屏胶乳腺X线摄影和数字化乳腺X线摄影的对比研究

数字乳腺X线摄影（DM）较屏胶乳腺X线摄影（SFM）具有更多的优势,其对于图像的获取、储存和显示都是相互分离的,每个系统都能优化产生最佳效果,而且数字图像能够由计算机处理并显示为多种形式。因此,DM系统正逐渐替代SFM系统并成为筛查及诊断乳腺癌的常规手段。就DM和SFM的成像原理、图像质量、图像处理以及临床应用进行比较。     

乳腺X线摄影与乳腺计算机摄影技术的比较分析

目的：比较计算机摄影（CR）与屏／胶系统在乳腺摄片应用中的优缺点。方法：分别选取CR摄片和屏／胶摄片各100份，经三位有经验的中级以上医师和两名技师进行分析研究。结果：屏／胶摄片在空间分辨率和钙化点的发现率要优于CR摄片，但在对比度、清晰度、后处理方面CR摄片明显优于屏／胶摄片。结论：数字乳腺摄影值的提倡应用。     

数字化乳腺X线摄影的图像质量分析

目的 探讨影响数字化乳腺X线摄影图像质量的各种因素,以提高乳腺X线摄影技术在影像诊断中的价值.方法 随机抽取2006-10-12间200例经数字化乳腺X线摄影的资料,评价摄影体位、投照技术、机械设备等因素对图像各方面质量的影响.结果 数字化乳腺X线摄影的一级片93.5%(187/200),二级片4.5%(9/200),三级片2%(4/200).在二级片、三级片中,摄影体位不标准4例(2%),压迫不完全2例(1%),异物伪影1例(0.5%),被检查者身体伪影2例(1%),影像板伪影2例(1%),设备校正不良1例(0.5%)以及照片保存不当1例(0.5%).结论 在数字化乳腺X线摄影中,医技人员的投照及操作技术是提高图像质量的关键,被检者和机械设备等是相关因素.     

全数字化乳腺摄影与乳腺计算机X线摄影的临床应用对比分析

目的: 比较全数字化乳腺摄影(FFDM)系统与计算机X线摄影(computed radiography,CR)系统在诊断乳腺疾病中的临床应用价值.材料和方法: 回顾2006-01～2007-06 CR检查300例和2007-07～12 FFDM检查300例的临床及影像资料,分析图像质量,统计受检者的照射剂量,比较技术操作、图像质量控制与后处理技术、工作效率等方面的优势.结果: CR和FFDM同时清楚显示皮肤、皮下组织、血管及腺体和导管等结构分别为45.5%(300例)和99.2%(300例);检查时间(包括图像采集及后处理时间),FFDM为5～10min/人,CR为15～20min/人;摄影条件,FFDM为26～30kV,26～60mAs,CR为30～45kV,36～100mAs;FFDM照射剂量(乳房压迫厚度5cm,有滤线栅)为0.5～2.0mGy,CR照射剂量(乳房压迫厚度5cm,有滤线栅)1.0～2.5mGy.FFDM对乳腺癌的诊断敏感性、特异性和准确性分别为83.3%、75%、80%,与CR差异非常显著(P＜0.05).结论: FFDM的图像质量、后处理功能、工作流程能力、患者吸收剂量及FFDM对乳腺癌的诊断敏感性、特异性和准确性均明显优于CR,更有利于乳腺检查.     

含碘对比剂在数字化全野乳腺X线摄影中的应用:初步结果

目的 :探讨含碘对比剂在数字化全野乳腺X线摄影中的应用价值。方法 :初期模型研究后 ,对 7例患者行数字乳腺X线摄影 (美国GE公司Senographe 2 0 0 0D) ,即用一种特殊的滤线束 ,在注射 80ml碘对比剂 (Ultravist 3 70 ,德国ScheringAG)前 ,以及注射后 60、12 0和 180s进行乳腺摄影 ,将增强前后的乳腺X线摄影进行减影 ,并将减影图像与动态增强MRI对比研究。结果 :采用初期模型研究摸索出的对比增强数字乳腺摄影条件进行人体乳腺摄影 ,显示所有病例肿瘤内的对比剂聚积较好。结论 :在乳腺X线摄影中采用特殊的滤线法、合适的X线参数、适当…     

