MAMMOMAT Inspiration Tomosynthesis Unique Feature Training for Radiologists

MAMMOMAT Inspiration Tomosynthesis Unique Feature Training for Radiologists   You should now be able to:   List the unique features of the Siemens MAMMOMAT Inspiration with Tomosynthesis option   Describe the Multiple Reader Multiple Case (MRMC) study conducted by Siemens prior to FDA approval   Identify the indications for Tomosynthesis use   Summarize the Quality Control procedures required for Tomosynthesis    Recognize the cautions when utilizing Tomosynthesis Upon completing this course, the physician will be able to: List the unique features of the Siemens MAMMOMAT Inspiration with Tomosynthesis option   Describe the Multiple Reader Multiple Case (MRMC) study conducted by Siemens prior to FDA approval   Identify the indications for Tomosynthesis use   Summarize the Quality Control procedures required for Tomosynthesis   Recognize the cautions when utilizing Tomosynthesis MAMMOMAT Inspiration with Tomosynthesis option   Detector Material:  Amorphous Selenium   Same type of detector utilized by Hologic   GE utilizes an Amorphous Silicon detector 50 degree Acquisition of 25 projections* Siemens acquires its tomo sweep over a 50 degree angle obtaining 25 projection images during the scan Every 2 degrees an image is taken   This is different from other Tomo vendors Hologic: 15 degree angle with 15 projection images GE: 25 degree angle with 9 projection images   Siemens has the WIDEST angle allowing for more separation of tissue and optimum depth resolution *The projection images are acquired at an extremely low dose and should NOT be used for diagnosis -25 degrees to + 25 degrees for CC The tube completes a sweep from -25 to + 25 in the cranial caudal view   Any 50 degree angle for MLOs When acquiring the MLO view the technologist may choose the necessary angle per patient body habitus and the unit will perform the scan and take the images from that point Average glandular dose for a 40-49 mm breast thickness is approximately 2.0 mGy per Siemens Clinical Study   Approximately twice the dose for a 2D mammogram of the same thickness Examples One 2D image < 1 mGy* One 3D scan ≤ 2 mGy* Continuous Tube Movement Hologic: continuous sweep GE: step and shoot   30 second Acquisition It takes approximately 25 seconds to acquire 1 tomo scan due to the 50 degree angle and 25 projection images W/Rh anode filter combination used for ALL breast thicknesses   GRID is used for 2D and retracted for 3D Same as Hologic GE utilizes grid for 2D and 3D 2 different compression plates – Reconstruction and spatial resolution do NOT depend on the compression plate used Special filtered back projection algorithm is used to reconstruct the tomo slices Enhanced edges of masses, calcifications, and spiculations Reduces artifacts Increases sharpness Equalizes tissue density Faster processing time 2D pixel size/ pitch : 85 Micron By acquiring 25 projection views, Siemens does NOT have to utilize pixel binning Same spatial resolution for 2D and 3D = 85 Micron Hologic utilizes binning Depending on paddle size, spatial resolution = 97 – 117 Micron GE no pixel binning Overall lower detector spatial resolution for 2D and 3D  = 100 Micron   Reconstructed Voxels .085mm x .085mm x 1mm  A voxel is simply the 3D equivalent of a pixel Smallest distinguishable element of a 3D object Reconstructed Slice Thickness 1 MM separated by 1MM Siemens takes the 25 projection images and utilizes the filtered back projection to reconstruct 1 mm slices of tissue Every patient will have the same # of projections Every patient will have a different # of reconstructed slices depending on compression thickness, compression plate, and compression force 2nd Reconstruction can be selected for calcifications Calcification segmentation algorithm Optimizes calcification visibility The Multiple Reader Multiple Case (MRMC) study was performed by Siemens in order to examine radiologists' accuracy in detecting and diagnosing cancers when reading 3D as an adjunct to 2D.  The following pages will present the findings of this study. Siemens Conducted a MRMC study prior to FDA Tomosynthesis submission Data Collection from 7 US clinical sites 22 Readers with varying experience levels 300 Cases selected for the study (50 Cancers, 85 Benign, & 165 Negative) Key finding ALL readers improved accuracy in detecting and diagnosing cancers when reading 3D as an adjunct to 2D   Study proved when using tomo in addition to 2D on average Diagnostic accuracy increased Cancer detection rate increased Identification of malignant lesions  increased Non cancer recall and patient recall rate both declined Reader sensitivity increased Overall superiority for all breast densities was shown when compared to 2D FFDM alone The MAMMOMAT Inspiration with Tomosynthesis option is indicated for 2D and 3D acquisition for screening and diagnostic exams For Screening purposes, the FDA has approved the exam MUST consist of: 2D CC and MLO views of each breast 2D CC and MLO views plus 3D CC and MLO views of each breast   Before conducting quality control tests for tomosynthesis, make sure that the screening quality control tests have been performed without errors   The technologist must also peform a quarterly tomo calibration Breast implants Use caution when imaging implants Adjust compression and system parameter settings accordingly If the swivel arm stops during exposure Release the exposure button and compression of patient Making measurements Do NOT use projection images or slices to perform critical measurements Assure the correct projection view is assigned to the correct image Ensures accurate reporting and diagnosis Avoid Injury Ensure patient is properly positioned and head is back away from face shield as this moves during exposure   Please follow the instructions below to print your Certificate of Completion Return to the list of courses Just below the "Launch" button for this course, you should now see a "Print Certificate" button Click the "Print Certificate" button You can Open the certificate, or save it to your system Keep the certificate for your records so that you are in accordance with MQSA requirements for the Tomosynthesis Unique Feature training.   In this section we will be presenting multiple tomosynthesis case studies. Please take your time in reviewing these case studies and proceed through the knowledge checks as requested.  This is a 74 year old woman who presented for a screening mammogram. Select the links below to review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D    This is a 64 year old woman who presented for a screening mammogram. Select the links below to review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 76 year old women who presented for a screening mammogram. Review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 56 year old woman who presented for a screening mammogram.  Select the links below to review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 56 year old woman who presented for a screening mammogram.  Select the links below to review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 53 year old woman with recent abnormal left MRI. Screening mammogram 6 months ago was normal.  Select the links below to review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 58 year old female who presented for diagnostic evaluation of left bloody nipple discharge. Select the links below to Review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 53 year old female who presented for a screening mammography. Select the links below to Review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 54 year old female who presented for a screening mammography.  Select the links below to Review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 53 year old woman presenting for screening mammogram. Select the links below to Review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D   This is a 42 year old women who presented for a screening mammogram. Select the links below to Review the bilateral FFDM and tomosynthesis images.     Right CC 2D & 3D Right CC 2D & 3D   Left CC 2D & 3D Left CC 2D & 3D   Right MLO 2D & 3D Right MLO 2D & 3D   Left MLO 2D & 3D Left MLO 2D & 3D