Skip to main content
SpringerLink
Log in

Technical and clinical breast cancer screening performance indicators for computed radiography versus direct digital radiography

European Radiology Aims and scope Submit manuscript

Cite this article

Abstract

Objectives

To compare technical and clinical screening performance parameters between computed radiography (CR) and direct digital radiography (DR) systems.

Methods

The number of women screened with CR was 73,008 and with DR 116,945. Technical and patient dose survey data of 25 CR and 37 DR systems were available. Technical performance was expressed by threshold thickness values at the mean glandular dose (MGD) level of routine practice. Clinical indicators included recall rate (RR), cancer detection rate (CDR), percentage of ductal carcinoma in situ (DCIS), percentage of cancers with T-scores smaller than 1 cm and positive predictive value (PPV).

Results

Contrast threshold values for the 0.1-mm gold disk were 1.44 μm (SD 0.13 μm) for CR and 1.20 μm (SD 0.13 μm for DR). MGD was 2.16 mGy (SD 0.36 mGy) and 1.35 mGy (SD 0.32 mGy) for CR and DR respectively. We obtained for CR, respectively DR, the following results: RR in the first round of 5.48 % versus 5.61 %; RR in subsequent rounds of 2.52 % versus 2.65 %; CDR of 0.52 % versus 0.53 %; DCIS of 0.08 % versus 0.11 %; a rate of cancers with T-scores smaller than 1 cm of 0.11 % versus 0.11 %; PPV of 18.45 % versus 18.64 %; none of them was significantly different.

Conclusion

Our screening indicators are reassuring for the use of CR and DR, with CR operating at 60 % higher MGD.

Key Points

• Breast cancer screening can employ both computed (CR) and direct digital radiography (DR).

• Screening performance parameters for CR and DR technology are not significantly different.

• Screening parameters are in accordance with European Guidelines.

• Radiation doses employed for CR are generally 60 % greater than for DR.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. The official journal of the European Union, ‘Council Recommendation of 2 December 2003 on Cancer Screening’ (2003/878/EC), L327/34 – L327/38, Dec 16, 2003

  2. Perry N, Broeders M, de Wolf C, Törnberg S, Holland R, von Karsa L (2006) European Guidelines for breast cancer screening and diagnosis. Office for the Official Publications of the European Communities, Luxemburg

    Google Scholar 

  3. Bick U, Diekmann F (2009) Digital mammography. Springer Verlag, Berlin

    Google Scholar 

  4. IAEA Human Health Series, No 17. Quality assurance programme for digital mammography. Downloadable from http://www.iaea.org/Publications/index.html

  5. Marshall NW, Monnin P, Bosmans H, Bochud FO, Verdun FR (2011) Image quality assessment in digital mammography: part I. Technical characterization of the systems’. Phys Med Biol 56:4201–4220

    Article  PubMed  CAS  Google Scholar 

  6. Rivetti S, Lanconelli N, Campanini R et al (2006) Comparison of different commercial FFDM units by means of physical characterization and contrast-detail analysis. Med Phys 33:4198–4209

    Article  PubMed  Google Scholar 

  7. Warren LM, Mackenzie A, Cooke J et al (2012) Effect of image quality on calcification detection in digital mammography. Med Phys 39:3202–3213

    Article  PubMed  Google Scholar 

  8. Monnin P, Marshall NW, Bosmans H, Bochud FO, Verdun FR (2011) Image quality assessment in digital mammography: part II. NPWE as a validated alternative for contrast detail analysis. Phys Med Biol 56:4221–4238

    Article  PubMed  CAS  Google Scholar 

  9. Pisano ED, Gatsonis C, Hendrick E et al (2005) Diagnostic performance of digital versus film mammography for breast-cancer screening; Digital Mammographic Imaging Screening Trial (DMIST) Investigators Group. N Engl J Med 353:1773–1783

    Article  PubMed  CAS  Google Scholar 

  10. 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

    Article  PubMed  Google Scholar 

  11. Skaane P, Balleyguier C, Diekmann F et al (2005) Breast lesion detection and classification: comparison of screen-film mammography and full-field digital mammography with soft-copy reading–observer performance study. Radiology 237:37–44

    Article  PubMed  Google Scholar 

  12. Lewin JM, Hendrick RE, D’Orsi CJ et al (2001) Comparison of full-field digital mammography with screen-film mammography for cancer detection: results of 4,945 paired examinations. Radiology 218:873–880

    PubMed  CAS  Google Scholar 

  13. Hambly NM, McNicholas MM, Phelan N, Hargaden GC, O'Doherty A, Flanagan FL (2009) Comparison of digital mammography and screen-film mammography in breast cancer screening: a review in the Irish breast screening program’. AJR Am J Roentgenol 193:1010–1018

    Article  PubMed  Google Scholar 

  14. Bluekens AM, Karssemeijer N, Beijerinck D et al (2010) Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates. Eur Radiol 20:2067–2073

