Korean J Radiol.  2005 Dec;6(4):214-220. 10.3348/kjr.2005.6.4.214.

Screen-Film Mammography and Soft-Copy Full-Field Digital Mammography: Comparison in the Patients with Microcalcifications

• Kim HS
• Han BK
• Choo KS
• Jeon YH
• Kim JH
• Choe YH

• KMID: 1777278
• DOI: http://doi.org/10.3348/kjr.2005.6.4.214

Abstract

OBJECTIVE
We wanted to compare the ability of screen-film mammography (SFM) and soft-copy full-field digital mammography (s-FFDM) on two different monitors to detect and characterize microcalcifications. MATERIALS AND METHODS: The images of 40 patients with microcalcifications (three patients had malignant lesion and 37 patients had benign lesion), who underwent both SFM and FFDM at an interval of less than six months, were independently evaluated by three readers. Three reading sessions were undertaken for SFM and for FFDM on a mammography-dedicated review workstation (RWS, 2K x 2.5K), and for FFDM on a high-resolution PACS monitor (1.7K x 2.3K). The image quality, breast composition and the number and conspicuity of the microcalcifications were evaluated using a three-point rating method, and the mammographic assessment was classified into 4 categories (normal, benign, low concern and moderate to great concern). RESULTS: The image quality, the number and conspicuity of the microcalcifications by s-FFDM (on the RWS, PACS and both) were superior to those by SFM in 85.0%, 80.0% and 52.5% of the cases, respectively (p < 0.01), and those by the s-FFDM on the two different monitors were similar in 15.0%, 12.5% and 35.0% of the cases, respectively (p > 0.01). The mammographic assessment category for the microcalcifications in the three reading sessions was similar. CONCLUSION: s-FFDM gives a superior image quality to SFM and it is better at evaluating microcalcifications. In addition, s-FFDM with the PACS monitor is comparable to s-FFDM with the RWS for evaluating microcalcifications.

Keyword

Radiography, digital; Mammography; Microcalcification; Screens and films; Breast radiography; Soft copy reading

MeSH Terms

*Radiographic Image Enhancement
Mammography/*methods
Humans
Female
Calcinosis/*radiography
Breast Diseases/*radiography

Figure

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  Fig. 1 Soft-copy workstation for digital mammography. The figure shows the soft-copy display system using a 2×2.5 K mammography-dedicated review workstation (General Electric Medical Systems, Buc, France).

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  Fig. 2 Distribution of the results of the comparison between the full-field digital mammography on a PACS monitor and the full-field digital mammography on a review workstation by three readers. Image quality (A), number (B) and conspicuity (C) of microcalcifications in screen-film mammography versus full-field digital mammography.

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  Fig. 3 Comparison of image quality. Scratch and dust artifacts are noted in A and it is difficult to differentiate the microcalcification from the dust in A, resulting in superior image quality of the full-field digital mammography (B).

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  Fig. 4 Comparison of the number and conspicuity of the microcalcifications. Many more calcifications with a clear margin are noted in the full-field digital mammography (B) than in a screen-film mammography (A).

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  Fig. 5 A 48-year-old woman with an increased number of clustered microcalcifications in the left breast. She underwent breast-conserving surgery for an infiltrating ductal carcinoma of the right breast two years ago. The ACR BI-RADS mammographic assessment category of the microcalcification was more consistent with the pathologic result in the full-field digital mammography (B) than in the screen-film mammography (A), as assessed by all three interpreters. These microcalcifications were confirmed to be mucocele-like tumor with atypical ductal hyperplasia by a stereotaxic mammotome biopsy. A and B were performed at the same time.

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