乳腺病变的数字化摄影与屏片摄影之比较研究

目的:比较数字化乳腺摄影与屏片乳腺摄影对于乳腺病变的显示效果,明确数字化乳腺摄影的临床应用价值.材料和方法:本研究包括60例本院乳腺手术患者,同时进行前瞻性的屏片和数字化乳腺摄影,根据BI-RADS描述、诊断影像,并与病理结果对照分析,比较两者对乳腺病变的诊断价值.结果:数字化和屏片乳腺摄影对于乳腺病变的大多数影像学表现,其显示效果差异无统计学意义.数字化乳腺摄影显示钙化灶的效果优于屏片乳腺摄影,且有明显的统计学意义.结论:数字化乳腺摄影已达到与屏片乳腺摄影相同的诊断效果,且数字化乳腺摄影显示钙化灶具有相当的优势.     

数字化摄影与普通X线摄影的对比分析

数字化摄影与普通X线摄影投照条件及影像质量的对比分析。     

数字化乳腺摄影的临床应用价值

目的 探讨数字化乳腺摄影在临床工作中的应用价值.资料与方法 按顺序抽取接受数字化乳腺摄影和传统屏片乳腺摄影检查的各500例患者的影像资料,就其图像病变显示率、摄片质量及照射剂量进行对比评价.结果 (1)数字化乳腺摄影与传统屏片乳腺摄影对病变显示率的比较如下:微小钙化分别为26%和11.2%(P=0.000),肿块分别为15.2%和10.8%(P=0.039),结构扭曲分别为18%和8.8%(P=0.000),皮肤、乳头影改变分别为4.8%和1.8%(P=0.008).两组差异有统计学意义.(2)照射剂量及重检率比较:数字化乳腺摄影照射剂量较传统屏片乳腺摄影减少,因设备因素引起的重检率为0;传统屏片乳腺摄影因设备凶素引起的重检率为1.4%.结论 数字化乳腺摄影检查技术及图像的病变显示率均优于传统屏片乳腺摄影.数字化乳腺摄影系统操作简便、成像快捷、辐射较低,具有较高的临床应用价值.     

乳腺数字化X线摄影的医用专业显示器应用研究

目的:通过对乳腺病变影像学特征的显示率比较,评价医用专业显示器的应用价值.方法:按序抽取接受数字化乳腺摄影的500名患者影像资料,分别传入我院PACS中配置医用专业显示器的工作站和另一配置普通显示器的工作站.分别就显示器的性能参数及乳腺病变影像学特征的显示率进行对比评价.结果:医用专业显示器在亮度、分辨率、灰阶、像素上都优于普通显示器,在乳腺病变征象显示率方面,医用专业显示器显示肿块(24.2%)、微小钙化(56.8%)和不对称致密影(21.8%)均优于普通显示器(分别为18.6%,P=0.037;11.2%,P=0.000;14%,P=0.000).结论:医用专业显示器具有高分辨率、高清晰度、均匀亮度及细致灰阶,对乳腺肿块、微小钙化、不对称致密影的显示均优于普通显示器,有利于软阅读模式下的乳腺影像诊断.     

Dose comparison between screen/film and full-field digital mammography

The study purpose was the comparison between doses delivered by a full-field digital mammography system and a screen/film mammography unit, both using the same type of X-ray tube. Exposure parameters and breast thickness were collected for 300 screen/film (GE Senographe DMR) and 296 digital mammograms (GE Senographe 2000D). The entrance surface air kerma (ESAK) was calculated from anode/filter combination, kV_p and mAs values and breast thickness, by simulating spectra through a program based on a catalogue of experimental X-ray spectra. The average glandular dose (AGD) was also computed. Results showed an overall reduction of average glandular dose by 27% of digital over screen/film mammography. The dose saving was about 15% for thin and thick breasts, while it was between 30% and 40% for intermediate thicknesses. Full-field digital mammography dose reduction is allowed by wider dynamic range and higher efficiency of digital detector, which can be exposed at higher energy spectra than screen/film mammography, and by the separation between acquisition and displaying processes.     