    Article  PubMed  Google Scholar 

  15. Bluekens AM, Holland R, Karssemeijer N, Broeders MJ, den Heeten GJ (2012) Comparison of digital screening mammography and screen-film mammography in the early detection of clinically relevant cancers: a multicenter study. Radiology 265:707–714

    Article  PubMed  Google Scholar 

  16. Sala M, Comas M, Macià F, Martinez J, Casamitjana M, Castells X (2009) Implementation of digital mammography in a population-based breast cancer screening program: effect of screening round on recall rate and cancer detection. Radiology 252:31–39

    Article  PubMed  Google Scholar 

  17. Van Ongeval C, Van Steen A, Vande Putte G et al (2010) Does digital mammography in a decentralized breast cancer screening program lead to screening performance parameters comparable with film-screen mammography? Eur Radiol 20:2307–2314

    Article  PubMed  Google Scholar 

  18. Vinnicombe S, Pinto Pereira SM, McCormack VA, Shiel S, Perry N, Dos Santos Silva IM (2009) Full-field digital versus screen-film mammography: comparison within the UK breast screening program and systematic review of published data. Radiology 251:347–358

    Article  PubMed  Google Scholar 

  19. Lipasti S, Anttila A, Pamilo M (2010) Mammographic findings of women recalled for diagnostic work-up in digital versus screen-film mammography in a population-based screening program. Acta Radiol 51:491–497

    Article  PubMed  Google Scholar 

  20. Skaane P (2009) Studies comparing screen-film mammography and full-field digital mammography in breast cancer screening: updated review. Acta Radiol 50:3–14

    Article  PubMed  CAS  Google Scholar 

  21. Thierens H, Bosmans H, Buls N et al (2009) Type testing of physical characteristics of digital mammography systems for screening within the Flemish breast cancer screening programme. Eur J Radiol 70:539–548

    Article  PubMed  Google Scholar 

  22. Dance DR, Skinner CL, Young KC, Beckett JR, Kotre CJ (2000) Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol. Phys Med Biol 45:3225–3240

    Article  PubMed  CAS  Google Scholar 

  23. Michielsen K, Jacobs J, Bosmans H (2007) Patient dosimetry for mammography. AIP Conference Proceedings of the Fourth International Summer School on Nuclear Physics Methods and Accelerators in Biology and Medicine 958:292–293

  24. Chevalier M, Morán P, Ten JI, Fernández Soto JM, Cepeda T, Vañó E (2004) Patient dose in digital mammography. Med Phys 31:2471–2479

    Article  PubMed  Google Scholar 

  25. Young KC, Cook JJH, Okudo JM, Bosmans H (2006) Comparison of software and human observers in reading images of the CDMAM test object to assess digital mammography systems. Proc SPIE 6142, 614206-1 – 614206-13

    Google Scholar 

  26. Bennett RL, Blanks RG, Moss SM (2009) Evaluation of extension of breast screening to women aged 65–70 in England using screening performance measures. Br J Cancer 100:1043–1047

    Article  PubMed  CAS  Google Scholar 

  27. Marshall NW, Lemmens K, Bosmans H (2012) Physical evaluation of a needle photostimulable phosphor based CR mammography system. Med Phys 39:811–824

    Article  PubMed  CAS  Google Scholar 

  28. Yaffe MJ, Mainprize JG (2011) Risk of radiation-induced breast cancer from mammographic screening. Radiology 258:98–105

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University Hospitals Leuven, Leuven, Belgium

    Hilde Bosmans, Kim Lemmens, Federica Zanca, Chantal Van Ongeval & Andre Van Steen

  2. QCC, Ghent University, Ghent, Belgium

    An De Hauwere & Hubert Thierens

  3. Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Department of Public Health, Ghent University, Ghent, Belgium

    Koen Van Herck, Luc Bleyen & Griet Mortier

  4. Vroegtijdige Opsporing Borstklierkanker West-Vlaanderen vzw, Bruges, Belgium

    Patrick Martens

  5. Leuven University Center of Cancer Screening, Leuven, Belgium

    Gretel Vande Putte, Eliane Kellen & Erik Van Limbergen

Authors
  1. Hilde Bosmans
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. An De Hauwere
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kim Lemmens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Federica Zanca
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hubert Thierens
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chantal Van Ongeval
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Koen Van Herck
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Andre Van Steen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Patrick Martens
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Luc Bleyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Gretel Vande Putte
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Eliane Kellen
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Griet Mortier
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Erik Van Limbergen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hilde Bosmans.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Bosmans, H., De Hauwere, A., Lemmens, K. et al. Technical and clinical breast cancer screening performance indicators for computed radiography versus direct digital radiography. Eur Radiol 23, 2891–2898 (2013). https://doi.org/10.1007/s00330-013-2876-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-013-2876-0

Keywords

search

Navigation