. The racial/ethnic patterns of mammography use in our study do not explain racial/ethnic differences in breast cancer stage or mortality. PMID:15712789

  3. CADx Mammography

    NASA Astrophysics Data System (ADS)

    Costaridou, Lena

    Although a wide variety of Computer-Aided Diagnosis (CADx) schemes have been proposed across breast imaging modalities, and especially in mammography, research is still ongoing to meet the high performance CADx requirements. In this chapter, methodological contributions to CADx in mammography and adjunct breast imaging modalities are reviewed, as they play a major role in early detection, diagnosis and clinical management of breast cancer. At first, basic terms and definitions are provided. Then, emphasis is given to lesion content derivation, both anatomical and functional, considering only quantitative image features of micro-calcification clusters and masses across modalities. Additionally, two CADx application examples are provided. The first example investigates the effect of segmentation accuracy on micro-calcification cluster morphology derivation in X-ray mammography. The second one demonstrates the efficiency of texture analysis in quantification of enhancement kinetics, related to vascular heterogeneity, for mass classification in dynamic contrast-enhanced magnetic resonance imaging.

  4. Screening Mammography

    PubMed Central

    Humphrey, Linda L.; Ballard, David J.

    1988-01-01

    Breast cancer is the most commonly occurring cancer in women and, until recently surpassed by lung cancer, was the leading cause of cancer-related death in women. It is the leading cause of death in women aged 39 to 44 years. The American Cancer Society has estimated that there will be 135,000 new cases of breast cancer and 42,300 breast cancer-related deaths in 1988. It is now predicted that breast cancer will develop in one out of every ten women in the United States. Given the clinical and public health significance of breast cancer, annual screening with mammography and clinical breast examination is recommended for women aged 50 and older to reduce breast cancer mortality. PMID:3407172

  5. Jahr der Geowissenschaften

    NASA Astrophysics Data System (ADS)

    Wohnlich, Stefan

    2002-06-01

    Das System Erde ist Leitthema des "Jahres der Geowissenschaften", das von der Bundesministerin für Bildung und Forschung in den Vordergrund der Initiative "Wissenschaft im Dialog" für 2002 gestellt wurde. Es soll aufzeigen, dass wir in einer empfindlichen Umwelt leben, die auf die natürlichen Schwankungen, z. B. des Klimas, genauso empfindlich reagiert wie auf die rücksichtslose Nutzung der Erde durch den Menschen. Damit rückt auch das Thema Grundwasser als Teil des globalen Wasserkreislaufes in den Mittelpunkt der derzeitigen Öffentlichkeitsarbeit. Wenn wir uns die bisherige Resonanz auf das Jahr der Geowissenschaften anschauen, dann ist festzustellen, dass gerade die Bereitschaft aus den Medien zur Aufnahme von Geowissenschaftlichen Themen erstaunlich groß ist. Aus dem Bereich des Grund- und Trinkwassers snd vor allem in Universitätsstädten bereits größere Veranstaltungen durchgeführt worden oder stehen noch im Laufe des Jahres aus (Information unter: www.planeterde.de). Tatsächlich ist der Dialog von Wissenschaft und Praxis mit der Öffentlichkeit ein vorrangiges Ziel auch der Fachsektion Hydrogeologie. Nur allzu leicht tritt dieses Ziel im Alltagsbetrieb in den Hintergrund. Die deutschen Universitäten und Wissenschaftsorganisationen haben in die Öffentlichkeitsarbeit erst in den letzten Jahren verstärkt Ideen und Mittel investiert. Dabei ist gerade das Verständnis für die Chancen und Risiken der Forschung und damit auch der Hochschullehre in der breiten Öffentlichkeit eine unabdingbare Voraussetzung. Aber nicht nur die wissenschaftliche Organisationen sind auf die Akzeptanz einer breiten Öffentlichkeit für wissenschaftlich fundiertes Arbeiten angewiesen, sondern auch die von Fachwissen geprägten Aufgaben im Umfeld des Grundwassers brauchen das Verständnis für ihre oft aufwändigen Untersuchungen. Ich habe in den letzten Monaten mehrere Vorträge an verschiedenen Gymnasien zum Thema "Ressource Grundwasser" gehalten. Die Resonanz war f

  6. Disparities in Screening Mammography

    PubMed Central

    Peek, Monica E; Han, Jini H

    2004-01-01

    OBJECTIVE This paper describes trends in screening mammography utilization over the past decade and assesses the remaining disparities in mammography use among medically underserved women. We also describe the barriers to mammography and report effective interventions to enhance utilization. DESIGN We reviewed medline and other databases as well as relevant bibliographies. MAIN RESULTS The United States has dramatically improved its use of screening mammography over the past decade, with increased rates observed in every demographic group. Disparities in screening mammography are decreasing among medically underserved populations but still persist among racial/ethnic minorities and low-income women. Additionally, uninsured women and those with no usual care have the lowest rates of reported mammogram use. However, despite apparent increases in mammogram utilization, there is growing evidence that limitations in the national survey databases lead to overestimations of mammogram use, particularly among low-income racial and ethnic minorities. CONCLUSIONS The United States may be farther from its national goals of screening mammography, particularly among underserved women, than current data suggests. We should continue to support those interventions that increase mammography use among the medically underserved by addressing the barriers such as cost, language and acculturation limitations, deficits in knowledge and cultural beliefs, literacy and health system barriers such as insurance and having a source regular of medical care. Addressing disparities in the diagnostic and cancer treatment process should also be a priority in order to affect significant change in health outcomes among the underserved. PMID:15009798

  7. 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 ...

  8. Regulatory Compliance in Mammography.

    PubMed

    Loesch, Jennifer

    2016-01-01

    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

  9. FDA Certified Mammography Facilities

    MedlinePlus

    ... Home Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Radiation-Emitting Products Home Radiation-Emitting Products Mammography Quality Standards Act and Program Consumer Information (MQSA) Search ...

  10. Communicating with mammography patients.

    PubMed

    Kamm, B L

    2000-01-01

    This article examines the barriers that prevent many women from undergoing mammography and strategies that can help them overcome those barriers. It also describes techniques for effective, individualized patient communication and education. Mammographers will learn how to ask the right questions, listen effectively for stated and unstated messages and determine which methods to use when communicating with different patients.

  11. 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 ...

  12. 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.

  13. 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.

  14. Cassette-based digital mammography.

    PubMed

    Seibert, J A; Boone, J M; Cooper, V N; Lindfors, K K

    2004-10-01

    Over the past several years, digital mammography systems have been installed clinically across North America in small but growing numbers. A photostimulable phosphor-based full-field digital mammography image was evaluated in this investigation. Commonly known as computed radiography (CR), its use closely mimics the screen-film mammography paradigm. System performance using modulation transfer function (MTF) and detective quantum efficiency (DQE) metrics show MTF(2.5 mm(-1)) = 0.5, DQE(2.5 mm(-1)) = 0.3, and MTF(5.0 mm(-1)) = 0.2, DQE(5.0 mm(-1)) = 0.05, for a 26 kVp beam, 0.03 mm molybdenum tube filtration, 4.5 cm tissue attenuation, and 15 mR incident exposure to the detector. Slightly higher DQE values were measured at 32 kVp with 0.025 mm rhodium tube filtration. CR mammography advantages include the ability to use existing mammography machines, where multiple rooms can be converted to "digital" operation, which allows overall cost savings compared to integrated digital mammography systems. Chief disadvantages include the labor-intensive handling of the cassettes prior to and after the imaging exam, lack of a direct interface to the x-ray system for recording technique parameters, and relatively slow processing time. Clinical experience in an IRB-approved research trial has suggested that digital mammography with photostimulable storage phosphors and a dedicated CR reader is a viable alternative to conventional screen-film mammography. PMID:15453806

  15. 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.

  16. Process mapping in screening mammography.

    PubMed

    Whitman, G J; Venable, S L; Downs, R L; Garza, D; Levy, S; Ophir, K J; Spears, K F; Sprinkle-Vincent, S K; Stelling, C B

    1999-05-01

    Successful screening mammography programs aim to screen large numbers of women efficiently and inexpensively. Development of an effective screening mammography program requires skilled personnel, solid infrastructure, and a robust computer system. A group of physicians, technologists, computer support personnel, and administrators carefully analyzed a growing screening mammography program as a series of steps, starting with the request for the examination and ending with the receipt of a hard-copy consultation. The analysis involved a detailed examination of every step and every possible outcome in the screening process. The information gained through process mapping may be used for identification of systemic and personnel problems, allocation of resources, modification of workplace architecture, and design of computer networks. Process mapping is helpful for those involved in designing and improving screening mammography programs. Viewing a process (i.e., obtaining a screening mammogram) as a series of steps may allow for the identification of inefficient components that may limit growth. PMID:10342216

  17. Mammography and breast cancer screening.

    PubMed

    Bassett, L W; Manjikian, V; Gold, R H

    1990-08-01

    Breast radiography should be performed only with film-screen mammography or xeromammography. At least two views of each breast should be obtained, and for film-screen mammography, at least one of these should be the oblique view. Quality assurance is becoming a significant concern in breast cancer screening. The ACR Mammography Accreditation Program takes into account the qualifications of the personnel, the performance of the x-ray equipment, and a peer review of the final product: the diagnostic image. The mammographic signs of malignancy can be divided into primary, secondary, and indirect. The accuracy of mammography depends on several factors, but the greatest limitation is the density of the breast tissue. Very dense tissue makes detection of breast cancer difficult, and a negative mammogram should never deter one from a biopsy of a clinically suspect mass. New consensus guidelines for breast cancer screening were developed to bring uniformity to the recommendations of the American Cancer Society, the National Cancer Institute, and various professional medical societies. These new guidelines reflect the encouraging results from recent clinical trials, as well as some discouraging reports on breast self-examination and the baseline mammogram. The underutilization of screening mammography is a problem of significant concern to both private and public health agencies. Barriers to mammographic screening include lack of awareness of the benefits of screening, physicians' misconceptions about patient compliance, concerns about radiation risk and overdiagnosis, fear of mastectomy, a perception that a mammogram involves great discomfort, and relatively high cost. Nationwide educational programs are under way to counter misconceptions about mammography, and various strategies are evolving to overcome the other barriers. Sonography is a useful adjunct to mammography for cyst-solid differentiation, but mammography is the only imaging modality effective for the early

  18. Outcomes of modern screening mammography.

    PubMed

    Kerlikowske, K; Barclay, J

    1997-01-01

    The University of California, San Francisco, Mobile Mammography Screening Program is a low-cost, community-based breast cancer screening program that offers mammography to women of diverse ethnic backgrounds (36% nonwhite) in six counties in northern California. Analysis of data collected on approximately 34,000 screening examinations from this program shows that the positive predictive value and sensitivity of modern screening mammography to be lower for women aged 40 to 49 years compared to women aged 50 and older. This lower performance is due to the lower prevalence of invasive breast cancer in younger women and possibly to age differences in breast tumor biology. Because of this lower performance, women in their forties may be subjected to more of the negative consequences of screening, which include additional diagnostic evaluations and the associated morbidity and anxiety, the potential for detecting and surgically treating clinically insignificant breast lesions, and the false reassurance resulting from normal mammographic results. Since the evidence is not compelling that the benefits of mammography screening outweigh the known risks for women aged 40 to 49 years, women considering mammography screening should be informed of the risks, potential benefits, and limitations of screening mammography, so that they can make individualized decisions based on their personal risk status and utility for the associated risks and potential benefits of screening.

  19. 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.

  20. [Vegetarische und vegane Ernährung bei Kindern - Stand der Forschung und Forschungsbedarf].

    PubMed

    Keller, Markus; Müller, Stine

    2016-01-01

    Die Praxis vegetarischer Ernährungsformen ist in Deutschland im letzten Jahrzehnt deutlich angestiegen. Allerdings ist der Anteil vegetarischer und veganer Kinder dabei unbekannt. Studien mit Erwachsenen zeigen das präventive Potenzial, aber auch potenzielle Schwachstellen pflanzenbasierter Kostformen. Die Vorteile und Risiken einer vegetarischen bzw. veganen Ernährung im Kindesalter wurden bisher jedoch relativ selten untersucht. Außerdem lassen das unterschiedliche Alter der Kinder, das heterogene Studiendesign sowie die teilweise geringe Probandenzahl der Studien keine verbindlichen Aussagen zu. In dieser Übersichtsarbeit werden die Ergebnisse der wenigen Studien zu vegetarisch und vegan ernährten Kindern (< 12 Jahren) in Nordamerika und Europa zusammengefasst. Demnach lag die Zufuhr von Nahrungsenergie und Makronährstoffen vegetarischer und veganer Kinder meist näher an den Empfehlungen der Fachgesellschaften als die Ernährung gleichaltriger Mischkostkinder. Ebenso wiesen vegetarisch und vegan ernährte Kinder eine höhere Zufuhr von und bessere Versorgung mit verschiedenen Vitaminen und Mineralstoffen auf. Häufiger zeigten sich jedoch Defizite bei Vitamin B12, Zink, Kalzium, Eisen und Vitamin D. Das Wachstum und die Entwicklung vegetarisch und vegan ernährter Kinder entsprachen weitgehend den Referenzstandards, wobei sie dazu tendierten, leichter, schlanker und (< 5 Jahren) auch kleiner zu sein. Aufgrund der unzureichenden Studienlage besteht erheblicher Forschungsbedarf zu den Auswirkungen einer vegetarischen und veganen Ernährung im Kindesalter.

  1. [Vegetarische und vegane Ernährung bei Kindern - Stand der Forschung und Forschungsbedarf].

    PubMed

    Keller, Markus; Müller, Stine

    2016-01-01

    Die Praxis vegetarischer Ernährungsformen ist in Deutschland im letzten Jahrzehnt deutlich angestiegen. Allerdings ist der Anteil vegetarischer und veganer Kinder dabei unbekannt. Studien mit Erwachsenen zeigen das präventive Potenzial, aber auch potenzielle Schwachstellen pflanzenbasierter Kostformen. Die Vorteile und Risiken einer vegetarischen bzw. veganen Ernährung im Kindesalter wurden bisher jedoch relativ selten untersucht. Außerdem lassen das unterschiedliche Alter der Kinder, das heterogene Studiendesign sowie die teilweise geringe Probandenzahl der Studien keine verbindlichen Aussagen zu. In dieser Übersichtsarbeit werden die Ergebnisse der wenigen Studien zu vegetarisch und vegan ernährten Kindern (< 12 Jahren) in Nordamerika und Europa zusammengefasst. Demnach lag die Zufuhr von Nahrungsenergie und Makronährstoffen vegetarischer und veganer Kinder meist näher an den Empfehlungen der Fachgesellschaften als die Ernährung gleichaltriger Mischkostkinder. Ebenso wiesen vegetarisch und vegan ernährte Kinder eine höhere Zufuhr von und bessere Versorgung mit verschiedenen Vitaminen und Mineralstoffen auf. Häufiger zeigten sich jedoch Defizite bei Vitamin B12, Zink, Kalzium, Eisen und Vitamin D. Das Wachstum und die Entwicklung vegetarisch und vegan ernährter Kinder entsprachen weitgehend den Referenzstandards, wobei sie dazu tendierten, leichter, schlanker und (< 5 Jahren) auch kleiner zu sein. Aufgrund der unzureichenden Studienlage besteht erheblicher Forschungsbedarf zu den Auswirkungen einer vegetarischen und veganen Ernährung im Kindesalter. PMID:27160086

  2. 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)

  3. 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.

  4. 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…

  5. Mammography 1984: challenge to radiology

    SciTech Connect

    McLelland, R.

    1984-07-01

    Mammography has made major contributions in the detection and diagnosis of breast cancer. It is the only reliable means of detecting nonpalpable cancers and can detect many small breast cancers in early stages, when they may be curable. It should be applied more widely, especially in screening asymptomatic women aged 40 or over. Restraints on its optimal application to the control of breast cancer are the expense of examination and the lack of properly trained and committed radiologists. These are challenges to radiology that must be addressed.

  6. A Bayesian network for mammography.

    PubMed Central

    Burnside, E.; Rubin, D.; Shachter, R.

    2000-01-01

    The interpretation of a mammogram and decisions based on it involve reasoning and management of uncertainty. The wide variation of training and practice among radiologists results in significant variability in screening performance with attendant cost and efficacy consequences. We have created a Bayesian belief network to integrate the findings on a mammogram, based on the standardized lexicon developed for mammography, the Breast Imaging Reporting And Data System (BI-RADS). Our goal in creating this network is to explore the probabilistic underpinnings of this lexicon as well as standardize mammographic decision-making to the level of expert knowledge. PMID:11079854

  7. Building an intranet digital mammography case library

    NASA Astrophysics Data System (ADS)

    Zhang, Hong; Lou, Shyhliang A.; Fan, Yu; Sickles, Edward A.; Huang, H. K.

    2000-05-01

    To practice mammography diagnosis effectively, radiologists expect convenient access to well-organized and authoritative mammography related information, especially when there is case in question. The purpose of this study is to build infrastructural diagnosis support by incorporating various clinical information into a digital mammography case library, and allow user to search the library based on mammographic findings. The digital mammography case library has a three- tier architecture: (1) Back-end mammography databases integrate multimedia clinical information from various operational systems, including RIS and PACS. Cases are stored in a finding index database powered by an object-relational database with finding-coded reports, which are modeled around the ACR BI-RADS (American College of Radiology, Breast Imaging Report and Data System) standard. (2) The middle-end application controllers process application logic, such as user authorization, HTTP request handling, database connection and dynamic HTML page generation. (3) Web-based user interface is developed for authorized Intranet personnel to formulate query based on radiological finding (such as mass, calcification and architectural distortion), shape and assessment, using ACR BI-RADS specified lexicon. The case library so far has 103 cases selected from over 800 digital mammography studies carried out at the Mt. Zion hospital, UCSF, during an on-going digital telemammography project. We believe that an Intranet based digital mammography case library with mammographic finding search capability facilitates continuous medical education and online decision support, by providing exemplary study to compare with case in question.

  8. 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

  9. Family/friend recommendations and mammography intentions: the roles of perceived mammography norms and support.

    PubMed

    Molina, Yamile; Ornelas, India J; Doty, Sarah L; Bishop, Sonia; Beresford, Shirley A A; Coronado, Gloria D

    2015-10-01

    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 intentions. Theory suggests that family/friend recommendations increase perceived mammography norms (others believe a woman should obtain a mammogram) and support (others will help her obtain a mammogram), which in turn increase mammography intentions and use. We tested these hypotheses with data from the ¡Fortaleza Latina! study, a randomized controlled trial including 539 Latinas in Washington State. Women whose family/friend recommended they get a mammogram within the last year were more likely to report mammography intentions, norms and support. Perceived mammography norms mediated the relationship between family/friend recommendations and intentions, Mediated Effect = 0.38, 95%CI [0.20, 0.61], but not support, Mediated Effect = 0.002, 95%CI [-0.07, 0.07]. Our findings suggest perceived mammography norms are a potential mechanism underlying the effect of family/friend recommendations on mammography use among Latinas. Our findings make an important contribution to theory about the associations of social interactions, perceptions and health behaviors. PMID:26324395

  10. Family/friend recommendations and mammography intentions: the roles of perceived mammography norms and support

    PubMed Central

    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 intentions. Theory suggests that family/friend recommendations increase perceived mammography norms (others believe a woman should obtain a mammogram) and support (others will help her obtain a mammogram), which in turn increase mammography intentions and use. We tested these hypotheses with data from the ¡Fortaleza Latina! study, a randomized controlled trial including 539 Latinas in Washington State. Women whose family/friend recommended they get a mammogram within the last year were more likely to report mammography intentions, norms and support. Perceived mammography norms mediated the relationship between family/friend recommendations and intentions, Mediated Effect = 0.38, 95%CI [0.20, 0.61], but not support, Mediated Effect = 0.002, 95%CI [−0.07, 0.07]. Our findings suggest perceived mammography norms are a potential mechanism underlying the effect of family/friend recommendations on mammography use among Latinas. Our findings make an important contribution to theory about the associations of social interactions, perceptions and health behaviors. PMID:26324395

  11. Mammography and breast sonography in transsexual women.

    PubMed

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

    2010-06-01

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

  12. 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…

  13. [Efficacy of storage phosphor-based digital mammography in diagnosis of breast cancer--comparison with film-screen mammography].

    PubMed

    Kitahama, H

    1991-05-25

    The aim of this study is to present efficacy of storage phosphor-based digital mammography (CR-mammography) in diagnosis of breast cancer. Ninety-seven cases with breast cancer including 44 cases less than 2 cm in macroscopic size (t1 cases) were evaluated using storage phosphor-based digital mammography (2000 x 2510 pixels by 10 bits). Abnormal findings on CR-mammography were detected in 86 cases (88.7%) of 97 women with breast cancer. Sensitivity of CR-mammography was 88.7%. It was superior to that of film-screen mammography. On t1 breast cancer cases, sensitivity on CR-mammography was 88.6%. False negative rate in t1 breast cancer cases was reduced by image processing using CR-mammography. To evaluate microcalcifications, CR-mammograms and film-screen mammograms were investigated in 22 cases of breast cancer proven pathologically the existence of microcalcifications and 11 paraffin tissue blocks of breast cancer. CR-mammography was superior to film-screen mammography in recognizing of microcalcifications. As regards the detectability for the number and the shape of microcalcifications, CR-mammography was equivalent to film-screen mammography. Receiver operating characteristic (ROC) analysis by eight observers was performed for CR-mammography and film-screen mammography with 54 breast cancer patients and 54 normal cases. The detectability of abnormal findings of breast cancer on CR-mammography (ROC area = 0.91) was better than that on film-screen mammography (ROC area = 0.88) (p less than 0.05). Efficacy of storage phosphor-based digital mammography in diagnosis of breast cancer was discussed and demonstrated in this study.

  14. Transition From Film to Digital Mammography

    PubMed Central

    van Ravesteyn, Nicolien T.; van Lier, Lisanne; Schechter, Clyde B.; Ekwueme, Donatus U.; Royalty, Janet; Miller, Jacqueline W.; Near, Aimee M.; Cronin, Kathleen A.; Heijnsdijk, Eveline A.M.; Mandelblatt, Jeanne S.; de Koning, Harry J.

    2015-01-01

    Introduction The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides mammograms and diagnostic services for low-income, uninsured women aged 40–64 years. Mammography facilities within the NBCCEDP gradually shifted from plain-film to digital mammography. The purpose of this study is to assess the impact of replacing film with digital mammography on health effects (deaths averted, life-years gained [LYG]), costs (for screening and diagnostics), and number of women reached. Methods NBCCEDP 2010 data and data representative of the program’s target population were used in two established microsimulation models. Models simulated observed screening behavior including different screening intervals (annual, biennial, irregular) and starting ages (40, 50 years) for white, black, and Hispanic women. Model runs were performed in 2012. Results The models predicted 8.0–8.3 LYG per 1,000 film screens for black women, 5.9–7.5 for white women, and 4.0–4.5 for Hispanic women. For all race/ethnicity groups, digital mammography had more LYG than film mammography (2%–4%), but had higher costs (34%–35%). Assuming a fixed budget, 25%–26% fewer women could be served, resulting in 22%–24% fewer LYG if all mammograms were converted to digital. The loss in LYG could be reversed to an 8%–13% increase by only including biennial screening. Conclusions Digital could result in slightly more LYG than film mammography. However, with a fixed budget, fewer women may be served with fewer LYG. Changes in the program, such as only including biennial screening, will increase LYG/screen and could offset the potential decrease in LYG when shifting to digital mammography. PMID:25891052

  15. 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.

  16. 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

  17. [Contrast media in MR mammography].

    PubMed

    Tontsch, P; Bauer, M; Birmelin, G; von Landenberg, E; Moeller, T B; Raible, G

    1997-03-01

    A standardized relationship between concentration of contrast media and normalized signal intensity should be the basis of a diagnostic evaluation of MR-mammography at different sites and with different sequences. In this work we compared the dynamic range of the MR-compatible contrast medium Magnevist at different sequences and machines. For this purpose we made measurements with a phantom, consisting of MR-compatible glass tubes filled with contrast medium of different concentrations. The glass tubes were placed in a water bath. All measurements were made with breast coils. The signal intensity of the glass tubes was normalized to the signal intensity of the native probe (water = 1). These normalized dynamic curves were compared with each other in order to find, for the different machines, the sequence which is nearest to a defined "Standard-Curve". As this task proved not possible for all machines, we measured how the dynamic curves of the different machines related to the "Standard-Curve". For all sequences we made also measurements with a female student to assure the quality of the pictures. Thus the participating radiologists can now compare their dynamic measurements of breast lesions with each other. PMID:9172669

  18. 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.

  19. Developing a digital mammography data warehouse

    NASA Astrophysics Data System (ADS)

    Zhang, Hong; Cao, Xinhua; Wong, Stephen T. C.; Lou, Shyhliang A.; Sickles, Edward A.

    2001-08-01

    This paper discusses our initial efforts to design and develop a digital mammography data warehouse to facilitate clinical and research activities. Data warehouse is a complete and consistent integration of data from many information sources. It enables users to explore the warehouse for various analysis and decision support purposes. We are designing an infra-structural information system by incorporating various kinds of breast imaging data, from a diversity of existing clinical systems, into a digital data warehouse. Various types of breast imaging data, including patient demographics, family history, digital mammography and radiological reports, will be acquired for the University of California San Francisco digital mammography PACS modules, as well as Radiological Information System.

  20. Mammography and palpable cancer of the breast.

    PubMed

    Edeiken, S

    1988-01-15

    The statistical analysis documented in this article was performed to determine the accuracy of mammography in diagnosing a palpable cancer of the breast. All of the women studied underwent mammography after the discovery of the cancer, which was proven by biopsy; the cancer did not involve the skin. All mammograms that demonstrated any abnormality in the area of the cancer were deemed to be positive. This study demonstrates that 22% of the women who have a palpable cancer of the breast will have a false-negative mammogram; 44% will be women of 50 and younger, and 13% will be women more than 50 years of age. Mammography is detrimental if used to avoid biopsy when there is a persistent mass, especially in younger women. It is concluded that biopsy should be performed on every undiagnosed, persistent, dominant mass without consideration of the mammogram. PMID:3334960

  1. Computer analysis of mammography phantom images (CAMPI)

    NASA Astrophysics Data System (ADS)

    Chakraborty, Dev P.

    1997-05-01

    Computer analysis of mammography phantom images (CAMPI) is a method for objective and precise measurements of phantom image quality in mammography. This investigation applied CAMPI methodology to the Fischer Mammotest Stereotactic Digital Biopsy machine. Images of an American College of Radiology phantom centered on the largest two microcalcification groups were obtained on this machine under a variety of x-ray conditions. Analyses of the images revealed that the precise behavior of the CAMPI measures could be understood from basic imaging physics principles. We conclude that CAMPI is sensitive to subtle image quality changes and can perform accurate evaluations of images, especially of directly acquired digital images.

  2. Mammography screening behavior in older women caregivers.

    PubMed

    Chang, B L; Sarna, L; Carter, P A

    2001-01-01

    The purposes of this study are to explore older caregivers' mammography participation and the facilitators and barriers to mammography screening. Of the 52 older female caregivers with a mean age of 65 years (range 50-90) interviewed by telephone, 80.8% had had a mammogram within 12 months. Significant facilitators included health care provider recommendation and beliefs in the efficacy of treatment. Significant barriers included health care providers' failure to recommend mammograms, caregiver procrastination, fear of pain, and lack of symptoms. Caregivers with higher burden reported less frequent self- and provider-conducted breast examinations.

  3. Access to Mammography Facilities and Detection of Breast Cancer by Screening Mammography: A GIS Approach.

    PubMed

    Rahman, Selina; Price, James H; Dignan, Mark; Rahman, Saleh; Lindquist, Peter S; Jordan, Timothy R

    2009-01-01

    OBJECTIVES: The objective of the study was to examine the association between access to mammography facilities and utilization of screening mammography in an urban population. METHODS: Data on female breast cancer cases were obtained from an extensive mammography surveillance project. Distance to mammography facilities was measured by using GIS, which was followed by measuring geographical access to mammography facilities using Floating Catchment Area (FCA) method (considering all available facilities within an arbitrary radius from the woman's residence by using Arc GIS 9.0 software). RESULTS: Of 2,024 women, 91.4% were Caucasian; age ranged from 25 to 98 years; most (95%) were non-Hispanic in origin. Logistic regression found age, family history, hormone replacement therapy, physician recommendation, and breast cancer stage at diagnosis to be significant predictors of having had a previous mammogram. Women having higher access to mammography facilities were less likely to have had a previous mammogram compared to women who had low access, considering all the facilities within 10 miles (OR=0.41, CI=0.22-0.76), 30 miles (OR=0.52, CI=0.29-0.91) and 40 miles (OR=0.51, CI=0.28-0.92) radiuses. CONCLUSIONS: Physical distance to mammography facilities does not necessarily predict utilization of mammogram and greater access does not assure greater utilizations, due to constraints imposed by socio economic and cultural barriers. Future studies should focus on measuring access to mammography facilities capturing a broader dimension of access considering qualitative aspect of facilities, as well as other travel impedances. PMID:20628557

  4. 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

  5. Towards in vivo TLD dosimetry in mammography.

    PubMed

    Warren-Forward, H M; Duggan, L

    2004-05-01

    While phantoms are used for quality control assessment of the mammography unit, in vivo dose measurements are necessary to account for the variation in size and composition of the female breast. The use of thermoluminescent dosimeters (TLDs) in mammography has been limited due to TLD visibility. The aim of this current investigation was to access the suitability of a paper-thin LiF:Mg,Cu,P TLD (GR-200F) for in vivo dosimetric mammography measurements. The visibility of GR-200F has been directly compared with LiF:Mg,Cu,P TLDs (GR-200A) using a number of commercially available phantoms. The phantoms of thickness 2-5 cm were imaged over the range of tube potentials (24-28 kVp) used clinically. Both types of TLD were placed on the surface of the phantoms allowing assessment of visibility, entrance surface dose (ESD) and field homogeneity. In vivo assessment of ESD and visibility was also carried out on a volunteer undergoing a routine mammography examination. The positions of the GR-200F TLDs were not identified either on the image of the Leeds TOR(MAM) phantom or the patient mammograms. The average ESD for the Leeds phantom was 8.8 mGy, while the patient ESD was 13 mGy. It is now possible to perform in vivo measurements with the potential of increasing the accuracy of the doses measured for women that do not conform to a standard breast thickness or density.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 75 FR 11542 - Agency Information Collection Activities; Proposed Collection; Comment Request; Mammography...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-11

    ... Collection; Comment Request; Mammography Quality Standards Act Requirements AGENCY: Food and Drug... Mammography Quality Standards Act requirements. DATES: Submit written or electronic comments on the collection... techniques, when appropriate, and other forms of information technology. The Mammography Quality...

  12. 78 FR 13681 - Agency Information Collection Activities; Proposed Collection; Comment Request; Mammography...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... Collection; Comment Request; Mammography Quality Standards Act Requirements AGENCY: Food and Drug... associated with the Mammography Quality Standards Act requirements. DATES: Submit either electronic or... of information technology. Mammography Quality Standards Act Requirements--21 CFR Part 900...

  13. Umsetzung der Unternehmensstrategie mit der Balanced Scorecard

    NASA Astrophysics Data System (ADS)

    Crespo, Isabel; Bergmann, Lars; Portmann, Stefan; Lacker, Thomas; Lacker, Michael; Fleischmann, Jürgen; Kozó, Hans

    Die Balanced Scorecard (BSC) ist ein Ansatz zum strategischen Management, der neben der Ausrichtung des Unternehmens auf finanzielle Zielwerte ebenso großes Gewicht auf so genannte weiche Faktoren legt, die den wirtschaftlichen Erfolg eines Unternehmens erst ermöglichen. Das entscheidende Merkmal der Balanced Scorecard ist dabei, dass sie ein ausgewogenes System strategischer Ziele herstellt, welches das Unternehmen hinsichtlich der vier Perspektiven Finanzen, Kunden, interne Prozesse und Mitarbeiter und Potenziale strategisch ausrichtet (Kaplan u. Norton 1997).

  14. Advanced Breast Cancer as Indicator of Quality Mammography

    NASA Astrophysics Data System (ADS)

    Gaona, Enrique

    2003-09-01

    Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the Mexican Republic. Mammography is the more important screening tool for detecting early breast cancer. Screening mammography involves taking x-rays from two views from each breast, typically from above (cranial-caudal view, CC) and from an oblique or angled view (mediolateral-oblique, MLO). The purpose of this study was to carry out an exploratory survey of the issue of patients with advanced breast cancer who have had a screening mammography. A general result of the survey is that 22.5% of all patients (102) with advanced breast cancer that participated in the study had previous screening mammography. But we should consider that 10% of breast cancers are not detected by mammography. Only 70% of the family doctors prescribed a diagnostic mammography when the first symptoms were diagnosed.

  15. Digital Mammography Imaging: Breast Tomosynthesis and Advanced Applications

    PubMed Central

    Helvie, Mark A.

    2011-01-01

    Synopsis This article discusses recent developments in advanced derivative technologies associated with digital mammography. Digital breast tomosynthesis – its principles, development, and early clinical trials are reviewed. Contrast enhanced digital mammography and combined imaging systems with digital mammography and ultrasound are also discussed. Although all these methods are currently research programs, they hold promise for improving cancer detection and characterization if early results are confirmed by clinical trials. PMID:20868894

  16. Der Weltraum. Die Originalfotografien der NASA.

    NASA Astrophysics Data System (ADS)

    Klotz, H.

