Digital and Computer-Aided Mammography

Digital mammography uses an electronic system to record an image of the breast that can be stored on a computer instead of on hardcopy films. There are a number of digital mammography technologies under evaluation. The potential advantages of digital mammography include improvements in image contrast, manipulation of the image after it is performed (avoiding repeats for technical problems), elimination of lost films, reduction in film library maintenance costs, and the ability to transmit the images over long distances (telemammography). Challenges and potential problems for digital mammography include a need to prove equivalence in detection and diagnosis with conventional mammography, the high cost of digital mammography equipment, and lagging workstation technology. Computer-aided detection and diagnosis (CAD) uses analysis by a computer program to assist the interpreting physician in identifying abnormal findings on mammograms and in making a benign versus malignant diagnosis of calcifications and masses. Several studies suggest that this technology can reduce the incidence of missed cancers and improve the positive predictive value for biopsies. CAD can be performed after digitization of hardcopy films but is best suited to digitally acquired soft copy images.