Improving Image Quality in Mammography

Image Quality in Mammography Identify criteria for why mammography requires high contrast sensitivity compared to other radiographic procedures Explain why mammography requires the highest visibility of detail compared to other radiographic procedures Identify the general anatomical conditions that have an effect on contrast sensitivity Associate the importance of compression and the negative effects of not enough compression Utilize all of the features of the Inspiration and Novation to obtain the best image possible By the end of this course you should be able to: Analog vs. Digital Mammography Present Major Differences: Image Capture Image Processing Image Display Image Storage What has not changed: Compression Analog Image Quality Film Processor Intensifying Screens Viewing Film Media for recording: Full Ring Media for transporting: Limited options Media for storage: Storage space needed Media for display: This is the ONLY copy! Processor Development Need correct balance of chemicals Fixing and Washing Need correct balance Drying Could add unwanted density to image Intensifying Screens Same sensitivity or speed Assures consistency amongst technologists Source of variability Varied screens could cause decrease in image quality QA Test to verify Film screen contact View Box Luminance Masking Room Illumination Digital Image Quality Receptor: Constant sensitivity over wide range of exposures Image Processing: Based on exposure parameters Windowing: Ability to electronically manipulate images Digital Image Receptor One receptor size to accommodate most breasts Constant sensitivity over wide range of exposures Digital image will have relatively low contrast but will be uniform over the full exposure range Ability to apply numerous processing parameters Contrast processing to enhance image quality Novation has low, normal and high contrast Further enhanced by windowing Five Factors Mammography Requirements for Image Quality Testing Image Quality Breast Anatomy Compression Getting the Image Quality from your Novation High contrast sensitivity Low blurring   Low noise Minimal artifacts Appropriate projections A major requirement Characteristic of imaging process Anatomy vs. pathology   Some blurring on all images Reduces visibility of detail Especially significant in mammography Unsharpness     Spatial resolution Visibility of detail Reduction in perceived sharpness Often used interchangeably Occurs during the formation of the image The ability to separate objects Reduced by blurring Measured by line pair phantom Visibility of Detail Effected by blurring Tested by using a phantom Comes from 3 sources Motion Focal spot Receptor/Display system Undesirable Obscures calcifications   Caused by underexposure Skin folds Deodorant or powder Additional body parts Medial-Lateral Oblique Cranial-Caudal Straight Lateral Compression Magnification View Rolled View The Phantom Visibility Requirements Size and thickness Choose appropriate exposure parameters Fatty replaced vs. dense Fatty requires less exposure   Improve contrast sensitivity Reduce variations in breast thickness Reduce blurring Reduce overlying structures Reduce radiation dose System determines the proper amount of compression Based on individual breast characteristics Achieves optimum patient comfort and image quality Optimum Compression (OpComp)® Optimum Dose (OpDose)® Imaging Processing Parameter Group (IPPG) Compression Paddles Trust the system Achieve unchanging and correct compression Only functions with the 18 x 24, 24 x 30, and 20 x 22 compression paddles Not activated by manual compression Patients with implants Patients who recently had breast surgery When using flexible paddles Spot compression Magnification table Unit automatically suggests the appropriate program (kV and target filter combination Based on compressed thickness of breast Compression force must be at least 6 kg Indicated by flashing light Rigid Compression Paddle Standard use Flexible Compression Paddle Special use   Axillary areas   Male breasts   Small breasts   Implant push-back You have now completed the course Improving Image Quality in Mammography.  You should now be able to: Identify criteria for why mammography requires high contrast sensitivity compared to other radiographic procedures Explain why mammography requires the highest visibility of detail compared to other radiographic procedures Identify the general anatomical conditions that have an effect on contrast sensitivity Associate the importance of compression and the negative effects of not enough compression Utilize all of the features of the Novation to obtain the best image possible   Technologist   Patient   System