Zusammenfassung
Vordringliches Ziel eines organisierten Mammographiescreenings ist es, medizinische Versorgung auf hohem Niveau flächendeckend zu vertretbaren Kosten anzubieten. Die folgende Übersicht legt dar, wie diese beiden Aspekte des Screenings, Qualität und Kosteneffizienz, in idealer Weise durch einen rein digitalen Workflow unterstützt werden. Digitale Mammographiesysteme gewährleisten eine gleich bleibend hohe Bildqualität, Wiederholungsaufnahmen auf Grund von Fehlbelichtungen entfallen. Dedizierte Mammographiescreening-Workstations mit Integration von Bildbetrachtung und Befundung ermöglichen eine effiziente Softcopy-Befundung. Arbeitsabläufe wie Doppelbefundung, Archivierung und Bereitstellung von Voraufnahmen sowie der Informationsaustausch zwischen den Mitgliedern des zertifizierten Teams der Screeningeinheit und mit anderen weiterbehandelnden Ärzten werden durch das Vorliegen der Bilddaten in digitaler Form deutlich erleichtert.
Abstract
The overriding goal of an organized mammography screening program is to offer high level medical care to everyone at a justifiable cost. The following overview will demonstrate how both aspects of screening, quality and cost efficiency, are supported by a fully digital workflow. Digital mammography systems allow for a constant high image quality and repeat examinations due to overexposure or underexposure can be avoided. Dedicated mammography screening workstations with integration of image viewing and reporting enable efficient softcopy reading. Many aspects of the screening workflow, such as double reading, archiving and retrieval of stored films, as well as information exchange between members of the certified team of the screening unit and other physicians involved in the further treatment, are made significantly easier by the presence of image data in digital form.
Literatur
Berns EA, Hendrick RE, Cutter GR (2002) Performance comparison of full-field digital mammography to screen-film mammography in clinical practice. Med Phys 29: 830–834
Berns EA, Hendrick RE, Solari M et al. (2006) Digital and screen-film mammography: comparison of image acquisition and interpretation times. AJR Am J Roentgenol 187: 38–41
Bick U (2000) Digitale Vollfeldmammographie. Fortschr Röntgenstr 172: 957–964
Bick U (2006) Mammographie-Screening in Deutschland: Wie, wann und warum? Fortschr Röntgenstr 178: 957–969
Bick U, Diekmann F (2007) Digital mammography: what do we and what don’t we know? Eur Radiol 17: 1931–1942
Bird RE, Wallace TW, Yankaskas BC (1992) Analysis of cancers missed at screening mammography. Radiology 184: 613–617
Birdwell RL, Bandodkar P, Ikeda DM (2005) Computer-aided detection with screening mammography in a university hospital setting. Radiology 236: 451–457
Bloomquist AK, Yaffe MJ, Mawdsley GE et al. (2006) Lag and ghosting in a clinical flat-panel selenium digital mammography system. Med Phys 33: 2998–3005
Burnside ES, Park JM, Fine JP et al. (2005) The use of batch reading to improve the performance of screening mammography. AJR Am J Roentgenol 185: 790–796
Cupples TE, Cunningham JE, Reynolds JC (2005) Impact of computer-aided detection in a regional screening mammography program. AJR Am J Roentgenol 185: 944–950
Duijm LE, Groenewoud JH, Hendriks JH et al. (2004) Independent double reading of screening mammograms in The Netherlands: effect of arbitration following reader disagreements. Radiology 231: 564–570
Freer TW, Ulissey MJ (2001) Screening mammography with computer-aided detection: prospective study of 12,860 patients in a community breast center. Radiology 220: 781–786
Fröhlich CP, Weigel C, Mohr M et al. (2007) Teleradiologie im Mammographie-Screening: Evaluation eines Testnetzes mit dedizierten Befundungsstationen. Fortschr Röntgenstr 179: 137–145
Gennaro G, Baldelli P, Taibi A et al. (2004) Patient dose in full-field digital mammography: an Italian survey. Eur J Radiol 14: 645–652
Kassenärztliche Bundesvereinigung (2004) Einführung eines bundesweiten Mammographie-Screening-Programms. Dtsch Ärztebl 101: Beilage Heft 4
Kassenärztliche Bundesvereinigung (2005) Änderungen der Anlage 9.2 (Versorgung im Rahmen des Programms zur Früherkennung von Brustkrebs durch Mammographie-Screening) der Bundesmantelverträge: Mindestanforderungen an die apparative Ausstattung der Röntgendiagnostikeinrichtungen. Dtsch Ärztebl 102: A 1309
Malich A, Fischer DR, Bottcher J (2006) CAD for mammography: the technique, results, current role and further developments. Eur Radiol 16: 1449–1460
Obenauer S, Luftner-Nagel S, von Heyden D et al. (2002) Screen film vs full-field digital mammography: image quality, detectability and characterization of lesions. Eur Radiol 12: 1697–1702
Perry N, Broeders M, de Wolf C et al. (2006) European guidelines for quality assurance in breast cancer screening and diagnosis, 4th edn. Office for Official Publications of the European Communities, Luxemburg
Pisano ED, Cole EB, Kistner EO et al. (2002) Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display. Radiology 223: 483–488
Pisano ED, Gatsonis C, Hendrick E et al. (2005) Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med 353: 1773–1783
Pisano ED, Yaffe MJ (2005) Digital mammography. Radiology 234: 353–362
Roelofs AA, van Woudenberg S, Otten JD et al. (2006) Effect of soft-copy display supported by CAD on mammography screening performance. Eur Radiol 16: 45–52
Rosselli Del Turco M, Mantellini P, Ciatto S et al. (2007) Full-field digital versus screen-film mammography: comparative accuracy in concurrent screening cohorts. AJR Am J Roentgenol 189: 860–866
Samei E, Saunders RS jr, Baker JA et al. (2007) Digital mammography: effects of reduced radiation dose on diagnostic performance. Radiology 243: 396–404
Skaane P, Hofvind S, Skjennald A (2007) Randomized trial of screen-film versus full-field digital mammography with soft-copy reading in population-based screening program: follow-up and final results of Oslo II study. Radiology 244: 708–717
Skaane P, Skjennald A (2004) Screen-film mammography versus full-field digital mammography with soft-copy reading: randomized trial in a population-based screening program – the Oslo II Study. Radiology 232: 197–204
Vigeland E, Klaasen H, Klingen TA et al. (2008) Full-field digital mammography compared to screen film mammography in the prevalent round of a population-based screening programme: the Vestfold County Study. Eur Radiol 18: 183–191
Warren RM, Young JR, McLean L et al. (2003) Radiology review of the UKCCCR Breast Screening Frequency Trial: potential improvements in sensitivity and lead time of radiological signs. Clin Radiol 58: 128–132
Weigel S, Girnus R, Czwoydzinski J et al. (2007) Digitale Mammografie im Screening: Parenchymdosis und initiale Performance-Parameter. Fortschr Röntgenstr 179: 892–895
Interessenkonflikt
U. Bick, F. Diekmann und E. M. Fallenberg sind als Referenten auf Veranstaltungen tätig, die durch eine oder mehrere der Firmen Carestream, GE, Hologic, MeVis BreastCare und Siemens organisiert oder finanziell unterstützt werden, und haben in diesem Rahmen Vortragshonorare und/oder Reisekostenunterstützung erhalten.
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Bick, U., Diekmann, F. & Fallenberg, E. Workflow in der digitalen Screeningmammographie. Radiologe 48, 335–344 (2008). https://doi.org/10.1007/s00117-008-1633-x
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DOI: https://doi.org/10.1007/s00117-008-1633-x