Implications of using high contrast mammography X-ray film-screen combinations

S Meeson1, KC Young1, A Rust2, MG Wallis3, J Cooke4,ML Ramsdale2

1National Co-ordinating Centre for the Physics of Mammography, Department of Medical Physics, St. Luke’s Wing, Royal Surrey County Hospital, Guildford GU2 7XX, 2Regional Radiation Protection Service, Department of Medical Physics, St. Luke’s Wing, Royal Surrey County Hospital, Guildford GU2 7XX, 3Warwickshire, Solihull & Coventry Breast Screening Centre, Coventry and Warwickshire Hospital, Stoney Stanton Road, Coventry CV1 4FH, and 4Jarvis Breast Screening Centre, 60 Stoughton Road, Guildford GU1 1LJ, UK

The objective of this study was to determine the implicationsof using Fuji AD-M and Kodak min-R 2000, two high contrast X-rayfilm types developed for mammography. Evaluation of the FujiAD-M film was divided into two parts. The first part was a contralateralcomparison between mammograms using Fuji AD-M and Fuji UM-MAHC filmscreen combinations. Fuji AD-M contrast was about25% higher than that of Fuji UM-MA HC. The effect of increasedcontrast on image quality was investigated by visually gradingthe quality of information in different parts of each mammogram.Fuji AD-M film was generally judged to be better for overalldiagnosis. However, 2.3% of mammograms produced using Fuji AD-Mfilm were not acceptable and might have led to a technical recallof the patient. In the second part of this study, sets of mammogramsfrom women attending mobile screening units were reviewed. Oneunit used Fuji AD-M film and the other used Kodak min-R 2000film. Both samples of mammograms were digitized and analysed.The average film gradients between an optical density (OD) of0.25 and 2.00 above base plus fog were 4.38 for Fuji AD-M filmand 3.77 for Kodak min-R 2000 film. The main breast regionsof the mammograms were judged to be satisfactorily displayedwhen breast tissues were above ODs of approximately 0.6 forFuji AD-M film and 0.8 for Kodak min-R 2000 film.

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