Comparison between image quality in electronic zoom and geometric magnification in digital mammography

Magnification mammography is performed to enhance the visibility of small structures at the expense of relatively high radiation dose as a complementary examination to standard mammography. The introduction of post-processing capabilities and the widespread use of digital mammography has promoted some controversy in the last decade on whether similar visibility can be achieved using electronic zoom. The aim of this study is to compare the visibility of small structures in images obtained by the two techniques stated above for different exposure conditions.

Images of a Fluke Biomedical Model 18-220 Mammography Accreditation Phantom were obtained using standard techniques and geometric magnification, using a digital mammography unit, with different exposure factors. Three different target/filter combinations (Mo/Mo,Mo/Rh,Rh/Rh), variable kVp (26-32), and automatic exposure control were used. Images obtained using standard technique were electronically zoomed and compared to the corresponding magnification mammograms. Comparisons were based on the visibility of structures evaluated by five senior technologist with extensive experience in mammography. Statistical analysis was performed using non-parametric tests.

Visibility of structures was not affected by the kV used for a given target/filter combination for both techniques (p > 0.065). Target/filter combination of Mo/Mo provided better visibility of micro-calcification and fibers (p < 0.026) in geometric magnification technique and Mo/Rh in the digital zoom technique. No significant differences were observed in the visibility of simulated breast masses. The overall image score was significantly higher (p < 0.001) for geometric magnification over the digital zoom for Mo/Mo & Rh/Rh combinations.

Although sufficient image quality was maintained in electronically zoomed images, geometric magnification provided better overall visualization of structures in the phantom.