    This book is based on an exhibition in 1985 of many of the spectacular images obtainedby NASA's planetary missions and Earth reconnaissance satellites during the past two decades. The exhibition was organized by the Baxter Art Gallery, California Institute of Technology, Pasadena. The photographs have been prepared by the Jet Propulsion Laboratory, Pasadena.Contents: Das Sonnensystem - eine geowissenschaftliche Betrachtung (W. Ziegler). Der beharrliche Beobachter (C. Knight).Der Weltraum. Ranger - Der Mond. Surveyor - Der Mond. Lunar-Orbiter -Der Mond. Mariner 4, 6, 7 - Mars. Mariner 10 - Venus, Merkur. Viking - Mars. Voyager - Jupiter. Voyager - Saturn. Voyager - Uranus. Voyager - Neptun. Seasat. IRAS. SIR-A und SIR-B. Galileo. Beta Pictoris. Laufende Weltraumprojekte. Zukünftige Weltraumprojekte. Ein Blick zurück... und nach vorn (M. Maegraith). Anhang - Die Probleme der Bildübertragung. Chronologie der Weltraumflüge.

  17. Time perspective and perceived risk as related to mammography screening.

    PubMed

    Griva, Fay; Anagnostopoulos, Fotios; Potamianos, Gregory

    2013-01-01

    The present study explored the relation of time perspective to perceived risk for breast cancer and mammography screening. Women free from breast cancer (N = 194), eligible for mammography screening in terms of age, completed the Zimbardo Time Perspective Inventory (Zimbardo & Boyd, 1999) and measures of perceived risk, attitude toward performing mammography screening, intention to get a mammogram, and mammography screening behavior. Hierarchical multiple regression analysis revealed that perceived risk of breast cancer (β= .18, p < .01) and intention to be screened (β = .35, p < .01) were significantly associated with mammography screening, after controlling for the effects of sociodemographic (e.g., age, education, and economic level) and health-related variables (e.g., family history of breast cancer and previous benign breast disease). Path analyses including the main psychological variables indicated that perceived risk was indirectly related to intention via attitude (β = .17, p < .01), and to mammography screening through attitude and intention (β = .06, p < .01). Attitude was indirectly related to mammography screening via intention (β = .20, p < .01). Also, a significant indirect association was observed between future orientation and mammography screening, via perceived risk (β = .10, p < .01). Theoretical implications of study findings and suggestions for future research on use of mammography are presented.

  18. 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.

  19. 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

  20. A mammography quality assurance test program.

    PubMed

    Burgess, A

    1979-11-01

    The design and implementation of a program to investigate remote quality assurance testing for film mammography is described. The measurements included tube output, x-ray machine and processor stability, and film quality. Mammography phantoms and film sensitometric strips were distributed monthly to 24 regional hospitals. Most of the hospital processors and x-ray machines performed in a stable manner during the 12-month test period. It was found that x-ray machine useful beams could be reliably measured using nonscreen films. The main utility of the phantom was to identify cases of poor image quality. The measurements performed on the phantom image could not be used to diagnose specific causes of poor images. PMID:493542

  1. Digital Mammography: Improvements in Breast Cancer Diagnostic

    NASA Astrophysics Data System (ADS)

    Montaño Zetina, Luis Manuel

    2006-01-01

    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.

  2. 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.

  3. Toward Clinically Compatible Phase-Contrast Mammography.

    PubMed

    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.

  4. Mobile screening mammography for the corporate customer.

    PubMed

    Kettlehake, J; Malott, J C

    1988-01-01

    While the concept of mobile imaging services is not new, mobile screening mammography has recently gained a great deal of attention, and several mobile breast screening programs are in operation throughout the United States. This article describes the development of a mobile breast screening program designed to attract corporations' employees as its primary source of participants. The design of the program, corporate concerns and operational issues are discussed as well as the findings of its first year of operation.

  5. Mammography compression force in New Zealand.

    PubMed

    Poletti, J L

    1994-06-01

    Maximum compression forces have been measured in New Zealand on 37 mammography machines, using a simple hydraulic device. The median measured maximum force was 145 N, and the range 58 to 230 N. Much greater attention needs to be paid to the setting of maximum force for compression devices by service personnel. Compression devices must be included in the quality assurance programme. Where indicated by the machine, the accuracy of the indicated force for some machines is poor. PMID:8074619

  6. 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.

  7. Characteristics of US counties with no mammography capacity.

    PubMed

    Peipins, Lucy A; Miller, Jacqueline; Richards, Thomas B; Bobo, Janet Kay; Liu, Ta; White, Mary C; Joseph, Djenaba; Tangka, Florence; Ekwueme, Donatus U

    2012-12-01

    Access to screening mammography may be limited by the availability of facilities and machines, and nationwide mammography capacity has been declining. We assessed nationwide capacity at state and county levels from 2003 to 2009, the most recent year for which complete data were available. Using mammography facility certification and inspection data from the Food and Drug Administration, we geocoded all mammography facilities in the United States and determined the total number of fully accredited mammography machines in each US County. We categorized mammography capacity as counties with zero capacity (i.e., 0 machines) or counties with capacity (i.e.,≥1 machines), and then compared those two categories by sociodemographic, health care, and geographic characteristics. We found that mammography capacity was not distributed equally across counties within states and that more than 27 % of counties had zero capacity. Although the number of mammography facilities and machines decreased slightly from 2003 to 2009, the percentage of counties with zero capacity changed little. In adjusted analyses, having zero mammography capacity was most strongly associated with low population density (OR = 11.0; 95 % CI 7.7-15.9), low primary care physician density (OR = 8.9; 95 % CI 6.8-11.7), and a low percentage of insured residents (OR = 3.3; 95 % CI 2.5-4.3) when compared with counties having at least one mammography machine. Mammography capacity has been and remains a concern for a portion of the US population--a population that is mostly but not entirely rural. PMID:22477670

  8. Kosmische Katastrophen und der Ursprung der Religion.

    NASA Astrophysics Data System (ADS)

    Hoyle, F.

    This book is a German translation, by V. Delavre, from the English original "The origin of the Universe and the origin of religion", published in 1993. Contents: E. Sens: Die unterbrochene Musikstunde. Einleitung zur deutschen Ausgabe. C. Ryskamp: Einführung. R. N. Anshen: Vorwort. F. Hoyle: Kosmische Katastrophen und der Ursprung der Religion - Die Folgen der Respektabilität; Eiszeiten und Kometen; Die allgemeine Situation in den Nacheiszeiten; Kometen und der Ursprung der Religionen; Der Übergang zu Mittelalter und Neuzeit. Diskussionsbeiträge: Ruth Nanda Anshen, Freeman Dyson, Paul Oscar Kristeller, John Archibald Wheeler, James Schwartz, Roger Shinn, Milton Gatch, Philip Solomon, Norman Newell. F. Hoyle: Schlußwort. A. Tollmann: Nachwort zur deutschen Ausgabe.

  9. A prospective assessment of racial/ethnic differences in future mammography behavior among women who had early mammography

    PubMed Central

    Kapp, Julie M.; Walker, Rod; Haneuse, Sebastien; Yankaskas, Bonnie C.

    2011-01-01

    BACKGROUND 29% of women aged 30-39 report having had a mammogram though sensitivity and specificity are low. We investigate racial/ethnic differences in future mammography behavior among women who had a baseline screening mammogram prior to age 40. METHODS Using 1994-2008 data from the Breast Cancer Surveillance Consortium (BCSC), we identified 29,390 women ages 35-39 with a baseline screening mammogram. We followed this cohort for two outcomes: (1) future BCSC mammography between ages 40-45; and (2) among those, delay in screening mammography until ages 43-45 compared to 40-42. Using adjusted log-linear models, we estimated the relative risk (RR) of these outcomes by race/ethnicity, while also considering the impact of false positive/true negative (FP/TN) baseline mammography results on these outcomes. RESULTS Relative to non-Hispanic white women, Hispanic women had an increased risk of no future BCSC mammography (RR: 1.21, 95% confidence interval (CI): 1.13-1.30); Asian women had a decreased risk (RR: 0.67, 95% CI: 0.61-0.74). Women with a FP, compared to TN, had a decreased risk of no future BCSC mammography (RR: 0.89, 95% CI: 0.85-0.95). Among those with future BCSC screening mammography, African American women were more likely to delay the timing (RR: 1.26, 95% CI: 1.09-1.45). The interaction between race/ethnicity and FP/TN baseline results was not significant. CONCLUSIONS Race/ethnicity is differentially associated with future BCSC mammography and the timing of screening mammography after age 40. IMPACT These findings introduce the need for research that examines disparities in lifetime mammography use patterns from the initiation of mammography screening. PMID:21242330

  10. [Comparative study between film mammography and xeromammography; including specimen radiography].

    PubMed

    Maeda, M; Hayakawa, K; Okuno, Y; Torizuka, T; Mitsumori, M; Soga, T; Misaki, T; Dokou, S; Ito, K

    1990-10-01

    We retrospectively evaluated preoperative film- and xeromammography of 23 cases with breast cancers, and compared with postoperative specimen radiography to assess tumor delineation and microcalcification detectability. In tumor detection and margin delineation, film mammography was superior to xeromammography, and in microcalcification, film mammography was equal to xeromammography. These results had a effect on the diagnosis of breast cancers.

  11. 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…

  12. Reproducibility of Mammography Units, Film Processing and Quality Imaging

    NASA Astrophysics Data System (ADS)

    Gaona, Enrique

    2003-09-01

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

  13. Grundlagen der Mechatronik

    NASA Astrophysics Data System (ADS)

    Roddeck, Werner

    Der Begriff Mechatronik ist ein Kunstwort, welches durch Eindeutschung des englischen Wortes "Mechatronics“ entstanden ist. Dieses ist wiederum eine Zusammenziehung der englischen Bezeichnungen für "Mechanics“ (Maschinenbau) und "Electronics“ (Elektrotechnik). Der Begriff wurde durch einen japanischen Ingenieur 1969 geprägt und durch eine japanische Firma bis 1972 als Warenzeichen gehalten.

  14. Annotation for information extraction from mammography reports.

    PubMed

    Bozkurt, Selen; Gulkesen, Kemal Hakan; Rubin, Daniel

    2013-01-01

    Inter and intra-observer variability in mammographic interpretation is a challenging problem, and decision support systems (DSS) may be helpful to reduce variation in practice. Since radiology reports are created as unstructured text reports, Natural language processing (NLP) techniques are needed to extract structured information from reports in order to provide the inputs to DSS. Before creating NLP systems, producing high quality annotated data set is essential. The goal of this project is to develop an annotation schema to guide the information extraction tasks needed from free-text mammography reports. PMID:23823416

  15. 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

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. Ethnic Differences in Decisional Balance and Stages of Mammography Adoption

    PubMed Central

    Otero-Sabogal, Regina; Stewart, Susan; Shema, Sarah J.; Pasick, Rena J.

    2010-01-01

    Behavioral theories developed through research with mainstream, English-speaking populations have been applied to ethnically diverse and underserved communities in the effort to eliminate disparities in early breast cancer detection. This study tests the validity of the transtheoretical model (TTM) decisional balance measure and the application of the TTM stages of change in a multiethnic, multilingual sample. A random sample of 1,463 Filipino, Latino, African American, Chinese, and White women aged 40 to 74 completed a phone survey of mammography beliefs and practices. Consistent with the TTM and independent of ethnicity, decisional balance was associated with mammography stage in all five ethnic groups when controlling for socioeconomic and other factors. In addition, having private insurance and a regular physician and being a long-time resident in the United States were positively associated with mammography maintenance. The application of the TTM for mammography is supported in a multiethnic and multilingual sample. PMID:16891624

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. Kants Theorie der Sonne: Physikgeschichte

    NASA Astrophysics Data System (ADS)

    Jacobi, Manfred

    2005-01-01

    Im Rahmen seiner Kosmogonie entwickelte der junge Immanuel Kant eine Theorie der Sonne. Sie ist ein einzigartiges Zeugnis seiner intuitiven Vorstellungskraft und beweist auch die Leistungsfähigkeit der damaligen, vorwiegend von Newton geprägten Weltsicht. Entstehung, Aufbau und Dynamik der Sonne werden in Kants Theorie ebenso erklärt wie etwa das Phänomen der Sonnenflecken.

  6. The supply of mammography resources in West Virginia.

    PubMed

    Artz, D R; Brown, M L; Barrett, M J

    1992-04-01

    The distribution of mammography machines and related resources in West Virginia, along with the distribution of breast cancer screen-eligible women, are examined using county-specific data. This data placed on a state map shows that it is not necessary to cross more than one county line anywhere within West Virginia in order to visit a mammography facility. The overall density of these machines is 20 per 100,000 women over 45, almost double the capacity needed for screening mammography. After taking into account the projected demand for mammography, the current average cost per exam is around $65-$100. If mammography machines were placed in all the counties without machines, the cost in those countries would be around $140 per exam. It would be cheaper to provide a travel allowance to women in rural counties than to install machines in these areas. Machines that are accredited by the American College of Radiologists, the most available indicator of quality mammography, are located only in densely populated areas of the state. PMID:1615640

  7. Training community health workers: factors that influence mammography use.

    PubMed

    Kratzke, Cynthia; Garzon, Laurel; Lombard, John; Karlowicz, Karen

    2010-12-01

    The purpose of this study was to assess factors that influence mammography use among volunteer community health workers (CHWs). Data trends indicate lower mammography rates among minority and low-income women. Although CHW interventions have been shown to promote mammography use among this population, training strategies and the use of a comprehensive needs assessment are lacking. Using a cross-sectional study design, data were collected via a mailed survey. The dependent variable was mammography use within the past 2 years. The independent variables were categorized according to the factors in the PRECEDE-PROCEED model. Predisposing factors included susceptibility, barriers, benefits, health motivation, self-efficacy, education, and age. Enabling factors included income, health insurance, and regular source of care. Reinforcing factors included physician recommendation to get a mammogram, social norms, and family history of breast cancer. Self-reported data from a mailed survey were obtained from a convenience sample of urban CHWS (N = 109) ages 40-73 with a mean age of 55 (SD = 9.43). The sample included 90% African American and 8% White women. Logistic regression results showed barriers to be predictive of mammography use among CHWs controlling for age, self-efficacy, health motivation, and social norms. The findings suggest CHW training focus on how to identify and address barriers to increase the likelihood of mammography use among CHWs. Future research is needed to identify cultural differences in barriers for minority CHWs.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. Mammography Prevalence within 2 Two Years (Age 40+) - Small Area Estimates

    Cancer.gov

    For mammography, a woman 40 years of age or older must have reported having at least one mammography in her life. Furthermore, she should have had the most recent one within the last two years by the time of interview.

  14. Die Kosmologie der Griechen.

    NASA Astrophysics Data System (ADS)

    Mittelstraß, J.

    Contents: 1. Mythische Eier. 2. Thales-Welten. 3. "Alles ist voller Götter". 4. Griechische Astronomie. 5. "Rettung der Phänomene". 6. Aristotelische Kosmololgie. 7. Aristoteles-Welt und Platon-Welt. 8. Noch einmal: die Göttlichkeit der Welt. 9. Griechischer Idealismus.

  15. 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…

  16. Mammography facilities are accessible, so why is utilization so low?

    PubMed Central

    Kuo, Tzy-Mey (May); Clayton, Laurel J.; Evans, W. Douglas

    2009-01-01

    Objective This study examines new socio-ecological variables reflecting community context as predictors of mammography use. Methods The conceptual model is a hybrid of traditional health-behavioral and socio-ecological constructs with an emphasis on spatial interaction among women and their environments, differentiating between several levels of influence for community context. Multilevel probability models of mammography use are estimated. The study sample includes 70,129 women with traditional Medicare fee-for-service coverage for inpatient and outpatient services, drawn from the SEER–Medicare linked data. The study population lives in heterogeneous California, where mammography facilities are dense but utilization rates are low. Results Several contextual effects have large significant impacts on the probability of mammography use. Women living in areas with higher proportions of elderly in poverty are 33% less likely to use mammography. However, dually eligible women living in these poor areas are 2% more likely to use mammography than those without extra assistance living in these areas. Living in areas with higher commuter intensity, higher violent crime rates, greater land use mix (urbanicity), or more segregated Hispanic communities exhibit −14%, −1%, −6%, and −3% (lower) probability of use, respectively. Women living in segregated American Indian communities or in communities where more elderly women live alone exhibit 16% and 12% (higher) probability of use, respectively. Minority women living in more segregated communities by their minority are more likely to use mammography, suggesting social support, but this is significant for Native Americans only. Women with disability as their original reason for entitlement are found 40% more likely to use mammography when they reside in communities with high commuter intensity, suggesting greater ease of transportation for them in these environments. Conclusions Socio-ecological variables reflecting

  17. 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

  18. 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.

  19. 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

  20. [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

  1. 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

  2. Characterizing mammography reports for health analytics.

    PubMed

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

    2011-10-01

    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 the transformation of a large data set of mostly unlabeled and free-text mammography data into a searchable and accessible collection, usable for analytics. We also describe several methods to characterize and analyze the data, including their temporal aspects, using information retrieval, supervised learning, and classical statistical techniques. We present experimental results that demonstrate the validity and usefulness of the approach, since the results are consistent with the known features of the data, provide novel insights about it, and can be used in specific applications. Additionally, based on the process of going from raw data to results from analysis, we present the architecture of a generic system for health analytics from clinical notes.

  3. Image toggling saves time in mammography

    PubMed Central

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

    2015-01-01

    Abstract. 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 [t(22)=5.11, p<.05]. The toggle viewing mode also led to a 5% improvement in diagnostic accuracy, though in our small sample this effect was not statistically reliable. Time savings were found even though successive mammograms were not perfectly aligned. Given the ever-increasing caseload for radiologists, this simple manipulation of how the images are viewed could save valuable time in clinical practice, allowing radiologists to read more cases or spend more time on difficult cases. PMID:26870746

  4. Feasibility of using LODOX technology for mammography

    NASA Astrophysics Data System (ADS)

    Lease, Alyson; Vaughan, Christopher; Beningfield, Stephan; Potgieter, Herman; Booysen, Andre

    2002-05-01

    The LODOX (Low Dose X-ray) Scanner, created by De Beers, is currently being clinically tested at the Trauma Unit of Groote Schuur Hospital and the University of Cape Town in South Africa. High quality images with exceedingly low radiation suggest that the technology may also be used to identify breast cancer lesions and microcalcifications. The measured LODOX modulation transfer function averages 6 percent at 10 cycles per millimeter, while the detected quantum efficiency is approximately 25 percent at 1 cycle per millimeter. The mean glandular doses calculated for a breast thickness of 4 cm at various intensities -- ranging from 0.022 rad at 70mAs to 0.043 rad at 125mAs -- were approximately 10 times less than the value designated by the American College of Radiology (0.3 rad per breast image). At 40kV, LODOX exhibits an average half value layer of 1.59 mm of Al (compared to 0.3 to 0.4 mm recommended for mammography), illustrating the unfavorable higher penetration of LODOX X-rays. The extremely low radiation dose delivered by the LODOX suggests that the technology would be feasible for detecting and diagnosing cancers in the sensitive tissue of the breast, once adjustments to X-ray range and beam hardness had been accomplished.

  5. Determination of shielding requirements for mammography.

    PubMed

    Okunade, Akintunde Akangbe; Ademoroti, Olalekan Albert

    2004-05-01

    Shielding requirements for mammography when considerations are to be given to attenuation by compression paddle, breast tissue, grid and image receptor (intervening materials) has been investigated. By matching of the attenuation and hardening properties, comparisons are made between shielding afforded by breast tissue materials (water, Lucite and 50%-50% adipose-glandular tissue) and some materials considered for shielding diagnostic x-ray beams, namely lead, steel and gypsum wallboard. Results show that significant differences exist between the thickness required to produce equal attenuation and that required to produce equal hardening of a given incident beam. While attenuation equivalent thickness produces equal exposure, it does not produce equal hardening. For shielding purposes, equivalence in exposure reduction without equivalence in penetrating power of an emerging beam does not amount to equivalence in shielding affordable by two different materials. Presented are models and results of sample calculations of additional shielding requirements apart from that provided by intervening materials. The shielding requirements for the integrated beam emerging from intervening materials are different from those for the integrated beam emerging from materials (lead/steel/gypsum wallboard) with attenuation equivalent thicknesses of these intervening materials. PMID:15191311

  6. 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.

  7. A compensated radiolucent electrode array for combined EIT and mammography

    PubMed Central

    Kao, Tzu-Jen; Saulnier, G J; Xia, Hongjun; Tamma, Chandana; Newell, J C; Isaacson, D

    2008-01-01

    Electrical impedance tomography (EIT), a non-invasive technique used to image the electrical conductivity and permittivity within a body from measurements taken on the body's surface, could be used as an indicator for breast cancer. Because of the low spatial resolution of EIT, combining it with other modalities may enhance its utility. X-ray mammography, the standard screening technique for breast cancer, is the first choice for that other modality. Here, we describe a radiolucent electrode array that can be attached to the compression plates of a mammography unit enabling EIT and mammography data to be taken simultaneously and in register. The radiolucent electrode array is made by depositing thin layers of metal on a plastic substrate. The structure of the array is presented along with data showing its x-ray absorbance and electrical properties. The data show that the electrode array has satisfactory radiolucency and sufficiently low resistance. PMID:17664644

  8. Mammography in Connecticut: current estimates of capacity and usage.

    PubMed

    Gregorio, D I; Kegeles, S; Parker, C; Benn, S

    1990-07-01

    All 124 registered mammography facilities in Connecticut were surveyed in 1988 to determine the availability, quality, and usage of mammography services. A total of 112 responses (90% return) were analyzed. By the measures considered here, capacity and quality of mammography in Connecticut is very good to excellent. Services are available in Connecticut in a wide array of locales, times, and settings. Since 1985, 95 new dedicated machines have been put into service. We estimate that current capacity may exceed 400,000 annual studies. Utilization is below current capacity; roughly 155,000 examinations were completed in 1988. Continued recognition of the procedure's effectiveness, particularly in screening women for evidence of early disease, can help reduce the burden of breast cancer. PMID:2394095

  9. Evaluating women's attitudes and perceptions in developing mammography promotion messages.

    PubMed

    Schechter, C; Vanchieri, C F; Crofton, C

    1990-01-01

    Breast cancer is a leading cause of cancer deaths in women. Although mammography is recognized as the most effective early detection method for breast cancer, it remains underutilized. Communications theory and practice, with its emphasis on formative research, can provide a basis for developing strategies effective in changing mammography-related behaviors. Formative research, an important component of communications planning, can offer information useful in developing suitable messages and materials. The National Cancer Institute conducted small group discussions with white and black women, ages 40 to 75, to explore their attitudes, knowledge, and beliefs about mammography. Findings reinforced the results from quantitative surveys indicating that a perceived lack of their own need for the examination, lack of a physician referral, and procrastination were the main reasons that the women reported for not having mammograms. The discussions provided detailed information about the factors that can be used to guide development of messages and materials to promote mammography use. The results indicate that strategies for messages directed to either black or white women ages 40 years and older need to stress the same key message points. The points are that all women ages 40 and older are at risk for breast cancer; breast cancer can be treated successfully if it is detected early enough; mammography can detect breast cancer before a lump can be felt by a woman or her physician; women need to follow screening guidelines for age and frequency for screening; and mammography is a low-risk, quick, and painless procedure. Communication channels to reach women should include television, newspapers, magazines, and information available in physicians' offices. PMID:2113683

  10. 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

  11. Mammography to screen asymptomatic women for breast cancer

    SciTech Connect

    Moskowitz, M.

    1984-09-01

    Despite the lack of absolute confirmation from a properly controlled clinical trial, there is now sufficient evidence to permit the working assumption that screening mammography beginning at age 40 will play a substantial role in controlling breast cancer. An anlaysis of available data indicates that the benefits of mammographic screening far exceed potential risk, and that earlier detection of cancer will actually add years to life rather than simply permit an earlier diagnosis. American radiologists are now challenged to provide screening mammography in an easily accessible and inexpensive form, so that it is effectively available to all women over age 40.

  12. 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

  13. Uncertainty modeling for ontology-based mammography annotation with intelligent BI-RADS scoring.

    PubMed

    Bulu, Hakan; Alpkocak, Adil; Balci, Pinar

    2013-05-01

    This paper presents an ontology-based annotation system and BI-RADS (Breast Imaging Reporting and Data System) score reasoning with Semantic Web technologies in mammography. The annotation system is based on the Mammography Annotation Ontology (MAO) where the BI-RADS score reasoning works. However, ontologies are based on crisp logic and they cannot handle uncertainty. Consequently, we propose a Bayesian-based approach to model uncertainty in mammography ontology and make reasoning possible using BI-RADS scores with SQWRL (Semantic Query-enhanced Web Rule Language). First, we give general information about our system and present details of mammography annotation ontology, its main concepts and relationships. Then, we express uncertainty in mammography and present approaches to handle uncertainty issues. System is evaluated with a manually annotated dataset DEMS (Dokuz Eylul University Mammography Set) and DDSM (Digital Database for Screening Mammography). We give the result of experimentations in terms of accuracy, sensitivity, precision and uncertainty level measures.

  14. Akteure in der Renaturierung

    NASA Astrophysics Data System (ADS)

    Wiegleb, Gerhard; Lüderitz, Volker

    Dieses Kapitel behandelt die Bedeutung von Akteuren in Renaturierungsprojekten. Renaturierung ist die absichtliche Veränderung der Umwelt in Richtung auf einen von den Akteuren als "naturnäher“ erachteten Zustand (Kapitel 1). Betroffen davon ist nicht nur die Umwelt der Akteure, sondern auch die Umwelt anderer. Daraus ergeben sich sowohl aktive wie passive Bezüge zur Renaturierung. Aktive und passive Rollen sind je nach Ausdehnung, Zeithorizont und Trägerschaft nicht immer trennbar, sodass die Unterscheidung in Akteure und Betroffene nur begrenzte Gültigkeit hat. Methodisch basiert die Untersuchung der Teilhabe an Renaturierung auf Akteurs- und Akzeptanzanalysen (vgl. Segert und Zierke 2004, Newig 2004). Die vorliegenden Ausführungen befassen sich schwerpunktmäßig mit dem Aspekt der Akteursanalyse. Die Frage der Akzeptanz wird kurz angesprochen (Kapitel 15, Umweltethische Aspekte). Anhand der Analyse zweier Fallstudien werden dann einige Schlussfolgerungen gezogen. Die Darstellung soll im Wesentlichen das Feld für zukünftig nötige Forschungsarbeiten strukturieren.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. Implications of Overdiagnosis: Impact on Screening Mammography Practices.

    PubMed

    Morris, Elizabeth; Feig, Stephen A; Drexler, Madeline; Lehman, Constance

    2015-09-01

    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).

  2. Artificial Neural Networks in Mammography Interpretation and Diagnostic Decision Making

    PubMed Central

    Burnside, Elizabeth S.

    2013-01-01

    Screening mammography is the most effective means for early detection of breast cancer. Although general rules for discriminating malignant and benign lesions exist, radiologists are unable to perfectly detect and classify all lesions as malignant and benign, for many reasons which include, but are not limited to, overlap of features that distinguish malignancy, difficulty in estimating disease risk, and variability in recommended management. When predictive variables are numerous and interact, ad hoc decision making strategies based on experience and memory may lead to systematic errors and variability in practice. The integration of computer models to help radiologists increase the accuracy of mammography examinations in diagnostic decision making has gained increasing attention in the last two decades. In this study, we provide an overview of one of the most commonly used models, artificial neural networks (ANNs), in mammography interpretation and diagnostic decision making and discuss important features in mammography interpretation. We conclude by discussing several common limitations of existing research on ANN-based detection and diagnostic models and provide possible future research directions. PMID:23781276

  3. 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

  4. Issues to Consider in Converting to Digital Mammography

    PubMed Central

    Pisano, Etta D.; Zuley, Margarita; Baum, Janet K.; Marques, Helga S.

    2007-01-01

    This paper will outline the reasons that many radiology practices are converting to digital mammography. In addition, we will provide basic information on the issues that must be considered in making the transformation. These include technical matters regarding image display, storage and retrieval, as well as clinical and ergonomic considerations. PMID:17888771

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

    PubMed Central

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

    2014-01-01

    Purpose: Mammographic density has been shown to be an indicator of breast cancer risk and also reduces the sensitivity of screening mammography. Currently, there is no accepted standard for measuring breast density. Dual energy mammography has been proposed as a technique for accurate measurement of breast density. The purpose of this study is to validate its accuracy in postmortem breasts and compare it with other existing techniques. Methods: Forty postmortem breasts were imaged using a dual energy mammography system. Glandular and adipose equivalent phantoms of uniform thickness were used to calibrate a dual energy basis decomposition algorithm. Dual energy decomposition was applied after scatter correction to calculate breast density. Breast density was also estimated using radiologist reader assessment, standard histogram thresholding and a fuzzy C-mean algorithm. Chemical analysis was used as the reference standard to assess the accuracy of different techniques to measure breast composition. Results: Breast density measurements using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean algorithm, and dual energy were in good agreement with the measured fibroglandular volume fraction using chemical analysis. The standard error estimates using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean, and dual energy were 9.9%, 8.6%, 7.2%, and 4.7%, respectively. Conclusions: The results indicate that dual energy mammography can be used to accurately measure breast density. The variability in breast density estimation using dual energy mammography was lower than reader assessment rankings, standard histogram thresholding, and fuzzy C-mean algorithm. Improved quantification of breast density is expected to further enhance its utility as a risk factor for breast cancer. PMID:25086548

  6. 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.

  7. 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

  8. 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

  9. A survey on performance status of mammography machines: image quality and dosimetry studies using a standard mammography imaging phantom.

    PubMed

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

    2012-07-01

    It is essential to perform quality control (QC) tests on mammography equipment in order to produce an appropriate image quality at a lower radiation dose to patients. Imaging and dosimetric measurements on 15 mammography machines located at the busiest radiology centres of Mumbai, India were carried out using a standard CIRS breast imaging phantom in order to see the level of image quality and breast doses. The QC tests include evaluations of image quality and the mean glandular doses (MGD), which is derived from the breast entrance exposure, half-value layer (HVL), compressed breast thickness (CBT) and breast tissue compositions. At the majority of the centres, film-processing and darkroom conditions were not found to be maintained, which is required to meet the technical development specifications for the mammography film in use as recommended by the American College of Radiology (ACR). In most of the surveyed centres, the viewbox luminance and room illuminance conditions were not found to be in line with the mammography requirements recommended by the ACR. The measured HVL values of the machines were in the range of 0.27-0.39 mm aluminium (Al) with a mean value of 0.33±0.04 mm Al at 28 kV(p) following the recommendation provided by ACR. The measured MGDs were in the range of 0.14-3.80 mGy with a mean value of 1.34 mGy. The measured MGDs vary between centre to centre by a factor of 27.14. Referring to patient doses and image quality, it was observed that only one mammography centre has exceeded the recommended MGD, i.e. 3.0 mGy per view with the value of 3.80 mGy and at eight mammography centres the measured central background density (CBD) values for mammography phantom image are found to be less than the recommended CBD limit value of 1.2-2.0 optical density. PMID:22090414

  10. Zum Stellenwert der Unterdruck-Instillationstherapie in der Dermatologie.

    PubMed

    Müller, Cornelia Sigrid Lissi; Burgard, Barbara; Zimmerman, Monika; Vogt, Thomas; Pföhler, Claudia

    2016-08-01

    Die Methoden zur Behandlung akuter und chronischer Wunden unterliegen einer steten Weiterentwicklung, Reevaluierung und Anwendung innovativer Therapieformen. Die Vakuumtherapie zur Wundbehandlung gehört zu den etablierten Behandlungsmodalitäten. Ein innovatives Verfahren kombiniert die Vakuumtherapie mit der automatisierten, kontrollierten Zufuhr und Drainage wirkstoffhaltiger Lösungen zur topischen Wundbehandlung im Wundbett und auch wirkstofffrei durch Instillation physiologischer Kochsalzlösung (Unterdruck-Instillationstherapie). Hierdurch können die Effekte der konventionellen Vakuumtherapie mit denen der lokalen Antisepsis kombiniert werden. Hierdurch kommt es zu einer Reduktion der Wundfläche, einer Induktion von Granulationsgewebe sowie einer Reduktion der Keimbesiedelung der Wunden. Bisher publizierte Studien konzentrieren sich auf die Anwendung dieses Therapieverfahrens zur Behandlung orthopädisch-chirurgischer Krankheiten. Die Datenlage bezüglich der Vakuum-Instillationstherapie in der Dermatochirurgie beschränkt sich derzeit auf Fallberichte und Einzelfallerfahrungen. Randomisierte, prospektive Studien zum Vergleich der Vakuum-Instillationstherapie zur Behandlung dermatologischer Krankheitsbilder existieren bislang nicht. Ziele des vorliegenden Artikels sind die Vorstellung der Vakuumtherapie mit Instillation einschließlich ihres Wirkprinzips, deren mögliche Komplikationen, die Diskussion erdenklicher Kontraindikationen sowie eine Übersicht über die aktuell verfügbare Datenlage. Zusammenfassend scheint sich die Evidenz zu verdichten, dass mittels Unterdruck-Instillationstherapie sowohl einfache als auch komplizierte Wunden effizient behandelt werden können, was sich in einer deutlichen Beschleunigung der Wundgranulation mit konsekutiv früher möglichem Defektverschluss äußert. PMID:27509413

  11. 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

  12. Effectiveness of Computer-Aided Detection in Community Mammography Practice

    PubMed Central

    Abraham, Linn; Taplin, Stephen H.; Geller, Berta M.; Carney, Patricia A.; D’Orsi, Carl; Elmore, Joann G.; Barlow, William E.

