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DIGITAL MAMMOGRAPHY

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DIGITAL MAMMOGRAPHY Powered By Docstoc
					   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

   Improved signal-to-noise ratio
   Ability to magnify, change contrast, or alter
    the brightness.
   Near instantaneous image acquisition
Digital versus Conventional




   Courtesy: Magee-Women’s Hospital of UPMC
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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