Comparative study in patients with microcalcifications: full-field digital mammography vs screen-film mammography

Abstract

The goal of this prospective study was to compare a fullfield digital mammography system (FFDM) to a conventional screenfilm mammography system (SFM) for the detection and characterization of microcalcifications. Fifty-five patients with 57 isolated microcalcification clusters were examined using a FFDM system (Senographe 2000D, GE Medical Systems, Milwaukee, Wis.) and a SFM system (Senographe DMR, GE Medical Systems, Milwaukee, Wis.). A conventional screen-film mammogram and a digital contact mammogram were obtained of each cluster. The image quality and the number of calcification particles were evaluated, and a characterization (BI-RADS 1-5) of microcalcifications was given by four experienced readers. Histopathology revealed 16 benign lesions (sclerosing adenosis, dysplasia, hamartoma, radial scar) in 15 patients and 21 malignant tumors (in situ car-cinoma, invasive carcinoma) in 20 patients. Twenty patients had benign changes verified by long-term follow-up. Image quality of FFDM was assessed as superior to SFM in more than 50% of the cases. The FFDM showed more calcifications in 41% of all cases. Sensitivity and specificity for FFDM vs SFM were 95.2 vs 91.9% and 41.4 vs 39.3%, respectively. Moreover, FFDM demonstrated a higher diagnostic accuracy (deviation: 0.86 BI-RADS steps) compared with FSM (deviation 0.93 BI-RADS steps). The FFDM system with a 100-µm pixel size provides better image quality than SFM in patients with mammographic microcalcifications. The FFDM has a higher sensitivity and a higher reliability in characterizing microcalcifications.

Screening ultrasound as an adjunct to mammography in women with mammographically dense breasts

“…Currently, greater than 90% mammography units operating in the United States are digital rather than film, 33 and studies have shown improved performance of digital mammography compared to film screen mammography in women with dense breast tissue. 6, 34, 35 While studies of film mammography have demonstrated declining sensitivity with increasing breast density, 6, 36 a more recent study of 231,034 digital mammograms from four mammography registries in the Breast Cancer Surveillance Consortium showed significantly improved sensitivity of digital mammography compared to film screen mammography in women with dense breast tissue. 6 Although not perfect, mammography is still the only screening test whose ability to reduce breast cancer mortality has been proven.…”

Digital versus screen film mammography: a clinical comparison

“…The spatial resolution of DM, however, is limited by pixel size. Despite this limitation, it has been found that the detection of microcalcifications on DM is equal to, if not better than, that of SFM [10, 11] (Figure 1). In a study by Fischer U et al, DM showed more calcification compared to SFM, having a higher sensitivity and reliability in characterising microcalcification.…”

“…In a study by Fischer U et al, DM showed more calcification compared to SFM, having a higher sensitivity and reliability in characterising microcalcification. This is due to the increased contrast resolution of DM which enhances its ability to visualise small high-contrast structures such as microcalcification [10]. …”

Modern Breast Cancer Detection: A Technological Review

“…Mammography is divided into discrete processes: image acquisition, image display, and image storage, so each can be optimized separately [13]. FFDM allows real-time image presentation, postimage processing, and digital storage [14, 15]. Digital mammographic images can be transmitted electronically (e.g., via the Internet) in a process known as telemammography [13], allowing the radiologist and the clinician to review the images from a remote location.…”