    2011-01-01

    Background Computer-aided detection (CAD) is applied during screening mammography for millions of US women annually, although it is uncertain whether CAD improves breast cancer detection when used by community radiologists. Methods We investigated the association between CAD use during film-screen screening mammography and specificity, sensitivity, positive predictive value, cancer detection rates, and prognostic characteristics of breast cancers (stage, size, and node involvement). Records from 684 956 women who received more than 1.6 million film-screen mammograms at Breast Cancer Surveillance Consortium facilities in seven states in the United States from 1998 to 2006 were analyzed. We used random-effects logistic regression to estimate associations between CAD and specificity (true-negative examinations among women without breast cancer), sensitivity (true-positive examinations among women with breast cancer diagnosed within 1 year of mammography), and positive predictive value (breast cancer diagnosed after positive mammograms) while adjusting for mammography registry, patient age, time since previous mammography, breast density, use of hormone replacement therapy, and year of examination (1998–2002 vs 2003–2006). All statistical tests were two-sided. Results Of 90 total facilities, 25 (27.8%) adopted CAD and used it for an average of 27.5 study months. In adjusted analyses, CAD use was associated with statistically significantly lower specificity (OR = 0.87, 95% confidence interval [CI] = 0.85 to 0.89, P < .001) and positive predictive value (OR = 0.89, 95% CI = 0.80 to 0.99, P = .03). A non-statistically significant increase in overall sensitivity with CAD (OR = 1.06, 95% CI = 0.84 to 1.33, P = .62) was attributed to increased sensitivity for ductal carcinoma in situ (OR = 1.55, 95% CI = 0.83 to 2.91; P = .17), although sensitivity for invasive cancer was similar with or without CAD (OR = 0.96, 95% CI = 0.75 to 1.24; P = .77). CAD was not associated with

  13. 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

  14. Van der Waals Forces

    NASA Astrophysics Data System (ADS)

    Parsegian, V. Adrian

    2006-03-01

    This should prove to be the definitive work explaining van der Waals forces, how to calculate them and take account of their impact under any circumstances and conditions. These weak intermolecular forces are of truly pervasive impact, and biologists, chemists, physicists and engineers will profit greatly from the thorough grounding in these fundamental forces that this book offers. Parsegian has organized his book at three successive levels of mathematical sophistication, to satisfy the needs and interests of readers at all levels of preparation. The Prelude and Level 1 are intended to give everyone an overview in words and pictures of the modern theory of van der Waals forces. Level 2 gives the formulae and a wide range of algorithms to let readers compute the van der Waals forces under virtually any physical or physiological conditions. Level 3 offers a rigorous basic formulation of the theory. Author is among the most highly respected biophysicists Van der Waals forces are significant for a wide range of questions and problems in the life sciences, chemistry, physics, and engineering, ranging up to the macro level No other book that develops the subject vigorously, and this book also makes the subject intuitively accessible to students who had not previously been mathematically sophisticated enough to calculate them

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. A device for measuring compression force in mammography.

    PubMed

    Thiele, D L; Simeoni, R J; Panaretos, S

    1993-03-01

    Compression in mammography is an accepted technique for improving image quality and reducing dose, but excessive compression can cause pain and other undesirable effects. Therefore, maximum compression force should be measured in a quality assurance programme. A compression force meter, based on a load cell design, has been constructed and used to make compression force measurements on three GE Senographe 600T mammography machines. These measurements show that the conversion from pneumatic pressure (as indicated on the machine) to applied compression force is given by Compression Force (N) = (79.0 +/- 0.9) x Pneumatic Pressure (bars) + (12.2 +/- 4.0). Using this equation and pneumatic pressure settings on nine GE Senographe 600T units in our quality assurance programme, the maximum compression force in clinical use ranges from 102 to 150 N with a mean of 126 N. This is lower than guidelines used in the United States and the United Kingdom. PMID:8470999

  20. 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

  1. 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

  2. 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

  3. Radiation risk from mammography: is it clinically significant

    SciTech Connect

    Feig, S.A.

    1984-09-01

    The observation of excess breast cancers among women exposed to high doses of radiation has led to speculation that a similar risk of smaller magnitude could result from the low doses of x-rays used in mammography. However, such risk is extremely small and seems negligible when compared with the potential benefit for mammographic screening performed according to the American Cancer Society and American College of Radiology Guidelines.

  4. Radiation risk from mammography: is it clinically significant

    SciTech Connect

    Feig, S.A.

    1984-09-01

    The observation of excess breast cancers among women exposed to high doses of radiation has led to speculation that a similar risk of smaller magnitude could result from the low doses of x-rays used in mammography. However, such risk is extremely small and seems negligible when compared with the potential benefit for mammographic screening performed according to the American Cancer Society and American College of Radiology guidelines.

  5. International exchange activities with East Asian countries through mammography.

    PubMed

    Endo, Tokiko; Morimoto, Tadaoki; Horita, Katsuhei; Kimura, Chiaki; Okazaki, Masatoshi; Fukuda, Mamoru

    2009-01-01

    The Japanese NPO Central Committee on Quality Control of Mammographic Screening has initiated international exchange activities regarding quality control of mammographic screening with the concerned organizations in East Asian countries with the objective of contributing to reducing breast cancer mortality in the region. This paper describes the status of the international exchanges that are being carried out in various East Asian countries in relation to mammography and also discusses future aspects. PMID:19034615

  6. 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).

  7. The influence of software filtering in digital mammography image quality

    NASA Astrophysics Data System (ADS)

    Michail, C.; Spyropoulou, V.; Kalyvas, N.; Valais, I.; Dimitropoulos, N.; Fountos, G.; Kandarakis, I.; Panayiotakis, G.

    2009-05-01

    Breast cancer is one of the most frequently diagnosed cancers among women. Several techniques have been developed to help in the early detection of breast cancer such as conventional and digital x-ray mammography, positron and single-photon emission mammography, etc. A key advantage in digital mammography is that images can be manipulated as simple computer image files. Thus non-dedicated commercially available image manipulation software can be employed to process and store the images. The image processing tools of the Photoshop (CS 2) software usually incorporate digital filters which may be used to reduce image noise, enhance contrast and increase spatial resolution. However, improving an image quality parameter may result in degradation of another. The aim of this work was to investigate the influence of three sharpening filters, named hereafter sharpen, sharpen more and sharpen edges on image resolution and noise. Image resolution was assessed by means of the Modulation Transfer Function (MTF).In conclusion it was found that the correct use of commercial non-dedicated software on digital mammograms may improve some aspects of image quality.

  8. Phase mammography - a new technique for breast investigation

    NASA Astrophysics Data System (ADS)

    Ingal, Viktor N.; Beliaevskaya, Elena A.; Brianskaya, Alla P.; Merkurieva, Raisa D.

    1998-09-01

    A new phase radiography technique for investigation and diagnosis of neoplasms in breast tissue is proposed. Forty-four mammography samples with adenocarcinoma that had been prepared after mastectomy were tested in a new phase radiography device. It was shown that the phase images manifest the changes in parenchyma structure due to malignancy and microcalcifications up to in size. Results obtained were verified by histological examination. A contrast of the phase images of small microcalcifications and distortions of the stroma architecture ranges up to 40-60%; spatial resolution is about . The proposed technique offers outstanding possibilities for digital mammography. The small and large details of structure manifest themselves with practically the same contrast. Phase images differ from those obtained in mammography and many details still require further decoding.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. Mammography in asymptomatic women aged 40-49 years

    PubMed Central

    Silva, Flávio Xavier; Katz, Leila; Souza, Alex Sandro Rolland; Amorim, Melania Maria Ramos

    2014-01-01

    OBJECTIVE To assess findings of mammography of and interventions resulting from breast cancer screening in women aged 40-49 years with no increased risk (typical risk) of breast cancer. METHODS This cross-sectional study evaluated women aged 40-49 years who underwent mammography screening in a mastology reference center in Recife, PE, Northeastern Brazil, between January 2010 and October 2011. Women with breast-related complaints, positive findings in the physical examination, or high risk of breast cancer were excluded. RESULTS The 1,000 mammograms performed were classified into the following Breast Imaging-Reporting and Data System (BI-RADS) categories BI-RADS 0, 232; BI-RADS 1, 294; BI-RADS 2, 294; BI-RADS 3, 16; BI-RADS 4A, 2; BI-RADS 5, 1. There was one case of grade II invasive ductal carcinoma and various interventions, including 469 ultrasound scans, 53 referrals to mastologists, 11 cytological examinations, and 8 biopsies. CONCLUSIONS Mammography screening in women aged 40-49 years with typical risk of breast cancer led to the performance of other interventions. However, it also resulted in increased costs without demonstrable efficacy in decreasing mortality. PMID:26039396

  15. 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.

  16. Image segmentation and 3D visualization for MRI mammography

    NASA Astrophysics Data System (ADS)

    Li, Lihua; Chu, Yong; Salem, Angela F.; Clark, Robert A.

    2002-05-01

    MRI mammography has a number of advantages, including the tomographic, and therefore three-dimensional (3-D) nature, of the images. It allows the application of MRI mammography to breasts with dense tissue, post operative scarring, and silicon implants. However, due to the vast quantity of images and subtlety of difference in MR sequence, there is a need for reliable computer diagnosis to reduce the radiologist's workload. The purpose of this work was to develop automatic breast/tissue segmentation and visualization algorithms to aid physicians in detecting and observing abnormalities in breast. Two segmentation algorithms were developed: one for breast segmentation, the other for glandular tissue segmentation. In breast segmentation, the MRI image is first segmented using an adaptive growing clustering method. Two tracing algorithms were then developed to refine the breast air and chest wall boundaries of breast. The glandular tissue segmentation was performed using an adaptive thresholding method, in which the threshold value was spatially adaptive using a sliding window. The 3D visualization of the segmented 2D slices of MRI mammography was implemented under IDL environment. The breast and glandular tissue rendering, slicing and animation were displayed.

  17. Evaluation der zentralen TUM-Lernplattform

    NASA Astrophysics Data System (ADS)

    Schulze, Elvira; Baume, Matthias; Graf, Stephan; Gergintchev, Ivan

    Die Notwendigkeit der Qualitätssicherung und -kontrolle für innovative universitäre Lehr-/Lernszenarien ist in der Praxis unbestritten. Die Wirksamkeit der Einführung der zentralen Lernplattform CLIX Campus der imc AG an der TUM wurde mittels quantitativer und qualitativer Evaluation überprüft. Als statistische Bewertungsgrundlage wurde der Erreichungsgrad bestimmter Projektziele herangezogen. Aufbauend auf den theoretischen Grundlagen der Evaluation von Bildungsangeboten gibt diese Studie Aufschluss über die Ergebnisse der Datenerhebungen sowie die Einschätzung der Plattform aus Nutzersicht und belegt die wesentliche Bedeutung der durchgängigen IT-Infrastruktur und speziell der einheitlichen Verfügbarkeit der eLearning Angebote.

  18. Entwicklung und methodische Verbesserung der Arbeitssicherheit in der Instandhaltung

    NASA Astrophysics Data System (ADS)

    Galinski, Marek

    Die Hüttenwerke Krupp Mannesmann gehören zu den führenden Stahlherstellern in Europa. Die Instandhaltung ist einerseits den Anlagen vor Ort zugeordnet, andererseits gibt es für werksweite bzw. spezielle Themen eine zentrale Instandhaltung. Die im Folgenden beschriebenen Methoden wurden für das gesamte Unternehmen entwickelt, jedoch je nach Organisationseinheit unterschiedlich adaptiert und unterschiedlich intensiv verfolgt. Die zentrale Instandhaltung hat insbesondere in den letzten 12 Jahren der Arbeitssicherheit einen hohen Stellenwert beigemessen, und hervorragende Ergebnisse erzielt. So ist die Unfallhäufigkeit in der zentralen Instandhaltung von ca. 30 anzeigepflichtigen Unfällen pro eine Million verfahrener Stunden vor ca. 15 Jahren auf Null in 2007 gesunken! In 2008 konnte dieses hervorragende Ergebnis gehalten werden. Zwei Jahre unfallfrei! Wer hätte das vor 15 Jahren gedacht? Der Schwerpunkt des Beitrags liegt auf der Erläuterung der Ansatzpunkte mit denen dieses Ergebnis erreicht wurde und der Darstellung der Methoden incl. der Anpassung an die veränderten Ansatzpunkte in den betroffenen Bereichen. Die beschriebenen Methoden sind in der zentralen Instandhaltung so angewendet worden.

  19. 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.

  20. 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

  1. Neue Entwicklungen in der Berufsdermatologie.

    PubMed

    Diepgen, Thomas L

    2016-09-01

    Berufsbedingte Hautkrankheiten nach BK-Nr. 5101 stehen in Deutschland seit vielen Jahren an der Spitze der angezeigten Berufskrankheiten. Durch die Optimierung von Maßnahmen der primären, sekundären und tertiären Prävention können heutzutage die meisten Betroffenen im Beruf verbleiben. Zum 01.01.2015 wurde die Berufskrankheitenverordnung (BKV) novelliert und es wurde die BK-Nr. 5103 "Plattenepithelkarzinome oder multiple aktinische Keratosen der Haut durch natürliche UV-Strahlung" als neue Berufskrankheit in die BK-Liste der BKV aufgenommen. Die Definition von "multipel" bedeutet dabei entweder mehr als fünf einzelne aktinische Keratosen innerhalb eines Zeitraums von 12 Monaten oder das Vorliegen einer Feldkanzerisierung von größer 4 cm(2) . Wichtige Aspekte dieser neuen Berufskrankheit werden aufgezeigt und diskutiert sowie Neuerungen bei der BK 5101 angesprochen. PMID:27607028

  2. 76 FR 60848 - National Mammography Quality Assurance Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... 301-948-8900. Contact Person: Shanika Craig, Center for Devices and Radiological Health, Food and Drug...) accreditation body review of soft copy mammography images; and (3) reporting breast density on mammography... issues pending before the committee. Written submissions may be made to the contact person on or...

  3. Clinical value of mammography in diagnosis and identification of breast mass

    PubMed Central

    Li, Hongjun; Zhang, Shanhua; Wang, Qingyuan; Zhu, Rongguang

    2016-01-01

    Objective: To study the effect and clinical value of mammography in the diagnosis of breast lump so as to improve the diagnosis level of breast cancer. Methods: A retrospective analysis was carried out on clinical data of 110 patients with mammary lump confirmed by pathology to study the compliance of mammography diagnosis and Pathology diagnosis in breast lump, and the detection of microcalcifications, phyllode, and observe the image performance of mammography. Taking infitrating ductal carcinoma (IDC) as an example, the correlation of image performance and clinical pathological features of different types was studied so as to predict if mammography performance was effective in the treatment and prognosis in breast cancer. Results: Taking Breast Imaging Reporting and Data System (BI-RADS) grade 4A as the critical point, the sensitivity, specificity and accuracy of mammography was 90.80% (109/120), 84.60% (126/149) and 87.40% (235/269); taking BI-RADS grade 4B as the critical point, the sensitivity, specificity and accuracy of mammography was 85.00% (102/120), 93.30% (139/149) and 89.60% (241/269); the correlation analysis suggested that, there was some kind of correlation between the mammography performance and clinical features of breast cancer. Conclusion: Mammography is worth being promoted in clinic for its significant clinical value in diagnosing and identifying breast lump. PMID:27648060

  4. 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…

  5. 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.

  6. Clinical value of mammography in diagnosis and identification of breast mass

    PubMed Central

    Li, Hongjun; Zhang, Shanhua; Wang, Qingyuan; Zhu, Rongguang

    2016-01-01

    Objective: To study the effect and clinical value of mammography in the diagnosis of breast lump so as to improve the diagnosis level of breast cancer. Methods: A retrospective analysis was carried out on clinical data of 110 patients with mammary lump confirmed by pathology to study the compliance of mammography diagnosis and Pathology diagnosis in breast lump, and the detection of microcalcifications, phyllode, and observe the image performance of mammography. Taking infitrating ductal carcinoma (IDC) as an example, the correlation of image performance and clinical pathological features of different types was studied so as to predict if mammography performance was effective in the treatment and prognosis in breast cancer. Results: Taking Breast Imaging Reporting and Data System (BI-RADS) grade 4A as the critical point, the sensitivity, specificity and accuracy of mammography was 90.80% (109/120), 84.60% (126/149) and 87.40% (235/269); taking BI-RADS grade 4B as the critical point, the sensitivity, specificity and accuracy of mammography was 85.00% (102/120), 93.30% (139/149) and 89.60% (241/269); the correlation analysis suggested that, there was some kind of correlation between the mammography performance and clinical features of breast cancer. Conclusion: Mammography is worth being promoted in clinic for its significant clinical value in diagnosing and identifying breast lump.

  7. 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…

  8. 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

  9. 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…

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

    PubMed

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

    2009-12-01

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

  11. Obesity, Gynecological Factors, and Abnormal Mammography Follow-Up in Minority and Medically Underserved Women

    PubMed Central

    Wujcik, Debra; Lin, Jin-Mann S.; Grau, Ana; Wilson, Veronica; Champion, Victoria; Zheng, Wei; Egan, Kathleen M.

    2009-01-01

    Abstract Background The relationship between obesity and screening mammography adherence has been examined previously, yet few studies have investigated obesity as a potential mediator of timely follow-up of abnormal (Breast Imaging Reporting and Data System [BIRADS-0]) mammography results in minority and medically underserved patients. Methods We conducted a retrospective cohort study of 35 women who did not return for follow-up >6 months from index abnormal mammography and 41 who returned for follow-up ≤6 months in Nashville, Tennessee. Patients with a BIRADS-0 mammography event in 2003–2004 were identified by chart review. Breast cancer risk factors were collected by telephone interview. Multivariate logistic regression was performed on selected factors with return for diagnostic follow-up. Results Obesity and gynecological history were significant predictors of abnormal mammography resolution. A significantly higher frequency of obese women delayed return for mammography resolution compared with nonobese women (64.7% vs. 35.3%). A greater number of hysterectomized women returned for diagnostic follow-up compared with their counterparts without a hysterectomy (77.8% vs. 22.2%). Obese patients were more likely to delay follow-up >6 months (adjusted OR 4.09, p = 0.02). Conversely, hysterectomized women were significantly more likely to return for timely mammography follow-up ≤6 months (adjusted OR 7.95, p = 0.007). Conclusions Study results suggest that weight status and gynecological history influence patients' decisions to participate in mammography follow-up studies. Strategies are necessary to reduce weight-related barriers to mammography follow-up in the healthcare system including provider training related to mammography screening of obese women. PMID:19558307

  12. Materialbereitstellung in der Montage

    NASA Astrophysics Data System (ADS)

    Nyhuis, Peter; Wiendahl, Hans-Peter; Fiege, Torsten; Mühlenbruch, Helge

    Die Montage verarbeitet eine sehr große Anzahl unterschiedlicher Teile und Baugruppen in zahlreichen Varianten. Sie müssen mit hoher Zuverläs-sigkeit am richtigen Ort zur richtigen Zeit in der richtigen Qualität and zu den richtigen Kosten bereit stehen. Im Gegensatz zum Ausgangsmaterial in einer Fertigung sind sie funktionsfähig and damit meist empfindlich. Bevor sie an einer Montageeinrichtung eintreffen, sind auf dem Wege vom Hersteller zum Verbauort drei unterschiedliche Abschnitte zu erkennen, die von unterschiedlichen inner- und außerbetrieblichen Akteuren geplant, durchgeführt and überwacht werden.

  13. Quantenphysikalischer Ursprung der Eichidee

    NASA Astrophysics Data System (ADS)

    Bopp, Fritz

    Betrachtet man die Quantenphysik als Zusammenspiel von elementaren Erzeugungs- und Vernichtungsprozessen, so sind Eichfeldtheorien nicht nur möglich, sondern auch notwendig. Die komplex konjugierten Phasenfaktoren jedes Paares von Erzeugungs- und Vernichtungsoperatoren sind nämlich. willkürlich wählbar. Darum müssen Quantenfeldtheorien vollständig phaseninvariant sein. Das ist ohne Eichfelder nicht möglich.Dem steht im Wege, daß die Diracgleichung nicht einmal global vollständig phaseninvariant ist. Multipliziert man nämlich die Komponenten der Erzeugungs- und Vernichtungsoperatoren mit verschiedenen konstanten Phasenfaktoren, so ändern sich die Diracmatrizen. Nur die Diracschen Vertauschungsrelationen bleiben invariant. Doch sind die Diracgleichungen vor und nach der Transformation physikalisch äquivalent. Man kann also sagen: Systeme freier Fermionen werden erst durch die Klasse aller äquivalenten Diracgleichungen vollständig dargestellt.Da die Diracschen Vertauschungsrelationen gegen beliebige unitäre Transformationen invariant sind, ist die Klasse äquivalenter Diracgleichungen U 4-invariant. Unitäre Diagonalmatrizen liefern willkürliche Phasentransformationen der Spinorkomponenten, so daß die zur Gruppe U 4 gehörigen Eichfelder zu eine allgemein phaseninvarianten Theorie führen. Sie ist so eng mit der QED verwandt, daß wir von einer erweiterten Quantenelektrodynamik, EQE, sprechen können.Hier soll nur gezeigt werden, daß die EQE existiert. Dabei liefert die invariante Untergruppe U 1 von U 4 die QED. Die komplementäre Untergruppe SU 4 umschließt vier Untergruppen SU 3, drei Untergruppen O 4 und sechs Untergruppen SU 2. Letztere könnten den drei Paaren von Quarks und den drei Paaren von Leptonen entsprechen, wobei sich die Quarkpaare zu einer Gruppe SU 3 zusammenschließen. Mehr als zweimal drei Paare von elementaren Fermionen gibt es in der EQE nicht. Sie wird zwar kaum mit der vereinigten QED und QCD identisch sein. Doch sollte sie

  14. Kosten der Renaturierung

    NASA Astrophysics Data System (ADS)

    Hampicke, Ulrich

    Die Kapitel 3 bis 14 dieses Buches verdeutlichen die Verschiedenartigkeit der Renaturierungsprozesse in unterschiedlichen Ökosystemen und lassen keinen Zweifel daran, dass deren Kosten auch sehr weit auseinanderklaffen können. Die Kosten können gering sein, wenn die Renaturierung nur darin besteht, ein Biotop, das niemand braucht, sich selbst zu überlassen. Sie können aber auch sehr hoch sein, wenn etwa Sedimente eines Sees ausgebaggert und als Sondermüll entsorgt und aufwändige Klärkapazitäten installiert werden müssen.

  15. 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

  16. 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

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

    PubMed Central

    Moodi, Mitra; Rezaeian, Mohsen; Mostafavi, Firoozeh; Sharifirad, Golam-Reza

    2012-01-01

    Background: Breast cancer remains a substantial health concern in Iran due to delay and late stage at diagnosis and treatment. Despite the potential benefits of mammography screening for early detection of breast cancer, the performance of this screening among Iranian women is low. For planning appropriate intervention, this study was carried out to identify mammography rates and explore determinants of mammography screening behavior in females of Isfahan, Iran. Materials and Methods: In this population-based study, 384 women of 40 years and older were interviewed by telephone. The Farsi version of Champion's Health Belief Model scale (CHBMS) was used to examine factors associated with mammography screening. The obtained data were analyzed by SPSS (version 16.0) using statistical Chi-square, Fisher Exact test, t-test and multiple logistic regression model to identify the importance rate of socio-demographic and Health Belief Model (HBM) variables to predict mammography screening behavior. In all of tests, the level of significant was considered a = 0.05. Results: Mean age ± SD of women was 52.24 ± 8.2 years. Of the 384 participants, 44.3% reported at least one mammogram in their lifetime. Logistic regression analysis indicated that women were more likely to have mammography if they heard/read about breast cancer (OR = 4.17, 95% CI 2.09, 8.34), menopause in lower age (OR = 0.2, 95% CI 0.87, 0.99) and history of breast problem (OR = 0.9, 95% CI 0.12, 0.32). Also, women who perceived more benefits of mammography (OR = 1.84, 95% CI 1.63, 2.09), fewer barriers of mammography (OR = 0.91, 95% CI 0.86, 0.96) and had more motivation for health (OR = 0.94, 95% CI 0.89, 1) were more likely to have mammography. Conclusion: The findings indicated that the rate of mammography screening among women in Isfahan province is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the first priority for

  18. Der Strahlenkranz im sonnigen Wasser

    NASA Astrophysics Data System (ADS)

    Schlichting, Hans Joachim

    2000-01-01

    Wie in der Kunst gibt es auch in der Natur neben dem kreisförmigen Heiligenschein einen strahlenförmigen Nimbus um den Kopfschatten "auserwählter" Personen. Er ist in leicht getrübtem Wasser zu beobachten.

  19. Zeit im Wandel der Zeit.

    NASA Astrophysics Data System (ADS)

    Aichelburg, P. C.

    Contents: Einleitung(P. C. Aichelburg). 1. Über Zeit, Bewegung und Veränderung (Aristoteles). 2. Ewigkeit und Zeit (Plotin). 3. Was ist die Zeit? (Augustinus). 4. Von der Zeit (Immanuel Kant). 5. Newtons Ansichten über Zeit, Raum und Bewegung (Ernst Mach). 6. Über die mechanische Erklärung irreversibler Vorgänge (Ludwig Boltzmann). 7. Das Maß der Zeit (Henri Poincaré). 8. Dauer und Intuition (Henri Bergson). 9. Die Geschichte des Unendlichkeitsproblems (Bertrand Russell). 10. Raum und Zeit (Hermann Minkowski). 11. Der Unterschied von Zeit und Raum (Hans Reichenbach). 12. Newtonscher und Bergsonscher Zeitbegriff (Norbert Wiener). 13. Die Bildung des Zeitbegriffs beim Kinde (JeanPiaget).14. Eine Bemerkung über die Beziehungen zwischen Relativitätstheorie und der idealistischen Philosophie (Kurt Gödel). 15. Der zweite Hauptsatz und der Unterschied von Vergangenheit und Zukunft (Carl Friedrich v. Weizsäcker). 16. Zeit als physikalischer Begriff (Friedrich Hund). 17. Zeitmessung und Zeitbegriff in der Astronomie (Otto Heckmann). 18. Kann die Zeit rückwärts gehen? (Martin Gardner). 19. Zeit und Zeiten (Ilya Prigogine, Isabelle Stengers). 20. Zeit als dynamische Größe in der Relativitätstheorie (P. C. Aichelburg).

  20. Clear-PEM, a dedicated PET camera for mammography

    NASA Astrophysics Data System (ADS)

    Lecoq, P.; Varela, J.

    2002-06-01

    Preliminary results suggest that Positron Emission Mammography (PEM) can offer a noninvasive method for the diagnosis of breast cancer. Metabolic images from PEM contain unique information not available from conventional morphologic imaging techniques and aid in expeditiously establishing the diagnosis of cancer. A dedicated machine seems to offer better perspectives in terms of position resolution and sensitivity. This paper describes the concept of Clear-PEM, the system presently developed by the Crystal Clear Collaboration at CERN for an evaluation of this approach. This device is based on new crystals introduced by the Crystal Clear as well as on modern data acquisition techniques developed for the large experiments in high energy physics experiments.

  1. 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

  2. Average glandular dose and phantom image quality in mammography

    NASA Astrophysics Data System (ADS)

    Oliveira, M.; Nogueira, M. S.; Guedes, E.; Andrade, M. C.; Peixoto, J. E.; Joana, G. S.; Castro, J. G.

    2007-09-01

    Doses in mammography should be maintained as low as possible without reducing the high image quality needed for early detection of the breast cancer. The breast is composed of tissues with very close composition and densities. It increases the difficulty to detect small changes in the normal anatomical structures which may be associated with breast cancer. To achieve the standards of definition and contrast for mammography, the quality and intensity of the X-ray beam, the breast positioning and compression, the film-screen system, and the film processing have to be in optimal operational conditions. This study sought to evaluate average glandular dose (AGD) and image quality on a standard phantom in 134 mammography units in the state of Minas Gerais, Brazil, between December 2004 and May 2006. AGDs were obtained by means of entrance kerma measured with TL LiF100 dosimeters on phantom surface. Phantom images were obtained with automatic exposure technique, fixed 28 kV and molybdenum anode-filter combination. The phantom used contained structures simulating tumoral masses, microcalcifications, fibers and low contrast areas. High-resolution metallic meshes to assess image definition and a stepwedge to measure image contrast index were also inserted in the phantom. The visualization of simulated structures, the mean optical density and the contrast index allowed to classify the phantom image quality in a seven-point scale. The results showed that 54.5% of the facilities did not achieve the minimum performance level for image quality. It is mainly due to insufficient film processing observed in 61.2% of the units. AGD varied from 0.41 to 2.73 mGy with a mean value of 1.32±0.44 mGy. In all optimal quality phantom images, AGDs were in this range. Additionally, in 7.3% of the mammography units, the AGD constraint of 2 mGy was exceeded. One may conclude that dose level to patient and image quality are not in conformity to regulations in most of the facilities. This

  3. 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.

  4. Knowledge discovery from structured mammography reports using inductive logic programming.

    PubMed

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

    2005-01-01

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

  5. 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

  6. Breast cancer detection: radiologists’ performance using mammography with and without automated whole-breast ultrasound

    PubMed Central

    Dean, Judy; Lee, Sung-Jae; Comulada, W. Scott

    2010-01-01

    Objective Radiologist reader performance for breast cancer detection using mammography plus automated whole-breast ultrasound (AWBU) was compared with mammography alone. Methods Screenings for non-palpable breast malignancies in women with radiographically dense breasts with contemporaneous mammograms and AWBU were reviewed by 12 radiologists blinded to the diagnoses; half the studies were abnormal. Readers first reviewed the 102 mammograms. The American College of Radiology (ACR) Breast Imaging Reporting and Data System (BIRADS) and Digital Mammographic Imaging Screening Trial (DMIST) likelihood ratings were recorded with location information for identified abnormalities. Readers then reviewed the mammograms and AWBU with knowledge of previous mammogram-only evaluation. We compared reader performance across screening techniques using absolute callback, areas under the curve (AUC), and figure of merit (FOM). Results True positivity of cancer detection increased 63%, with only a 4% decrease in true negativity. Reader-averaged AUC was higher for mammography plus AWBU compared with mammography alone by BIRADS (0.808 versus 0.701) and likelihood scores (0.810 versus 0.703). Similarly, FOM was higher for mammography plus AWBU compared with mammography alone by BIRADS (0.786 versus 0.613) and likelihood scores (0.791 versus 0.614). Conclusion Adding AWBU to mammography improved callback rates, accuracy of breast cancer detection, and confidence in callbacks for dense-breasted women. PMID:20632009

  7. Is the supply of mammography machines outstripping need and demand? An economic analysis.

    PubMed

    Brown, M L; Kessler, L G; Rueter, F G

    1990-10-01

    The number of dedicated mammography machines installed in the United States has grown explosively. It is estimated that almost 10,000 machines will be installed by 1990, whereas the projected demand for screening mammography will require only approximately 2,600 machines, if the machines are used in a moderately efficient manner. The excess supply of mammography resources raises concern from an economic perspective for several reasons. First, such a condition means that health care resources are being used inefficiently. Second, the low average utilization rate of mammography equipment implied by these results necessitates charging a high price-over $100, on average-to cover costs. This price is above the $50 usually associated with low-cost screening mammography programs, and it may impede a desirable public health trend to increase use of mammography screening. Third, the existence of many mammography facilities operating at low capacity levels is inefficient from a health systems perspective, increasing the cost of quality assurance and medical record keeping. The current condition of excess supply is probably unsustainable over the long term. PMID:2393209

  8. Degree of Enhancement on Contrast Enhanced Spectral Mammography (CESM) and Lesion Type on Mammography (MG): Comparison Based on Histological Results

    PubMed Central

    Łuczyńska, Elżbieta; Niemiec, Joanna; Hendrick, Edward; Heinze, Sylwia; Jaszczyński, Janusz; Jakubowicz, Jerzy; Sas-Korczyńska, Beata; Rys, Janusz

    2016-01-01

    Background Contrast enhanced spectral mammography (CESM) is a new method of breast cancer diagnosis in which an iodinated contrast agent is injected and dual-energy mammography is obtained in multiple views of the breasts. The aim of this study was to compare the degree of enhancement on CESM with lesion characteristics on mammography (MG) and lesion histology in women with suspicious breast lesions. Material/Methods The degree of enhancement on CESM (absent, weak, medium, or strong) was compared to lesion characteristics on MG (mass, mass with microcalcifications, or microcalcifications alone) and histology (infiltrating carcinoma, intraductal carcinoma, or benign) to compare sensitivity of the two modalities and to establish correlations that might improve diagnostic accuracy. Results Among 225 lesions identified with CESM and MG, histological evaluation revealed 143 carcinomas (127 infiltrating, 16 intraductal) and 82 benign lesions. This is the largest cohort investigated with CESM to date. The sensitivity of CESM was higher than that of MG (100% and 90%, respectively, p=0.010). Medium or strong enhancement on CESM and the presence of a mass on MG was the most likely indictor of malignancy (55.1% p=0.002). Among benign lesions, 60% presented as enhancement on CESM (were false-positive), and most frequently as medium or weak enhancement, together with a mass on MG (53%, p=0.047). Unfortunately, the study did not find combinations of MG findings and CESM enhancement patterns that would be helpful in defining false-positive lesions. We observed systematic overestimation of maximum lesion diameter on CESM compared to histology (mean difference: 2.29 mm). Conclusions Strong or medium enhancement on CESM and mass or mass with microcalcifications on MG were strong indicators of malignant transformation. However, we found no combination of MG and CESM characteristics helpful in defining false-positive lesions. PMID:27768681

  9. Screen-Film Mammography and Soft-Copy Full-Field Digital Mammography: Comparison in the Patients with Microcalcifications

    PubMed Central

    Kim, Hye Seong; Choo, Ki-Seok; Jeon, Yong Hwan; Kim, Jung-Han; Choe, Yeon Hyeon

    2005-01-01

    Objective We wanted to compare the ability of screen-film mammography (SFM) and soft-copy full-field digital mammography (s-FFDM) on two different monitors to detect and characterize microcalcifications. Materials and Methods The images of 40 patients with microcalcifications (three patients had malignant lesion and 37 patients had benign lesion), who underwent both SFM and FFDM at an interval of less than six months, were independently evaluated by three readers. Three reading sessions were undertaken for SFM and for FFDM on a mammography-dedicated review workstation (RWS, 2K×2.5K), and for FFDM on a high-resolution PACS monitor (1.7K×2.3K). The image quality, breast composition and the number and conspicuity of the microcalcifications were evaluated using a three-point rating method, and the mammographic assessment was classified into 4 categories (normal, benign, low concern and moderate to great concern). Results The image quality, the number and conspicuity of the microcalcifications by s-FFDM (on the RWS, PACS and both) were superior to those by SFM in 85.0%, 80.0% and 52.5% of the cases, respectively (p < 0.01), and those by the s-FFDM on the two different monitors were similar in 15.0%, 12.5% and 35.0% of the cases, respectively (p > 0.01). The mammographic assessment category for the microcalcifications in the three reading sessions was similar. Conclusion s-FFDM gives a superior image quality to SFM and it is better at evaluating microcalcifications. In addition, s-FFDM with the PACS monitor is comparable to s-FFDM with the RWS for evaluating microcalcifications. PMID:16374078

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. [Van-der-Woude Syndrome].

