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Digital Mammography

Digital mammography was introduced in the early 2000s as an upgrade from conventional film mammography. It provides improved image quality with a higher signal-to-noise ratio and the ability to manipulate images. A large retrospective study found that digital mammography was significantly more accurate than film for pre- and perimenopausal women under 50 with dense breasts. Computer-aided detection software is used to highlight areas of concern on digital mammograms and detects 90% of cancers but has a high false positive rate. While digital mammography is more expensive than conventional mammography, targeted use for women with dense breasts costs around $50,000 per quality-adjusted life year gained.

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117 views11 pages

Digital Mammography

Digital mammography was introduced in the early 2000s as an upgrade from conventional film mammography. It provides improved image quality with a higher signal-to-noise ratio and the ability to manipulate images. A large retrospective study found that digital mammography was significantly more accurate than film for pre- and perimenopausal women under 50 with dense breasts. Computer-aided detection software is used to highlight areas of concern on digital mammograms and detects 90% of cancers but has a high false positive rate. While digital mammography is more expensive than conventional mammography, targeted use for women with dense breasts costs around $50,000 per quality-adjusted life year gained.

Uploaded by

Anas Yahya
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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DIGITAL

MAMMOGRAPHY
Krista Davenport
July 31, 2008
A Brief History
- 1913 Albert Salomon, German surgeon

- 1950s - Jacob Gershon-Cohen began to
advocate widespread use of X-rays for
screening

- December 2005 RSNA brings digital
mammography to US
Instant Upgrade
Improved signal-to-noise ratio
Ability to magnify, change contrast, or alter
the brightness.
Near instantaneous image acquisition
Courtesy: Magee-Womens Hospital of UPMC
Digital versus Conventional
Digital Mammographic Imaging Screening Trial
(DMIST)
Retrospective study of 49,500 asymptomatic women
Assessed accuracy of digital vs film mammograms

RESULTS:
Digital mammography significantly more accurate in pre-
and perimenopausal women under 50 with dense
breasts
Nonsignificant trend toward improved accuracy with film
mammograms in women over 65 with fatty breasts
Courtesy: MIAS digital mammogram database
Computer-Aided Detection
Software program that highlights areas of concern on digital
mammograms
Uses image processing algorithms and decision threshold
parameters to detect features in an image likely to be of clinical
significance
Very sensitive detects 90% of all cancers
However, has a high rate of false positives (2-4 per study)
http://www.imagingeconomics.com/issues/articles/2005-12_04.asp

cost issues
Digital mammography is expensive!

Using digital technology in all women would
cost >$300,000 per QALY gained
Targeted use of digital mammography on
basis of age/breast density costs ~$50,000
per QALY gained
References
Pisano E, Gatsonis C, Hendrick E, Yaffe M, Baum J, Acharyya S, Conant E, Fajardo L, Bassett L, D'Orsi C, Jong
R, and Rebner M. Diagnostic Performance of Digital versus Film Mammography for Breast Cancer Screening -
The Results of the American College of Radiology Imaging Network (ACRIN) Digital Mammographic Imaging
Screening Trial (DMIST). NEJM, published online September 16, 2005 and in print on October 27, 2005.
Full Field Digital Mammography: A New Breast Cancer Screening Tool. Dr. Mark Helvie, Dept of Radiology, Univ
of Michigan
Tosteson ANA, Stout NK, Friback DG, Acharyya S, Herman BA, Hannah LG, Pisano ED. Cost-Effectiveness of
Digital Mammography Breast Cancer Screening. Ann Intern Med. 2008;148:1-10.
Grainger & Allison's Diagnostic Radiology, 5th ed.
http://www.ucdmc.ucdavis.edu/welcome/features/20070502_cancer_Fenton_cad/index.html

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