Comparative performance of modern digital mammography systems in a large breast screening program

Area of Science:

• Radiology
• Medical Imaging
• Breast Cancer Screening

Background:

• Digital mammography systems, including computed radiography (CR) and digital radiography (DR), are used in large breast screening programs.
• Assessing image quality and clinical performance is crucial for optimizing mammography screening.

Purpose of the Study:

• To compare physical image quality measures between CR and DR mammography systems.
• To evaluate differences in clinical cancer detection rates between CR and DR systems within a large screening program.

Main Methods:

• Routine quality assurance measurements included modulation transfer function, noise equivalent quanta, lesion detectability (d'), and air kerma.
• Mammography accreditation phantom images were also evaluated.
• Clinical cancer detection rates were compared between sites using CR and DR technology.

Main Results:

• DR systems demonstrated higher modulation transfer functions, noise equivalent quanta, lesion detectability, and phantom scores compared to CR systems.
• DR systems exhibited lower failure rates related to low signal-to-noise ratio and high dose.
• Sites using CR technology reported approximately 30.6% lower breast cancer detection rates than those using DR.

Conclusions:

• Physical image quality measures, including spatial resolution and signal-to-noise ratio, indicate better performance with DR systems.
• The findings are consistent with previous research showing lower cancer detection rates for CR systems in screening mammography.