    PubMed

    Del Frari, B; Amort, M; Janecke, A R; Schutte, B C; Piza-Katzer, H

    2008-01-01

    We report on two families with different expression of a Van-der-Woude-Syndrome (VWS) and with proven mutation of the IRF6- gene. The Van-der-Woude syndrome is a rare disease, typically consisting of congenital pits of the lower lip in combination with cleft lip or cleft palate or both. The Van-der-Woude syndrome is an autosomal dominant syndrome with variable expression. The penetrance is between 0,89 and 0,99. It is important to establish the correct diagnosis by careful investigation of patients with cleft lip or cleft palate and their parents. Genetic counselling is recommended in such cases. PMID:18095255

  20. Biochips und ihr Einsatz in der Lebensmittelanalytik

    NASA Astrophysics Data System (ADS)

    Huber, Ingrid; Zeltz, Patric

    Mit der Verbreitung des Begriffes "Biochip“ in den biotechnologischen Medien wurde Ende der 1990er-Jahre zunächst der Eindruck erweckt, dass die Computerelektronik in die molekularbiologischen Anwendungen eingestiegen ist [18]. In nur wenigen Jahren hat sich die Biochiptechnologie zu einem Verfahren entwickelt, das aus der molekularbiologischen Grundlagenforschung nicht mehr wegzudenken ist und über eine Vielzahl von Einsatzbereichen verfügt. Die Biochiptechnologie ermöglicht die Miniaturisierung von DNA-, RNA- bzw. Proteinanalytik in hochparallelen Formaten. Dieser hohe Parallelisierungsgrad ist einer der wesentlichen Vorteile dieser Technik gegenüber klassischen molekularbiologischen Methoden. Sie wird heutzutage vor allem in der Genomforschung eingesetzt, für Genexpressionsstudien, zum Screening von single nucleotide polymorphisms (SNPs), in der pharmakogenetischen Forschung sowie in der Erforschung von Erbkrankheiten und in der Krebsforschung [1, 7, 19]. Neben vielen weiteren Bereichen finden Biochips auch spezielle Anwendungen in der Lebensmittelanalytik.

  1. Der evolutionäre Naturalismus in der Ethik

    NASA Astrophysics Data System (ADS)

    Kaiser, Marie I.

    Charles Darwin hat eindrucksvoll gezeigt, dass der Mensch ebenso wie alle anderen Lebewesen ein Produkt der biologischen Evolution ist. Die sich an Darwin anschließende Forschung hat außerdem plausibel gemacht, dass sich nicht nur viele der körperlichen Merkmale des Menschen, sondern auch (zumindest einige) seiner Verhaltensdispositionen in adaptiven Selektionsprozessen herausgebildet haben. Die Vorstellung, dass auch die menschliche Moralität evolutionär bedingt ist, scheint daher auf den ersten Blick ganz überzeugend. Schließlich hat die Evolutionstheorie in den vergangenen Jahrzehnten in vielen Bereichen (auch außerhalb der Biologie) ihre weitreichende Bedeutung unter Beweis gestellt. Warum sollte, so könnte man beispielsweise fragen, gerade die Fähigkeit des Menschen, moralische Normen aufzustellen und gemäß ihnen zu handeln, nicht evolutionär erklärt werden können? Und warum sollte eine solche evolutionäre Erklärung der menschlichen Moralität irrelevant für die Rechtfertigung moralischer Normen sein? Warum sollte die Ethik eine Bastion der Philosophen bleiben, für die evolutionsbiologische Forschungsergebnisse über den Menschen und seine nächsten Verwandten keinerlei Relevanz besitzen?

  2. 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

  3. 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

  4. Identifying Minimally Acceptable Interpretive Performance Criteria for Screening Mammography1

    PubMed Central

    Sickles, Edward A.; Monsees, Barbara S.; Bassett, Lawrence W.; Brenner, R. James; Feig, Stephen A.; Smith, Robert A.; Rosenberg, Robert D.; Bogart, T. Andrew; Browning, Sally; Barry, Jane W.; Kelly, Mary M.; Tran, Khai A.; Miglioretti, Diana L.

    2010-01-01

    Purpose: To develop criteria to identify thresholds for minimally acceptable physician performance in interpreting screening mammography studies and to profile the impact that implementing these criteria may have on the practice of radiology in the United States. Materials and Methods: In an institutional review board–approved, HIPAA-compliant study, an Angoff approach was used in two phases to set criteria for identifying minimally acceptable interpretive performance at screening mammography as measured by sensitivity, specificity, recall rate, positive predictive value (PPV) of recall (PPV1) and of biopsy recommendation (PPV2), and cancer detection rate. Performance measures were considered separately. In phase I, a group of 10 expert radiologists considered a hypothetical pool of 100 interpreting physicians and conveyed their cut points of minimally acceptable performance. The experts were informed that a physician’s performance falling outside the cut points would result in a recommendation to consider additional training. During each round of scoring, all expert radiologists’ cut points were summarized into a mean, median, mode, and range; these were presented back to the group. In phase II, normative data on performance were shown to illustrate the potential impact cut points would have on radiology practice. Rescoring was done until consensus among experts was achieved. Simulation methods were used to estimate the potential impact of performance that improved to acceptable levels if effective additional training was provided. Results: Final cut points to identify low performance were as follows: sensitivity less than 75%, specificity less than 88% or greater than 95%, recall rate less than 5% or greater than 12%, PPV1 less than 3% or greater than 8%, PPV2 less than 20% or greater than 40%, and cancer detection rate less than 2.5 per 1000 interpretations. The selected cut points for performance measures would likely result in 18%–28% of interpreting

  5. 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.

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

    PubMed

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

    2015-07-01

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

  7. 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.

  8. First breast cancer mammography screening program in Mexico: initial results 2005-2006.

    PubMed

    Rodríguez-Cuevas, Sergio; Guisa-Hohenstein, Fernando; Labastida-Almendaro, Sonia

    2009-01-01

    Breast cancer is the most frequent malignant neoplasia worldwide. In emergent countries as Mexico, an increase has been shown in frequency and mortality, unfortunately, most cases in advanced loco-regional stages developed in young women. The success of breast screening in mortality reduction has been observed since 1995 in Western Europe and the United States, where as many as 40% mortality reduction has been achieved. Most countries guidelines recommends an annual or biannual mammography for all women >40 years of age. In 2005, FUCAM, a nonlucrative civil foundation in Mexico join with Mexico City government, initiated the first voluntary mammography screening program for women >40 years of age residing in Mexico City's Federal District. Mammographies were carried out with analogical mammographs in specially designed mobile units and were performed in the area of women's domiciles. This report includes data from the first 96,828 mammographies performed between March 2005 and December 2006. There were 1% of mammographies in Breast Imaging Reporting and Data System 0, 4, or 5 and 208 out of 949 women with abnormal mammographies (27.7%) had breast cancer, a rate of 2.1 per thousand, most of them in situ or stage I (29.4%) or stage II (42.2%) nevertheless 21% of those women with abnormal mammography did not present for further clinical and radiologic evaluation despite being personally notified at their home addresses. The breast cancer rate of Mexican women submitted to screening mammography is lower than in European or North American women. Family history of breast cancer, nulliparity, absence of breast feeding, and increasing age are factors that increase the risk of breast cancer. Most cancers were diagnosed in women's age below 60 years (68.5%) with a mean age of 53.55 corroborating previous data published. It is mandatory to sensitize and educate our population with regard to accepting to visit the Specialized Breast Centers.

  9. Correlation between molybdenum target mammography signs and pathological prognostic factors of breast cancer.

    PubMed

    Zhang, Y; Ma, A D; Jia, H X

    2016-01-01

    This study explores the correlation between molybdenum target (mo-target) mammography signs and pathological prognostic factors of breast cancer. We selected 320 breast cancer patients who were treated between January 2014 and January 2016; using single-factor and multiple-factor logistic regression method, we made correlation analysis on their clinical features, pathological features and mo-target mammography signs. Among mo-target mammography signs, lumps accompanied with calcification and blurry edge were associated with high histologic grades; lumps accompanied with calcification and clear edge were associated with Ki-67 positive; compared with the patients who had lumps with non-stellate edges, positive rates of estrogen receptor (ER) and progesterone receptor (PR) were significantly higher for the patients who had lumps with stellate edges (p < 0.01), while positive rate of human epidermal growth factor receptor-2 (HER-2) and tumor proliferative activity were significantly lower (p < 0.05, p < 0.01). According to the study, we can conclude that mo-target mammography signs mainly include lumps and calcification. Mo-target mammography can improve the accuracy of diagnosis and reduce misdiagnosis or missed diagnosis. Part of mo-target mammography signs are associated with clinical pathology prognostic factors; by grasping the relation, breast cancer patient conditions are expected to be relieved.

  10. [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.

  11. Breast cancer screening: emerging role of new imaging techniques as adjuncts to mammography.

    PubMed

    Houssami, Nehmat; Lord, Sarah J; Ciatto, Stefano

    2009-05-01

    Early detection of breast cancer has been shown to reduce breast cancer deaths in randomised controlled trials (RCTs) of mammography in women aged 50-69 years, with weaker evidence of benefit in those aged 40-49 or 70 years and older. Magnetic resonance imaging (MRI) and ultrasonography have been evaluated in breast cancer screening, relative to, or in addition to, mammography, in selected populations; neither test has been examined in an RCT, and thus evidence of associated screening benefit is uncertain. MRI is more sensitive than mammography in screening women with suspected or proven inherited mutations of the breast cancer genes. The addition of MRI in screening this population detects 8-24 additional cancers per 1000 screens, but also significantly increases a woman's risk of being recalled for investigation or surgical biopsy for false-positive findings. In Australia, Medicare funding for MRI screening of women in specific risk groups was announced in February 2009. Ultrasonography can detect cancers not identified on mammography in asymptomatic women with dense breast tissue. Incremental ultrasound cancer detection is reported in 0.27%-0.46% of women with mammography-negative dense breasts; evidence varies on its association with false-positive findings. Computer-aided detection (CAD) is a complementary tool to mammography, prompting the reader to consider lesions on the mammogram that may represent cancer. Emerging evidence and improved CAD technology are likely to help define its role in breast screening. PMID:19413520

  12. [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

  13. 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.

  14. 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

  15. Mammography mass detection: a multi-stage hybrid approach

    NASA Astrophysics Data System (ADS)

    Sahba, Nima; Tavakoli, Vahid; Ahmadian, Alireza; Giti, Masoumeh

    2009-02-01

    Here in this paper a combined method of pixel based and region based mass detection is proposed. In the first step, the background and pectoral muscle are filtered from mammography images and the image contrast is enhanced using an adaptive density weighted approach. Then, in a coarse level, suspected regions are extracted based on mathematical morphology and adaptive thresholding methods. Finally, to reduce the false positives produced in the coarse stage, a useful feature vector based on ranklet transform is obtained and fed into a support vector machine classifier to detect masses. MIAS (Mammographic Image Analysis Society) and Imam Hospital databases were used to evaluate the performance of the algorithm. The sensitivity and specificity of the proposed method are 74% and 91% respectively. The proposed algorithm shows a high degree of robustness in detecting masses of different shapes.

  16. High-Resolution Mammography Detector Employing Optical Switching Readout

    NASA Astrophysics Data System (ADS)

    Irisawa, Kaku; Kaneko, Yasuhisa; Yamane, Katsutoshi; Sendai, Tomonari; Hosoi, Yuichi

    Conceiving a new detector structure, FUJIFILM Corporation has successfully put its invention of an X-ray detector employing "Optical Switching" into practical use. Since Optical Switching Technology allows an electrode structure to be easily designed, both high resolution of pixel pitch and low electrical noise readout have been achieved, which have consequently realized the world's smallest pixel size of 50×50 μm2 from a Direct-conversion FPD system as well as high DQE. The digital mammography system equipped with this detector enables to acquire high definition images while maintaining granularity. Its outstanding feature is to be able to acquire high-precision images of microcalcifications which is an important index in breast examination.

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. Optimization of mammography with respect to anatomical noise

    NASA Astrophysics Data System (ADS)

    Fredenberg, E.; Svensson, B.; Danielsson, M.; Lazzari, B.; Cederström, B.

    2011-03-01

    Beam quality optimization in mammography traditionally considers detection of a target obscured by quantum noise on a homogenous background. It can be argued that this scheme does not correspond well to the clinical imaging task because real mammographic images contain a complex superposition of anatomical structures, resulting in anatomical noise that may dominate over quantum noise. Using a newly developed spectral mammography system, we measured the correlation and magnitude of the anatomical noise in a set of mammograms. The results from these measurements were used as input to an observer-model optimization that included quantum noise as well as anatomical noise. We found that, within this framework, the detectability of tumors and microcalcifications behaved very differently with respect to beam quality and dose. The results for small microcalcifications were similar to what traditional optimization methods would yield, which is to be expected since quantum noise dominates over anatomical noise at high spatial frequencies. For larger tumors, however, low-frequency anatomical noise was the limiting factor. Because anatomical structure has similar energy dependence as tumor contrast, optimal x-ray energy was significantly higher and the useful energy region wider than traditional methods suggest. Measurements on a tissue phantom confirmed these theoretical results. Furthermore, since quantum noise constitutes only a small fraction of the noise, the dose could be reduced substantially without sacrificing tumor detectability. Exposure settings used clinically are therefore not necessarily optimal for this imaging task. The impact of these findings on the mammographic imaging task as a whole is, however, at this stage unclear.

  3. High resolution CT mammography for surgical biopsy specimens

    SciTech Connect

    Raptopoulos, V.; Baum, J.K.; Hochman, M.; Houlihan, M.J.

    1996-03-01

    Our goal was to assess the performance of high resolution CT on breast biopsy specimens before considering the reevaluation of refined CT techniques in patients with breast abnormalities. High resolution CT was done in 44 surgical biopsy specimens following conventional X-ray specimen mammography. The specimens comprised 38 palpable and nonpalpable soft tissue abnormalities with mean size of 19 mm and 6 specimens with clustered microcalcifications only. There were 21 carcinomas, 10 fibroadenomas, and 13 other benign conditions. Evaluation of CT and conventional images was done separately, and a feature-grading list was used to compare the two modalities. In fatty specimens, grading of morphologic features of masses and the confidence to detect a soft tissue abnormality were equal with both techniques. CT significantly improved the confidence to detect a mass in 17 specimens with dense tissue: On a scale of 0-10, the mean score for detection was 3.8 with radiography and 5.8 with CT (p < 0.008). For clustered microcalcifications, X-ray was superior to CT. The mean CT attenuation of 18 malignant masses (82 HU) was significantly lower than the mean attenuation of 10 fibroadenomas (131 HU; p = 0.003). CT scans of the American College of Radiology test phantom met the requirements for X-ray accreditation. For soft tissue abnormalities, CT specimen mammography performed equally as or better than specimen radiography. These in vitro results suggest potential advantages for increased sensitivity and specificity with CT and justify further investigations. 25 refs., 4 figs.

  4. Visibility of microcalcifications in computed and screen-film mammography

    NASA Astrophysics Data System (ADS)

    Cowen, Arnold R.; Launders, Jason H.; Jadav, Mark; Brettle, David S.

    1997-08-01

    Due to the clinically and technically demanding nature of breast x-ray imaging, mammography still remains one of the few essentially film-based radiological imaging techniques in modern medical imaging. There are a range of possible benefits available if a practical and economical direct digital imaging technique can be introduced to routine clinical practice. There has been much debate regarding the minimum specification required for direct digital acquisition. One such direct digital system available is computed radiography (CR), which has a modest specification when compared with modern screen-film mammography (SFM) systems. This paper details two psychophysical studies in which the detection of simulated microcalcifications with CR has been directly compared to that with SFM. The first study found that under scatter-free conditions the minimum detectable size of microcalcification was approximately for both SFM and CR. The second study found that SFM had a 4.6% higher probability of observers being able to correctly identify the shape of diameter test details; there was no significant difference for either larger or smaller test details. From the results of these studies it has been demonstrated that the modest specification of CR, in terms of limiting resolution, does not translate into a dramatic difference in the perception of details at the limit of detectability. When judging the imaging performance of a system it is more important to compare the signal-to-noise ratio transfer spectrum characteristics, rather than simply the modulation transfer function.

  5. 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

  6. 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

  7. Strategies for digital mammography interpretation in a clinical patient population.

    PubMed

    van den Biggelaar, Frank J H M; Kessels, Alphons G H; van Engelshoven, Jos M A; Flobbe, Karin

    2009-12-15

    Mammography is the basic imaging modality for early detection of breast cancer. The aim of this prospective study was to evaluate the impact of different mammogram reading strategies on the diagnostic yield in a consecutive patient population referred for digital mammography to a hospital. First, the effect of using computer-aided detection (CAD) software on the performance of mammogram readers was studied. Furthermore, the impact of employing technologists as either prereaders or double readers was assessed, as compared to the conventional strategy of single reading by a radiologist. Digital mammograms of 1,048 consecutive patients were evaluated by a radiologist and 3 technologists with and without the use of CAD software. ROC analysis was used to study the effects of the different strategies. In the conventional strategy, an overall area under the curve (AUC) of 0.92 was found, corresponding to a sensitivity of 84% and specificity of 94%. When applying CAD software, the AUCs were similar before and after CAD for all readers (mean of 0.95). Employing technologists in prereading and double reading of mammograms resulted in a mean AUC of 0.91 and 0.96, respectively. In the prereading strategy, the corresponding sensitivity and specificity were 81 and 96%; in the double reading strategy they were 96 and 79%, respectively. Concluding, in this clinical population, systematic application of CAD software by either radiologist or technologists failed to improve the diagnostic yield. Furthermore, employing technologists as double readers of mammograms was the most effective strategy in improving breast cancer detection in daily clinical practice. PMID:19672861

  8. Patterns of mammography use among Hispanic, American Indian, and non-Hispanic White women in New Mexico, 1994-1997.

    PubMed

    Gilliland, F D; Rosenberg, R D; Hunt, W C; Stauber, P; Key, C R

    2000-09-01

    For screening efforts to maximally reduce mortality in the general population, a large proportion of women need to utilize mammography routinely. To investigate utilization of mammography in a community setting, the authors used population-based data collected by the New Mexico Mammography Project for residents of the Albuquerque, New Mexico, metropolitan area for the period 1994-1997. The authors computed screening rates and the proportion of women who routinely use mammography. The utilization of mammography was low. Only 50% of the women aged 50-74 years were screened each year. Less than one third of women aged 40-49 years or 75 years and older were screened annually. The percentage of women who routinely used mammography on an annual or biennial basis was low in all age groups, especially among Hispanics and American Indians. Women aged 50-74 years had the highest percentage of routine annual mammography use, ranging from 30% in non-Hispanic Whites to 20% in Hispanics. Current utilization of mammography in community-based screening efforts is unlikely to achieve a potential 30% reduction in breast cancer mortality. Interventions are needed to increase the routine use of mammography.

  9. 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

  10. 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.

  11. Profiles of IgE Sensitization to Der f 1, Der f 2, Der f 6, Der f 8, Der f 10, and Der f 20 in Korean House Dust Mite Allergy Patients

    PubMed Central

    Jeong, Kyoung Yong; Lee, June Yong; Son, Mina; Yi, Myung-hee; Yong, Tai-Soon; Shin, Jung U; Lee, Kwang Hoon; Kim, Yoon-Ju; Park, Kyung Hee; Park, Hye Jung; Lee, Jae-Hyun

    2015-01-01

    Purpose Measurement of IgE specific to purified house dust mite (HDM) allergens may improve allergy diagnosis. This study aimed to investigate the sensitization profiles of Korean HDM allergic subjects suffering from respiratory allergy and atopic dermatitis (AD) to Der f 1, Der f 2, Der f 6, Der f 8, Der f 10, and Der f 20. Methods Recombinant HDM allergens were produced in Pichia pastoris (Der f 1) or Escherichia coli (5 allergens). IgE reactivity to the individual recombinant allergens and total extract of mite was assessed by ELISA. Results Der f 1 was recognized by 79.1%, Der f 2 by 79.1%, Der f 6 by 9.3%, Der f 8 by 6.2%, Der f 10 by 6.2%, and Der f 20 by 6.6% of the patients' sera tested, while the prevalence of IgE reactivity to total mite extract was 94.7%. Combination of Der f 1 and Der f 2 had a sensitivity of 87.6%. Specific IgE to Der f 2 alone was detected from 89.4% of HDM-sensitized respiratory allergy subjects and 92.3% to the combination of the 2 major allergens Der f 1 and Der f 2. However, sera from fewer patients with AD, namely 72.4% and 71.0%, recognized Der f 1 and Der f 2, respectively. The combination of 2 major allergens allowed diagnosis of 84.5% of the AD patients. No correlation between sensitization to specific allergens and HDM allergy entity was found. Conclusions Der f 2 was the most frequently sensitized allergen among the HDM-sensitized respiratory and AD patients in Korea, and the combination of the group 1 and 2 major allergens increased the diagnostic sensitivity. Minor allergens did not significantly improve diagnostic sensitivity. However, further studies are needed to analyze the relationship between sensitization to other HDM allergens and the disease entity of the HDM allergy. PMID:25749773

  12. Strategische Planung in der Medizintechnik

    NASA Astrophysics Data System (ADS)

    Leewe, Jörn

    Für den Aufstieg und den Niedergang der Unternehmen spielt die Über- oder Unterlegenheit der Technologie eine zentrale Rolle. Mindestens im gleichen Maße ist jedoch auch ein umsichtiges Management und eine sorgfältige strategische Planung für den Erfolg verantwortlich. Nur ein profitables Unternehmen, welches nachhaltige Gewinne erzielt, ist in der Lage, eine Spitzenforschung aus eigener Kraft zu finanzieren. Dies klingt zunächst trivial. In der langjährigen Consulting-Praxis sind wir jedoch diversen Unternehmen begegnet, die diese Maxime vernachlässigt haben und aufgrund mangelhafter Planungen eine Insolvenz dann nicht mehr abwenden konnten. Damit es erst gar nicht dazu kommt, sollten unterschiedliche Handlungsalternativen im voraus entwickelt und bewertet werden. Die Strategie, also das systematische Aufbauen von Wettbewerbsvorteilen, sollte regelmässig überprüft werden und eine finanzielle Entwicklung des Produktes oder des Unternehmens sollte regelmäßig antizipiert und simuliert werden. Dieser Beitrag soll Einblicke in die strategische Planung erlauben, erhebt allerdings aufgrund der Komplexität des Themas keinen Anspruch auf Vollständigkeit.

  13. Comparative Effectiveness of Combined Digital Mammography and Tomosynthesis Screening for Women with Dense Breasts

    PubMed Central

    Cevik, Mucahit; Alagoz, Oguzhan; Sprague, Brian L.; Tosteson, Anna N. A.; Miglioretti, Diana L.; Kerlikowske, Karla; Stout, Natasha K.; Jarvik, Jeffrey G.; Ramsey, Scott D.; Lehman, Constance D.

    2015-01-01

    Purpose To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. Materials and Methods An established, discrete-event breast cancer simulation model was used to estimate the comparative clinical effectiveness and cost-effectiveness of biennial screening with both digital mammography and tomosynthesis versus digital mammography alone among U.S. women aged 50–74 years with dense breasts from a federal payer perspective and a lifetime horizon. Input values were estimated for test performance, costs, and health state utilities from the National Cancer Institute Breast Cancer Surveillance Consortium, Medicare reimbursement rates, and medical literature. Sensitivity analyses were performed to determine the implications of varying key model parameters, including combined screening sensitivity and specificity, transient utility decrement of diagnostic work-up, and additional cost of tomosynthesis. Results For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis. Conclusion Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50–74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations vs $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice. © RSNA, 2014 Online

  14. 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

  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. 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

  17. ‘It’s Easier Said Than Done’: Perspectives on Mammography From Women With Intellectual Disabilities

    PubMed Central

    Wilkinson, Joanne E.; Deis, Cristina E.; Bowen, Deborah J.; Bokhour, Barbara G.

    2011-01-01

    PURPOSE Women with intellectual disabilities (or mental retardation) are living longer, receiving primary care in the community, and have equal rates of breast cancer compared with women in the general population, but they have lower rates of mammography. Although several public campaigns have successfully raised the mammography rate for racial and ethnic minority women, they have not penetrated the community of women with intellectual disabilities. No research to date has explored potential barriers to mammography for these women by involving the women themselves as participants. METHODS We undertook a qualitative study to explore the perceptions and understanding of mammography for women with intellectual disabilities and some of the potential reasons they would or would not have the test. Twenty-seven intellectually disabled women were recruited through a variety of community groups and interviewed using a semistructured interview guide. Data were analyzed using qualitative techniques from grounded theory. RESULTS Participants in this study described being poorly prepared for mammography: they did not understand its purpose and were not prepared for the logistics of the experience. The latter was more upsetting to participants and contributed to their negative perceptions of mammography. Participants reported feeling unprepared and singled out for being unprepared, despite their desire to have at least 1 mammogram, as do other women their age. CONCLUSIONS Women with intellectual disabilities perceive mammography differently than do women who do not have intellectual disabilities, and their perception is informed by inadequate knowledge, anxiety, and inadequate preparation. These themes should be considered when planning cancer prevention interventions with this population and when counseling individual women in the clinical setting. PMID:21403141

  18. 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.

  19. 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.

  20. Twisted Van der Waals Systems

    NASA Astrophysics Data System (ADS)

    Gani, Satrio; Rossi, Enrico

    Van der Waals systems formed by two-dimensional (2D) crystals and nanostructures possess electronic properties that make them extremely interesting for basic science and for possible technological applications. By tuning the relative angle (the twist angle) between the layers, or nanostructures, forming the Van der Waals systems experimentalists have been able to control the stacking configuration of such systems. We study the dependence on the twist angle of the electronic properties of two classes of Van der Waals systems: double layers formed by two, one-atom thick, layers of a metal dichalcogenide such as molybdenum disulfide (MoS2), and graphene nanoribbons on a hexagonal boron nitride substrate. We present results that show how, for both classes of systems, the electronic properties can be strongly tuned via the twist angle. Work supported by ACS-PRF-53581-DNI5 and NSF-DMR-1455233.

  1. Historisches Rätsel Der rastlose Amerikaner

    NASA Astrophysics Data System (ADS)

    Loos, Andreas

    2004-09-01

    In der Schule, die er mit acht Jahren zum ersten Mal von innen sah, hielt man ihn nicht für allzu helle - schließlich hinkte der Kleine oft hinter der Klasse her. Und es hat etwas Tragisches, wenn der wohl berühmteste Erfinder aller Zeiten und Halter von 2000 Patenten im Alter über seinen Vater sagt: Er dachte, ich sei dumm. Und ich meinte schon fast selbst, ich sei ein Dummkopf.

  2. 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

  3. 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

  4. Accuracy of Screening Mammography Interpretation by Characteristics of Radiologists

    PubMed Central

    Barlow, William E.; Chi, Chen; Carney, Patricia A.; Taplin, Stephen H.; D’Orsi, Carl; Cutter, Gary; Hendrick, R. Edward; Elmore, Joann G.

    2011-01-01

    Background Radiologists differ in their ability to interpret screening mammograms accurately. We investigated the relationship of radiologist characteristics to actual performance from 1996 to 2001. Methods Screening mammograms (n = 469 512) interpreted by 124 radiologists were linked to cancer outcome data. The radiologists completed a survey that included questions on demographics, malpractice concerns, years of experience interpreting mammograms, and the number of mammograms read annually. We used receiver operating characteristics (ROC) analysis to analyze variables associated with sensitivity, specificity, and the combination of the two, adjusting for patient variables that affect performance. All P values are two-sided. Results Within 1 year of the mammogram, 2402 breast cancers were identified. Relative to low annual interpretive volume (≤1000 mammograms), greater interpretive volume was associated with higher sensitivity (P = .001; odds ratio [OR] for moderate volume [1001–2000] = 1.68, 95% CI = 1.18 to 2.39; OR for high volume [>2000] = 1.89, 95% CI = 1.36 to 2.63). Specificity decreased with volume (OR for 1001–2000 = 0.65, 95% CI = 0.52 to 0.83; OR for more than 2000 = 0.76, 95% CI = 0.60 to 0.96), compared with 1000 or less (P = .002). Greater number of years of experience interpreting mammograms was associated with lower sensitivity (P = .001), but higher specificity (P = .003). ROC analysis using the ordinal BI-RADS interpretation showed an association between accuracy and both previous mammographic history (P = .012) and breast density (P<.001). No association was observed between accuracy and years interpreting mammograms (P = .34) or mammography volume (P = .94), after adjusting for variables that affect the threshold for calling a mammogram positive. Conclusions We found no evidence that greater volume or experience at interpreting mammograms is associated with better performance. However, they may affect sensitivity and specificity

  5. 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

  6. 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

  7. 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

  8. FDA & digital mammography: why has FDA required full field digital mammography systems to be regulated as potentially dangerous devices for more than 10 years?

    PubMed

    Nields, Morgan W

    2010-05-01

    Digital mammography is routinely used in the US to screen asymptomatic women for breast cancer and currently over 50% of US screening centers employ the technology. In spite of FDAs knowledge that digital mammography requires less radiation than film mammography and that its equivalence has been proven in a prospective randomized trial, the agency has failed to allow the technology market access via the 510(k) pre market clearance pathway. As a result of the restrictive Pre Market Approval process, only four suppliers have received FDA approval. The resulting lack of a competitive market has kept costs high, restricted technological innovation, and impeded product improvements as a result of PMA requirements. Meanwhile, at least twelve companies are on the market in the EU and the resulting competitive market has lowered costs and provided increased technological choice. A cultural change with new leadership occurred in the early 90's at FDA. The historical culture at the Center for Devices and Radiological Health of collaboration and education gave way to one characterized by a lack of reliance on outside scientific expertise, tolerance of decision making by unqualified reviewers, and an emphasis on enforcement and punishment. Digital mammography fell victim to this cultural change and as a result major innovations like breast CT and computer aided detection technologies are also withheld from the market. The medical device law, currently under review by the Institute of Medicine, should be amended by the Congress so that new technologies can be appropriately classified in accordance with the risk based assessment classification system detailed in Chapter V of the Federal Food, Drug, and Cosmetic Act. A panel of scientific experts chartered by the NIH or IOM should determine the classification appropriate for new technologies that have no historical regulatory framework. This would be binding on FDA. Unless the law is changed we will likely again experience

  9. Der Begriff der Verständlichkeit in der modernen Physik (1948).

    PubMed

    Feyerabend, Paul K

    2016-06-01

    This is a critical transcription of Paul Feyerabend's earliest extant essay "Der Begriff der Verständlichkeit in der modernen Physik" (1948) recovered from the European Forum Alpbach archives. In it, Feyerabend defends positivism as a progressive framework for scientific research in certain stages of scientific development. He argues that in physics visualizability (Anschaulichkeit) and intelligibility (Verständlichkeit) are time-conditioned concepts: what is deemed visualizable in the development of physical theories is relative to a specific historical context and changes over time. He concludes that from time to time the abandonment of visualizability is crucial for progress in physics, as it is conducive to major theory change, illustrating the point on the basis of advances in atomic theory. PMID:27269264

  10. Performance of mammography equipment in the Macedonian breast screening campaign 2008/2009.

    PubMed

    Gershan, V; Antevska-Grujoska, S

    2011-09-01

    Breast screening campaign in Macedonia started in the end of 2007 and 19 national mammography departments were included. Contrary to the European Guidelines for Quality Assurance in Mammography Screening, the quality assurance activities were not implemented before the start of the campaign, except at the University Clinic of Radiology, Skopje. The quality control tests were performed for the very first time at 13 mammography units under a licence-obtaining procedure. One of the machines was suspended from clinical and screening practice due to heavy malfunction of the generator, X-ray tube and automatic exposure control (AEC) system. Only 3 of the 13 mammography machines met the criteria for tube voltage (kV) accuracy. Two of the seven AEC systems were calibrated in the optimal optical density (OD) range (OD >1.4). AEC settings corresponded to the recommendations at eight units, while nine units met basic overall image quality criteria. Mean glandular dose (MGD) was higher than the recommended level of 2.5 mGy in four departments. Mean gradient of the film G(0.25-2.0) was below 2.8 at four units. Only two light boxes had a luminance of >1700 cd m(-2) and six rooms had an ambient light level of <50 lx. The findings of this work clearly suggest that the performance of the mammography equipment involved in the campaign in almost 50 % do not supply basic quality criteria for a breast screening programme. PMID:21733866

  11. 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.

