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DIGITAL MAMMOGRAPHY

DIGITAL MAMMOGRAPHY. Krista Davenport July 31, 2008. A Brief History. 1913 Albert Salomon, German surgeon 1950’s - Jacob Gershon-Cohen began to advocate widespread use of X-rays for screening December 2005 – RSNA brings digital mammography to US. Instant Upgrade.

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DIGITAL MAMMOGRAPHY

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  1. DIGITAL MAMMOGRAPHY Krista Davenport July 31, 2008

  2. A Brief History • 1913 Albert Salomon, German surgeon • 1950’s - Jacob Gershon-Cohen began to advocate widespread use of X-rays for screening • December 2005 – RSNA brings digital mammography to US

  3. Instant Upgrade • Improved signal-to-noise ratio • Ability to magnify, change contrast, or alter the brightness. • Near instantaneous image acquisition

  4. Digital versus Conventional Courtesy: Magee-Women’s Hospital of UPMC

  5. 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

  6. Courtesy: MIAS digital mammogram database

  7. 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)

  8. http://www.imagingeconomics.com/issues/articles/2005-12_04.asphttp://www.imagingeconomics.com/issues/articles/2005-12_04.asp

  9. 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

  10. 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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