Mammography

Past & PresentSimilar equipments were & are still being used,

these can be called as old fashioned equipments

cone

Tube

Breast Stand

Mammography

In digital mammography screen-film system has been replaced by Detectors to give the digital images

Mammography

Present & future

CCD camera

Work station

Equipments look like this

Mammogram

These digital mammograms are surely better in resolution & details

Standard views:

45* Medio lateral Oblique (MLO view)/

Lundgren’s view

Craniocaudal view (CC view)

RCC RMLOLCC LMLO

Left Craniocaudal

Right Craniocaudal

Right Mediolateral

Oblique

Left Mediolateral Oblique

LATLeft Axillary Tail

LCV Left Cleavage

LFBLeft From Below

LLMOLeft Lateromedial

Oblique

LMLLet Mediolateral

LRLLeft Roll Lateral

LRMLeft Roll Medial

LLMLeft Lateromedial

Extended CC view / Cleopatra’s view

Extended CC view- medial or lateral rotation

True Lateral view

Axillary view

Cleavage view

Paddle compression view

Magnification view

Eklund view (for breast implants)

Extended CC view medially rotated

Extended CC view laterally rotated

Magnification view

CONVENTIONAL CC VIEW EKLUND CC VIEW

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

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

Courtesy: MIAS digital mammogram database

Instant Upgrade

• Improved signal-to-noise ratio

• Ability to magnify, change contrast, or alter the brightness.

• Near instantaneous image acquisition

Courtesy: Magee-Women’s Hospital of UPMC

Digital versus Conventional

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

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

Thank you

Talk about this session with your friends….It will add to your knowledge

pkpopli@hotmail.com