  12. 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

  13. [Usefulness and risks of routine mammography for the detection of breast cancer].

    PubMed

    Hernández-Valencia, Marcelino; Hernández-Quijano, Tomás; Zárate, Arturo; Saucedo, Renata

    2014-01-01

    It has been accepted that preclinicall detection of breast cancer by means of the routine practice of mammography could discover the disease at its initial stage; therefore, practicing a mammography annually became widespread as a preventive health measure to diagnose the disease and prevent death due to breast cancer. Over time, the benefit of detection tests has been questioned and demonstration of their benefit, as well as that of the undesirable effects they might cause, has been demanded. There is recent information with regard to an absence of difference in terms of breast cancer mortality as final index between women with or without routine mammography. Additionally, a 20 % frequency has been observed in false-positive diagnoses, with high numbers of women undergoing unnecessary diagnostic procedures due to suspicion of a non-clinically apparent presumed cancer. In Mexico, from 2004 on, the popularity of mammography to detect and effectively cure cancer has increased. Acceptance can be attributted to how easily detection campaigns can be promoted, since most women accept that mastography can offer the opportunity of receiving an early treatment that reduces dissemination and prevents early mortality. The age at which it is convenient to perform the first mammography, how frequently it should be repeated and even the age for its discontinuation is still under debate and no consensus has been reached.

  14. 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.

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

    PubMed Central

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

    2013-01-01

    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

  16. Ancillary Services Provided from DER

    SciTech Connect

    Campbell, J.B.

    2005-12-21

    Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

  17. Concordance of population-based estimates of mammography screening

    PubMed Central

    Boudreau, Denise M.; Luce, Casey L.; Ludman, Evette; Bonomi, Amy E.; Fishman, Paul A.

    2007-01-01

    Objective Estimates of adherence to mammography screening guidelines vary, in part, due to lack of consensus on defining adherence. This study estimated adherence to repeat (two successive on-time screenings) and regular screening (three or more successive screenings) and evaluated the impact of varying operational definitions and evaluation periods. Methods The study included women aged 50–80 without a history of breast cancer who: were on a biennial screening cycle and due for a screening mammogram between 1995 and 1996; underwent screening (index date) in response to a reminder letter; and belonged to Group Health, an integrated health care delivery system in Washington State, for six or more years after the index date. Automated records provided information on enrollment, health care utilization, and procedures. Results Among 1336 women, 67–82% experienced a repeat screen. Adherence to regular screening over the six year evaluation period was 42–84%—and higher with longer allowable intervals between screenings, when definitions did not require on-schedule screenings, when intervals were reset after a diagnostic mammogram, and for shorter evaluation periods. Conclusion Estimates of adherence to screening guidelines varied by the operational definition of “success” and time period of evaluation. Consensus in definitions and terminology is needed to compare evaluations. PMID:17698182

  18. Photon-counting spectral phase-contrast mammography

    NASA Astrophysics Data System (ADS)

    Fredenberg, E.; Roessl, E.; Koehler, T.; van Stevendaal, U.; Schulze-Wenck, I.; Wieberneit, N.; Stampanoni, M.; Wang, Z.; Kubik-Huch, R. A.; Hauser, N.; Lundqvist, M.; Danielsson, M.; Åslund, M.

    2012-03-01

    Phase-contrast imaging is an emerging technology that may increase the signal-difference-to-noise ratio in medical imaging. One of the most promising phase-contrast techniques is Talbot interferometry, which, combined with energy-sensitive photon-counting detectors, enables spectral differential phase-contrast mammography. We have evaluated a realistic system based on this technique by cascaded-systems analysis and with a task-dependent ideal-observer detectability index as a figure-of-merit. Beam-propagation simulations were used for validation and illustration of the analytical framework. Differential phase contrast improved detectability compared to absorption contrast, in particular for fine tumor structures. This result was supported by images of human mastectomy samples that were acquired with a conventional detector. The optimal incident energy was higher in differential phase contrast than in absorption contrast when disregarding the setup design energy. Further, optimal weighting of the transmitted spectrum was found to have a weaker energy dependence than for absorption contrast. Taking the design energy into account yielded a superimposed maximum on both detectability as a function of incident energy, and on optimal weighting. Spectral material decomposition was not facilitated by phase contrast, but phase information may be used instead of spectral information.

  19. Mammographic artifacts on full-field digital mammography.

    PubMed

    Choi, Jae Jeong; Kim, Sung Hun; Kang, Bong Joo; Choi, Byung Gil; Song, ByungJoo; Jung, Haijo

    2014-04-01

    This study investigates the incidence of full-field digital mammographic (FFDM) artifacts with three systems at two institutions and compares the artifacts between two detector types and two grid types. A total of 4,440 direct and 4,142 indirect FFDM images were reviewed by two radiologists, and artifacts were classified as patient related, hardware related, and software processing. The overall incidence of FFDM artifacts was 3.4% (292/8,582). Patient related artifacts (motion artifacts and skin line artifacts) were the most commonly detected types (1.7%). Underexposure among hardware related artifacts and high-density artifacts among software processing artifacts also were common (0.7 and 0.5%, respectively). These artifacts, specific to digital mammography, were more common with the direct detector type and the crossed air grid type than with the indirect type and linear grid type (p < 0.05). The most common mammographic artifacts on FFDM were patient related, which might be controlled by the instruction of a patient and technologist. Underexposure and high-density artifacts were more common with direct detector and crossed air type of grid.

  20. 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.

  1. 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

  2. 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.

  3. Observer model optimization of a spectral mammography system

    NASA Astrophysics Data System (ADS)

    Fredenberg, Erik; Åslund, Magnus; Cederström, Björn; Lundqvist, Mats; Danielsson, Mats

    2010-04-01

    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. Contrast-enhanced spectral imaging has been thoroughly investigated, but unenhanced imaging may be more useful because it comes as a bonus to the conventional non-energy-resolved absorption image at screening; there is no additional radiation dose and no need for contrast medium. We have used a previously developed theoretical framework and system model that include quantum and anatomical noise to characterize the performance of a photon-counting spectral mammography system with two energy bins for unenhanced imaging. The theoretical framework was validated with synthesized images. Optimal combination of the energy-resolved images for detecting large unenhanced tumors corresponded closely, but not exactly, 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. Optimization with respect to the signal-to-quantum-noise ratio, commonly referred to as energy weighting, deteriorated detectability. For small microcalcifications or tumors on uniform backgrounds, however, energy subtraction was suboptimal whereas energy weighting provided a minute improvement. The performance was largely independent of beam quality, detector energy resolution, and bin count fraction. It is clear that inclusion of anatomical noise and imaging task in spectral optimization may yield completely different results than an analysis based solely on quantum noise.

  4. Contrast visibility of simulated microcalcifications in full field mammography systems

    NASA Astrophysics Data System (ADS)

    Carton, Ann-Katherine; Bosmans, Hilde; Van Ongeval, Chantal; Souverijns, Geert; Rogge, Frank; Marchal, Guy

    2003-05-01

    We evaluated the visibility of simulated subtle microcalcifications in real digital mammograms acquired with a flat-panel system (GE) and a CR system (Fuji). Ideal templates of microcalcifications were created, based on the attenuation characteristics of subtle microcalcifications from biopsied specimen in magnified images. X-ray transmission coefficients were expressed in Al-equivalent thickness. In this way, the X-ray transmission of a particular lesion could be re-calculated for other X-ray beams, different mammography systems and for different breast thickness. Extra corrections for differences in spatial resolution were based on the pre-sampled MTF. Zero to 10 simulated microcalcifications were randomly distributed in square frames. These software phantoms were then inserted in sets of raw mammograms of the modalities under study. The composed images were compressed, processed and printed as in clinical routine. Two experienced radiologists indicated the locations of the microcalcifications and rated their detection confidence. It is possible to assess the visibility of 'well controlled" microcalcifications in digital clinical mammograms. Microcalcifications were better visible in the CR images than in the flat panel images. This psychophysical method comes close to the radiologists" practice. It allows fpr including processing and visualization in the analysis and was well appreciated by our radiologists.

  5. Task-based lens design with application to digital mammography

    PubMed Central

    Chen, Liying; Barrett, Harrison H.

    2006-01-01

    Recent advances in model observers that predict human perceptual performance now make it possible to optimize medical imaging systems for human task performance. We illustrate the procedure by considering the design of a lens for use in an optically coupled digital mammography system. The channelized Hotelling observer is used to model human performance, and the channels chosen are differences of Gaussians. The task performed by the model observer is detection of a lesion at a random but known location in a clustered lumpy background mimicking breast tissue. The entire system is simulated with a Monte Carlo application according to physics principles, and the main system component under study is the imaging lens that couples a fluorescent screen to a CCD detector. The signal-to-noise ratio (SNR) of the channelized Hotelling observer is used to quantify this detectability of the simulated lesion (signal) on the simulated mammographic background. Plots of channelized Hotelling SNR versus signal location for various lens apertures, various working distances, and various focusing places are presented. These plots thus illustrate the trade-off between coupling efficiency and blur in a task-based manner. In this way, the channelized Hotelling SNR is used as a merit function for lens design. PMID:15669625

  6. 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%.

  7. Seamless lesion insertion in digital mammography: methodology and reader study

    NASA Astrophysics Data System (ADS)

    Pezeshk, Aria; Petrick, Nicholas; Sahiner, Berkman

    2016-03-01

    Collection of large repositories of clinical images containing verified cancer locations is costly and time consuming due to difficulties associated with both the accumulation of data and establishment of the ground truth. This problem poses a significant challenge to the development of machine learning algorithms that require large amounts of data to properly train and avoid overfitting. In this paper we expand the methods in our previous publications by making several modifications that significantly increase the speed of our insertion algorithms, thereby allowing them to be used for inserting lesions that are much larger in size. These algorithms have been incorporated into an image composition tool that we have made publicly available. This tool allows users to modify or supplement existing datasets by seamlessly inserting a real breast mass or micro-calcification cluster extracted from a source digital mammogram into a different location on another mammogram. We demonstrate examples of the performance of this tool on clinical cases taken from the University of South Florida Digital Database for Screening Mammography (DDSM). Finally, we report the results of a reader study evaluating the realism of inserted lesions compared to clinical lesions. Analysis of the radiologist scores in the study using receiver operating characteristic (ROC) methodology indicates that inserted lesions cannot be reliably distinguished from clinical lesions.

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. Mammography equipment performance, image quality and mean glandular dose in Malta.

    PubMed

    Borg, M; Badr, I; Royle, G J

    2013-09-01

    In this first Maltese national mammography survey, the effectiveness of direct digital (DR) mammography in breast cancer screening has been confirmed. Patient data were made available from three clinics out of the participating nine. A dose survey of mean glandular dose (MGD) calculated for 759 patients examined in the state-owned mammography facilities was performed. An MGD national diagnostic reference level was set at 1.87 mGy for patients with breast compression thicknesses (BCT) between 5.0 and 7.0 cm. This range was selected since patient data were retrieved from three clinics only and the results showed that other international BCT reference levels may be unsuitable for the Maltese population. In fact, the overall average BCT was 5.75 ± 1.4 cm. The survey results have shown that the technical standard of mammographic equipment in the Malta National Breast Screening Programme is on a par with other countries, including its Western European counterparts.

  13. Automated detection of ambiguity in BI-RADS assessment categories in mammography reports.

    PubMed

    Bozkurt, Selen; Rubin, Daniel

    2014-01-01

    An unsolved challenge in biomedical natural language processing (NLP) is detecting ambiguities in the reports that can help physicians to improve report clarity. Our goal was to develop NLP methods to tackle the challenges of identifying ambiguous descriptions of the laterality of BI-RADS Final Assessment Categories in mammography radiology reports. We developed a text processing system that uses a BI-RADS ontology we built as a knowledge source for automatic annotation of the entities in mammography reports relevant to this problem. We used the GATE NLP toolkit and developed customized processing resources for report segmentation, named entity recognition, and detection of mismatches between BI-RADS Final Assessment Categories and mammogram laterality. Our system detected 55 mismatched cases in 190 reports and the accuracy rate was 81%. We conclude that such NLP techniques can detect ambiguities in mammography reports and may reduce discrepancy and variability in reporting. PMID:24743074

  14. Automated detection of ambiguity in BI-RADS assessment categories in mammography reports.

    PubMed

    Bozkurt, Selen; Rubin, Daniel

    2014-01-01

    An unsolved challenge in biomedical natural language processing (NLP) is detecting ambiguities in the reports that can help physicians to improve report clarity. Our goal was to develop NLP methods to tackle the challenges of identifying ambiguous descriptions of the laterality of BI-RADS Final Assessment Categories in mammography radiology reports. We developed a text processing system that uses a BI-RADS ontology we built as a knowledge source for automatic annotation of the entities in mammography reports relevant to this problem. We used the GATE NLP toolkit and developed customized processing resources for report segmentation, named entity recognition, and detection of mismatches between BI-RADS Final Assessment Categories and mammogram laterality. Our system detected 55 mismatched cases in 190 reports and the accuracy rate was 81%. We conclude that such NLP techniques can detect ambiguities in mammography reports and may reduce discrepancy and variability in reporting.

  15. 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.

  16. American Indian community leader and provider views of needs and barriers to mammography.

    PubMed

    Daley, Christine M; Filippi, Melissa; James, Aimee S; Weir, Maria; Braiuca, Stacy; Kaur, Baljit; Choi, Won S; Greiner, K Allen

    2012-04-01

    Breast cancer incidence is rising and mortality is disproportionately high among American Indians and Alaska Natives, yet screening rates remain low. Using community-based participatory research, we conducted interviews with community leaders (n = 13) and providers from the Indian Health Service, tribal clinics, and urban safety-net clinics (n = 17). Participants in both groups identified similar needs, including culturally-appropriate mammography education, use of Native elders as patient navigators, and an emphasis on preventive care. Pertinent barriers included culturally-specific issues (e.g., historic mistrust and gender roles), cost, transportation, and fear of mammography and potential results. The results reflect the struggles of promoting mammography across diverse populations.

  17. 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

  18. 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

  19. Are Health-care Relationships Important for Mammography Adherence in Latinas?

    PubMed Central

    Wang, Judy; Yi, Bin; Harrison, Toni Michelle; Feng, Shibao; Huerta, Elmer E.; Mandelblatt, Jeanne S.

    2008-01-01

    Background Latinas are the fastest growing racial ethnic group in the United States and have an incidence of breast cancer that is rising three times faster than that of non-Latino white women, yet their mammography use is lower than that of non-Latino women. Objectives We explored factors that predict satisfaction with health-care relationships and examined the effect of satisfaction with health-care relationships on mammography adherence in Latinas. Design and Setting We conducted a cross-sectional survey of 166 Latinas who were ≥40 years old. Women were recruited from Latino-serving clinics and a Latino health radio program. Measurements Mammography adherence was based on self-reported receipt of a mammogram within the past 2 years. The main independent variable was overall satisfaction with one’s health-care relationship. Other variables included: self report of patient-provider communication, level of trust in providers, primary language, country of origin, discrimination experiences, and perceptions of racism. Results Forty-three percent of women reported very high satisfaction in their health-care relationships. Women with high trust in providers and those who did not experience discrimination were more satisfied with their health-care relationships compared to women with lower trust and who experienced discrimination (p < .01). Satisfaction with the health-care relationship was, in turn, significantly associated with mammography adherence (OR: 3.34, 95% CI: 1.47–7.58), controlling for other factors. Conclusions Understanding the factors that impact Latinas’ mammography adherence may inform intervention strategies. Efforts to improve Latina’s satisfaction with physicians by building trust may lead to increased use of necessary mammography. PMID:18839258

  20. 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

  1. The role of social capital in African-American women's use of mammography.

    PubMed

    Dean, Lorraine; Subramanian, S V; Williams, David R; Armstrong, Katrina; Charles, Camille Zubrinsky; Kawachi, Ichiro

    2014-03-01

    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 2586, 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

  2. 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

  3. Racial and Ethnic Differences in Use of Mammography Between Medicare Advantage and Traditional Medicare

    PubMed Central

    2013-01-01

    Background Breast cancer is a leading cause of mortality for women in all racial/ethnic groups. We compared use of mammography by race/ethnicity in Medicare health maintenance organizations (HMOs), preferred provider organizations (PPOs), and traditional Medicare. Methods We matched 495 836 women in HMOs and 81 480 women in PPOs who were aged 65 to 69 years during 2009 to women enrolled in traditional Medicare by race/ethnicity, Medicaid eligibility status, and geographic area. We identified mammography use from the Healthcare Effectiveness Data and Information Set for Medicare HMOs and PPOs and from claims data for traditional Medicare with the same specifications. We then compared racial/ethnic differences in rates of mammography in HMOs and PPOs to matched populations in traditional Medicare and estimated differences with z tests. All statistical tests were two-sided. Results Relative to matched white women, mammography rates were statistically significantly higher for black, Hispanic, and Asian/Pacific Islander women in HMOs (6.1, 5.4, and 0.9 percentage points, respectively; all P ≤ .003) and statistically significantly lower for all three groups in traditional Medicare (3.3, 7.4, and 7.7 percentage points, respectively; all P < .001). Similar improvements in mammography rates also were observed in PPOs among all minority groups relative to traditional Medicare. Conclusions Higher rates of mammography in HMOs and PPOs were associated with a reversal of racial and ethnic differences observed in traditional Medicare. These differences may be related to lower patient cost-sharing and better systems to promote preventive services in managed care plans, as well as unmeasured characteristics or beliefs of minority women who enroll in these health plans relative to those in traditional Medicare. PMID:24316600

  4. A case of melioidosis of the breast present at screening mammography.

    PubMed

    Lengren, J; Withey, G; Hack, J

    2002-02-01

    A previously well 54-year-old woman presented for screening mammography with a 3-day history of an inflamed lump in her right breast. She was subsequently admitted to hospital with acute melioidosis where right breast abscesses were drained. Following recovery and discharge, she was reviewed at the mammographic screening unit where her previous abnormal mammogram was found to be due to melioidosis. To our knowledge this is the first reported case of melioidosis of the breast and its appearance on mammography and ultrasound are described.

  5. 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

  6. Mammography in 1980: an historical perspective and present state of the art

    SciTech Connect

    Snyder, R.E.

    1980-01-01

    Continued improvement in mammographic techniques, with marked reduction in radiation exposure, now makes mammography an essential part of the workup of any breast problem in women over age 30-35. Breast patterns alone cannot be used as the basis for determining high or low risk patients, but they can guide the clinician in deciding what are the proper intervals between mammograms. With increasing use of mammography, emphasis has now changed from the diagnosis of obvious cancers to the evaluation of minimal or questionable mammographic findings. Such occult masses or calcifications require needle localization, with or without specimen radiography, to ensure removal of the proper areas for histologic study.

  7. 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

  8. Views of mammography screening among U.S. Black and Hispanic immigrant women and their providers.

    PubMed

    Wallace, Phyllis M; Torres, Shioban; Beltran, Jeanette; Cohen-Boyar, Ronni

    2014-01-01

    Views of ethnic immigrant women's experiences about mammography screening are important to determine barriers to cancer screening. We explored perceptions and barriers about mammography screening and breast health services among Haitian, Hispanic, Portuguese, and Somali women (n = 51) using semistructured interviews. Providers (n = 19) offered insight into health system barriers. Content analysis was conducted using qualitative data from the 2011 Komen Massachusetts needs assessment. Grounded theory was employed to explore themes and patterns in narratives. Six themes represented knowledge, health care, culture, spirituality, survivorship, and health systems improvement. Results may inform breast health policies that impact ethnic immigrant women in Massachusetts.

  9. Verbesserung der Prozessbedingungen beim Einlippentiefbohren durch unterschiedliche Formen der Vorschubmodulation

    NASA Astrophysics Data System (ADS)

    Eisseler, Rocco

    Das Tiefbohren mit Einlippenwerkzeugen ist bei vielen Anwendungen das Verfahren der ersten Wahl, vor allem wenn kleine und kleinste Bohrungsdurchmesser, ein sehr großes Verhältnis zwischen Bohrtiefe und Durchmesser (l/D) und eine hohe Bearbeitungsqualität gefordert werden. Der erreichbare Durchmesserbereich des Verfahrens liegt zwischen D = 0,5 mm und 40 mm, wobei die möglichen Bohrtiefen von l = 3 x D bis 250 x D reichen. Diese Werte beziehen sich auf das Vollbohren, beim Aufbohren können noch größere Durchmesser erreicht werden [1]. Die erreichbare Oberflächenqualität ist so hoch, dass in den meisten Fällen auf eine nachfolgende Feinbearbeitung verzichtet werden kann.

  10. 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.

  11. Identification, segmentation, and characterization of microcalcifications on mammography

    NASA Astrophysics Data System (ADS)

    Drukker, Karen; Malkov, Serghei; Avila, Jesus; Kerlikowske, Karla; Joe, Bonnie; Krings, Gregor; Creasman, Jennifer; Drukteinis, Jennifer S.; Pereira, Malesa M.; Kazemi, Leila; Shepherd, John; Giger, Maryellen

    2016-03-01

    The purpose was to develop a characterization method for breast lesions visible only as microcalcifications on digital mammography. The method involved 4 steps: 1) image preprocessing through morphological filtering, 2) un-supervised identification of microcalcifications in the region surrounding the radiologist-indicated location through k-means clustering, 3) segmentation of the identified microcalcifications using an active contour model, and 4) characterization by computer-extracted image-based phenotypes describing properties of individual microcalcifications, cluster, and surrounding parenchyma. The image-based phenotypes were investigated for their ability to distinguish - individually, i.e., without merging with other phenotypes with a classifier - between invasive breast cancers, in-situ (non-invasive) breast cancers, fibroadenomas, and other benign-type lesions. The data set contained diagnostic mammograms of 82 patients with 2 views per patient - cranio-caudal (CC) and medio-lateral (ML) views of the affected breast with a single biopsy-proven finding indicated per view - with 7 invasive cancers, 14 in situ cancers, 13 fibroadenomas, and 48 other benign-type lesions. Analysis was performed per lesion and calculated phenotypes were averaged over views. Performance was assessed using ROC analysis with individual phenotypes as decision variables in the tasks of a) pairwise distinction amongst the 4 finding types, b) distinction between each finding type and all others, and c) distinction between cancer and non-cancer. Different phenotypes emerged as the best performers with areas under the ROC curve ranging from 0.69 (0.05) to 0.92 (0.09) depending on the task. We obtained encouraging preliminary results beyond the classification of cancer versus non-cancer in the distinction between different types of breast lesions visible as mammographic calcifications.

  12. 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.

  13. Quantitative volumetric breast density estimation using phase contrast mammography.

    PubMed

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

    2015-05-21

    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.

  14. Threshold contrast visibility of microcalcifications in digital mammography

    NASA Astrophysics Data System (ADS)

    Carton, Ann-Katherine G.; Bosmans, Hilde; Vandenbroucke, Dirk; Van Ongeval, Chantal; Souverijns, Geert; Rogge, Frank; Marchal, Guy

    2004-05-01

    The purpose of this study is to describe a method that allows the calculation of a contrast-detail curve for a particular system configuration using simulated micro calcifications into clinical mammograms. We made use of simulated templates of micro calcifications and adjusted their x-ray transmission coefficients and resolution to the properties of the mammographic system under consideration (4). We expressed the thickness of the simulated micro calcifications in terms of Al equivalence. In a first step we validated that the thickness of very small Al particles with well known size and thickness can be calculated from their x-ray transmission characteristics at a particular X-ray beam energy. Then, micro calcifications with equivalent diameters in the plane of the detector ranging from 300 to 800 μm and thicknesses, expressed in Al equivalent, covering 77 to 800 μm were simulated into the raw data of real clinical images. The procedure was tested on 2 system configurations: the GE Senographe 2000 D and the Se based Agfa Embrace DM1000 system. We adapted the X-ray transmissions and spatial characteristics of the simulated micro calcifications such that the same physical micro calcification could be simulated into images with the specific exposure parameters (Senographe 2000D: 28 kVp-Rh/Rh, Embrace DM1000: 28 kVp-Mo/Rh), compressed breast thickness (42+/-5mm) and detector under consideration. After processing and printing, 3 observers scored the visibility of the micro calcifications. We derived contrast-detail curves. This psychophysical method allows to summarize the performance of a digital mammography detector including processing and visualization.

  15. 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

  16. 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.

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

    PubMed Central

    Lopez-McKee, Gloria; Bader, Julia

    2011-01-01

    Breast cancer is the leading cause of cancer deaths among Hispanic women in the United States. Unfortunately Hispanic women exhibit poor mammography screening participation, are diagnosed at later stages of the disease, and have lower survival rates than non-Hispanic white women. Several cultural and psycho-social factors have been found to influence mammography screening participation among Hispanic women. We will begin by presenting the theoretical framework that grounded this research program to develop an instrument to assess factors contributing to poor mammography participation among Hispanic women. We will also summarize the early stages in the development of the English and Spanish Mammography Beliefs and Attitudes Questionnaire (MBAQ and SMBAQ) for use with low-health-literacy Mexican-American women. Next we will describe the initial psychometric testing of the MBAQ/SMBAQ, after which we will present the psychometric testing of the SMBAQ with low-health-literacy women. This will be followed by a discussion of the modification of the MBAQ and SMBAQ subscales. We’ll conclude with a discussion of the instruments and share our assessment regarding the limitations of this research program, where the program stands to date, and the implications for practice and future research. PMID:22088158

  18. Barriers and facilitators related to mammography use among lower educated Mexican women in the USA

    PubMed Central

    Tejeda, Silvia; Thompson, Beti; Coronado, Gloria D; Martin, Diane P

    2009-01-01

    This study explores barriers to and facilitators of breast cancer screening and how people in a woman’s social networks influence these screening behaviors. A total of 40 semi-structured qualitative interviews were conducted in rural Washington State (USA) among Mexican women aged 50 and over. Eligible women reported either having had a mammogram within the last two years, over two years ago, or never. We found that lack of health insurance, the perception that the mammogram is painful, and fear of finding cancer were cited as barriers to participation in mammography screening. Women who had lived in the US for a shorter period were more likely to report never having had a mammogram than women who had lived in the US for a longer period. Women often cited daughters and female friends as those from whom they received advice or encouragement to receive a mammogram. Few differences were found related to network size and mammography use among the groups. These findings may be useful in designing interventions to promote mammography screening among Mexican women. Including daughters in intervention activities may help facilitate mammography use among Mexican women. PMID:19152992

  19. 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…

  20. 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.

  1. 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...

  2. 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

  3. 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 §...

  4. 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...

  5. 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…

  6. A Reconstruction Algorithm for Breast Cancer Imaging With Electrical Impedance Tomography in Mammography Geometry

    PubMed Central

    Kao, Tzu-Jen; Isaacson, David; Saulnier, Gary J.; Newell, Jonathan C.

    2009-01-01

    The conductivity and permittivity of breast tumors are known to differ significantly from those of normal breast tissues, and electrical impedance tomography (EIT) is being studied as a modality for breast cancer imaging to exploit these differences. At present, X-ray mammography is the primary standard imaging modality used for breast cancer screening in clinical practice, so it is desirable to study EIT in the geometry of mammography. This paper presents a forward model of a simplified mammography geometry and a reconstruction algorithm for breast tumor imaging using EIT techniques. The mammography geometry is modeled as a rectangular box with electrode arrays on the top and bottom planes. A forward model for the electrical impedance imaging problem is derived for a homogeneous conductivity distribution and is validated by experiment using a phantom tank. A reconstruction algorithm for breast tumor imaging based on a linearization approach and the proposed forward model is presented. It is found that the proposed reconstruction algorithm performs well in the phantom experiment, and that the locations of a 5-mm-cube metal target and a 6-mm-cube agar target could be recovered at a target depth of 15 mm using a 32 electrode system. PMID:17405377

  7. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Full-field digital mammography system. 892.1715 Section 892.1715 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1715 Full-field digital...

  8. 21 CFR 892.1715 - Full-field digital mammography system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Full-field digital mammography system. 892.1715 Section 892.1715 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1715 Full-field digital...

  9. Tailored Interventions to Promote Mammography Screening: A Meta-Analytic Review

    PubMed Central

    Sohl, Stephanie J.; Moyer, Anne

    2007-01-01

    Objective To evaluate the effectiveness of tailored interventions, designed to reach one specific person based on her unique characteristics, for promoting mammography use. Method This systematic review used meta-analytic techniques to aggregate the effect size of 28 studies published from 1997 through 2005. Potential study-level moderators of outcomes (sample, intervention, and methodological characteristics) were also examined. Results A small but significant aggregate odds ratio effect size of 1.42 indicated that women exposed to tailored interventions were significantly more likely to get a mammogram (p < 0.001). The type of population recruited and participants’ pre-intervention level of mammography adherence did not significantly influence this effect. Tailored interventions that used the Health Belief Model and included a physician recommendation produced the strongest effects. Interventions delivered in person, by telephone, or in print were similarly effective. Finally, defining adherence as a single recent mammogram as opposed to regular or repeated mammograms yielded higher effect sizes. Conclusion Tailored interventions, particularly those that employ the Health Belief Model and use a physician recommendation, are effective in promoting mammography screening. Future investigations should strive to use more standardized definitions of tailoring and assessments of mammography outcomes. PMID:17643481

  10. 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…

  11. 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

  12. Barriers and facilitators related to mammography use among lower educated Mexican women in the USA.

    PubMed

    Tejeda, Silvia; Thompson, Beti; Coronado, Gloria D; Martin, Diane P

    2009-03-01

    This study explores barriers to and facilitators of breast cancer screening and how people in a woman's social network influence these screening behaviors. A total of 40 semi-structured qualitative interviews were conducted in rural Washington State (USA) among Mexican women aged 50 and over. Eligible women reported either having had a mammogram within the last two years, over two years ago, or never. We found that lack of health insurance, the perception that the mammogram is painful, and fear of finding cancer were cited as barriers to participation in mammography screening. Women who had lived in the US for a shorter period were more likely to report never having had a mammogram than women who had lived in the US for a longer period. Women often cited daughters and female friends as those from whom they received advice or encouragement to receive a mammogram. Few differences were found related to network size and mammography use among the groups. These findings may be useful in designing interventions to promote mammography use. Including daughters in intervention activities may help facilitate mammography use among Mexican women.

  13. 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

  14. 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

  15. 75 FR 68200 - Medical Devices; Radiology Devices; Reclassification of Full-Field Digital Mammography System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-05

    ... controls). The device type is intended to produce planar digital x-ray images of the entire breast; this... digital x-ray images of the entire breast. This generic type of device may include digital mammography... 892.1715. The final rule uses the term ``planar'' instead of ``full- field'' to describe digital...

  16. Factors influencing mammography participation in Canada: an integrative review of the literature

    PubMed Central

    Hanson, K.; Montgomery, P.; Bakker, D.; Conlon, M.

    2009-01-01

    This integrative review critically examines quantitative and qualitative evidence concerning factors influencing the participation of Canadian women in mammography. Empirical studies published between 1980 and 2006 were identified and retrieved by searching electronic databases and references listed in published studies. Among the 1461 citations identified and screened, 52 studies met the inclusion criteria and were independently appraised by two researchers. Extracted data were categorized, summarized, compared, and interpreted within and across studies. The presentation of barriers and facilitators to mammography was guided by the Pender Health Promotion Model. Findings from this review showed that no published studies were specific to settings in Saskatchewan, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, and the three Canadian territories. The most common barriers to screening were membership in an ethnic minority and concerns about pain, radiation, and embarrassment. The recommendation of a health care provider for mammography was found to be the most common facilitator for the engagement of women in this health behaviour. The targeting of specific strategies aimed at overcoming identified barriers and the enhancement of facilitators are essential to improving mammography participation rates throughout Canada. PMID:19862363

  17. 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,...

  18. 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,...

  19. 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…

  20. Quality of images acquired with and without grid in digital mammography.

    PubMed

    Al Khalifah, Khaled H; Brindhaban, Ajit; Saeed, Raed A

    2014-01-01

    In this study, we assessed the quality of digital mammography images acquired with a grid and without a grid for different kVp values. A digital mammography system was used for acquisition of images of the CIRS Model 015 Mammography Accreditation Phantom. The images were obtained in the presence of the grid and then with the grid removed from the system. The energy of the X-rays was varied between 26 and 32 kVp. The images were evaluated by five senior radiologic technologists with extensive experience in mammography. Statistical analysis was carried out with the Mann-Whitney non-parametric test with the level of significance set at p = 0.05. The comparison between images obtained with a grid and without a grid indicated that, for the visibility of fibers, the non-grid images at 28 kVp were significantly (p = 0.032) better than the images acquired with a grid. At all other kVp values, the images were not statistically different regarding the visibility of fibers. For the visibility of specks and masses, the images did not show any significant differences at any of the kVp values of the study. Imaging with kVp higher than 30 requires a grid to improve the visibility of fibrous calcifications and specks. For the visibility of masses at 32 kVp, no statistically significant differences between the grid and non-grid images were found.