ROC analysis comparing screen film mammography and digital mammography

PURPOSE: To compare the diagnosis performances of radiologists on screen film versus digital mammography. MATERIAL: and methods: Two sets of 123 mammograms, screen film mammography and storage phosphor digital mammography, are studied comparatively with ROC analysis. RESULTS: Phantom study show that conventional method give better scores for usual tension but the detectability of smaller microcalcification is equivalent. To obtain with digital technic the same conventional score you have to increase the radiation dose. Roc Curves, simulated "detection" mode showed that radiologists performed with higher accuracy with conventional system but this difference is weekly statistically significant. ROC Curves, simulated "diagnostic" mode showed the same results wit no statistically significant difference but when the decision to go to the biopsy is the gold standard, ROC Curves were essentially equivalent for both film screen and digital mammography system. The readers consistently considered the digital mammograms to be less suspicious for cancer findings. The agreement study as proposed by the FDA indicate that probability of a positive digital mammograms given a positive screen film is 75% (threshold value 90%) and the probability of a negative digital mammograms given a negative analog film is 85% (threshold value 85%). CONCLUSION: Analysis of specific discrepancies indicate that spatial resolution is an essential limiting factor for digital method but high resolution phosphor plate are interesting in imaging treated breast, radioluscent lesion, fatty benign tumor, hamartoma, intramammary lymph node, breast with prosthesis.     

数字化乳腺摄影与普通钼靶摄影在小乳癌诊断中的对比分析

目的：探讨数字化乳腺摄影在小乳癌诊断中的优越性。方法：经手术病理证实的小乳癌57例，采用数字化乳腺摄影及普通钼靶摄影方法。结果：数字化乳腺摄影诊断51例，其敏感性、特异性、准确性分别为89．4％、95．O％、90.9％；普通钼靶摄影术前诊断46例，其敏感性、特异性、准确性分别为80．7％、85．O％、81．8％。结论：在小乳癌诊断中。数字化乳腺摄影在敏感性、特异性、准确性方面均优于普通钼靶摄影。     

Performance comparison of single-view digital breast tomosynthesis plus single-view digital mammography with two-view digital mammography

Objective

To determine the performance of combined single-view mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus single-view cranio-caudal (CC) mammography (MX) compared with that of standard two-view digital mammography.

Methods

A multi-reader multi-case (MRMC) receiver-operating characteristic (ROC) study was conducted, involving six breast radiologists. Two hundred fifty patients underwent bilateral MX and DBT imaging. MX and DBT images with the adjunct of the CC-MX view from 469 breasts were evaluated and rated independently by six readers. Differences in mean areas under the ROC curves (AUCs), mean sensitivity and mean specificity were analysed by analysis of variance (ANOVA) to assess clinical performance.

Results

The combined technique was found to be non-inferior to standard two-view mammography (MX_(CC+MLO)) in mean AUC (difference: +0.021;95 % LCL = ?0.011), but was not statistically significant for superiority (P?=?0.197). The combined technique had equivalent sensitivity to standard mammography (76.2 % vs. 72.8 %, P?=?0.269) and equivalent specificity (84.9 % vs. 83.0 %, P?=?0.130). Specificity for benign lesions was significantly higher with the combination of techniques versus mammography (45.6 % vs. 36.8 %, P?=?0.002).

Conclusion

In this enriched study population, the combination of single-view MLO tomosynthesis plus single-view CC mammography was non-inferior to that of standard two-view digital mammography in terms of ROC curve area, sensitivity and specificity.

