Comparison of 2.3 & 5 mega pixel (MP) resolution monitors when detecting mammography image blurring

Background - Image blurring in Full Field Digital Mammography (FFDM) is reported to be a problem within many UK breast screening units resulting in significant proportion of technical repeats/recalls. Our study investigates monitors of differing pixel resolution, and whether there is a difference in blurring detection between a 2.3 MP technical review monitor and a 5MP standard reporting monitor. Methods - Simulation software was created to induce different magnitudes of blur on 20 artifact free FFDM screening images. 120 blurred and non-blurred images were randomized and displayed on the 2.3 and 5MP monitors; they were reviewed by 28 trained observers. Monitors were calibrated to the DICOM Grayscale Standard Display Function. T-test was used to determine whether significant differences exist in blurring detection between the monitors. Results - The blurring detection rate on the 2.3MP monitor for 0.2, 0.4, 0.6, 0.8 and 1 mm blur was 46, 59, 66, 77and 78% respectively; and on the 5MP monitor 44, 70, 83 , 96 and 98%. All the non-motion images were identified correctly. A statistical difference (p <0.01) in the blurring detection rate between the two monitors was demonstrated. Conclusions - Given the results of this study and knowing that monitors as low as 1 MP are used in clinical practice, we speculate that technical recall/repeat rates because of blurring could be reduced if higher resolution monitors are used for technical review at the time of imaging. Further work is needed to determine monitor minimum specification for visual blurring detection.

Mammography equipment

Mammography is one of the most technically demanding examinations in radiology, and it requires X-ray technology designed specifi cally for the task. The pathology to be imaged ranges from small (20–100 μm) high density microcalcifications to ill-defi ned low contrast masses. These must be imaged against a background of mixed densities. This makes demonstrating pathology challenging. Because of its use in asymptomatic screening, mammography must also employ as low a radiation dose as possible.

Psychological impact of diagnostic exams

Introduction: Anxiety is a common problem in primary care and specialty medical settings. Treating an anxious patient takes more time and adds stress to staff. Unrecognized anxiety may lead to exam repetition, and impedance of exam performance. Objective: The aim of the study was to examine the anxiety levels of patients who are to undergo diagnostic exams related to cancer diagnostic: PET/CT and mammography. Methods: Two hundred and thirty two patients who undergo PET/CT and one hundred thirteen women who undergo mammography filled out one questionnaire after the procedure to determine their concerns, expectations and perceptions of anxiety. Results: Our results show that the main causes of anxiety in patients who are having a PET/CT is the fear of the procedure itself and fear of the results. Patients who suffered from greater anxiety were those who were scanned during the initial stage of an oncological disease. On the other hand, the diagnostic is the main cause of anxiety in women who are requiring a mammography. 28% of the women reported having experienced pain or intense pain. Conclusions: The performance of diagnostic exams related to cancer diagnostic like a PET/CT and a mammography are important and statistically generators of anxiety. Patients are often poorly informed and present with a range of anxieties that may ultimately affect examination quality. These results provide expertise that can be used in the development of future training programs to integrate post-graduate courses of health professionals.

Equipment quality control

Mammography equipment must be evaluated to ensure that images will be of acceptable diagnostic quality with lowest radiation dose. Quality Assurance (QA) aims to provide systematic and constant improvement through a feedback mechanism to address the technical, clinical and training aspects. Quality Control (QC), in relation to mammography equipment, comprises a series of tests to determine equipment performance characteristics. The introduction of digital technologies promoted changes in QC tests and protocols and there are some tests that are specific for each manufacturer. Within each country specifi c QC tests should be compliant with regulatory requirements and guidance. Ideally, one mammography practitioner should take overarching responsibility for QC within a service, with all practitioners having responsibility for actual QC testing. All QC results must be documented to facilitate troubleshooting, internal audit and external assessment. Generally speaking, the practitioner’s role includes performing, interpreting and recording the QC tests as well as reporting any out of action limits to their service lead. They must undertake additional continuous professional development to maintain their QC competencies. They are usually supported by technicians and medical physicists; in some countries the latter are mandatory. Technicians and/or medical physicists often perform many of the tests indicated within this chapter. It is important to recognise that this chapter is an attempt to encompass the main tests performed within European countries. Specific tests related to the service that you work within must be familiarised with and adhered too.

Qualidade de imagem em mamografia: apresentação do músculo grande peitoral na incidência oblíqua médio-lateral

A mamografia é, atualmente, o principal método de diagnóstico imagiológico da patologia mamária, sendo, por isso, essencial a produção consistente de imagens mamográficas de elevada qualidade. Assim, e uma vez que a mamografia visa a maximização da visualização do tecido mamário, o principal objetivo deste estudo consiste em investigar a apresentação mamográfica do músculo grande peitoral na incidência oblíqua médio-lateral (OML) da mama. Pretendeu-se relacionar os padrões técnicos de aquisição de imagem à forma de apresentação do referido músculo, avaliando-os de acordo com os atuais critérios de qualidade de imagem. As imagens mamográficas foram recolhidas a partir de duas instituições hospitalares de referência do Porto, sendo posteriormente efetuada uma análise e tratamento estatístico dos indicadores qualitativos e quantitativos de qualidade das mesmas. Numa análise global por instituição, e tendo por base estes indicadores, a instituição que utiliza uma angulação fixa do potter-bucky, independentemente do biótipo corporal da paciente, apresentou resultados melhores, indicando assim que a existência de falhas devido a erros de posicionamento é menor por comparação aos critérios de qualidade padrão. Constatou-se, portanto, que a angulação do potter-bucky tem um impacto relevante e estatisticamente significativo na qualidade das imagens mamográficas.