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

    PubMed

    Fernández, M A; Tortolero-Luna, G; Gold, R S

    1998-01-01

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

  2. Trends of Mammography Use in a National Breast Cancer Screening Program, 2004-2008

    PubMed Central

    Lim, Sun Mi; Choi, Kui Son; Jun, Jae Kwan; Park, Eun-Cheol; Kim, Yeonju; Han, Mi Ah; Oh, Dong Kwan; Shim, Jung Im

    2010-01-01

    Purpose Korea started breast cancer screening as part of the National Cancer Screening Program (NCSP) in 1999. In order to identify under-served groups, we investigated mammography uptake in the National Breast Cancer Screening Program. Materials and Methods The study population was participants in the National Breast Cancer Screening Program from 2004 to 2008. We analyzed participation rates by insurance type, age group, and area of residence. Results Total participation rates for breast cancer screening increased from 18.2% in 2004 to 35.0% in 2008. The participation rate in the group aged 60 to 69 years showed the greatest increase, 21.3%, among the four age groups. Although the screening rate increased continuously, the participation rate of the Medical Aid Program (MAP) group was low compared to the National Health Insurance (NHI) group. Moreover, the increasing trend of mammography uptake in the MAP group was much lower than that of the NHI group. Conclusion The participation rate for breast cancer screening in the NCSP in Korea has increased. However, the participation rate in mammography among MAP recipients is still lower than that of NHI beneficiaries. To increase mammography uptake, it is important to make it available to everyone by ensuring inclusion of all population subgroups. PMID:21253321

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

    PubMed

    Lopez-McKee, Gloria; Bader, Julia

    2011-03-21

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

  4. Declining Mammography Screening in a State Medicaid Fee-for-Service Program: 1999–2008

    PubMed Central

    Madhavan, S. Suresh; Khanna, Rahul; Remick, Scot C.

    2012-01-01

    Abstract Objective To evaluate and compare annual and biennial mammography screening rates across age, race, and geographic location (rural-urban) and to determine mammography screening persistence over 10 years among women enrolled in the West Virginia (WV) Medicaid Fee-for-Service (FFS) program. Methods The WV Medicaid FFS administrative claims data for women recipients aged 40–64 from 1999 to 2008 were used for study purposes. Annual and biennial screening rates and persistence with screening were determined for women who were continuously enrolled in the WV Medicaid FFS program for respective calendar years. Results A steady decline in the annual and biennial screening rates over a 10-year period (1999–2008) was observed among women recipients aged 40–64 years in the WV Medicaid FFS program, and screening persistence was also lower. Both annual and biennial screening rates and persistence varied by different demographic characteristics. Conclusions Although mammography screening services are covered under Medicaid programs, underuse persists as a major concern. The results of this study emphasize the need to identify and address barriers to mammography screening in low-income rural populations. PMID:22568434

  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. Contribution of the Unified Health Care System to mammography screening in Brazil, 2013*

    PubMed Central

    Freitas-Junior, Ruffo; Rodrigues, Danielle Cristina Netto; Corrêa, Rosangela da Silveira; Peixoto, João Emílio; de Oliveira, Humberto Vinícius Carrijo Guimarães; Rahal, Rosemar Macedo Sousa

    2016-01-01

    Objective To estimate the coverage of opportunistic mammography screening performed via the Brazilian Sistema Único de Saúde (SUS, Unified Health Care System), at the state and regional level, in 2013. Materials and Methods This was an ecological study in which coverage was estimated by determining the ratio between the number of mammograms performed and the expected number of mammograms among the population of females between 50 and 69 years of age. The number of mammograms performed in the target population was obtained from the Outpatient Database of the Information Technology Department of the SUS. To calculate the expected number of mammograms, we considered 58.9% of the target population, the proportion that would be expected on the basis of the recommendations of the Brazilian National Cancer Institute. Results In 2013, the estimated national coverage of mammography screening via the SUS was 24.8%. The mammography rate ranged from 12.0% in the northern region to 31.3% in the southern region. When stratified by state, coverage was lowest in the state of Pará and highest in the state of Santa Catarina (7.5% and 35.7%, respectively). Conclusion The coverage of mammography screening performed via the SUS is low. There is a significant disparity among the Brazilian states (including the Federal District of Brasília) and among regions, being higher in the south/southeast and lower in the north/northeast.

  7. Targeted Intervention Strategies to Increase and Maintain Mammography Utilization Among African American Women

    PubMed Central

    Partridge, Edward; Dignan, Mark; Holt, Cheryl; Johnson, Rhoda; Nagy, Chris; Person, Sharina; Wynn, Theresa; Scarinci, Isabel

    2010-01-01

    Objectives. We assessed the impact of a theory-based, culturally relevant intervention designed to increase mammography screening among African American women in 8 underserved counties in Alabama. Methods. Using principles derived from the Stages of Change, Community Health Advisor, and Community Empowerment models, we developed strategies to increase mammography screening. Trained volunteers (N = 143) provided tailored messages to encourage adoption and maintenance of mammography screening. We collected baseline and follow-up data on 1513 women in the communities targeted for the intervention. Our goal was to decrease the number of women in stage 1 (never screened) while increasing the number of women in stage 2 (infrequently screened) and stage 3 (regularly screened). Results. At baseline, 14% (n = 211) of the women were in stage 1, 16% (n = 247) were in stage 2, and 70% (n = 1055) were in stage 3. After the 2-year intervention, 4% (n = 61) of the women remained in stage 1, 20% (n = 306) were in stage 2, and 76% (n = 1146) were in stage 3. Conclusions. Tailored motivational messages and peer support can increase mammography screening rates for African American women. PMID:21068422

  8. 42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... purpose of early detection of breast cancer, and includes a physician's interpretation of the results...

  9. 42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... purpose of early detection of breast cancer, and includes a physician's interpretation of the results...

  10. 42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... purpose of early detection of breast cancer, and includes a physician's interpretation of the results...

  11. 42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... purpose of early detection of breast cancer, and includes a physician's interpretation of the results...

  12. 42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... purpose of early detection of breast cancer, and includes a physician's interpretation of the results...

  13. Sterblichkeit: der paradoxe Kunstgriff des Lebens - Eine Betrachtung vor dem Hintergrund der modernen Biologie

    NASA Astrophysics Data System (ADS)

    Verbeek, Bernhard

    Leben gibt es auf der Erde seit fast 4 Mio. Jahren, trotz allen Katastrophen. Die Idee des Lebens scheint unsterblich. Der Tod aber offenbar auch. Jedes Lebewesen ist davon bedroht, ja für Menschen und andere "höhere“ Lebewesen ist er im Lebensprogramm eingebaut - todsicher. Diese Tatsache ist alles andere als selbstverständlich. Ist sie überhaupt kompatibel mit dem Prinzip der Evolution, nach dem der am besten Angepasste überlebt?

  14. Tycho Brahe - Instrumentenbauer und Meister der Beobachtungstechnik

    NASA Astrophysics Data System (ADS)

    Wolfschmidt, Gudrun

    Vor der Erfindung des Fernrohrs war der dänische Astronom Tycho Brahe (1546 - 1601) der bedeutendste beobachtende Astronom. Von seinem Observatorium Uraniborg auf der - damals dänischen - Insel Hven ist heute noch der Grundriß erkennbar, von Stjerneborg sind die Fundamente erhalten, die Kuppeln in den 1950er Jahren ergänzt. In der Astronomie-Ausstellung im Deutschen Museum gibt es ein Modell der Sternwarte Uraniborg und der zugehörigen Instrumente (Maßstab 1:10); das größere Modell wurde dem Technischen Museum in Malmö geschenkt. Die Instrumente, die er in den Observatorien Uraniborg und Stjerneborg benutzte, sind nicht erhalten. Aber es gibt gute Beschreibungen der Instrumente (Halbkreis, Quadranten, Sextanten, Armillarsphären, Triquetrum, Himmelsglobus) in seinem Buch Astronomiae instauratae mechanica (Wandsbek 1598). Eine Nachbildung des großen hölzernen Quadranten kann man im Runden Turm in Kopenhagen sehen. Zwei Sextanten, hergestellt für Tycho um 1600 von Jost Bürgi und Erasmus Habermel, gibt es noch im Nationalmuseum für Technik in Prag. Ähnlichkeiten von Tychos Instrumenten mit Groß-Instrumenten aus dem islamischen Kulturkreis sind auffällig. Tycho Brahes Meßgeräte markieren einen großen Fortschritt in der Entwicklung astronomischer Instrumente und Meßtechniken und bilden die Grundlage für den weiteren Fortschritt der Positionsastronomie und der damit verbundenen Tabellenwerke. Die Nachwirkungen sind bis ins 17. und 18. Jahrhundert nachweisbar.

  15. Friedrich Möglich - sein Beitrag zum Aufbau der Physik in der DDR. Friedrich Möglich - langjähriger Mitherausgeber und Chefredakteur der Annalen der Physik

    NASA Astrophysics Data System (ADS)

    Rompe, Robert

    Friedrich Möglich, ein Schüler von Max von Laue und Erwin Schrödinger, übernahm 1947 die Chefredaktion der Annalen der Physik.Translated AbstractFriedrich Möglich - His Contributions to the Formation of Physics in GDRFriedrich Möglich a student of Max von Laue and Erwin Schrödinger took over as editor in chief of Annalen der Physik in 1947.

  16. 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

  17. Kosmische Weiten. Kurze Geschichte der Entfernungsmessung im Weltall.

    NASA Astrophysics Data System (ADS)

    Herrmann, D. B.

    Contents: 1. Einleitung. 2. Trigonometrische (jährliche) Fixsternparallaxen. 3. Fotometrische Parallaxen. 4. Überblick über weitere Methoden der Entfernungsbestimmung. 5. Entfernungen der extragalaktischen Objekte. 6. Ausblick. 7. Elementare Grundlagen der Entfernungsbestimmung.

  18. Association Between Individual and Geographic Factors and Nonadherence to Mammography Screening Guidelines

    PubMed Central

    McDonald, Kaila; Sherman, Recinda; Kinney, Anita Y; Stroup, Antoinette M

    2014-01-01

    Abstract Background: This study investigates factors that are associated with nonadherence to mammography screening guidelines in Utah, a state where mammography screening rates have remained consistently lower than national averages. Methods: We examined data on reported mammography use among women aged 40–74 years from the 2008 and 2010 Utah Behavioral Risk Factor Surveillance System (n=5,197, weighted n=417,064). Logistic regression models were used to estimate the effects of individual-level and geographic (travel time to nearest mammography facility, geographic accessibility, and rural/urban residence) factors on the odds of a woman not reporting receiving a mammogram in the last 2 years. Results: In 2008 and 2010, a disproportionate number of women aged 40–49 (43.1%, 95% confidence interval [CI] 39.9%–46.3%) reported not receiving a mammogram within the last 2 years compared to women 50–74 (26.8%, 95% CI 24.9%–28.7%). None of the geographic factors were significant predictors of screening adherence. Based on covariate adjusted models, statistically significant (p<0.05) factors associated with increased odds of not receiving mammogram within the last 2 years included not having a regular physician, no health insurance, being aged 40–49, income less than $25,000, and the presence of three or more children in the home. Conclusion: Mammography screening efforts in Utah should focus on improving access to insurance or a regular source of health care. Future research should also consider how best to address extreme time demands and competing priorities that present potential barriers for women with large families, resulting in lower screening levels among these women. PMID:24865409

  19. Characteristics Associated with Mammography Screening among Both Hispanic and Non-Hispanic White Women

    PubMed Central

    Hines, Lisa; Byers, Tim; Risendal, Betsy; Slattery, Martha L.; Sweeney, Carol; Baumgartner, Kathy B.; Giuliano, Anna

    2009-01-01

    Abstract Aims This study explores whether certain population characteristics are associated with adherence to mammography screening guidelines among Hispanic and non-Hispanic white (NHW) women living in the southwestern United States. Methods Participants in a population-based study (4-Corners' Breast Cancer Study) included in this analysis were 790 Hispanic women and 1441 NHW women. Multivariate logistic regression was used to compute the ethnic-specific adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association of the outcome variable (adherent vs. nonadherent) and its correlates. Women were adherent if they had obtained their first mammogram between 41 and 50 years of age and had received at least one mammogram per 2 years or less. Results Ethnic-specific associations were observed with certain population characteristics and mammography adherence. Specifically, characteristics that were significantly associated with adherence among Hispanic women were younger age (50–59 years), having a family history of breast cancer, nulliparity, hormone replacement therapy (HRT) use, nonsteroidal anti-inflammatory drug (NSAID) use, and performing regular breast self-examinations (BSE). Among NHW women, younger age (50–59 years), family history of breast cancer, obesity, consuming moderate amounts of alcohol, and taking HRT were associated with mammography adherence. When adjusting for the evaluated population characteristics, the relationship between ethnicity and mammography adherence was no longer apparent. Conclusions Ethnic-specific characteristics appear to explain differences in mammography adherence among Hispanic and NHW women. Disparities in screening rates, late-stage disease and breast cancer mortality that impact Hispanic women could potentially be addressed more effectively by interventions that specifically target the unique characteristics of the Hispanic population. PMID:19754247

  20. Practical application of a scan-rotate equalization geometry to mammography.

    PubMed

    Sabol, J M; Soutar, I C; Plewes, D B

    1996-12-01

    The presence of dense fibroglandular tissue within the breast is the most significant cause of failure to detect breast cancer with mammography. The dense tissue often produces a range of exposure which exceeds the useful dynamic range of film-screen mammography. It has been shown that equalization radiography overcomes the latitude limitations of film-screen imaging. Equalization compensates for regional variations in x-ray transmission within the patient through spatial modulation of the entrance exposure. We have proposed rotary scanning equalization radiography (RSER), a scan-rotate geometry for efficient equalization radiography. In RSER the image receptor is exposed by repeated scans of a source-modulated fan beam. The fan beam is rotated with respect to the patient between scans. Numerical simulations and theoretical analysis have shown that the superposition of exposure from appropriately modulated fan beams at a variety of angles is an entrance exposure that effectively equalizes the film exposure. The design and characteristics of a prototype RSER imaging system are described. Anthropomorphic breast phantom images are used to determine the improvement in image contrast obtained with RSER, the expected tube loading, and the presence of artifacts. RSER increases the fraction of the breast imaged with high contrast (at least 90% of peak gradient) from 46% (conventional mammography) to 80%. Subjective examination of the phantom images show that RSER achieves image quality very similar to that of much less efficient equalization geometries with only 2.7 times greater tube loading than conventional mammography. As predicted by theoretical analysis of exposure artifacts in RSER, the prototype RSER system is relatively immune to artifacts. Exposure artifacts were demonstrated for extreme variations in x-ray transmission within the patient. These results show that RSER is an efficient, practical means of overcoming the latitude limitations of film

  1. 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.

  2. 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.

  3. Noise power spectra of images from digital mammography detectors.

    PubMed

    Williams, M B; Mangiafico, P A; Simoni, P U

    1999-07-01

    Noise characterization through estimation of the noise power spectrum (NPS) is a central component of the evaluation of digital x-ray systems. We begin with a brief review of the fundamentals of NPS theory and measurement, derive explicit expressions for calculation of the one- and two-dimensional (1D and 2D) NPS, and discuss some of the considerations and tradeoffs when these concepts are applied to digital systems. Measurements of the NPS of two detectors for digital mammography are presented to illustrate some of the implications of the choices available. For both systems, two-dimensional noise power spectra obtained over a range of input fluence exhibit pronounced asymmetry between the orthogonal frequency dimensions. The 2D spectra of both systems also demonstrate dominant structures both on and off the primary frequency axes indicative of periodic noise components. Although the two systems share many common noise characteristics, there are significant differences, including markedly different dark-noise magnitudes, differences in NPS shape as a function of both spatial frequency and exposure, and differences in the natures of the residual fixed pattern noise following flat fielding corrections. For low x-ray exposures, quantum noise-limited operation may be possible only at low spatial frequency. Depending on the method of obtaining the 1D NPS (i.e., synthetic slit scanning or slice extraction from the 2D NPS), on-axis periodic structures can be misleadingly smoothed or missed entirely. Our measurements indicate that for these systems, 1D spectra useful for the purpose of detective quantum efficiency calculation may be obtained from thin cuts through the central portion of the calculated 2D NPS. On the other hand, low-frequency spectral values do not converge to an asymptotic value with increasing slit length when 1D spectra are generated using the scanned synthetic slit method. Aliasing can contribute significantly to the digital NPS, especially near the

  4. 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

  5. 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

  6. Von Humboldt bis Einstein. Berlin als Weltzentrum der exakten Wissenschaften.

    NASA Astrophysics Data System (ADS)

    Meschkowski, H.

    Contents: 1. Die Anfänge. 2. Die Ära Dirichlet-Jacobi. 3. Der Ausbau der experimentellen Naturwissenschaften. 4. Alexander von Humboldt. 5. Berlin wird "Weltzentrum" der Mathematik. 6. Die Ära Helmholtz. 7. Neue Arbeitsweisen der Astronomie. 8. Chemie: Forschung und Industrie. 9. Max Planck. 10. Ins technische Zeitalter. 11. Zur Mathematik der zwanziger Jahre. 12. Albert Einstein. 13. Fortschritte der Grundlagenforschung. 14. Erwin Schrödinger: Physiker, Philosoph und Poet. 15. Zum Schluß.

  7. Der Kalte Krieg in der Peripherie Griechische Physiker und Atomenergie nach dem Zweiten Weltkrieg

    NASA Astrophysics Data System (ADS)

    Vlahakis, George N.

    Die vorliegende Arbeit analysiert Ansichten griechischer Physiker zur Atomenergie und deren mögliche Anwendung nach dem Zweiten Weltkrieg, insbesondere während des Kalten Kriegs. Einerseits werden Ansichten von Physik- Professoren griechischer Universitäten präsentiert - beispielsweise von Dimitrios Hondros, der Student von Arnold Sommerfeld und Mitarbeiter von Peter Debye in München war, und andererseits wird die Politik der griechischen Regierung für die Etablierung eines Forschungsinstitutes diskutiert, das der Entwicklung der Atomenergie dienen sollte; ebenfalls wird eine öffentliche Meinungsumfrage zu diesen Thema, die in den Tageszeitungen der damaligen Zeit präsentiert wurde, diskutiert.

  8. 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

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

    PubMed

    Park, Ah Young; Seo, Bo Kyoung; Cho, Kyu Ran; Woo, Ok Hee

    2016-03-01

    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

  10. [Contribution of mammography and echography to the diagnosis of breast cancer in Dakar: apropos of 25 cases].

    PubMed

    Diop-Ba, S; Badiane, M; Niang, E H; Ly Ba, A; Alfidja, A; Favre, Y

    1997-01-01

    The authors studied mammographic features of 25 patients with malignant breast disease. 24 of them had ultrasonographic (US) exploration. The study appreciates epidemiological, mammographic and US aspects; It also appreciates the correlation between images and histology. The mean age is 40. Six women (26%) had family history cancer. The mean reason of the exploration is a mass in 76%. At mammography, contours of cancerous opacities are irregular in 56%, regular in 16%. In 20%, the cancer showed no opacity. At US, we find a lack that appears irregular in 48%, regular in 24%, without traduction in 4%, non precised in 24%. Mammography sensitivity was 80%, false negative rate 28% and false positive rate 8% against respectively 96%, 32% et 12% for echography. This study shows that US is more sensitive but less specific than mammography. However, we recommend the use of mammography and echography together because in Senegal, cancer happens at an earlier age at with breast is easier to analyze at US.

  11. Wilhelm Julius Foerster und die "Vereinigung von Freunden der Astronomie und kosmischen Physik" (1891 bis 1914).

    NASA Astrophysics Data System (ADS)

    Tiemann, K.-H.

    Am 19. Mai 1891 wurde ins Leben gerufen die "Vereinigung von Freunden der Astronomie und der kosmischen Physik (nachfolg.: V.A.P.) - eine der beiden institutionellen Vorläufer der sich 1953 konstituierenden "Vereinigung der Sternfreunde".

  12. Erlebniseinkauf in der Innenstadt mit hoher Akzeptanz

    NASA Astrophysics Data System (ADS)

    Pangels, Rolf

    2002-03-01

    Im Oktober 2000 führte die BAG zum zehnten Mal die über die Grenzen des Einzelhandels bekannte Untersuchung "Kundenverkehr" in mehr als hundertfünfzig deutschen Städten durch. In Kooperation mit der Swiss Retail Federation sowie mit Unterstützung der femged (European Federation of Medium-size and Major Retailers) wurde die Untersuchung erstmals auch in der Schweiz und in Österreich durchgeführt. Es beteiligten sich insgesamt 463 Unternehmen an der Untersuchung, die knapp 9,5 Mio. Besucher gezählt haben und davon mehr als 360.000 Kunden nach bestimmten Parametern befragten. Die Daten für Deutschland wurden, wie in den Jahren zuvor, vom Institut für Handelsforschung an der Universität Köln ausgewertet. Die Zahlen der Untersuchung in der Schweiz und Österreich wurden von der wirtschafts- und sozialwissenschaftlichen Beratungsgesellschaft ECON-Consult in Köln zusammengetragen und analysiert.

  13. What factors explain disparities in mammography rates among Asian American immigrant women? A population-based study in California

    PubMed Central

    Ryu, So Yeon; Crespi, Catherine M.

    2013-01-01

    BACKGROUND The purpose of this study was to compare rates of screening mammography among immigrant women in five Asian American ethnic groups in California, and ascertain the extent to which differences in mammography rates among these groups are attributable to differences in known correlates of cancer screening. METHODS Using 2009 data from the California Health Interview Survey, we compared the rates of mammography among Chinese, Filipino, Japanese, Korean, and Vietnamese immigrants 40 years and older. To assess the impact of Asian ethnicity on participation in screening, we performed multiple logistic regression analysis with models that progressively adjusted for acculturation, socio-demographic characteristics, access to health care and breast cancer risk factors, and examined the predicted probabilities of screening after adjusting for these factors. FINDINGS Participation in screening mammography differed according to ethnicity, with Filipina and Vietnamese Americans having the highest rates and Korean Americans having the lowest rates of lifetime and recent (past two years) screening. These differences decreased substantially after adjusting for acculturation, socio-demographic factors and risk factors of breast cancer but differences still remained, most notably for Korean Americans, who continued to have the lowest predicted probability of screening even after adjustment for these factors. CONCLUSIONS This analysis draws attention to low mammography screening rates among Asian American immigrants, especially recent immigrants who lack health insurance. Given that their breast cancer incidence is rising with length of stay in the United States, it is very important to increase regular mammography screening in these groups. PMID:24183415

  14. Development of the mammography beliefs and attitudes questionnaire for low-health-literacy Mexican-American women.

    PubMed

    Lopez-McKee, Gloria

    2011-01-01

    Low-income, low-health-literacy Mexican-American women exhibit poor mammography screening participation and are being diagnosed at later stages of breast cancer than are non-Hispanic white women. No instrument has been available to measure the impact of cultural and psycho-social factors on the intent to seek mammography screening participation in this population. In this article the author describes the development process of the English Mammography Beliefs and Attitudes Questionnaire (MBAQ) and the Spanish Mammography Beliefs and Attitudes Questionnaire (SMBAQ). The Theory of Planned Behavior is the theoretical framework underlying these instruments designed to measure intent to seek mammography screening in low-health-literacy Mexican-American women. The process of developing the MBAQ utilized input from low-health-literacy Mexican-American women and an expert committee. The MBAQ was translated into Spanish and assessed for content validity and reading level. In the discussion, the author explains why the MBAQ and SMBAQ are appropriate tools for use with low-health-literacy Mexican-American women to measure their intentions to seek mammography screening. Limitations of the study and implications for practice and research are presented. PMID:21800927

  15. 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

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

    NASA Astrophysics Data System (ADS)

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

    2001-09-01

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

  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. Development of the mammography beliefs and attitudes questionnaire for low-health-literacy Mexican-American women.

    PubMed

    Lopez-McKee, Gloria

    2010-11-24

    Low-income, low-health-literacy Mexican-American women exhibit poor mammography screening participation and are being diagnosed at later stages of breast cancer than are non-Hispanic white women. No instrument has been available to measure the impact of cultural and psycho-social factors on the intent to seek mammography screening participation in this population. In this article the author describes the development process of the English Mammography Beliefs and Attitudes Questionnaire (MBAQ) and the Spanish Mammography Beliefs and Attitudes Questionnaire (SMBAQ). The Theory of Planned Behavior is the theoretical framework underlying these instruments designed to measure intent to seek mammography screening in low-health-literacy Mexican-American women. The process of developing the MBAQ utilized input from low-health-literacy Mexican-American women and an expert committee. The MBAQ was translated into Spanish and assessed for content validity and reading level. In the discussion, the author explains why the MBAQ and SMBAQ are appropriate tools for use with low-health-literacy Mexican-American women to measure their intentions to seek mammography screening. Limitations of the study and implications for practice and research are presented.

  19. Diagnostic Accuracy of Digital Screening Mammography with and without Computer-aided Detection

    PubMed Central

    Lehman, Constance D.; Wellman, Robert D.; Buist, Diana S.M.; Kerlikowske, Karla; Tosteson, Anna N. A.; Miglioretti, Diana L.

    2016-01-01

    Importance After the Food and Drug Administration (FDA) approved computer-aided detection (CAD) for mammography in 1998, and Centers for Medicare and Medicaid Services (CMS) provided increased payment in 2002, CAD technology disseminated rapidly. Despite sparse evidence that CAD improves accuracy of mammographic interpretations, and costs over $400 million dollars a year, CAD is currently used for the majority of screening mammograms in the U.S. Objective To measure performance of digital screening mammography with and without computer-aided detection in U.S. community practice. Design, Setting and Participants We compared the accuracy of digital screening mammography interpreted with (N=495,818) vs. without (N=129,807) computer-aided detection from 2003 through 2009 in 323,973 women. Mammograms were interpreted by 271 radiologists from 66 facilities in the Breast Cancer Surveillance Consortium. Linkage with tumor registries identified 3,159 breast cancers in 323,973 women within one year of the screening. Main Outcomes and Measures Mammography performance (sensitivity, specificity, and screen detected and interval cancers per 1,000 women) was modeled using logistic regression with radiologist-specific random effects to account for correlation among examinations interpreted by the same radiologist, adjusting for patient age, race/ethnicity, time since prior mammogram, exam year, and registry. Conditional logistic regression was used to compare performance among 107 radiologists who interpreted mammograms both with and without computer-aided detection. Results Screening performance was not improved with computer-aided detection on any metric assessed. Mammography sensitivity was 85.3% (95% confidence interval [CI]=83.6–86.9) with and 87.3% (95% CI 84.5–89.7) without computer-aided detection. Specificity was 91.6% (95% CI=91.0–92.2) with and 91.4% (95% CI=90.6–92.0) without computer-aided detection. There was no difference in cancer detection rate (4

  20. 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

  1. 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

  2. Zooming method (× 2.0) of digital mammography vs digital magnification view (× 1.8) in full-field digital mammography for the diagnosis of microcalcifications

    PubMed Central

    Kim, M J; Youk, J H; Kang, D R; Choi, S H; Kwak, J Y; Son, E J; Kim, E-K

    2010-01-01

    The purpose of this study was to determine whether the interpretation of microcalcifications assessed on images zoomed (× 2.0) from digital mammograms is at least equivalent to that from digital magnification mammography (× 1.8) with respect to diagnostic accuracy and image quality. Three radiologists with different levels of experience in mammography reviewed each full-field digital mammography reader set for 185 patients with pathologically proven microcalcification clusters, which consisted of digital magnification mammograms (MAGs) with a magnification factor of 1.8 and images zoomed from mammograms (ZOOM) with a zoom factor of 2.0. Each radiologist rated their suspicion of breast cancer in microcalcific lesions using a six-point scale and the image quality and their confidence in the decisions using a five-point scale. Results were analysed according to display methods using areas under the receiver operating characteristic curves (Az value) for ZOOM and MAGs to interpret microcalcifications, and the Wilcoxon matched pairs signed rank test for image quality and confidence levels. There was no statistically significant difference in the level of suspicion of breast cancer between the ZOOM and MAG groups (Az = 0.8680 for ZOOM; Az = 0.8682 for MAG; p = 0.9897). However, MAG images were significantly better than ZOOM images in terms of visual imaging quality (p < 0.001), and the confidence level with MAG was better than with ZOOM (p < 0.001). In conclusion, the performance of radiologists in the diagnosis of microcalcifications using ZOOM was similar to that using MAGs, although image quality and confidence levels were better using MAGs. PMID:19752171

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

    PubMed

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

    2008-06-01

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

  4. 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

  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. Thermoluminescence of zirconium oxide nanostructured to mammography X-ray beams.

    PubMed

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

    2012-07-01

    In the present work thermoluminescent (TL) response of zirconium oxide (ZrO2) nanostructured induced by mammography X-ray radiation was investigated. Measurements were made of the response per unit air kerma of ZrO2 with mammography equipment parameters (semiautomatic exposure control, 24 kVp and 108 mAs). The calibration curves were obtained by simultaneously irradiating ZrO2 samples and ion chamber. Samples of ZrO2 showed a linear response as a function of entrance skin air kerma. The observed results in TL properties suggest that ZrO2 nanostructured could be considered as an effective material for X-ray beams dosimetry if appropriate calibration procedures are performed.

  7. Correlates of mammography screening among Hispanic women living in lower Rio Grande Valley farmworker communities.

    PubMed

    Palmer, Richard C; Fernandez, Maria E; Tortolero-Luna, Guillermo; Gonzales, Alicia; Mullen, Patricia Dolan

    2005-08-01

    Factors contributing to the underuse of mammography screening by female Hispanic farmworkers aged 50 years and older in the Lower Rio Grande Valley were determined through home-based, Spanish-language personal interviews (N = 200). Questions covered adherence to screening mammography guidelines (mammogram within 2 years), healthcare access, sociodemographic characteristics, and theoretical constructs related to breast cancer screening in the literature. Multivariate findings indicated that adherent women were 3.6 times more likely to have health insurance. Self-efficacy for obtaining a mammogram and decisional balance were also significantly related to adherence; age, income, and education variables were not associated, perhaps because of restricted variation. Results indicate continuing efforts are needed to ensure that medically underserved migrant farmworker women have access to health care services. In addition, efforts to increase their self-efficacy in obtaining a mammogram and to counter negative attitudes and opinions by stressing the positive prognosis associated with early detection are warranted.

  8. 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.

  9. 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

  10. Conversion factors between human and automatic readouts of CDMAM phantom images of CR mammography systems

    NASA Astrophysics Data System (ADS)

    Figl, Michael; Homolka, Peter; Osanna-Elliott, Angelika; Semturs, Friedrich; Kaar, Marcus; Hummel, Johann

    2016-09-01

    In mammography screening, profound assessment of technical image quality is imperative. The European protocol for the quality control of the physical and technical aspects of mammography screening (EPQCM) suggests using an alternate fixed choice contrast-detail phantom-like CDMAM. For the evaluation of technical image quality, human or automated readouts can be used. For automatic evaluation, a software (cdcom) is provided by EUREF. If the automated readout indicates unacceptable image quality, additional human readout may be performed overriding the automated readout. As the latter systematically results in higher image quality ratings, conversion factors between both methods are regularly applied. Since most image quality issues with mammography systems arise within CR systems, an assessment restricted to CR systems with data from the Austrian Reference Center in the mammography screening program has been conducted. Forty-five CR systems were evaluated. Human readouts were performed with a randomisation software to avoid bias due to learning effects. Additional automatic evaluation allowed for the computation of conversion factors between human and automatic readouts. These factors were substantially lower compared to those suggested by EUREF, namely 1.21 compared to 1.62 (EUREF UK method) and 1.42 (EUREF EU method) for 0.1 mm, and 1.40 compared to 1.83 (EUREF UK) and 1.73 (EUREF EU) for 0.25 mm structure size, respectively. Using either of these factors to adjust patient dose in order to comply with image quality requirements results in differences in the dose increase of up to 90%. This necessitates a consensus on their proper application and limits the validity of the assessment methods. Clear criteria for CR systems based on appropriate studies should be promoted.

  11. 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

  12. In vivo absorbed dose measurements in mammography using a new real-time luminescence technique.

    PubMed

    Aznar, M C; Hemdal, B; Medin, J; Marckmann, C J; Andersen, C E; Bøtter-Jensen, L; Andersson, I; Mattsson, S

    2005-04-01

    A dosimetry system based on radioluminescence (RL) and optically stimulated luminescence (OSL) from carbon doped aluminium oxide (Al2O3:C) crystals was developed for in vivo absorbed dose measurements in mammography. A small cylindrical crystal of Al2O3:C (diameter 0.48 mm and length 2 mm) was coupled to the end of a 1 mm diameter optical fibre cable. Owing to their small size and characteristic shape, these probes can be placed on the body surface in the field of view during the examination, without compromising the reading of the mammogram. Our new technique was tested with a mammography unit (Siemens Mammomat 3000) and screen-film technique over a range of clinically relevant X-ray energies. The results were compared with those obtained from an ionization chamber usually used for the determination of absorbed dose in mammography. The reproducibility of measurements was around 3% (1 standard deviation) at 4.5 mGy for both RL and OSL data. The dose response was found to be linear between 4.5 mGy and 30 mGy. The energy dependence of the system is around 18% between 23 kV and 35 kV. In vivo measurements were performed during three patient examinations. It was shown that entrance and exit doses could be measured. The presence of the small probes did not significantly interfere with the diagnostic quality of the images. Entrance doses estimated by RL/OSL results agreed within 3% with entrance surface dose values calculated from the ionization chamber measurements. These results indicate a considerable potential for use in routine control and in vivo dose measurements in mammography.

  13. An adaptive algorithm for the detection of microcalcifications in simulated low-dose mammography

    NASA Astrophysics Data System (ADS)

    Treiber, O.; Wanninger, F.; Führ, H.; Panzer, W.; Regulla, D.; Winkler, G.

