A critical comparison of three full field digital mammography systems using figure of merit

Full field digital mammography (FFDM) has been progressively introduced in medical centers in recent years. However, it is questionable which exposure parameters are suitable in order to reduce the glandular breast doses as they are related to induced carcinogenesis. The goal of this study was to compare the average glandular doses (AGD) and image quality of three FFDM systems namely Siemens Mammomat NovationDR, Hologic Lorad Selenia and General Electric Senographe Essential using a Figure of Merit. A Computerized Imaging Reference Systems (CIRS) tissue equivalent breast phantom which consists of phototimer compensation plate with different thickness and glandularity was exposed in fully automatic exposure control mode in the cranio-caudal projection similar to clinical settings. Thermoluminescent dosimeter 100H (TLD- 100H) was used to measure the entrance surface air kerma (ESAK), the AGD was calculated using European protocol whilst the image quality was assessed quantitatively by measuring the contrast to noise ratio (CNR) value. The obtained values were used to calculate the Figure of Merit (FOM) to analyze the effectiveness of the system. Repeated Measures ANOVA analysis showed that there is a significant difference (p<0.05) in the mean value of AGD and CNR between the three FFDM systems. Hologic Lorad Selenia system contrbuted the highest AGD value while General Electric Senographe Essential had the highest CNR and FOM value. In conclusion, this study may provide an objective criterion during the selection of a mammography unit by using the figure of merit for screening or diagnostic purpose.