Advanced Imaging

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Advanced Imaging Magazine

Updated: January 12th, 2011 10:01 AM CDT

Improving Results in Screening Mammograms

New study reviews more than 231,000 mammograms to show benefits of CAD compared to double-reading without it
The PeerView feature of the Hologic R2 CAD system
© Hologic
The PeerView feature of the Hologic R2 CAD system outlines the central density of a detected mass or distortion so the radiologist can evaluate the margin, shape and interior characteristics. Detected microcalcifications are highlighted so the radiologist can determine the number, shape and distribution.
The R2 system
© Hologic
The R2 system is designed to pinpoint regions of interest, efficiently drawing the radiologist’s eye to important image features. Calcification clusters are marked with the familiar R2 triangle and masses with the R2 asterisk. A special EmphaSize variable size feature displays marks in variable sizes correlating to the prominence of a mass or calcification features.
The R2 DMax™ platform
© Hologic
The R2 DMax™ platform, including ImageChecker™ CAD and DigitalNow™ film digitizing software can scan each film in just 22 seconds.
A Selenia direct digital image with R2 PeerView® CAD
© Hologic
A Selenia direct digital image with R2 PeerView® CAD outlines a density and highlights a cluster of microcalcifications to help visualize and analyze the specific features that may indicate malignancy.
The R2 CAD system
© Hologic
The R2 CAD system pinpoints the region of interest marking the mass with the traditional R2 asterisk and calcifications with the traditional R2 triangle.
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By Barry Hochfelder

The numbers are frightening and staggering. The American Cancer Society says breast cancer is the most common cancer among women in the United States, other than skin cancer. It is the second leading cause of cancer death in women, after lung cancer.

The ACS says that about 182,460 women in the United States will be found to have invasive breast cancer in 2008. About 40,480 women will die from the disease this year. Right now there are about two and a half million breast cancer survivors in the United States. The chance of a woman having invasive breast cancer some time during her life is about 1 in 8. The chance of dying from breast cancer is about 1 in 35. Breast cancer death rates are going down. This is probably the result of finding the cancer earlier and improved treatment.

One of the keys to early detection and treatment is a mammogram, an x-ray of the breast. A screening mammogram is for women who do not appear to have breast problems. Women who have symptoms, such as a lump, skin change or nipple discharge, will have what's called a diagnostic mammogram. About 1 in 10 women who get a mammogram will need more pictures taken. But most of these women do not have breast cancer. Only 2 to 4 of every 1,000 mammograms leads to a diagnosis of cancer.

Although the use of x-rays to examine the breast was first introduced more than 90 years ago, modern mammography has only existed since 1969, when the first dedicated x-ray machines used just for breast imaging became available. Since then, the technology has advanced a great deal, so that today's mammogram is very different even from those of the mid-1980s.

Imaging technology, of course, is playing a major, ongoing role. A recent study, published in the on-line version of the American Journal of Roentgenology, the scientific journal of the American Roentgen Ray Society, compared computer-aided detection (CAD) to double-reading without CAD. It compared recall rate, sensitivity, positive predictive value and cancer detection rate for each.

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