[The diagnostic accuracy of a digital mammography system with photostimulable storage phosphors used with automatic...

Even though digital mammography might potentially yield major advantages in management, biology and diagnosis, state-of-the-art digitalization is still in a clinical experimental phase. To assess the diagnostic accuracy of a digital mammography system with storage phosphors, we analyzed 320 digital and 320 conventional mammograms acquired in lateral-oblique projection in the same patients. Digital mammography capabilities in identifying and characterizing breast lesions were compared with those of conventional mammography; the presence/absence of lesions and their benign/malignant nature were investigated. Complete conventional mammography was our gold standard. The digital system did not miss any malignant lesion but it did miss some benign lesions (focal masses) which had been depicted with conventional mammography, especially small low-contrast opacities. Microcalcifications were better depicted on digital images which showed, at the same time, tissues of different density, thanks to their wider dynamic range. Digital mammography yielded a false positive result on a cluster of microcalcifications, because its spatial resolution is lower. The diagnostic yield of digital mammography was poorer only in the detection of small low-contrast lesions and in the characterization of microcalcifications. To conclude, in our experience, the storage phosphor system seems to be suitable for clinical mammography, but only with careful monitoring; in contrast, we think it is not yet suitable for screening purposes.