Key Points

? Breast tomosynthesis (DBT) has emerged as a valuable adjunct to mammography (MX). ? Combination DBT/MX demonstrated non-inferior clinical performance to standard two-view MX. ? Combination DBT/MX was superior to two-view MX in recognising benign lesions. ? Combination DBT/MX reduced variability compared with two-view MX.     

Full-field digital mammography compared to screen film mammography in the prevalent round of a population-based screening programme: the Vestfold County Study

The purpose of the study was to compare the performance of full-field digital mammography (FFDM) with soft-copy reading to screen film mammography (SFM) used during the first prevalent 2-year round of population-based screening. A total of 18,239 women aged 50–69 years were screened with FFDM as part of the Norwegian Breast Cancer Screening Programme (NBCSP). Process indicators were compared to data from 324,763 women screened with SFM using the common national database of the NBCSP. The cancer detection rates were 0.77% (140/18,239) for FFDM and 0.65% (2,105/324,763) for SFM (p = 0.058). For ductal carcinoma in situ (DCIS) alone, the results were: FFDM 0.21% (38/18,239) compared to SFM 0.11% (343/324,763) (p < 0.001). Recall rates due to positive mammography were for FFDM 4.09% (746/18,239), while for SFM 4.16% (13,520/324,764) (p = 0.645), due to technically insufficient imaging: FFDM 0.22% (40/18,239) versus SFM 0.61% (1,993/324,763) (p < 0.001). The positive predictive value (PPV) in the FFDM group was 16.6% (140/843), while 13.5% (2,105/15,537) for SFM (p = 0.014). No statistically significant differences were recorded concerning histological morphology, tumour size, or lymph node involvement. In conclusion FFDM had a significantly higher detection rate for DCIS than SFM. For invasive cancers no difference was seen. FFDM also had a significantly higher PPV and a significantly lower technical recall rate.     

The status of film/screen mammography. Results of the BENT study.

Results of the Breast Exposure: Nationwide Trends (BENT) study are presented. In this study, data were collected from 42 states and several other jurisdictions and the number of facilities found to have unusually high or low exposures during mammography was determined. Surveyors trained by representatives of the Bureau of Radiological Health then worked with these facilities to determine the source of the problem and recommend corrective measures. Contrast was found to be reduced by high "inherent" filtration, high kVp, or inappropriate imaging conditions, while resolution was impaired by excessive exposure time, as well as inappropriate imaging conditions. These and other problems are discussed and correlated with image quality.     

Clinical comparison of full-field digital mammography and screen-film mammography for detection of breast cancer

OBJECTIVE: The purpose of this work is to compare full-field digital mammography and screen-film mammography for the detection of breast cancer in a screening population. SUBJECTS AND METHODS: Full-field digital mammography was performed in addition to screen-film mammography in 6736 examinations of women 40 years old and older presenting for screening mammography at either of two institutions. Two views of each breast were acquired with each technique. The digital and screen-film mammograms were each interpreted independently. In addition to a clinical assessment, each finding was assigned a probability of malignancy for use in receiver operating characteristic analysis. In cases in which the digital and screen-film interpretations differed, a side-by-side analysis was performed to determine the reasons for the discrepancy. With few exceptions, findings detected on either technique were evaluated with additional imaging and, if warranted, biopsy. RESULTS: Additional evaluation was recommended on at least one technique in 1467 cases. These additional evaluations led to 181 biopsies and the detection of 42 cancers. Nine cancers were detected only on digital mammography, 15 were detected only on screen-film mammography, and 18 were detected on both. The difference in cancer detection is not statistically significant (p > 0.1). Digital mammography resulted in fewer recalls than did screenfilm mammography (799 vs 1007, p < 0.001). The difference between the receiver operating characteristic curve area for digital (0.74) and screen-film (0.80) mammography was not significant (p > 0.1). Reasons for discrepant interpretations of cancer were approximately equally distributed among those relating to lesion conspicuity, lesion appearance, and interpretation. CONCLUSION: No significant difference in cancer detection was observed between digital mammography and screen-film mammography. Digital mammography resulted in fewer recalls than did screen-film mammography.