    2003-02-01

    This paper uses the task of microcalcification detection as a benchmark problem to assess the potential for dose reduction in x-ray mammography. We present the results of a newly developed algorithm for detection of microcalcifications as a case study for a typical commercial film-screen system (Kodak Min-R 2000/2190). The first part of the paper deals with the simulation of dose reduction for film-screen mammography based on a physical model of the imaging process. Use of a more sensitive film-screen system is expected to result in additional smoothing of the image. We introduce two different models of that behaviour, called moderate and strong smoothing. We then present an adaptive, model-based microcalcification detection algorithm. Comparing detection results with ground-truth images obtained under the supervision of an expert radiologist allows us to establish the soundness of the detection algorithm. We measure the performance on the dose-reduced images in order to assess the loss of information due to dose reduction. It turns out that the smoothing behaviour has a strong influence on detection rates. For moderate smoothing, a dose reduction by 25% has no serious influence on the detection results, whereas a dose reduction by 50% already entails a marked deterioration of the performance. Strong smoothing generally leads to an unacceptable loss of image quality. The test results emphasize the impact of the more sensitive film-screen system and its characteristics on the problem of assessing the potential for dose reduction in film-screen mammography. The general approach presented in the paper can be adapted to fully digital mammography.

  14. [Psychological adjustment of short interval follow-up mammography: about 50 cases].

    PubMed

    Barreau, B; Tastet, S; Stinès, J; Picot, V; Guibert-Tamisier, L; Brault, I; Gillet, J M; Fawzi, M; Audigey, I; Pousse, T; Dilhuydy, M H

    2003-01-01

    The objective was to investigate women's perceptions and the perceived stress experience when undergoing surveillance mammography for benign lesions (ACR3, BI-RADS). A semi-prospective study was carried out on women with diagnosed "probably benign" breast abnormalities. It was a multicentric study from 1st March to 10th June 2002. The survey was performed at the first follow-up mammography and included questions about perceptions and perceived stress related to the follow-up experience. The response is analysed with chi-square test. Fifty women (35-75 years) answered the questionnaire. All women were satisfied with reception. The mammographies were painful (23 cases). Subsequent time seemed to be too long (seven cases) and they were anxious in 19 cases. Quality of life was spoiled (disturbed) (20 cases). Professional and social perturbations were not frequent (four cases). Speaking to a relative is frequent (39 cases), but patients were not satisfied with it (33 cases). Medical information was estimated (47 cases) but was not satisfactory (36 cases). The median of the stress scale is 4-5. There are two pickaxes, one at 2 (11 cases), the second at 5 (8 cases). "Low-stressed" women could have an avoidance coping. "High-stressed" women could use a helplessness- hopelessness coping strategy. Women reported a good and informative medical support and adequate comprehension of the short follow-up mammography. They were reassured by the medical care, but the evaluation of the stress level shows it to be high, probably due to the uncertainty of diagnosis.

  15. 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.

  16. 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

  17. Educational interventions to improve screening mammography interpretation: a randomized, controlled trial

    PubMed Central

    BM, Geller; A, Bogart; PA, Carney; EA, Sickles; RA, Smith; B, Monsees; LW, Bassett; DM, Buist; K, Kerlikowske; T, Onega; B, Yankaskas; S, Haneuse; DA, Hill; M, Wallis; DL, Miglioretti

    2014-01-01

    Purpose Conduct a randomized controlled trial of educational interventions to improve performance of screening mammography interpretation. Materials and Methods We randomly assigned physicians who interpret mammography to one of three groups: (1) self-paced DVD; (2) live, expert-led educational session; or (3) control. The DVD and live interventions used mammography cases of varying difficulty and associated teaching points. Interpretive performance was compared using a pre-/post-test design. Sensitivity, specificity, and positive predictive value (PPV) were calculated relative to two outcomes: cancer status and consensus of three experts about recall, and each were compared using logistic regression adjusting for pre-test performance. Results 102 radiologists completed all aspects of the trial. After adjustment for pre-intervention performance, the odds of improved sensitivity for correctly identifying a lesion relative to expert recall were 1.34 times higher for DVD participants than controls (95% confidence interval [CI]: 1.00, 1.81; P=0.050). The odds of improved PPV for correctly identifying a lesion relative to both expert recall (odds ratio [OR]=1.94, 95% CI: 1.24, 3.05; P=0.004) and cancer status (OR=1.81, 95% CI: 1.01, 3.23; P=0.045) were significantly improved for DVD participants compared to controls with no significant change in specificity. For the live-intervention group, specificity was significantly lower than the control group (OR relative to expert recall=0.80; 95% CI: 0.64, 1.00; P=0.048; OR relative to cancer=0.79; 95% CI: 0.65, 0.95; P=0.015). Conclusion In this randomized controlled trial, the DVD educational intervention resulted in a significant improvement in mammography interpretive screening performance on a test-set, which could translate into improved clinical interpretative performance. PMID:24848854

  18. Performance of digital screening mammography among older women in the U.S

    PubMed Central

    Henderson, Louise M.; O’Meara, Ellen S.; Braithwaite, Dejana; Onega, Tracy

    2015-01-01

    Background Although healthy women aged 65 have a life expectancy of 20 years, there is a paucity of data on the performance of digital screening mammography among these women. We examined the performance and outcomes of digital screening mammography among a national group of women aged 65 and older. Methods Using Breast Cancer Surveillance Consortium data from 2005–2011 we included 296,496 full field digital screening mammograms among 133,042 women ages 65 and older without a history of breast cancer. We calculated sensitivity, specificity, positive predictive value (PPV), recall and 95% confidence intervals (95%CI) across the spectrum of age and breast density. We used multivariate logistic regression to compare mammography accuracy, cancer detection rates (CDRs), and tumor characteristics by age and breast density. Results Multivariate analyses showed a significant decrease in recall rate with age (p-value for trend<0.001) and significant increases in specificity, PPV1, and CDR with age (p-value for trend <0.001, <0.001, and 0.01 respectively). Sensitivity did not vary significantly with age. Among women with cancer, the proportion with invasive disease increased with age from 76% at 65–74 years to 81% at 80+. There was a higher proportion of late stage cancers and positive lymph nodes in women ages 65–74 compared to older age groups. Conclusions Specificity, PPV1, recall rate, and CDR of digital screening mammography improved with increased age. In addition, as age increased the proportion of invasive versus ductal carcinoma in-situ cases rose, while the proportion of cases with positive nodes decreased. PMID:25537958

  19. Feasibility and Acceptability of Conducting a Randomized Clinical Trial Designed to Improve Interpretation of Screening Mammography

    PubMed Central

    Carney, Patricia A.; Bogart, Andy; Sickles, Edward A.; Smith, Robert; Buist, Diana SM; Kerlikowske, Karla; Onega, Tracy; Miglioretti, Diana L.; Rosenberg, Robert; Yankaskas, Bonnie C.; Geller, Berta M.

    2014-01-01

    Purpose To describe recruitment, enrollment and participation in a study of U.S. radiologists invited to participate in a randomized controlled trial of two continuing medical education interventions designed to improve interpretation of screening mammography. Methods We collected recruitment, consent, and intervention-completion information as part of a large study involving radiologists in California, Oregon, Washington, New Mexico, New Hampshire, North Carolina, and Vermont. Consenting radiologists were randomized to receive either a one-day live, expert-led educational session; a self-paced DVD with similar content; or to a control group (delayed intervention). The impact of the interventions was assessed using a pre- and post-intervention test set design. All activities were IRB-approved and HIPAA compliant. Results Of 403 eligible radiologists, 151/403 (37.5%) consented to participate in the trial and 119/151 (78.8%) completed the pre–intervention test set, leaving 119 available for randomization to one of the two intervention groups or to controls. Female radiologists were more likely than males to consent to and complete the study (p= 0.03). Consenting radiologists who completed all study activities were more likely to have been interpreting mammography for ≤10 years compared to radiologists who consented and did not complete all study activities or did not consent at all. The live intervention group was more likely to report their intent to change their clinical practice as a result of the intervention compared to those who received the DVD (50% versus 17.6%, p=0.02). The majority of participants in both interventions groups felt the interventions were a useful way to receive CME mammography credits Conclusions Community radiologists found interactive interventions designed to improve interpretative mammography performance acceptable and useful for clinical practice. This suggests CME credits for radiologists should, in part, be for examining practice

  20. 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.

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

    PubMed

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

    2011-08-01

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

  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. 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.

  4. Nonsingular van der Waals potentials

    NASA Astrophysics Data System (ADS)

    Lu, J. X.; Marlow, W. H.

    1995-09-01

    Universal, spherical, nonsingular van der Waals interactions including retardation effect are developed for atoms and small molecules through a semiclassical field approach. Consideration of the finite molecular size effect removes the short-distance singular behavior inherent in the widely used potentials obtained from the point-molecule approximation. Physical arguments lead to the molecular size parameter a (in atomic units) as 1/a=1.25(I/IH)1/2, except for a system that involves at least an atom or a molecule with very different first and second ionization potentials, and for such a system the above numerical factor 1.25 is replaced by unity. Here I and IH are the first ionization potentials for the atom or molecule considered and for a hydrogen atom, respectively. The nonsingular potentials have been tested for the following representative systems: H2 (3Σ+u), He2, Ar2, NaK (3Σ+), LiHg (2Σ+), He-HF, Ne-HF, HF-HF, and Ar-HCl. Very good agreement has been found for each of the systems. Based on the above systems studied, an empirical relation has been obtained between the parameter b in the Born-Mayer repulsive potential Ae-bR and the molecular size parameters (a1 and a2). Applying this relation to dozens of systems with known b from either self-consistent-field calculations or experiments, surprisingly good agreements have been obtained. By the same token, another empirical formula is obtained that relates the van der Waals minimum well parameter Rm to the molecular size parameters (a1 and a2) and the first ionization potentials (Ix and Iy) of interacting species. Again, very good agreements have been achieved in comparison with dozens of systems with known experimental Rm's.

  5. Qualitätsmanagement in der Lebensmittelindustrie

    NASA Astrophysics Data System (ADS)

    Thorn, Volker

    Die wesentlichen Kunden der Lebensmittelindustrie sind der Einzel- und Großhandel und die Verbraucher. Jedes Unternehmen kann mittel- und langfristig nur existieren, wenn seine Kunden zufrieden sind. Kunden sind zufrieden, wenn ihre Erwartungen, die sie an Produkt, Service und Preis stellen, erfüllt werden. Also die bestimmte erwartete Qualität (Leistung) sichergestellt wird. Trotz aller Bemühungen und Anstrengungen der Anbieter, Qualitätsprodukte auf den Markt zu bringen, kames in den letzten Jahren immer wieder zu Lebensmittelskandalen.

  6. Symmetriebrechung und Emergenz in der Kosmologie.

    NASA Astrophysics Data System (ADS)

    Mainzer, K.

    Seit der Antike wird der Aufbau des Universums mit einfachen und regulären (symmetrischen) Grundstrukturen verbunden. Diese Annahme liegt selbst noch den Standardmodellen der relativistischen Kosmologie zugrunde. Demgegenüber läßt sich die Emergenz neuer Strukturen von den Elementarteilchen über Moleküle bis zu den komplexen Systemen des Lebens als Symmetriebrechung verstehen. Symmetriebrechung und strukturelle Komplexität bestimmen die kosmische Evolution. Damit zeichnet sich ein fachübergreifendes Forschungsprogramm von Physik, Chemie und Biologie ab, in dem die Evolution des Universums untersucht werden kann.

  7. Mean glandular dose in six digital mammography services in Santiago, Chile: preliminary reference levels.

    PubMed

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

    2015-07-01

    The purpose of this paper was to estimate mean glandular dose levels (DG) in six digital mammography systems in Santiago, Chile, and to propose preliminary reference levels to execute mammography in Chile. The study was carried out assessing two direct digital systems and four computer-based radiography (CR) systems. Estimates of DG were calculated for different thicknesses of polymethyl methacrylate according to the quality control protocol in digital mammography of the Spanish Society of Medical Physics and NHSBSP Equipment Report 0604 Version 3. DG values ranged between 0.64 and 7.26 mGy for a range of 20- to 70-mm thickness, respectively. Thirty-six per cent of DG was higher than the acceptable dose level and 100 % of DG was higher than the desirable level. It is therefore necessary to optimise doses. The initial proposal to establish dose reference levels for DG would range between 0.90 and 6.40 mGy for a thickness range of 20 to 70 mm.

  8. Three-dimensional mammography reconstruction using low-dose projection images

    NASA Astrophysics Data System (ADS)

    Wu, Tao

    A method is described for the reconstruction of three-dimensional distribution of attenuation coefficient of the breast using a limited number of low dose projection images. This method uses the cone beam x-ray geometry, a digital detector and a constrained iterative reconstruction algorithm. The method has been tested on a digital Tomosynthesis mammography system. The total radiation dose to the patient is comparable to that used for one conventional mammogram. The reconstructed image has intrinsically high resolution (˜0.1mm) in two dimensions and lower resolution in the third dimension (˜1mm). Using this method, a breast that is projected into one two-dimensional image in conventional mammography is separated into layers parallel to the two high-resolution dimensions. The thickness of the layer is in the low-resolution dimension. The three-dimensional reconstruction increases the conspicuity of features that is often obscured by overlapping tissues in a single projection. Factors affecting the quality of reconstruction have been investigated by computer simulations. These factors include the scatter, the projection angular range, the shape of the breast and the x-ray energy. Non-uniform distribution of x-ray exposures among projection images and non-uniform-resolution image-acquisition are explored to optimize the image quality within an x-ray dose limit. The method is validated with reconstruction images of mammography phantoms, mastectomy specimens, computer simulations and volunteer patients.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Wavelet-based noise-model driven denoising algorithm for differential phase contrast mammography.

    PubMed

    Arboleda, Carolina; Wang, Zhentian; Stampanoni, Marco

    2013-05-01

    Traditional mammography can be positively complemented by phase contrast and scattering x-ray imaging, because they can detect subtle differences in the electron density of a material and measure the local small-angle scattering power generated by the microscopic density fluctuations in the specimen, respectively. The grating-based x-ray interferometry technique can produce absorption, differential phase contrast (DPC) and scattering signals of the sample, in parallel, and works well with conventional X-ray sources; thus, it constitutes a promising method for more reliable breast cancer screening and diagnosis. Recently, our team proved that this novel technology can provide images superior to conventional mammography. This new technology was used to image whole native breast samples directly after mastectomy. The images acquired show high potential, but the noise level associated to the DPC and scattering signals is significant, so it is necessary to remove it in order to improve image quality and visualization. The noise models of the three signals have been investigated and the noise variance can be computed. In this work, a wavelet-based denoising algorithm using these noise models is proposed. It was evaluated with both simulated and experimental mammography data. The outcomes demonstrated that our method offers a good denoising quality, while simultaneously preserving the edges and important structural features. Therefore, it can help improve diagnosis and implement further post-processing techniques such as fusion of the three signals acquired.

  16. The growth law of primary breast cancer as inferred from mammography screening trials data.

    PubMed Central

    Hart, D.; Shochat, E.; Agur, Z.

    1998-01-01

    Despite considerable progress in understanding tumour development, the law of growth for human tumours is still a matter of some dispute. In this study, we used large-scale mammography screening trial data to deduce the growth law of primary breast cancer. We compared the empirical tumour population size distributions of primary breast cancer inferred from these data to the distributions that correspond to various possible theoretical growth functions. From this, we showed that the data are inconsistent with the exponential, logistic and Gompertz laws, but support power law growth (exponent approximately 0.5). This law indicates unbounded growth but with slowing mass-specific growth rate and doubling time. In the clinical size ranges, it implies a greater decline in the mass-specific growth rate than would be predicted by the Gompertz law using the accepted parameters. This suggests that large tumours would be less sensitive to cycle-specific therapies, and be better treated first by non-cell cycle-specific agents. We discussed the use of our study to estimate the sensitivity of mammography for the detection of small tumours. For example, we estimated that mammography is about 30% less sensitive in the detection of tumours in the 1 to 1.5-cm range than it is in detecting larger tumours. PMID:9703287

  17. The impact of calibration phantom errors on dual-energy digital mammography

    PubMed Central

    Mou, Xuanqin; Chen, Xi; Sun, Lijun; Yu, Hengyong; Ji, Zhen; Zhang, Lei

    2010-01-01

    Microcalcification is one of the earliest and main indicators of breast cancer. Because dual-energy digital mammography could suppress the contrast between the adipose and glandular tissues of the breast, it is considered a promising technique that will improve the detection of microcalcification. In dual-energy digital mammography, the imaged object is a human breast, while in calibration measurements only the phantoms of breast tissue equivalent materials are available. Consequently, the differences between phantoms and breast tissues will lead to calibration phantom errors. Based on the dual-energy imaging model, formulae of calibration phantom errors are derived in this paper. Then, this type of error is quantitatively analyzed using publicly available data and compared with other types of error. The results demonstrate that the calibration phantom error is large and dominant in dual-energy mammography, seriously decreasing calculation precision. Further investigations on the physical meaning of calibration phantom error reveal that the imaged objects with the same glandular ratio have identical calibration phantom error. Finally, an error correction method is proposed based on our findings. PMID:18936520

  18. 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. PMID:26963449

  19. 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.

  20. AAPM/RSNA physics tutorial for residents: digital mammography: an overview.

    PubMed

    Mahesh, Mahadevappa

    2004-01-01

    Recent advances in digital detector technology have paved the way to full-field digital mammography (FFDM) systems. The performance of these systems has evolved to the point where replacement of screen-film mammography (SFM) systems is becoming realistic. Despite some commonality between the two techniques, there are fundamental differences in how images are recorded, displayed, and stored. These differences necessitate an understanding of the principles of detection and the characteristics of digital images. Several approaches have been taken in the development of FFDM systems: (a) slot scanning with a scintillator and a charge-coupled device (CCD) array, (b) a flat-panel scintillator and an amorphous silicon diode array, (c) a flat-panel amorphous selenium array, (d) a tiled scintillator with fiberoptic tapers and a CCD array, and (e) photostimulable phosphor plates (computed radiography). Although the initial cost of an FFDM system is high compared with that of an SFM system, digital mammography has inherent advantages, such as wide dynamic range, reduction in recall rates, potential for reduction in radiation dose, increased patient throughput, postprocessing capability, and digital acquisition. These advantages and the rapidly occurring technologic developments will help establish FFDM as a mainstay of breast evaluation. PMID:15537982

  1. Developing a comprehensive database management system for organization and evaluation of mammography datasets.

    PubMed

    Wu, Yirong; Rubin, Daniel L; Woods, Ryan W; Elezaby, Mai; Burnside, Elizabeth S

    2014-01-01

    We aimed to design and develop a comprehensive mammography database system (CMDB) to collect clinical datasets for outcome assessment and development of decision support tools. A Health Insurance Portability and Accountability Act (HIPAA) compliant CMDB was created to store multi-relational datasets of demographic risk factors and mammogram results using the Breast Imaging Reporting and Data System (BI-RADS) lexicon. The CMDB collected both biopsy pathology outcomes, in a breast pathology lexicon compiled by extending BI-RADS, and our institutional breast cancer registry. The audit results derived from the CMDB were in accordance with Mammography Quality Standards Act (MQSA) audits and national benchmarks. The CMDB has managed the challenges of multi-level organization demanded by the complexity of mammography practice and lexicon development in pathology. We foresee that the CMDB will be useful for efficient quality assurance audits and development of decision support tools to improve breast cancer diagnosis. Our procedure of developing the CMDB provides a framework to build a detailed data repository for breast imaging quality control and research, which has the potential to augment existing resources.

  2. Developing a Comprehensive Database Management System for Organization and Evaluation of Mammography Datasets

    PubMed Central

    Wu, Yirong; Rubin, Daniel L; Woods, Ryan W; Elezaby, Mai; Burnside, Elizabeth S

    2014-01-01

    We aimed to design and develop a comprehensive mammography database system (CMDB) to collect clinical datasets for outcome assessment and development of decision support tools. A Health Insurance Portability and Accountability Act (HIPAA) compliant CMDB was created to store multi-relational datasets of demographic risk factors and mammogram results using the Breast Imaging Reporting and Data System (BI-RADS) lexicon. The CMDB collected both biopsy pathology outcomes, in a breast pathology lexicon compiled by extending BI-RADS, and our institutional breast cancer registry. The audit results derived from the CMDB were in accordance with Mammography Quality Standards Act (MQSA) audits and national benchmarks. The CMDB has managed the challenges of multi-level organization demanded by the complexity of mammography practice and lexicon development in pathology. We foresee that the CMDB will be useful for efficient quality assurance audits and development of decision support tools to improve breast cancer diagnosis. Our procedure of developing the CMDB provides a framework to build a detailed data repository for breast imaging quality control and research, which has the potential to augment existing resources. PMID:25368510

  3. Evaluating the Figure of Merit in mammography utilizing Monte Carlo simulation

    NASA Astrophysics Data System (ADS)

    Delis, H.; Spyrou, G.; Costaridou, L.; Tzanakos, G.; Panayiotakis, G.

    2007-09-01

    Mammography represents the most powerful screening tool available for the early detection of breast cancer. As a screening technique, it addresses to asymptomatic women and therefore the implementation of the "As Low As Reasonably Achievable" (ALARA) principle is of increased importance. The overall optimization of any radiographic procedure requires the definition of a suitable Figure of Merit (FOM), based on a representative combination of image quality and dose characteristics. For the present study, Monte Carlo simulation of the mammographic process was utilized to derive the energy deposition inside the breast phantom and the signal beneath it. Certain signal characteristics (Subject Contrast (SC), Contrast to Noise Ratio (CNR), squared CNR) were studied (normalized to the output signal) and combined with appropriate dose indices (Entrance Surface Dose (ESD), Average Glandular Dose (AGD), Mid Plane Dose (MPD)) to extract an appropriate FOM index, suitable for spectrum based optimization. Results, for different breast glandularities and lesion sizes and compositions, demonstrate that the choice of the optimum spectrum strongly depends not only on the breast and lesion characteristics, but also on the selection of the utilized FOM index. For screen-film mammography, where the primary image quality index is considered the SC, the traditionally used Mo and Rh-anode spectra demonstrate improved overall performance, despite their inferior dosimetric characteristics compared to W-anode spectra. If digital mammography is considered, where the CNR is of primary importance, W-anode spectra demonstrate a noticeable improved performance.

  4. 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.

  5. Mammography outcomes in a practice setting by age: prognostic factors, sensitivity, and positive biopsy rate.

    PubMed

    Linver, M N; Paster, S B

    1997-01-01

    The separate unplanned analysis of women ages 40-49 in population-based randomized controlled trials has resulted in demonstration of statistically significant breast cancer mortality reduction due to screening mammography in only two of the individual trials, and in all such trials only through meta-analysis. Therefore, many researchers have utilized the surrogate endpoints of tumor size and axillary lymph node status to evaluate screening efficacy. For the present study, these endpoints were evaluated in an audit of 854 screen-detected cancers found in 147,125 mammographic examinations performed in women over 40 between 1988 and 1994 in a community practice setting. The concerns that mammography in the 40-49 group has a lower sensitivity and higher biopsy rate were also addressed. Median invasive tumor size and lymph node positivity were found to be equally small (1.0-1.1 cm and 13.5-12.2%, respectively), and the sensitivity and overall biopsy rate were found to be constant over all ages 40 and above. Positive biopsy rate (PBR) varied directly with increasing age, paralleling the measured cancer detection rate in each decade, with no abrupt change at age 50. We conclude that modern mammography in a community practice setting can successfully detect breast cancers with favorable prognostic factors and achieve constant sensitivity and acceptable PBRs in all women over 40. Our data also suggest that many of the large differences seen by inappropriately dividing data at age 50 decrease or disappear when analysis is performed by decade.

  6. 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

  7. 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

  8. 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.

  9. Werner Heisenberg zum 100. Geburtstag: Pionier der Quantenmechanik

    NASA Astrophysics Data System (ADS)

    Jacobi, Manfred

    2001-11-01

    Werner Heisenberg war eine der prägendsten Gestalten der Physik des 20. Jahrhunderts. Zu seinen wichtigsten Verdiensten gehören die Grundlegung der Quantenmechanik, die Formulierung der Unschärferelationen sowie die Beteiligung an der Ausarbeitung der Kopenhagener Deutung der Quantenmechanik. Darüber hinaus lieferte er Arbeiten von fundamentalem Charakter zur Theorie des Atomkerns, zur kosmischen Strahlung und zur Quantenfeldtheorie. Während des Krieges war er an den Arbeiten des Uranvereins beteiligt, der die Möglichkeit einer Entwicklung von Kernwaffen untersuchte, jedoch über Vorarbeiten zur Reaktorphysik nicht hinauskam. Wegen dieser Tätigkeit wurde er bei Kriegsende für einige Monate in England interniert. Nach seiner Rückkehr widmete er sich vor allem dem Aufbau der Physik in Deutschland, die während der NS-Zeit nahezu ihrer gesamten Substanz beraubt worden war.

  10. E-Learning an der TUM: Entwicklung - Status Quo - Perspektiven

    NASA Astrophysics Data System (ADS)

    Stross, Manfred; Baume, Matthias; Schulze, Elvira

    E-Learning an der Technischen Universität München (TUM) hat sich ähnlich wie an den meisten anderen Hochschulen als ein wesentliches Element der Hochschullehre etabliert. Seit mehr als einem Jahrzehnt werden in diesem Themenfeld Erfahrungen gesammelt und Entwicklungen vorangetrieben. Der Artikel beschäftigt sich zunächst mit E-Learning aus einer allgemeinen Perspektive und greift unterschiedliche Entwicklungsphasen der vergangenen Jahre auf. Im Anschluss daran wird der Fokus auf die TUM gesetzt. Der Beitrag zeigt die spezifische Entwicklung von E-Learning im Verlauf der vergangenen Jahre auf, nennt Funktionen und Verfahren von E-Learning und beschreibt Zielsetzungen für E-Learning an der TUM. Im Anschluss daran wird die aktuelle Situation anhand verschiedener Perspektiven analysiert. Den Abschluss des Beitrags bilden die Darstellung der zukünftigen Herausforderungen von E-Learning an der TUM und ein Ausblick auf weitere Entwicklungen.

  11. 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.

  12. Genetics Home Reference: van der Woude syndrome

    MedlinePlus

    ... people with this disorder are born with a cleft lip , a cleft palate (an opening in the roof ... People with van der Woude syndrome who have cleft lip and/or palate, like other individuals with these ...

  13. 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

  14. 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.

  15. 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

  16. 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

  17. Changes in the use of screening mammography: evidence from the 1987 and 1990 National Health Interview Surveys.

    PubMed Central

    Breen, N; Kessler, L

    1994-01-01

    OBJECTIVES: Mammography rates reported by women in the National Health Interview Surveys of 1990 and 1987 are examined. Why this screening modality is not more frequently used is explored. METHODS. Data from the 1987 and 1990 National Health Interview Surveys, conducted by the National Center for Health Statistics, are cross-tabulated and compared. RESULTS. In 1987, approximately 17% of women over 40 years of age reported having had a screening mammogram in the previous year. In 1990, the rate doubled. Race declined in importance; income and education remained strong, positive predictors of screening. CONCLUSIONS. Despite this dramatic increase, two thirds of women are not having screening mammograms. Use was not higher primarily because women did not realize that screening mammography tests for breast cancer in asymptomatic women. Primary care physicians are the main source of health education for screening mammography. The data suggest that public health programs to promote screening mammography should especially target primary care physicians and women with low incomes and education. Likewise, health care providers should ensure that their patients are referred to facilities that deliver high-quality mammography at low cost to make the procedure more accessible. PMID:8279613

  18. 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.

  19. 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

  20. Task-based strategy for optimized contrast enhanced breast imaging: analysis of six imaging techniques for mammography and tomosynthesis

    NASA Astrophysics Data System (ADS)

    Ikejimba, Lynda; Kiarashi, Nooshin; Lin, Yuan; Chen, Baiyu; Ghate, Sujata V.; Zerhouni, Moustafa; Samei, Ehsan; Lo, Joseph Y.

    2012-03-01

    Digital breast tomosynthesis (DBT) is a novel x-ray imaging technique that provides 3D structural information of the breast. In contrast to 2D mammography, DBT minimizes tissue overlap potentially improving cancer detection and reducing number of unnecessary recalls. The addition of a contrast agent to DBT and mammography for lesion enhancement has the benefit of providing functional information of a lesion, as lesion contrast uptake and washout patterns may help differentiate between benign and malignant tumors. This study used a task-based method to determine the optimal imaging approach by analyzing six imaging paradigms in terms of their ability to resolve iodine at a given dose: contrast enhanced mammography and tomosynthesis, temporal subtraction mammography and tomosynthesis, and dual energy subtraction mammography and tomosynthesis. Imaging performance was characterized using a detectability index d', derived from the system task transfer function (TTF), an imaging task, iodine contrast, and the noise power spectrum (NPS). The task modeled a 5 mm 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' was generated as a function of dose and iodine concentration. In general, higher dose gave higher d', but for the lowest iodine concentration and lowest dose, dual energy subtraction tomosynthesis and temporal subtraction tomosynthesis demonstrated the highest performance.

  1. Disparities in Mammography Rate Among Immigrant and Native-Born Women in the U.S.: Progress and Challenges

    PubMed Central

    Hillemeier, Marianne M.

    2013-01-01

    Disproportionately low mammography rates among U.S. immigrants have been of persistent concern. In light of policies to increase access to screening, this study identifies differences in factors associated with screening among immigrant and native-born women in 2000 and 2008. Data from immigrant and native-born women aged 40+ years in the 2000 and 2008 National Health Interview Surveys were included in descriptive and multivariate regression analyses. Mammography rates rose from 60.2 to 65.5 % among immigrant women, remaining lower than the 68.9 % rate among native-born in 2008. Among immigrants, short length of residency and lower education were associated with lower screening rates in 2000 but not in 2008, while public insurance coverage was positively associated with screening only in 2008. In contrast to immigrants, among the native-born education and income were associated with mammography receipt in 2008, and in both groups health care access was associated with greater screening rates. Policy initiatives aimed at increasing access to mammography may be positively affecting immigrant screening disparities. Access to primary care and public insurance coverage are likely to be very important in maintaining and furthering improvements in mammography rates. PMID:23430466

  2. Wie wissenschaftlich ist der Evolutionsgedanke?

    NASA Astrophysics Data System (ADS)

    Vollmer, Gerhard

    Darwin war ein besonnener Mann; alles Aufsehen war ihm zuwider. Trotzdem hat er eine Revolution ausgelöst, deren Wirkung nicht auf die Biologie beschränkt blieb. Seine Theorie lässt sich in fünf Teiltheorien zerlegen, die sich durch die Begriffe Artenwandel, Verwandtschaft alles Lebendigen und gemeinsamer Ursprung, Artenaufspaltung und Artenvielfalt, Gradualismus, natürliche Auslese charakterisieren lassen. Dadurch wurden mehrere religiöse und weitere weltanschauliche Überzeugungen in Frage gestellt. Deshalb wird die Evolutionstheorie auch heute noch vielfach kritisiert, ja bekämpft. Die Vorwürfe lassen sich ordnen nach den Kriterien, mit denen wir erfahrungswissenschaftliche Theorien beurteilen. Haltbar ist daran nur, dass es für die Evolutionstheorie zwar beliebig viele Bestätigungen gibt, aber nur wenige Widerlegungsmöglichkeiten. Durch die neuerdings entwickelten und durchgeführten Evolutionsexperimente ist die empirische Situation allerdings deutlich besser geworden. Am (erfahrungs)wissenschaftlichen Charakter der Evolutionstheorie besteht deshalb kein Zweifel.

