Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme

• Published in: European radiology 2014-08, Vol.24 (8), p.1808-1819
• Main Authors: Timmermans, Lore, De Hauwere, An, Bacher, Klaus, Bosmans, Hilde, Lemmens, Kim, Bleyen, Luc, Van Limbergen, Erik, Martens, Patrick, Van Steen, Andre, Mortier, Griet, Van Herck, Koen, Thierens, Hubert
• Format: Article
• Language: English
• Subjects: Aged; Belgium; Breast; Breast cancer; Breast Neoplasms - diagnosis; Diagnostic Radiology; Dosimetry; Early Detection of Cancer; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Mammography; Mammography - methods; Mass Screening - methods; Medical screening; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Program Evaluation; Quality control; Radiographic Image Enhancement - methods; Radiography; Radiology; Radiometry; Reproducibility of Results; Retrospective Studies; Sensors; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-014-3169-y

Objectives To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM). Methods Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme. Results Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30 % in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR. Conclusions No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR. Key Points • Performance parameters showed no major differences after digitalisation to CR or DR . • Transition from SFM to CR results in a higher mean glandular dose . • Transition from SFM to DR results in a lower mean glandular dose .