Comparison of Full-Field Digital Mammography with Screen-Film Mammography for Cancer Detection: Results of 4,945 Paired Examinations

Lewin, John M.; Hendrick, R. Edward; D’Orsi, Carl J.; Isaacs, Pamela K.; Moss, Lawrence J.; Karellas, Andrew; Sisney, Gale A.; Kuni, Christopher C.; Cutter, Gary

doi:10.1148/radiology.218.3.r01mr29873

Cited by 276 publications

(179 citation statements)

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“…Eligible studies were identified for ultrasound (Kolb et al, 1998;Buchberger et al, 1999;O'Driscol et al, 2001;Warner et al, 2001;Hou et al, 2002) magnetic resonance imaging (MRI) (Kuhl et al, 2000;Tilanus-Linthorst et al, 2000a, b;Stoutjesdijk et al, 2001;Warner et al, 2001), CAD (te Brake et al, 1998; Burhenne et al, 2000;Birdwell et al, 2001;Freer and Ulissey, 2001), and full-field digital mammography (FFDM) (Lewin et al, 2001(Lewin et al, , 2002. For ultrasound, MRI, and CAD, findings are summarised in Tables 1 -3.…”

Section: Resultsmentioning

confidence: 99%

“…Full-field digital mammography has the potential to improve image resolution and image processing and display techniques relative to conventional mammography. Full-field digital mammography has been examined in one study, which screened 4489 average-risk women 40 years and older (Lewin et al, 2001(Lewin et al, , 2002. In this study, 42 invasive cancers were detected (and four interval cancers were identified at 12 months).…”

Section: Evidence On New Technologies In Breast Cancer Screening L Irmentioning

confidence: 99%

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New technologies in screening for breast cancer: a systematic review of their accuracy

2004

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We systematically reviewed the literature on the accuracy of new technologies proposed for breast cancer screening. Four potential tests were identified (ultrasound, magnetic resonance imaging (MRI), full-field digital mammography (FFDM), and computer-aided detection (CAD)) for which primary studies met quality and applicability criteria and provided adequate data on test accuracy. These technologies have been assessed in cross-sectional studies of test accuracy where the new test is compared to mammography. Ultrasound, used as an adjunct to mammography in women with radiologically dense breasts, detects additional cancers and causes additional false positives. Magnetic resonance imaging may have a better sensitivity (but lower specificity) than mammography in selected high-risk women, but studies of this technology included small number of cancers. Computer-aided detection may enhance the sensitivity of mammography and warrants further evaluation in large prospective trials. One study of FFDM suggests that it may identify some cancers not identified on conventional mammography and may result in a lower recall rate. The evidence is currently insufficient to support the use of any of these new technologies in population screening, but would support further evaluation. British Journal of Cancer (2004) Despite recent controversy surrounding the efficacy of mammographic screening, it remains the only screening test for breast cancer that has been extensively evaluated in randomised controlled trials (RCTs) and shown to reduce breast cancer mortality (IARC, 2002;Nystrom et al, 2002). Since evidence exists that early detection reduces mortality from breast cancer, it is reasonable to evaluate a new screening test by assessing its effect on early detection of breast cancer. While RCTs examining mortality as an outcome are the gold standard, studies assessing new tests are commonly evaluated using surrogate measures as indicators of early breast cancer detection. These surrogate measures may be measurable at the time of screening or require follow-up. Immediate indicators include the cancer detection rate and the size, stage, and nodal status of cancers detected. The measure requiring follow-up is the interval cancer rate. Ascertainment of interval breast cancers poses a number of challenges that include identification (requiring linkage to cancer registries), standardisation, and validation of review and categorisation methods, as well as access to the films taken at diagnosis. Assessing whether tests differ in their interval cancer rate is best assessed by randomising people to the different tests. In designs in which women are assessed by both tests, women in whom cancers are detected by either test would obviously be identified and treated; interval cancers that arise thereafter would be those missed by both tests. To assess whether interval cancer rates differ between the tests is therefore best assessed by randomising women to the different tests. However, all of the immediately measurable surrogates can be asses...

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Section: Resultsmentioning

confidence: 99%

Section: Evidence On New Technologies In Breast Cancer Screening L Irmentioning

confidence: 99%

New technologies in screening for breast cancer: a systematic review of their accuracy

2004

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“…Larger clinical studies avoiding further irradiation include prospective randomised trials or retrospective comparisons from screening populations. Early clinical trials of digital mammography showed SFM to be superior or equivalent [18][19][20]. More recent trials have shown that CR and DR perform as well as or better than SFM [22][23][24][25][27][28][29][30][31], with improved detection of ductal carcinoma in situ presenting as clustered microcalcification in younger females and in those with dense breasts [21].…”

Section: Discussionmentioning

confidence: 99%

“…Although there are many clinical studies comparing the performance of 9,[18][19][20][21][22][23][24][25][26], there are fewer that compare CR with SFM or DR [8,25,[27][28][29][30][31][32]. We sought a method to compare the clinical diagnostic quality of two types of CR technology with that of SFM.…”

mentioning

confidence: 99%

Diagnostic quality of 50 and 100 µm computed radiography compared with screen–film mammography in operative breast specimens