  3. Checkpoint-Inhibitoren in der Immuntherapie: Ein Meilenstein in der Behandlung des malignen Melanoms.

    PubMed

    Wilden, Sophia M; Lang, Berenice M; Mohr, Peter; Grabbe, Stephan

    2016-07-01

    Seit Jahrzehnten ist bekannt, dass Tumoren vom Immunsystem erkannt und zerstört werden können. Diese, vor allem in Tierversuchen gewonnene Erkenntnis konnte jedoch in der Vergangenheit nicht zum Nutzen unserer Patienten umgesetzt werden, da immunonkologische Therapieansätze in den letzten Jahrzehnten in der Anwendung beim Menschen stets versagt haben. Daher hat, mit Ausnahme der adjuvanten Interferontherapie, keines dieser Verfahren den Einzug in die klinische Versorgung gefunden. Langzeitüberleben unter guter Lebensqualität war dabei sehr wenigen Patienten vorbehalten. Mit den neuen immunologischen Therapieansätzen wird jedoch sowohl das Langzeitüberleben als auch die Lebensqualität onkologischer Patienten neu definiert. Auf die neuen "Immun-Checkpoint-Inhibitoren" spricht erstmals ein relevanter Teil der behandelten Patienten an und diese zeigen in der Regel langandauernde Remissionen bis hin zur Heilung. Schon jetzt ist klar, dass die Immuntherapie in Zukunft eine der wesentlichen Therapiesäulen bei der Behandlung des metastasierten Melanoms und auch vieler anderer fortgeschrittener Tumoren bilden wird. In dieser Übersicht werden die wichtigsten neuen Therapiemodalitäten besprochen und sowohl deren Wirkprinzip als auch klinische Daten zum Therapieansprechen und zu erwartenden Nebenwirkungen der Therapie referiert. PMID:27373243

  4. A Comparative Study of the Diagnostic Value of Contrast-Enhanced Breast MR Imaging and Mammography on Patients with BI-RADS 3–5 Microcalcifications

    PubMed Central

    Li, Erni; Li, Jing; Song, Ying; Xue, Mei; Zhou, Chunwu

    2014-01-01

    Objective To retrospectively investigate the diagnostic value of breast MRI in patients with BI-RADS 3–5 microcalcifications in mammography. Methods Eighty-four patients with BI-RADS 3–5 microcalcifications on mammography underwent breast MR exams before surgical biopsy with a hookwire position under mammographic guidance. Two radiologists reviewed each lesion with BI-RADS by consensus. The diagnostic value of mammography and MRI was compared. Results Histopathological examination revealed 49 benign lesions and 42 malignant lesions. In the assessments of mammography, 21 lesions (23.1%) were assigned to category 3, 51 lesions (56.0%) to category 4, and 19 lesions (20.9%) to category 5. The area under the receiver operating characteristic(ROC) curve for mammography and MR assessment was 0.844, and 0.945, respectively (p<0.05). In cases of category 3 microcalcifications, the specificity of mammography and MR was 100%, and 95.2% (p = 1.000), respectively. In cases of category 4 microcalcifications, the specificity, PPV and accuracy of mammography was 0%, 45.1% and 45.1%; whereas those for MR was 82.1% (p<0.05), 80.8% (P = 0.003) and 86.3% (p<0.05). All microcalcifications of category 5 were correctly diagnosed by mammography and MR. Conclusions Breast MRI has the potential to significantly improve the diagnosis of category 4 microcalcifications on mammography. Among mammographic category 4 microcalcifications, about 82% of benign lesions can be degraded to BI-RADS 1∼3 by MRI. However for microcalcifications of category 3 and 5, MR exams do not show significant improvement over mammography. PMID:25365327

  5. The Association of English Functional Health Literacy and the Receipt of Mammography among Hispanic Women Compared to Non-Hispanic U.S.-Born White Women

    PubMed Central

    Kadivar, Hajar; Kenzik, Kelly M.; Dewalt, Darren A.; Huang, I-Chan

    2016-01-01

    Background Breast cancer is a leading cause of cancer death among Hispanic women in the U.S., and mammography is the recommended screening for early diagnosing and preventing breast cancer. Several barriers exist to influence mammography utilization including poor health literacy. However, it is unclear whether the effect of health literacy on mammography utilization is consistent between Hispanic women and non-Hispanic White women. The main objective of this study was to examine association between functional health literacy and the receipt of mammography among Hispanic women compared to non-Hispanic White women in the U.S. Methods A cross-sectional design using participants engaged in the National Assessment of Adult Literacy. Study sample comprised of 4,249 Hispanic and non-Hispanic U.S.-born White women ≥ 40 years of age who completed the functional health literacy assessment. Regression analyses were performed to test the association between health literacy and receipt of mammography. Among Hispanic women, analyses considered the influence of language-preference acculturation. Results Equal percentages of Hispanic (59.3%) and non-Hispanic White (60.6%) women received mammography. After adjusting for covariates, health literacy was positively associated with receiving mammography among U.S.-born White women (β = 0.14, p<0.001), but negatively associated with mammography among Hispanic women (β = -0.13, p<0.001). Analyses stratified by acculturation status revealed that higher health literacy was associated with lower mammography among language-preference acculturated Hispanic women (β = -0.48, p<0.001), yet an opposite result among less acculturated Hispanic women (β = 0.08, p<0.001). Conclusion Functional health literacy has different associations with mammography depending upon ethnicity. Language-preference acculturation may explain the differing association. PMID:27732660

  6. 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

  7. 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

  8. 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

  9. Newtons Wissenschaftslehre als Basis der Quantenphysik

    NASA Astrophysics Data System (ADS)

    Bopp, Fritz

    Es ist richtig zu sagen, die Quantenphysik folge nicht aus der auf Newtons Prinzipien beruhenden klassischen Physik. Es ist aber auch richtig, daß Newtons Wissenschaftslehre, die eng mit der Platonschen zusammenhängt und über diese hinausgeht, von der Quantenphysik nicht berührt wird, wie an anderer Stelle gezeigt ist. Hier wird Newtons Wissenschaftslehre genauer analysiert und der Unterschied zur kartesischen herausgearbeitet, was durch die Newtontradition verschleiert wird. Am Ende werden die Ergebnisse an Beispielen aus der Quantenoptik erläutert.Translated AbstractNewton's Epistemology as Basic Concept of Quantum PhysicsIt is correct to say that quantum physics cannot be derived from classical physics, which is founded on Newton's principles. However, it is also correct that Newton's epistemology, a more developed Platonian one, can be considered as basic for quantum physics. That is previously shown. Here, we remember Newton's epistemology more thoroughly, and consider particularly the difference to the Cartesian epistemology, a difference often veiled in the Newton tradition. Finally, we apply the result on some phenomena of quantum optics.

  10. Integrable extended van der Waals model

    NASA Astrophysics Data System (ADS)

    Giglio, Francesco; Landolfi, Giulio; Moro, Antonio

    2016-10-01

    Inspired by the recent developments in the study of the thermodynamics of van der Waals fluids via the theory of nonlinear conservation laws and the description of phase transitions in terms of classical (dissipative) shock waves, we propose a novel approach to the construction of multi-parameter generalisations of the van der Waals model. The theory of integrable nonlinear conservation laws still represents the inspiring framework. Starting from a macroscopic approach, a four parameter family of integrable extended van der Waals models is indeed constructed in such a way that the equation of state is a solution to an integrable nonlinear conservation law linearisable by a Cole-Hopf transformation. This family is further specified by the request that, in regime of high temperature, far from the critical region, the extended model reproduces asymptotically the standard van der Waals equation of state. We provide a detailed comparison of our extended model with two notable empirical models such as Peng-Robinson and Soave's modification of the Redlich-Kwong equations of state. We show that our extended van der Waals equation of state is compatible with both empirical models for a suitable choice of the free parameters and can be viewed as a master interpolating equation. The present approach also suggests that further generalisations can be obtained by including the class of dispersive and viscous-dispersive nonlinear conservation laws and could lead to a new type of thermodynamic phase transitions associated to nonclassical and dispersive shock waves.

  11. 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

  12. Quantification of breast density using dual-energy mammography with liquid phantom calibration.

    PubMed

    Lam, Alfonso R; Ding, Huanjun; Molloi, Sabee

    2014-07-21

    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.

  13. Association Between Time Spent Interpreting, Level of Confidence and Accuracy of Screening Mammography

    PubMed Central

    Carney, Patricia A.; Bogart, Andy; Geller, Berta M.; Haneuse, Sebastian; Kerlikowske, Karla; Buist, Diana SM; Smith, Robert; Rosenberg, Robert; Yankaskas, Bonnie C.; Onega, Tracy; Miglioretti, Diana L.

    2013-01-01

    Purpose To examine the effect of time spent viewing images and level of confidence on a screening mammography test set on interpretive performance. Materials and Methods Radiologists from six mammography registries participated in the study and were randomized to interpret one of four test sets and complete 12 survey questions. Each test set had 109 cases of digitized four-view screening film-screen mammograms with prior comparison screening views. Viewing time for each case was defined as the cumulative time spent viewing all mammographic images before recording which visible feature, if any, was the “most significant finding”. Log-linear regression fit via GEE was used to test the effect of viewing time and level of confidence in the interpretation on test set sensitivity and false-positive rate. Results 119 radiologists completed a test set and contributed data on 11,484 interpretations. Radiologists spent more time viewing cases that had significant findings or for which they had less confidence in interpretation. Each additional minute of viewing time increased the probability of a true positive interpretation among cancer cases by 1.12 (95% CI: 1.06, 1.19, p<0.001), regardless of confidence in the assessment. Among radiologists who were ‘very confident’ in their assessment, each additional minute of viewing time increased the adjusted risk of a false positive interpretation among non-cancer cases by 1.42 (95% CI 1.21, 1.68), and this viewing-time effect diminished with decreasing confidence. Conclusions Longer interpretation times and higher levels of confidence in the interpretation are both associated with higher sensitivity and false positive rates in mammography screening. PMID:22451568

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. Objective assessment of phantom image quality in mammography: a feasibility study.

    PubMed

    Castellano Smith, A D; Castellano Smith, I A; Dance, D R

    1998-01-01

    The need for test objects in mammography quality control programmes to provide an objective measure of image quality pertinent to clinical problems is well documented. However, interobserver variations may be greater than the fluctuations in image quality that the quality control programme is seeking to detect. We have developed a computer algorithm to score a number of features in the Leeds TOR(MAX) mammography phantom. Threshold scoring techniques have been applied in the first instance; scoring schemes which utilize measures such as signal-to-noise ratio and modulation have also been formulated. This fully automatic algorithm has been applied to a set of 10 films which have been digitized at 25 microns resolution using a Joyce-Loebl scanning microdensitometer. The films were chosen retrospectively from quality control test films to demonstrate: (a) a range of optimized imaging systems, and (b) variation from the optimum. The performance of the algorithm has been compared with that of five experienced observers, and has been shown to be as consistent as individual observers, but more consistent than a pool of observers. Problems have been encountered with the detection of small details, indicating that a more sophisticated localization technique is desirable. The computer performs more successfully with the scoring scheme which utilizes the full imaging information available, rather than with the threshold-determined one. However, both the observers and the computer algorithm failed to identify the non-optimum films, suggesting that the sensitivity of the TOR(MAX) test object may not be adequate for modern mammography imaging systems. PMID:9534699

  1. Computer-aided diagnostics of screening mammography using content-based image retrieval

    NASA Astrophysics Data System (ADS)

    Deserno, Thomas M.; Soiron, Michael; de Oliveira, Júlia E. E.; de A. Araújo, Arnaldo

    2012-03-01

    Breast cancer is one of the main causes of death among women in occidental countries. In the last years, screening mammography has been established worldwide for early detection of breast cancer, and computer-aided diagnostics (CAD) is being developed to assist physicians reading mammograms. A promising method for CAD is content-based image retrieval (CBIR). Recently, we have developed a classification scheme of suspicious tissue pattern based on the support vector machine (SVM). In this paper, we continue moving towards automatic CAD of screening mammography. The experiments are based on in total 10,509 radiographs that have been collected from different sources. From this, 3,375 images are provided with one and 430 radiographs with more than one chain code annotation of cancerous regions. In different experiments, this data is divided into 12 and 20 classes, distinguishing between four categories of tissue density, three categories of pathology and in the 20 class problem two categories of different types of lesions. Balancing the number of images in each class yields 233 and 45 images remaining in each of the 12 and 20 classes, respectively. Using a two-dimensional principal component analysis, features are extracted from small patches of 128 x 128 pixels and classified by means of a SVM. Overall, the accuracy of the raw classification was 61.6 % and 52.1 % for the 12 and the 20 class problem, respectively. The confusion matrices are assessed for detailed analysis. Furthermore, an implementation of a SVM-based CBIR system for CADx in screening mammography is presented. In conclusion, with a smarter patch extraction, the CBIR approach might reach precision rates that are helpful for the physicians. This, however, needs more comprehensive evaluation on clinical data.

  2. Weighing the Benefits and Burdens of Mammography Screening Among Women Age 80 Years or Older

    PubMed Central

    Schonberg, Mara A.; Silliman, Rebecca A.; Marcantonio, Edward R.

    2009-01-01

    Purpose To examine outcomes of mammography screening among women ≥ 80 years to inform decision making. Patients and Methods We conducted a cohort study of 2,011 women without a history of breast cancer who were age ≥ 80 years between 1994 and 2004 and who received care at one academic primary care clinic or two community health centers in Boston, MA. Medical record data were abstracted on all screening and diagnostic mammograms, breast ultrasounds and biopsies performed, all breast cancers diagnosed through December 31, 2006, and on sociodemographics. Date and cause of death were confirmed using the National Death Index. Results The majority of patients (78.6%) were non-Hispanic white and 51.4% (n = 1,034) had been screened with mammography since age 80 years. Among women who were screened, eight were diagnosed with ductal carcinoma in situ, 16 with early stage disease (1.5%), two with late stage disease, and one died as a result of breast cancer. Many (110; 11%) experienced a false-positive screening mammogram that led to 19 benign breast biopsies, eight refused work-up, and three experienced a false-negative screening mammogram; 97 were screened within 2 years of their death from other causes. There were no significant differences in the rate, stage, recurrence rate, or deaths due to breast cancer between women who were screened and those who were not screened. Conclusion The majority of women ≥ 80 years are screened with mammography yet few benefit. Meanwhile, 12.5% experience a burden from screening. The data from this study can be used to inform elderly women's decision making and potentially lead to more rational use of screening. PMID:19255318

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. Citations of scientific results and conflicts of interest: the case of mammography screening

    PubMed Central

    Rasmussen, Kristine; Jørgensen, Karsten Juhl; Gøtzsche, Peter C

    2013-01-01

    Introduction In 2001, a Cochrane review of mammography screening questioned whether screening reduces breast cancer mortality, and a more comprehensive review in Lancet, also in 2001, reported considerable overdiagnosis and overtreatment. This led to a heated debate and a recent review of the evidence by UK experts intended to be independent. Objective To explore if general medical and specialty journals differed in accepting the results and methods of three Cochrane reviews on mammography screening. Methods We identified articles citing the Lancet review from 2001 or updated versions of the Cochrane review (last search 20 April 2012). We explored which results were quoted, whether the methods and results were accepted (explicit agreement or quoted without caveats), differences between general and specialty journals, and change over time. Results We included 171 articles. The results for overdiagnosis were not quoted in 87% (148/171) of included articles and the results for breast cancer mortality were not quoted in 53% (91/171) of articles. 11% (7/63) of articles in general medical journals accepted the results for overdiagnosis compared with 3% (3/108) in specialty journals (p=0.05). 14% (9/63) of articles in general medical journals accepted the methods of the review compared with 1% (1/108) in specialty journals (p=0.001). Specialty journals were more likely to explicitly reject the estimated effect on breast cancer mortality 26% (28/108), compared with 8% (5/63) in general medical journals, p=0.02. Conclusions Articles in specialty journals were more likely to explicitly reject results from the Cochrane reviews, and less likely to accept the results and methods, than articles in general medical journals. Several specialty journals are published by interest groups and some authors have vested interests in mammography screening. PMID:23635839

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. Second Opinion Assessment in Diagnostic Mammography at a Breast Cancer Centre.

    PubMed

    Lorenzen, J; Finck-Wedel, A K; Lisboa, B; Adam, G

    2012-08-01

    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

  15. 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.

  16. Estimation of radiation risk from screening mammography: Recent trends and comparison with expected benefits

    SciTech Connect

    Feig, S.A.; Ehrlich, S.M. )

    1990-03-01

    On the basis of recent epidemiologic studies, the National Institutes of Health in 1985 provided a new estimate for radiation risk to the breast that employed a relative risk model and acknowledged greater dependence on age at exposure. Lifetime risks from a single mammogram may be calculated from this estimate and are lower than those based on the previous 1977 National Cancer Institute estimate. Possible years of life expectancy lost from annual mammography beginning at age 40 years may also be calculated and are negligible compared with estimates for years of life expectancy gained from such screening.

  17. American and European recommendations for screening mammography in younger women: a cultural divide?

    PubMed Central

    Jatoi, I; Baum, M

    1993-01-01

    The American Cancer Society advocates mammography screening for all women from age 40, whereas in Europe it is not recommended for women below the age of 50. Randomised prospective studies have failed to show a significant benefit from screening women aged under 50 and five potentially harmful effects of screening should be considered: lead time, overdiagnosis, radiation exposure, false positive results, and cost. Younger women must be properly informed about the potential for harm as well as for benefit before screening. Images p1482-a PMID:8281094

  18. 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

  19. [Validation of a questionnaire to assess consumer satisfaction with mammography screening, Rome (Italy)].

    PubMed

    Semyonov, Leda; Boggi, Roberto; Napoli, Massimo; Ravelli, Giuliana; Fulgenzi, Roberta; Landi, Adelaide; La Torre, Giuseppe

    2015-01-01

    Only 40% of women in the territory of the Local Health Unit RMA (Rome, Italy) adhere to the local breast cancer screening programme. A questionnaire was administered to participating women, to assess their level of satisfaction with the programme. A descriptive analysis, logistic regression and reliability analysis using the Cronbach's alpha as a measure of internal consistency, were performed. Most women who adhere to mammography screening are employers, retired, and with a low education. Factors that affect adherence include receiving a letter of invitation, intent to participate, age, and low education. The questionnaire is reliable for evaluating reasons affecting participation.

  20. 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.

  1. Kommunikationsanforderungen an verteilte Echtzeitsysteme in der Fertigungsautomatisierung

    NASA Astrophysics Data System (ADS)

    Just, Roman; Trsek, Henning

    Kommunikationssysteme der Automatisierung müssen hohe zeitliche Anforderungen erfüllen, damit die entsprechenden industriellen Anwendungen realisiert werden können. Im Gegensatz zum IT-Bereich sind diese Anforderungen jedoch häufig nicht genau bekannt, was insbesondere beim Einsatz von drahtlosen Technologien Probleme bereiten kann1. In dieser Arbeit werden Verkehrsmuster einer realen Anlage aus dem Bereich der Fertigungsautomatisierung bestimmt. Die Zwischenankunfts- und Latenzzeiten einzelner Sensorund Aktorsignale ermöglichen Rückschlüsse auf zeitliche Anforderungen und Charakteristiken der untersuchten Anwendung. Im Anschluss werden die erzielten Erkenntnisse hinsichtlich ausgewählter Kommunikationsanforderungen analysiert und aktuell gültige Anforderungen von realen Automatisierungsanlagen abgeleitet. Weiterhin werden sie zukünftig zur Entwicklung realitätsnaher Simulationsmodelle genutzt.

  2. TÜV - Zertifizierungen in der Life Science Branche

    NASA Astrophysics Data System (ADS)

    Schaff, Peter; Gerbl-Rieger, Susanne; Kloth, Sabine; Schübel, Christian; Daxenberger, Andreas; Engler, Claus

    Life Sciences [1] (Lebenswissenschaften) sind ein globales Innovationsfeld mit Anwendungen der Bio- und Medizinwissenschaften, der Pharma-, Chemie-, Kosmetik- und Lebensmittelindustrie. Diese Branche zeichnet sich durch eine stark interdisziplinäre Ausrichtung aus, mit Anwendung wissenschaftlicher Erkenntnisse und Einsatz von Ausgangsstoffen aus der modernen Biologie, Chemie und Humanmedizin sowie gezielter marktwirtschaftlich orientierter Arbeit.

  3. 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

  4. 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.

  5. 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.

  6. Computer-Assisted Mammography Feedback Program (CAMFP): An Electronic Tool for Continuing Medical Education

    PubMed Central

    Urban, Nicole; Longton, Gary M; Crowe, Andrea D; Drucker, Mariann J; Lehman, Constance D; Peacock, Susan; Lowe, Kimberly A; Zeliadt, Steve B; Gaul, Marcia A

    2007-01-01

    RATIONALE AND OBJECTIVES: Our goal was to develop and evaluate software to support a computer assisted mammography feedback program (CAMFP) to be used for continuing medical education (CME). MATERIALS AND METHODS: Thirty-five radiologists from our region signed consent to participate in an IRB-approved film-reading study. The radiologists primarily assessed digitized mammograms and received feedback in 5 film interpretation sessions. A bivariate analysis was used to evaluate the joint effects of the training on sensitivity and specificity, and the effects of image quality on reading performance were explored. RESULTS: Interpretation was influenced by the CAMFP intervention: Sensitivity increased (Δ sensitivity = 0.086, p <0.001) and specificity decreased (Δ specificity = −0.057, p=0.04). Variability in interpretation among radiologists also decreased after the training sessions (p = 0.035). CONCLUSION: The CAMFP intervention improved sensitivity and decreased variability among radiologist's interpretations. Although this improvement was partially offset by decreased specificity, the program is potentially useful as a component of continuing medical education of radiologists. Dissemination via the web may be possible using digital mammography. PMID:17707310

  7. 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.

  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. 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

  10. 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.

  11. Healthcare access and mammography screening in Michigan: a multilevel cross-sectional study

    PubMed Central

    2012-01-01

    Background Breast cancer screening rates have increased over time in the United States. However actual screening rates appear to be lower among black women compared with white women. Purpose To assess determinants of breast cancer screening among women in Michigan USA, focusing on individual and neighborhood socio-economic status and healthcare access. Methods Data from 1163 women ages 50-74 years who participated in the 2008 Michigan Special Cancer Behavioral Risk Factor Survey were analyzed. County-level SES and healthcare access were obtained from the Area Resource File. Multilevel logistic regression models were fit using SAS Proc Glimmix to account for clustering of individual observations by county. Separate models were fit for each of the two outcomes of interest; mammography screening and clinical breast examination. For each outcome, two sequential models were fit; a model including individual level covariates and a model including county level covariates. Results After adjusting for misclassification bias, overall cancer screening rates were lower than reported by survey respondents; black women had lower mammography screening rates but higher clinical breast examination rates than white women. However, after adjusting for other individual level variables, race was not a significant predictor of screening. Having health insurance or a usual healthcare provider were the most important predictors of cancer screening. Discussion Access to healthcare is important to ensuring appropriate cancer screening among women in Michigan. PMID:22436125

  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. Fabrication of two-dimensional x-ray antiscatter grids for mammography

    NASA Astrophysics Data System (ADS)

    Fischer, Kevin; Chadburi, Bidhan; Guckel, Henry; Tang, Cha-Mei

    2001-01-01

    Anti-scatter grids are used in mammography to improve the contrast and signal-to-noise ratio by minimizing scattered x- rays. Most commercially available mammographic anti-scatter grids are one-dimensional, focused arrays of lead lamellae, sandwiched between more x-ray transparent spacer materials such as fiber or wood. Two-dimensional (2D), air-core, focused, anti-scatter grids are expected to be able to significantly reduce scatter-to-primary ratio and increase primary transmission in mammography. Two prototype unfocused, 2D, air-core nickel (Ni) anti-scatter grids were fabricated. The fabrication method uses x-ray lithography and electroplating, LIGA, which allows the fabrication of high aspect ratio metal parts. The metal parts are released from substrate. The grids have 20 micrometer thick walls and 300 micrometer period. This geometry permits 87.1% transmission of primary radiation. Each layer of the grid is assembled from nine smaller grid pieces. The assembly technique allows construction of larger grids. Grids of a desired grid height are obtained by stacking the appropriate number of layers, each layer approximately 250 - 350 micrometer thick. The first prototype is 1.48 cm X 1.48 cm and 2.00 mm high and the second prototype is 1.32 cm X 1.44 cm and 1.78 mm high. Electroplating with lead/tin will also be reported.

  14. Laser interstitial thermotherapy (LITT) monitoring using high-resolution digital mammography: theory and experimental studies.

    PubMed

    Minhaj, Ahmed M; Mann, Fabrice; Milne, Peter J; Denham, David B; Salas, Nelson; Nose, Izuru; Damgaard-Iversen, Karsten; Parel, Jean-Marie; Robinson, David S

    2002-08-21

    Laser interstitial thermotherapy (LITT) is a minimally-invasive laser hyperthermia procedure for the treatment of localized tumours. Real-time monitoring of LITT is essential to control the extent of tumour destruction and ensure safe and effective treatments. The feasibility of using high-resolution digital x-ray mammography to monitor LITT of breast cancer was evaluated. Tissue phantoms including polyacrylamide hydrogel and cadaver porcine tissue were heated using a 980 nm diode laser delivered through optical fibres with diffusing tips. Digital images of the tissue phantoms were recorded with a high-resolution digital stereotactic breast biopsy system during heating. The recorded images were processed and analysed to detect heat-induced changes. No changes were detected during heating of the hydrogel. Pixel-by-pixel subtraction of the initial image from images taken during laser heating shows observable thermally-induced changes around the fibre during laser irradiation that correlate with the thermal denaturation zone observed by gross anatomy. These experiments demonstrate that high-resolution digital x-ray mammography can be used to detect heat-induced tissue changes during experimental LITT in fibro-fatty tissue.

  15. Short communication: kilovoltage measurement with rhodium target and filters on mammography X-ray machines.

    PubMed

    Underwood, A C; Law, J; Goodman, D A; Robinson, A; Rust, A

    1996-08-01

    X-ray machines used for mammography have, until recently, almost exclusively employed molybdenum (Mo) as anode material and filtration. In the UK, the RMI model 232 kVp meter is used extensively for the measurement of kilovoltage on such equipment. This unit is provided with switchable internal calibration only for molybdenum and molybdenum, or tungsten and aluminium, as anode and filtration, respectively. However, rhodium (Rh) has recently been introduced for filtration with either a molybdenum or rhodium anode in mammography equipment but, as yet, calibration facilities are not available for rhodium spectra. In this work, appropriate corrections for readings obtained with the RMI 232 kVp meter are derived for use with rhodium as filtration material with either molybdenum or rhodium anode material. An intercomparison between measurements made with four RMI model 232 kVp meters and nine IGE DMR X-ray sets was undertaken. The reproducibility of the instruments was confirmed and measurements of tube potential made on each of the X-ray sets pooled. Measurements were made from a nominal 25-35 kVp using Mo/Mo, Mo/Rh and Rh/Rh target/filter combinations. Corrections for readings obtained with Mo/Rh and Rh/Rh were produced by comparison with readings obtained with Mo/Mo, assuming stability of tube potential between anodes. The results are compared with data recently produced by the manufacturer of the meter. PMID:8949681

  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. 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

  18. 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

  19. 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

  20. [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

  1. Social Network Effects of Nonlifesaving Early-Stage Breast Cancer Detection on Mammography Rates

    PubMed Central

    Parker, Andrew M.

    2014-01-01

    Objectives. We estimated the effect of anecdotes of early-stage, screen-detected cancer for which screening was not lifesaving on the demand for mammography. Methods. We constructed an agent-based model of mammography decisions, in which 10 000 agents that represent women aged 40 to 100 years were linked together on a social network, which was parameterized with a survey of 716 women conducted through the RAND American Life Panel. Our model represents a population in equilibrium, with demographics reflecting the current US population based on the most recent available census data. Results. The aggregate effect of women learning about 1 category of cancers—those that would be detected but would not be lethal in the absence of screening—was a 13.8 percentage point increase in annual screening rates. Conclusions. Anecdotes of detection of early-stage cancers relayed through social networks may substantially increase demand for a screening test even when the detection through screening was nonlifesaving. PMID:25322304

  2. 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

  3. A review of mammography test objects for the calibration of resolution, contrast, and exposure

    SciTech Connect

    Kimme-Smith, C.; Bassett, L.W.; Gold, R.H. )

    1989-09-01

    Mandated and voluntary accreditation and quality control programs for mammography require the use of standardized mammography test objects. We evaluated eleven commercially available test objects and three prototype test objects, comparing them with respect to their resolution targets, contrast targets, and the dose they required when imaged by the same automatic exposure meter. Ion chamber and/or thermoluminescent dosimeter measurements of exposure were made with each test object, while attenuation was measured for seven. Measurements of dosage using acrylic (5 test objects) and tissue equivalent epoxy (9 test objects) showed as much as a 400% variation in the radiation supplied by the same automatic exposure device when differences in thicknesses of test objects were normalized. Speck visibility was as dependent on the composition of the specks and of the surrounding material as on the size of the specks. Contrast targets were adequate in only three test objects. Optical density differences between images of a 4-cm-thick breast and of different test object materials, also 4 cm in thickness, exposed to the same radiation, imply that untested acrylic or epoxy resin materials should not used in the calibration of automatic exposure controls.

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Effect of anode/filter combination on average glandular dose in mammography.

    PubMed

    Biegała, Michał; Jakubowska, Teresa; Markowska, Karolina

    2015-01-01

    A comparative analysis of the mean glandular doses was conducted in 100 female patients who underwent screening mammography in 2011 and 2013. Siemens Mammomat Novation with the application of the W/Rh anode/filter combination was used in 2011, whereas in 2013 anode/filter combination was Mo/Mo or Mo/Rh. The functioning of mammography was checked and the effectiveness of the automatic exposure control (AEC) system was verified by measuring compensation of changes in the phantom thickness and measuring tube voltage. On the base of exposure parameters, an average glandular dose for each of 100 female patients was estimated. The images obtained by using AEC system had the acceptable threshold contrast visibility irrespective of the applied anode/filter combination. Mean glandular doses in the females, examined with the application of the W/Rh anode/filter combination, were on average 23.6% lower than that of the Mo/Mo or Mo/Rh anode/filter combinations. It is recommended to use a combination of the W/Rh anode /filter which exhibited lower mean glandular doses.

  10. 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.

  11. A phantom using titanium and Landolt rings for image quality evaluation in mammography

    NASA Astrophysics Data System (ADS)

    de las Heras, Hugo; Schöfer, Felix; Tiller, Britta; Chevalier, Margarita; Zwettler, Georg; Semturs, Friedrich

    2013-04-01

    A phantom for image quality evaluation of digital mammography systems is presented and compared to the most widely used phantoms in Europe and the US. The phantom contains objects for subjective detection of Landolt rings (four-alternative, forced-choice task) and for objective calculation of signal-difference-to-noise ratios (SDNR), both in a titanium background within a 12-step wedge. Evaluating phantom images corresponding to exposures between 15 and 160 mAs (average glandular dose between 0.2 and 2 mGy), the resulting scores were compared to the scores obtained following the European EPQC and American College of Radiology (ACR) protocols. Scores of the Landolt test equal to 19 and 8.5 and SDNR equal to 20 and 11 were found to be equivalent to the acceptable limiting values suggested by EPQC and ACR. In addition, the Landolt and SDNR tests were shown to take into account the anatomical variations in thickness and tissue density within the breast. The simplified evaluation method presented was shown to be a sensitive, efficient and reliable alternative for image quality evaluation of mammography systems.

  12. Mammography screening and breast cancer tumor size in female members of a managed care organization.

    PubMed

    Frost, F J; Tollestrup, K; Trinkaus, K M; Rodgers, D; Kunde, T; Petersen, H V; Stidley, C A

    1998-07-01

    A study of temporal trends in mammography screening and changes in stage of disease at diagnosis was conducted among Hispanic and non-Hispanic white female members of the Lovelace Health Plan, Flexcare Plan, and Lovelace Senior Plan/Senior Options (LHP), a managed care organization. Two-year screening rates for female members ages 50-74 years were calculated for 1989-1996. From 1989-1996, mammography screening rates for non-Hispanic white female members increased from 65.5 to 71.6%, although this was not a statistically significant increase. Screening rates for Hispanic female members also increased from 50.6 to 62.7%, but they were significantly lower than for non-Hispanic white women. All breast cancers occurring among LHP female members ages 40-74 years were also identified for this same time period. A logistic regression model adjusting for age, year of diagnosis, ethnicity, and duration of enrollment prior to diagnosis found that statistically significant predictors of more advanced stage of disease at diagnosis included young age, diagnosis after 1991 for non-Hispanic white women, and diagnosis prior to 1992 for Hispanic women. Longer duration of enrollment prior to diagnosis was predictive of lower stage of disease, but the odds ratio was not statistically significant. For the time period 1992-1996, Hispanic women with breast cancer were more than twice as likely to have advanced stage of breast cancer compared with non-Hispanic white women (odds ratio, 2.12).

  13. 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.

  14. 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.

  15. Scatter free imaging for the improvement of breast cancer detection in mammography

    NASA Astrophysics Data System (ADS)

    Green, F. H.; Veale, M. C.; Wilson, M. D.; Seller, P.; Scuffham, J.; Pani, S.

    2016-10-01

    In mammography, the reduction of scattered x-rays is vital due to the low contrast or small dimension of the details that are searched for. The typical method of doing so in current conventional mammography is the anti-scatter grid. The disadvantage of this method is the absorption of a proportion of the primary beam and therefore an increase in dose is required to compensate for the loss of counts. An alternative method is proposed, using quasi-monochromatic beams and a pixellated spectroscopic detector. As Compton-scattered x-rays lose energy in the scattering process, they are detected at a lower energy in the spectrum. Therefore the spectrum can be windowed around the monochromatic energy peak, removing the scattered x-rays from the image. The work presented here shows contrast improvement of up to 50% and contrast to noise ratio improvements of around 20% for scatter free imaging in comparison to full spectrum imaging. Contrast improvements of around 45% were found when comparing scatter free images to conventional polychromatic imaging for both the low contrast test object and the Rachel anthropomorphic breast phantom.

  16. 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.

  17. Physician and Family Recommendations to Obtain a Mammogram and Mammography Intentions: The Moderating Effects of Perceived Seriousness and Risk of Breast Cancer

    PubMed Central

    Molina, Yamile; Thompson, Beti; Ceballos, Rachel M

    2014-01-01

    A growing body of literature has demonstrated psychosocial factors enable mammography intentions and usage among Latinas. Although these factors (e.g., family recommendations, breast cancer perceptions) likely influence one another, little research has examined interactive effects. The current study assessed the moderating effect of perceived breast cancer seriousness and risk on associations between recommendations to obtain mammography and mammography intentions. This sample included 97 Latinas in rural Eastern Washington State. After adjusting for age, two significant interactions emerged: perceived seriousness × physician recommendation and perceived risk × family recommendation. This exploratory study provides important directions for future communication research and planning to improve screening disparities. PMID:25558437

  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. A simplified edge illumination set-up for quantitative phase contrast mammography with synchrotron radiation at clinical doses

    NASA Astrophysics Data System (ADS)

    Longo, Mariaconcetta; Rigon, Luigi; Lopez, Frances C. M.; Chen, Rongchang; Dreossi, Diego; Zanconati, Fabrizio; Longo, Renata

    2015-02-01

    This work presents the first study of x-ray phase contrast imaging based on a simple implementation of the edge illumination method (EIXPCi) in the field of mammography with synchrotron radiation. A simplified EIXPCi set-up was utilized to study a possible application in mammography at clinical doses. Moreover, through a novel algorithm capable of separating and quantifying absorption and phase perturbations of images acquired in EIXPCi modality, it is possible to extract quantitative information on breast images, allowing an accurate tissue identification. The study was carried out at the SYRMEP beamline of Elettra synchrotron radiation facility (Trieste, Italy), where a mastectomy specimen was investigated with the EIXPCi technique. The sample was exposed at three different energies suitable for mammography with synchrotron radiation in order to test the validity of the novel algorithm in extracting values of linear attenuation coefficients integrated over the sample thickness. It is demonstrated that the quantitative data are in good agreement with the theoretical values of linear attenuation coefficients calculated on the hypothesis of the breast with a given composition. The results are promising and encourage the current efforts to apply the method in mammography with synchrotron radiation.

  20. 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