The politics of breast imaging.

There are numerous political issues concerned with the roles of breast imaging in the detection, diagnosis, and management of breast cancer. These include issues regarding screening mammography, quality control, and results including cost-effectiveness of medical-legal considerations, but also their relation to overall health care of other societal needs.

Diagnostic accuracy of Fischer Senoscan Digital Mammography versus screen-film mammography in a diagnostic mammography population.

Rationale And Objectives: To compare the diagnostic accuracy of the Fischer Senoscan Digital Mammography System with that of standard screen-film mammography in a population of women presenting for screening or diagnostic mammography.

Materials And Methods: Enrollment of patients took place at six different breast-imaging centers between 1997 and 1999. A total of 247 cases were selected for inclusion in the final reader study.

Factors predicting successful needle-localized breast biopsy.

Rationale And Objectives: The purpose of this study was to identify factors that predict successful removal of nonpalpable breast lesions with mammography-guided needle-localized breast biopsy.

Materials And Methods: Of the 455 consecutive patients referred for needle-localized breast biopsy of one or more nonpalpable breast lesions between January 1990 and December 1994, 272 (59.8%) had sufficiently complete data to be included in this study.

Diagnostic accuracy of digital mammography in patients with dense breasts who underwent problem-solving mammography: effects of image processing and lesion type.

Purpose: To determine effects of lesion type (calcification vs mass) and image processing on radiologist's performance for area under the receiver operating characteristic curve (AUC), sensitivity, and specificity for detection of masses and calcifications with digital mammography in women with mammographically dense breasts.

Materials And Methods: This study included 201 women who underwent digital mammography at seven U.S.

Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display.

Purpose: To compare the speed and accuracy of the interpretations of digital mammograms by radiologists by using printed-film versus soft-copy display.

Materials And Methods: After being trained in interpretation of digital mammograms, eight radiologists interpreted 63 digital mammograms, all with old studies for comparison. All studies were interpreted by all readers in soft-copy and printed-film display, with interpretations of images in the same cases at least 1 month apart.

Communicating results of diagnostic mammography: what do patients think?

Rationale And Objectives: The purpose of this study was to investigate women's preferences for who (radiologist or referring physician) should communicate the results of diagnostic mammography.

Materials And Methods: Data from 153 women presenting to two sites for diagnostic mammography between February and June 1995 were collected with a 24-item, self-administered, closed-ended survey. For both normal and abnormal hypothetical results, contingency tables with chi2 tests and multiple logistic regression were used to determine the association, if any, between women's characteristics and their preferences.

Informing patients of diagnostic mammography results: mammographer's opinions.

Purpose: The authors' purpose was to determine mammographers' practices and attitudes regarding disclosing results of diagnostic mammograms to patients.

Materials And Methods: In 1995, the authors mailed a questionnaire to 500 members of the Society of Breast Imaging; 399 (80%) responded to the survey.

Results: Three-quarters of respondents stated that mammographers should disclose results to their patients, and approximately half were already doing so (52% for normal results, 51% for abnormal results).

Has the mammography quality standards act affected the mammography quality in North Carolina?

Objective: The United States Food and Drug Administration implemented federal regulations governing mammography under the Mammography Quality Standards Act (MQSA) of 1992. During 1995, its first year in implementation, we examined the impact of the MQSA on the quality of mammography in North Carolina.

Materials And Methods: All mammography facilities were inspected during 1993-1994, and again in 1995.

Effects of processing conditions on mammographic image quality.

Rationale And Objectives: Any given mammographic film will exhibit changes in sensitometric response and image resolution as processing variables are altered. Developer type, immersion time, and temperature have been shown to affect the contrast of the mammographic image and thus lesion visibility. The authors evaluated the effect of altering processing variables, including film type, developer type, and immersion time, on the visibility of masses, fibrils, and speaks in a standard mammographic phantom.

Contrast limited adaptive histogram equalization image processing to improve the detection of simulated spiculations in dense mammograms.

The purpose of this project was to determine whether Contrast Limited Adaptive Histogram Equalization (CLAHE) improves detection of simulated spiculations in dense mammograms. Lines simulating the appearance of spiculations, a common marker of malignancy when visualized with masses, were embedded in dense mammograms digitized at 50 micron pixels, 12 bits deep. Film images with no CLAHE applied were compared to film images with nine different combinations of clip levels and region sizes applied.

Paget disease of the breast: a pictorial essay.

Paget disease of the breast accounts for approximately 2%-3% of breast cancers. It is characterized by infiltration of the nipple epidermis by adenocarcinoma cells, which cause an eczematous eruption on the nipple and areola. The clinical features are highly suggestive of the disease; awareness of these on the part of the clinician should lead to more prompt diagnosis and earlier initiation of appropriate treatment.

The effect of intensity windowing on the detection of simulated masses embedded in dense portions of digitized mammograms in a laboratory setting.

The purpose of this study was to determine whether intensity windowing (IW) improves detection of simulated masses in dense mammograms. Simulated masses were embedded in dense mammograms digitized at 50 microns/pixel, 12 bits deep. Images were printed with no windowing applied and with nine window width and level combinations applied.

Does intensity windowing improve the detection of simulated calcifications in dense mammograms?

This study attempts to determine whether intensity windowing (IW) improves detection of simulated calcifications in dense mammograms. Clusters of five simulated calcifications were embedded in dense mammograms digitized at 50-microns pixels, 12 bits deep. Film images with no windowing applied were compared with film images with nine different window widths and levels applied.

Interpretation time of serial chest CT examinations with stacked-metaphor workstation versus film alternator.

Purpose: Interpretation time of serial staging chest CT cases, which each contained current and previous examinations, with a simple prototype workstation called filmstack was experimentally compared with interpretation time with a film alternator.

Materials And Methods: The filmstack displayed a "stack" of sections for each examination; user controls allowed rapid selection of preset attenuation windows and both synchronized and unsynchronized scrolling. Eight radiologists were timed as they used the filmstack and the film alternator to interpret four ergonomically complex serial CT cases.

New modalities in breast imaging: digital mammography and magnetic resonance imaging.

Mammography is currently the only screening method available with proven capability to diagnose nonpalpable breast cancer. However, mammography does not detect all cancers. Cancers are more difficult to detect in radiographically dense breasts because lesions are obscured by breast tissue.

An update on mammography.

For at least 7°% of breast cancers there are no known causal factors other than gender and aging. Other possible risk factors include hormonal, genetic, nutritional, morphologic, environmental (chemical, pesticides, food additives), irradiation, and viruses. Japanese women have much less breast cancer than women in the U.