Screen film vs full-field digital mammography: image quality, detectability and characterization of lesions

Abstract

The objective of this study was to compare screen-film mammography (SFM) to full-field digital mammography (FFDM) regarding image quality as well as detectability and characterization of lesions using equivalent images of the same patient acquired with both systems. Two mammography units were used, one with a screen-film system (Senographe DMR) and the other with a digital detector (Senographe 2000D, both GEMS). Screen-film and digital mammograms were performed on 55 patients with cytologically or histologically proven tumors on the same day. Together with these, 75 digital mammograms of patients without tumor and the corresponding previous screen-film mammograms not older than 1.5 years were reviewed by three observers in a random order. Contrast, exposure, and the presence of artifacts were evaluated. Different details, such as the skin, the retromamillary region, and the parenchymal structures, were judged according to a three-point ranking scale. Finally, the detectability of microcalcifications and lesions were compared and correlated to histology. Image contrast was judged to be good in 76%, satisfactory in 20%, and unsatisfactory in 4% of screen-film mammograms. Digital mammograms were judged to be good in 99% and unsatisfactory in 1% of cases. Improper exposure of screen-film system occurred in 18% (10% overexposed and 8% underexposed). Digital mammograms were improperly exposed in 4% of all cases but were of acceptable quality after post-processing. Artifacts, most of them of no significance, were found in 78% of screen-film and in none of the digital mammograms. Different anatomical regions, such as the skin, the retromamillary region, and dense parenchymal areas, were better visualized in digital than in screen-film mammography. All malignant tumors were seen by the three radiologists; however, digital mammograms allowed a better characterization of these lesions to the Breast Imaging Reporting and Data System (BI-RADS;) [corrected] categories (FFDM better than SFM in 23 of 165 vs 9 of 165 judged cases in SFM). In conclusion, digital mammography offers a consistent, high image quality in combination with a better contrast and without artifacts. Lesion detection in digital images was equal to that in screen-film images; however, categorization of the lesions to the BI-RADS classification was slightly better.

The Role of Various Modalities in Breast Imaging

“…The acquired digital image can be stored in computer memory and printed out later as a fi lm or displayed and interpreted on a high-defi nition monitor. The ability to alter contrast and brightness permits further evaluation of abnormal areas to identify features diagnostic of benign and malignant disease [12][13][14] . Although the overall cancer-detection rate is similar in screen-fi eld and full-fi eld mammography, screenfi eld imaging has better image quality and fewer artefacts, and requires fewer patient recalls 14 .…”

Mammographic Artifacts on Full-Field Digital Mammography

“…Acquisition with the appropriate exposure parameters can correct this [1,2]. The incidence of underexposure on the indirect type of FFDM has been reported to be 4 % and on the screen-film system 8 % [3]. In the present study, the incidence of underexposure on the direct and indirect types of FFDM was a significantly lower 0.7 %.…”

“…Only one previous study has examined FFDM artifact incidence: comparing artifacts of screen-film mammography with FFDM. It showed that artifacts occurred in 78 % of screen-film mammography cases, but not at all in FFDM [3]. Crystallization and blooming artifacts, manifesting as blurring of image corners and white dots within a black halo, have been reported for the selenium-based digital mammography detector; these were thought to be detector-hardware related [5].…”

“…To date, there have been only several studies on FFDM artifacts [1][2][3][4][5], among which none has focused on artifact incidence. The goal of the present study was to investigate the incidence of FFDM artifacts classified as patientrelated, hardware-related, and software processing artifacts and to compare them according to their detector types and grid types.…”

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

“…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].…”