Pagliari

Hoàng²,

Reddy³

et al. 2012

BJR

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Objective: To compare reader ratings of the clinical diagnostic quality of 50 and 100 mm computed radiography (CR) systems with screen-film mammography (SFM) in operative specimens. Methods: Mammograms of 57 fresh operative breast specimens were analysed by 10 readers. Exposures were made with identical position and compression with three mammographic systems (Fuji 100CR, 50CR and SFM). Images were anonymised and readers blinded to the CR system used. A five-point comparative scoring system (22 to +2) was used to assess seven quality criteria and overall diagnostic value. Statistical analysis was subsequently performed of reader ratings (n516 925). Results: For most quality criteria, both CR systems were rated as equivalent to or better than SFM. The CR systems were significantly better at demonstrating skin edge and background tissue (p,1610 25 ). Microcalcification was best demonstrated on the CR50 system (p,1610 25 ). The overall diagnostic value of both CR systems was rated as being as good as or better than SFM (p,1610 25 ). Conclusion: In this clinical setting, the overall diagnostic performance of both CR systems was as good as or better than SFM, with the CR50 system performing better than the CR100. There are currently three technologies widely available for diagnostic mammography: screen-film mammography (SFM) and two forms of large-field digital mammography [1]. The use of the term full-field digital mammography (FFDM) varies in the published literature and has been applied to both computed radiography (CR) and direct digital radiography (DR). Small-field digital mammography (SFDM) is mainly used for imaging during stereotactic biopsy [2].The advantages of digital mammography over SFM include: improved sensitivity in dense breast tissue, reduced radiation dose, the ability to manipulate images for review, and digital storage and retrieval methods [3]. CR was the earliest digital system in use. Imaging cassettes contain a re-useable photostimulable phosphor, replacing the traditional screen-film cassettes, and are then transferred to a laser reader. DR has an in-built detector and reader. Digital mammography has a lower spatial resolution than SFM, but has a very high contrast resolution. This allows the overall resolution of digital mammography to be at least equivalent to SFM [4][5][6][7][8], even when viewing calcification smaller than the pixel size [9]. Some CR systems have not met the quality standards of a number of governing bodies for mammography, including the European Network of Reference Assessment Centres (EUREF) and the NHS Breast Screening Programme (NHSBSP) [10,11]. This is related to the resolution achievable with 100 mm cassettes [12]. It is now known that CR systems using 50 mm cassettes can provide improved resolution, at an acceptable mean glandular dose, and have been approved for screening by the NHSBSP [13][14][15].Phantom studies indicate that the resolution and performance of DR are greater than those of CR [16,17], but have limitations. Although there are many clini...

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“…A number of studies have been conducted to compare screen-film with digital mammography and results have shown that digital imaging is as good as SFM in population based screening practices [4][5][6][7][8] , although most of these studies rely on surrogate end points such as cancer detection rate, recall rate and tumour characteristics at diagnosis. Few studies have been done within an operational national screening programme [9][10][11][12] . Accurate evaluation of risks and benefits of digital imaging in the screening environment is necessary at a time when the value of screening itself is questioned [13,14] .…”

Section: Introductionmentioning

confidence: 99%

Is full field digital mammography equivalent in performance to screen film mammography? UK perspective

Bansal

Lyburn

Jones

2014

IJDI

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Aim: The purpose of this project was to compare the performance of full-field digital imaging (FFDM) with screen film mammography (SFM). Methods:Data from 24,876 and 32,142 women in SFM and FFDM group respectively was collected retrospectively and comparison was made of the recall rate, breast cancer detection rate and positive predictive value (PPV) for the recalls for the two screening modalities, screen film mammography (SFM) and full field digital mammography (FFDM). Difference in radiologic characteristics of the tumours and tumour type (Ductal carcinoma in situ {DCIS} versus invasive) was also evaluated. Statistical software SPSS (PASW18) was used for data analysis with Pearson chi-square and Mann-Whitney-U test used to compare the two groups. A p value of less that 0.05 was considered to indicate a statistically significant difference. Results:In the year 2008-2009(SFM group), there was a recall rate of 4.5% and a cancer detection rate of 7.5/1000 in the recalled group. For the year 2009-2010 (FFDM group), there was a recall rate of 4.9% and cancer detection rate of 8.8/1000 in the recalled group. There was no statistically significant difference between the recall rate and cancer detection rate between the two groups (p = 0.157). Within the digital group, there was 88(88%) invasive cancer and 12(12%) non-invasive cancer, whereas within the analogue group, there were 74 (92.5%) invasive cancer and 6(7.5%) non-invasive cancer. Most of the non-invasive cancers in the FFDM group were high grade with only one mixed low-intermediate grade. In the analogue group, 50% were high grade, rest being low or intermediate grade. The histological distribution of cancer between two groups was not found to be statistically significant (p = 0.108). Conclusion:Our study demonstrated FFDM was similar to SFM in terms of cancer detection rate, recall rate and positive predictive value for recalls. KeywordsScreen-film mammography, Full-field digital mammography, Ductal carcinoma in situ, Breast neoplasms, Cancer screening

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Comparison of Full-Field Digital Mammography with Screen-Film Mammography for Cancer Detection: Results of 4,945 Paired Examinations

Abstract: No difference in cancer detection rate has yet been observed between FFDM and SFM. FFDM has so far led to fewer recalls than SFM.

Cited by 276 publications

References 21 publications

New technologies in screening for breast cancer: a systematic review of their accuracy

New technologies in screening for breast cancer: a systematic review of their accuracy

Diagnostic quality of 50 and 100 µm computed radiography compared with screen–film mammography in operative breast specimens

Is full field digital mammography equivalent in performance to screen film mammography? UK perspective

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