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BREAST IMAGING. Claudia E. Galbo,M.D. USUHS Department of Radiology and Radiological Sciences. Breast Studies. Film-Screen Mammography: Screening and Diagnostic Ultrasound Digital Mammography Computer Aided Diagnosis Nuclear Medicine
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BREAST IMAGING Claudia E. Galbo,M.D. USUHS Department of Radiology and Radiological Sciences
Breast Studies • Film-Screen Mammography: Screening and Diagnostic • Ultrasound • Digital Mammography Computer Aided Diagnosis • Nuclear Medicine • MRI • CT • Galactography
Procedures • Needle Placement for Excisional Biopsy • US-guided Aspirations • US-guided Core Biopsies • Stereotactic Core Biopsies
MammogramStandard Views • Cranio-caudal View (CC) • Medial-lateral Oblique (MLO)
Digital Mammography • More inherent contrast than film-screen • Post-processing will save on patient dose • Telemammography option is an advantage • Optical disc storage of images eliminates film loss • At present time, resolution is better for film screen
Sensitivity of Mammography • 85% - 90% in fatty replaced breasts • 65% in dense breasts
Mammography Technique • Resolution is the important imaging parameter needed to detect microcalcifications • Contrast is the important parameter needed to detect masses
Primary Signs of Canceron Mammography • Mass • Calcifications
Secondary Signs of Canceron Mammography • Nipple Inversion • Architectural Distortion • Skin Thickening • Axillary Adenopathy • Skin Retraction • Tissue Asymmetry • Developing “Neodensity”
American College of RadiologyScreening MammographyGuidelines • Baseline Mammogram by age 40 • Mammogram every year after 40 • Clinical Breast Examination every year after 40
MQSAMammography Quality Standards Act • Passed 1992,Implemented 1OCT1994 • Federal quality standards • Must be met to legally operate in the U.S.
Stereotactic/US Core Biopsy • Less invasive, more economical, more efficient than excisional biopsy of the breast • 11 and 14 guage needle core samples obtained • As accurate as excisional biopsy
Core Biopsies • Patient is supine for US core biopsies • Patient is prone for most stereotactic core biopsies • Stereo procedures usually are used to sample calcifications; US cores are used to sample masses
Mammography Dose Limit • The FDA dose limit for a single view mammogram is 300mRAD