What’s new in mammography

• Published in: European journal of radiology 1998-05, Vol.27 (Suppl. 2), p.S234-S241
• Main Authors: Simonetti, Giovanni, Cossu, Elsa, Montanaro, Martina, Caschili, Cristiana, Giuliani, Valentina
• Format: Article
• Language: English
• Subjects: Angiography, Digital Subtraction; Biological and medical sciences; Breast cancer; Breast Neoplasms - diagnostic imaging; Computer aided diagnosis; Digital computers; Digital signal processing; Female; Genital system. Mammary gland; Humans; Image Interpretation, Computer-Assisted; Image quality; Investigative techniques, diagnostic techniques (general aspects); Laser diagnostics; Lasers; Mammography; Mammography - trends; Medical sciences; Mortality rate; Oncology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiographic Image Enhancement; Synchrotron radiation; Teleradiology; Tomography
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/S0720-048X(98)00069-2

Early diagnosis of breast cancer plays the leading role in reducing mortality rates and improving the patients’ prognosis: mammography is the most sensitive technique currently available for the detection of nonpalpable lesions and therefore the method of choice. However, mammography has some limitations and the technique must be improved with technological devices without affecting image quality. This could be the target to increase diagnostic accuracy. Mammography sensitivity and specificity are now improved with the digital computer assisted technique, teleradiology, digital tomosynthesis or digital angiography—used to study microvascularization—3D imaging or synchrotron light, and laser mammography. Such other technological devices as Mammospot reduce breast thickness and provide better breast compression. Digital mammography can be carried out with film or direct digitization. The advantages of the digital technique are a shorter examination time, less storage space, electronic image recording, with image ‘adjustments’ made by the radiologist, and especially computerized analysis. The computer aided diagnosis can be defined as the diagnosis made by the radiologist who considers the results of computerized analysis as a ‘second opinion’. In this way incidental mistakes made by radiologists, can be corrected by the computer analysis. Computers are a basic element also in teleradiology, which needs immediate and simultaneous admittance to the patient’s history and permits radiology optimization in rural areas too. As for tomosynthesis, it permits to study a single slice of the breast without glandular tissue overlapping, which is useful in dense breasts where the diagnosis can be made with a lower X-ray dose. Moreover, this method fits the current mammographic systems easily. 3D imaging is still a work in progress. Synchrotron mammography is used only on surgery specimens, where it exhibits high resolution and contrast, depicting structures and details missed by conventional mammography. Breast DSA allows the study of vessels