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Digital Mammography
The digital mammography is an electronic imaging procedure of the breast. The number of breast imaging facilities equipped with digital mammography (also called computed radiography mammogram (CRM), CR mammogram) is growing due to a number of advantages.
Digital images can be stored directly in a picture archiving and communication system (PACS) and allows the printing, enhancement, magnification, or brightness and contrast manipulation for further evaluation. The sensitivity of digital mammography compared to film mammography is better in women with dense breasts, a population at higher risk for breast cancer, due to these post processing possibilities.
'The American College of Radiology's (ACR) Imaging Network found that digital mammography detected up to 28 percent more cancers than film-screen mammography in women age 50 and younger, premenopausal and perimenopausal women, and women with dense breasts, as reported in October 2005 in the New England Journal of Medicine.'

Advantages of digital mammography:
Faster image acquisition;
shorter examination time;
improved contrast between dense and non-dense breast tissue;
under or over x-ray exposure can be corrected without repeated mammograms;
post processing of breast images for more accurate detection of breast cancer;
Easy storage and transmission over phone lines or a network.

Existing mammography equipment can be converted to 'digital' operation, which allows cost savings compared to integrated digital mammography systems.

See also Breast MRI.
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Breast Imaging
Breast imaging methods include mammography (mammogram), ultrasound, breast MRI, positron emission tomography, xeromammography, diaphanography and thermography.
Mammography is widely used as a screening method and diagnostic tool for breast cancer detection or evaluation of breast disease. Digital mammography takes multiple thin digital image 'slices' through the breast, which provides higher potential to see a small mass within dense tissue. The mammography quality standards act guarantees a high image quality.
Breast ultrasound (also called ultrasonography) should only be used as an additional imaging modality to evaluate specific breast abnormalities, especially to differentiate cystic from solid masses. Ultrasound is also used to guide needle breast biopsies.
Magnetic resonance imaging (MRI) is useful for breast MRI screening in cases of high cancer risk. In addition, multifocal breast cancer can be missed by standard practice mammography and can be early detected with breast MRI.
Mammogram
A mammogram is a low dose x-ray of the breast used to detect and diagnose breast disease, or to provide a baseline reference for later comparison. Multiple images are obtained by different positioning of the breast. The breast compression during mammography is an essential component to produce an optimal diagnostic mammogram. Film mammography units use film to both capture and display the image; digital mammography units use electronic equipment.
A spot compression reduces the thickness of the area of interest and improves contrast and separation of breast tissues.
Mammography
Mammography is a diagnostic imaging procedure of the breast to detect and evaluate breast disease. Mammography is widely used as a screening method and plays a key role in early breast cancer detection.
The screening mammography is used to detect breast changes in women who have no signs or symptoms or noticed breast abnormalities. The goal is to detect a breast tumor before any clinical signs are observable.
A diagnostic mammography is used to investigate suspicious breast changes, such as a breast lump, an unusual skin appearance, breast pain, nipple thickening or nipple discharge.
A breast screening or standard mammography requires two mammograms from different angles of each breast including craniocaudal view and mediolateral view. Additional images can be made from other angles or focus on microcalcifications or other suspicious areas.
A mammogram is created by special mammography equipment with long wavelength of the used x-rays. Film-screen mammography is still the most widely used technology, but the state of the art technique is digital mammography. Conventional x-ray equipment was used to produce mammograms until dedicated mammography equipment became available in the late 1960s. Film-screen mammography and xeromammography, introduced in the early 1970s, used lower radiation doses and produced sharper mammograms. The second generation of mammography systems has been introduced in the early 1980s. Chief disadvantages of analog mammography include the labor-intensive handling of the cassettes, relatively slow processing time, the lack of a direct interface to the x-ray system, and no post processing possibilities.
Mammograms of high quality should be done with the lowest radiation dose as possible. Adequate breast compression is important due to shortening of the exposure times, immobilization of the breast, reduction of motion and blurring and prevention of overpenetration by means of equalizing breast thickness.
Further breast imaging procedures include breast ultrasound and breast MRI.
Intensifying Screen
An intensifying screen is used to intensify the x-ray effect during radiation exposure of the x-ray film. Approximately 5% of the x-ray photons will be absorbed by the film only. Intensifying screens consist of a sheet of inorganic salts that emits fluorescent light when stroked by x-rays. The fluorescent input and output screens of the image intensifier are very similar to intensifying screens.
Calcium tungstate and rare earths are two common salts (also called phosphors) used for intensifying screens. For example, a calcium tungstate (CaWo4) screen can absorb around 40% of the x-ray photons and convert the radiation into light photons. A basic feature of this screen types is related to the position of the k-edge on the energy axis. Tungsten (W) is a heavy element has a k-edge at 69.5 keV, while that for rare earth elements is in around 50 keV.
The fraction of x-rays absorbed by a screen is depending on the speed. Factors affecting the speed of a screen:
the phosphor type;
the x-ray radiation absorption efficiency;
the radiation to light intrinsic conversion efficiency;
the thickness of the screen.
Mammography cassettes contain usually one intensifying screen, but most others use two screens per film cassette. The intensifying screen as part of a film screen system has been an important component in radiology to reduce the radiation dose of the patient. Today, the conventional film cassette is being replaced by an imaging plate used in digital systems.

See also Actinides, Cinefluorography and Added Filtration.
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