Comparison of full-field digital mammography and film-screen mammography: image quality and lesion detection

The objective of this study is to compare image quality and lesion detection for full field digital mammography (FFDM) and film-screen mammography (FSM). In 200 women we performed digital mammography of one breast and film-screen mammography of the other breast. Imaging parameters were set automatically. Image quality, visualization of calcifications and masses were rated by three readers independently. Mean glandular dose was calculated for both systems. We found no significant difference in mean glandular dose. Image quality was rated by reader A/B/C as excellent for FFDM in 153/155/167 cases and for FSM in 139/116/114 cases (p,0.03/0.001/0.001). Microcalcifications were detected by FFDM in 103/89/98 and by FSM in 76/76/76 cases (p,0.01/0.06/0.01). Detection of masses did not differ significantly. FFDM provided significantly better visibility of skin and nipple-areola region (p,0.01). FFDM demonstrated improved image quality compared with film-screen mammography. Microcalcification detection was also significantly better with the digital mammography system for two of the three readers. Digital technology is replacing conventional film-screen systems in all aspects of clinical radiology. Several digital mammography systems based on different physical con- cepts have been introduced and approved by the Food and Drug Administration in the last few years (1). The first system introduced was the full field digital mammography (FFDM) system based on amorphous silicon (General Electric Medical Systems, Milwaukee, WI), followed by the charge coupled device (CCD)-based slot-scan-system (Fischer Imaging, Denver, CO) and the FFDM based on