Comparison of acquisition parameters and breast dose in digital mammography and screen-film mammography in the American College of Radiology Imaging Network digital mammographic imaging screening trial

Abstract

Objective: The purpose of our study was to compare the technical performance of full-field digital mammography (FFDM) and screen-film mammography.

Materials and methods: The American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial enrolled 49,528 women to compare FFDM and screen-film mammography for screening. For quality assurance purposes, technical parameters including breast compression force, compressed breast thickness, mean glandular dose, and the number of additional views needed for complete breast coverage were recorded and analyzed for both FFDM and screen-film mammography on approximately 10% of study subjects at each site.

Results: Technical data were compiled on 5,102 study subjects at 33 sites. Clean data were obtained for 4,366 (88%) of those cases. Mean compression force was 10.7 dN for screen-film mammography and 10.1 dN for FFDM (5.5% difference, p < 0.001). Mean compressed breast thickness was 5.3 cm for screen-film mammography and 5.4 cm for FFDM (1.7% difference, p < 0.001). Mean glandular dose per view averaged 2.37 mGy for screen-film mammography and 1.86 mGy for FFDM, 22% lower for digital than screen-film mammography, with sizeable variations among digital manufacturers. Twelve percent of screen-film mammography cases required more than the normal four views, whereas 21% of FFDM cases required more than the four normal views to cover all breast tissue. When extra views were included, mean glandular dose per subject was 4.15 mGy for FFDM and 4.98 mGy for screen-film mammography, 17% lower for FFDM than screen-film mammography.

Conclusion: Our results show that differences between screen-film mammography and FFDM in compression force and indicated compressed breast thickness were small. On average, FFDM had 22% lower mean glandular dose than screen-film mammography per acquired view, with sizeable variations in average FFDM doses by manufacturer.

Fig. 1

Bar graph shows comparison of breast compression force between digital (darker gray) and screen-film (lighter gray) mammography by digital manufacturer, averaged over all views, subjects, and sites.

Fig. 2

Bar graph shows comparison of compressed breast thickness between digital (darker gray) and screen-film (lighter gray) mammography by digital manufacturer, averaged over all views, subjects, and sites.

Fig. 3

Bar graph shows comparison of mean glandular dose from single view for digital (darker gray) and screen-film (lighter gray) mammography by digital manufacturer, averaged over all views, subjects, and sites.

Fig. 4

Chart shows comparison of mean glandular dose from single view for screen-film (Δ) and digital (■) mammography versus compressed breast thickness for examinations conducted at Fischer SenoScan digital sites. Error bars represent 95% CIs. Where 95% CIs do not overlap, differences are statistically significant.

Fig. 5

Chart shows comparison of mean glandular dose from single view for screen-film (Δ) and digital (■) mammography versus compressed breast thickness for examinations conducted at Fujifilm CR digital sites. Error bars represent 95% CIs. Where 95% CIs do not overlap, differences are statistically significant.

Fig. 6

Chart shows comparison of mean glandular dose from single view for screen-film (Δ) and digital (■) mammography versus compressed breast thickness for examinations conducted at GE Healthcare Senographe 2000D digital sites. Error bars represent 95% CIs. Where 95% CIs do not overlap, differences are statistically significant.

Fig. 7

Chart shows comparison of mean glandular dose from single view for screen-film (Δ) and digital (■) mammography versus compressed breast thickness for examinations conducted at Hologic Selenia digital sites. No data were recorded below 2-cm breast thickness. Error bars represent 95% CIs. Where 95% CIs do not overlap, differences are statistically significant.

Fig. 8

Bar graph shows comparison of percentage of examinations requiring one or more extra views for digital (darker gray) and screen-film (lighter gray) mammography by digital manufacturer and for technical data collected at all sites.

Fig. 9

Bar graph shows comparison of percentage of extra views required beyond two views of each breast for digital (darker gray) and screen-film (lighter gray) mammography by digital manufacturer and for technical data collected at all sites.