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Eric A Berns

Publications and source records attributed to Eric A Berns.

4 recordsLinked to original sources

Digital and screen-film mammography: comparison of image acquisition and interpretation times.

OBJECTIVE: The objective of our study was to compare acquisition times and interpretation times of screening examinations using screen-film mammography and soft-copy digital mammography. MATERIALS AND METHODS: Technologist study acquisition time from examination initiation to release of the screenee was measured for both screen-film and digital mammography (100 cases each) in routine clinical practice. The total interpretation time for screening mammography was also measured for 183 hard-copy screen-film cases and 181 soft-copy digital cases interpreted by a total of seven breast imaging radiologists, four experienced breast imagers, and three breast imaging fellows. RESULTS: Screening mammography acquisition time averaged 21.6 minutes for screen-film and 14.1 minutes for digital, a highly significant 35% shorter time for digital than screen-film (p < 10(-17)). The average number of images per case acquired with digital mammography was higher than that for screen-film mammography (4.23 for screen-film, 4.50 for digital; p = 0.047). The total interpretation time averaged 1.4 minutes for screen-film mammography and 2.3 minutes for digital mammography, a highly significant 57% longer interpretation time for digital (p < 10(-11)). In addition, technical problems delaying interpretation were encountered in none of the 183 screen-film cases but occurred in nine (5%) of the 181 digital cases. CONCLUSION: Compared with screen-film mammography, the use of digital mammography for screening examinations significantly shortened acquisition time but significantly increased interpretation time. In addition, more technical problems were encountered that delayed the interpretation of digital cases.

Female↗

Community-based mammography practice: services, charges, and interpretation methods.

OBJECTIVE: The purpose of our study was to accurately describe facility characteristics among community-based screening and diagnostic mammography practices in the United States. MATERIALS AND METHODS: A survey was developed and applied to community-based facilities providing screening mammography in three geographically distinct locations in the states of Washington, Colorado, and New Hampshire. The facility survey was conducted between December 2001 and September 2002. Characteristics surveyed included facility type, services offered, charges for screening and diagnostic mammography, information systems, and interpretation methods, including the frequency of double interpretation. RESULTS: Among 45 responding facilities, services offered included screening mammography at all facilities, diagnostic mammography at 34 facilities (76%), breast sonography at 30 (67%), breast MRI at seven (16%), and nuclear medicine breast scanning at seven (16%). Most facilities surveyed were radiology practices in nonhospital settings. Eight facilities (18%) reported performing clinical breast examinations routinely along with screening mammography. Only five screening sites (11%) used computer-aided detection (CAD) and only two (5%) used digital mammography. Nearly two thirds of facilities interpreted screening mammography examinations on-site, whereas 91% of facilities interpreted diagnostic examinations on-site. Only three facilities (7%) interpreted screening examinations on line as they were performed. Approximately half of facilities reported using some type of double interpretation, although the methods of double interpretation and the fraction of cases double-interpreted varied widely across facilities. On average, approximately 15% of screening examinations and 10% of diagnostic examinations were reported as being double-interpreted. CONCLUSION: Comparison of this survey's results with those collected a decade earlier indicates dramatic changes in the practice of mammography, including a clear distinction between screening and diagnostic mammography, batch interpretation of screening mammograms, and improved quality assurance and medical audit tools. Diffusion of new technologies such as CAD and digital mammography was not widespread. The methods of double-interpretation and the fraction of cases double-interpreted varied widely across study sites.

Breast Neoplasms↗

Optimization of technique factors for a silicon diode array full-field digital mammography system and comparison to screen-film mammography with matched average glandular dose.

Contrast-detail experiments were performed to optimize technique factors for the detection of low-contrast lesions using a silicon diode array full-field digital mammography (FFDM) system under the conditions of a matched average glandular dose (AGD) for different techniques. Optimization was performed for compressed breast thickness from 2 to 8 cm. FFDM results were compared to screen-film mammography (SFM) at each breast thickness. Four contrast-detail (CD) images were acquired on a SFM unit with optimal techniques at 2, 4, 6, and 8 cm breast thicknesses. The AGD for each breast thickness was calculated based on half-value layer (HVL) and entrance exposure measurements on the SFM unit. A computer algorithm was developed and used to determine FFDM beam current (mAs) that matched AGD between FFDM and SFM at each thickness, while varying target, filter, and peak kilovoltage (kVp) across the full range available for the FFDM unit. CD images were then acquired on FFDM for kVp values from 23-35 for a molybdenum-molybdenum (Mo-Mo), 23-40 for a molybdenum-rhodium (Mo-Rh), and 25-49 for a rhodium-rhodium (Rh-Rh) target-filter under the constraint of matching the AGD from screen-film for each breast thickness (2, 4, 6, and 8 cm). CD images were scored independently for SFM and each FFDM technique by six readers. CD scores were analyzed to assess trends as a function of target-filter and kVp and were compared to SFM at each breast thickness. For 2 cm thick breasts, optimal FFDM CD scores occurred at the lowest possible kVp setting for each target-filter, with significant decreases in FFDM CD scores as kVp was increased under the constraint of matched AGD. For 2 cm breasts, optimal FFDM CD scores were not significantly different from SFM CD scores. For 4-8 cm breasts, optimum FFDM CD scores were superior to SFM CD scores. For 4 cm breasts, FFDM CD scores decreased as kVp increased for each target-filter combination. For 6 cm breasts, CD scores decreased slightly as kVp increased for Mo-Mo, but did not change significantly as a function of kVp for either Mo-Rh or Rh-Rh. For 8 cm breasts, Rh/Rh FFDM CD scores were superior to other target-filter combinations and increased significantly as kVp increased. These results indicate that low-contrast lesion detection was optimized for FFDM by using a softer x-ray beam for thin breasts and a harder x-ray beam for thick breasts, when AGD was kept constant for a given breast thickness. Under this constraint, optimum low-contrast lesion detection with FFDM was superior to that for SFM for all but the thinnest breasts.

Equipment Failure Analysis↗

Performance comparison of full-field digital mammography to screen-film mammography in clinical practice.

Results of acceptance testing 18 full-field digital mammography systems for clinical use and of conducting annual physics surveys of 38 screen-film mammography systems were compared in terms of exposure times, mean glandular breast doses, and image quality. These evaluations were made using the same test tools on all systems, with emphasis on assessing automatic exposure control performance and image quality on both digital and screen-film systems using clinical techniques. Survey results indicated that digital mammography systems performed similarly to screen-film systems in terms of exposure times and mean glandular doses for thin to intermediate breasts, but that digital mammography systems selected shorter exposure times and lower mean glandular doses for thicker breasts. For all breast thicknesses, digital mammography systems yielded mean contrast-detail scores higher than those for screen-film systems. For all breast thicknesses, the 18 digital mammography systems demonstrated less variance in terms of exposure times, mean glandular doses, and contrast-detail scores than did the 38 screen-film systems tested. These results indicate that the clinical use of digital mammography may generally improve image quality for equal or lower breast doses, while providing tighter control on exposures and image quality than screen-film mammography.

Biophysical Phenomena↗