Patient-Assisted Compression in Screening Mammography: Patient Experience and Image Quality

Abstract Objective Screening mammography is critical to reduce breast cancer mortality, yet many women cite pain from compression as a reason they avoid this test. We evaluated patient experience and image quality in screening patients opting for a handheld patient-assisted compression (PAC) device. Methods After institutional review board approval, women screened between February and July 2018 with a synthetic 2D/tomosynthesis mammography unit were offered use of a handheld PAC device. Patient experience through survey, image quality, compression thickness, compression force, and average glandular dose were evaluated and compared between women opting for PAC and women opting for technologist-controlled compression (TC). Multivariable ordinal logistic and linear regression models were estimated to control for age and breast density. In addition, for women opting for PAC, image quality obtained with their current PAC mammogram was compared with that obtained with their prior TC mammogram, by using Wilcoxon/Pearson tests. Results Seventy-three percent of women preferred their mammogram experience with PAC compared with their prior mammogram without PAC. Women using PAC reported decreased anxiety compared with those using TC, after controlling for age and breast density (adjusted odds ratio [aOR] 0.22 [95% confidence interval (CI): 0.09–0.49]). There were no significant differences in image quality, compression thickness, or average glandular dose in exams for women using PAC compared with exams for women using TC. Women using PAC had significantly more compression force than women using TC had (P = 0.012). Conclusions Mammography with PAC improves patient experience and results in similar image quality compared with mammography with TC.

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The relationship between compression force, image quality and radiation dose in mammography

South African Journal of Radiology ◽

10.4102/sajr.v13i4.486 ◽

2009 ◽

Vol 13 (4) ◽

pp. 86 ◽

Cited By ~ 5

Author(s):

A Korf ◽

C P Herbst ◽

W ID Rae

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Computed Radiography ◽

Compression Force ◽

Logarithmic Mean ◽

Allowable Limit ◽

Breast Compression ◽

Entrance Dose ◽

Average Glandular Dose ◽

The Relationship

Background. Mammography aims to obtain mammograms of best possible image quality with least possible radiation dose.1 Theoretically, an increase in breast compression gives a reduction in thickness, without changing the density, resulting in improved image quality and reduced radiation dose. Aim. This study aims to investigate the relationship between compression force, phantom thickness, image quality and radiation dose. The existence of a compression point beyond which increased compression gives a change in density rather than thickness is also considered. Method. Image quality is assessed with a contrast-detail phantom within Superflab phantom on a computed radiography (CR) mammography unit using automatic exposure control (AEC). Image quality is determined by visual inspection and image quality figure (IQF) scoring. The effect of compression and lesion depth on image quality is determined. Entrance and exit doses are calculated. The relationship between entrance dose, compression and thickness is investigated, as is the existence of a compression point beyond which a change in phantom density occurs. The average glandular dose (AGD) is calculated from the scanning average level (SAL) and logarithmic mean (LgM) according to Koen et al,2 and compared to the allowable limit. Results. The geometry effect was not observed. An improvement in image quality with increased compression was found. Entrance dose did decrease with increased compression. This trend was not observed with exit dose as AEC was used and exit dose was calculated from SAL values. The “change-in-density” point of compression was determined. Both LgM and SAL could be used successfully for AGD calculation.

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The Association of Mammography Environment and Image Quality

Journal of Breast Imaging ◽

10.1093/jbi/wbaa056 ◽

2020 ◽

Vol 2 (5) ◽

pp. 436-442

Author(s):

Shakira Sarquis-Kolber ◽

Kathy Schilling ◽

William J Hanney ◽

Morey J Kolber

Keyword(s):

Time Series ◽

Image Quality ◽

Interrupted Time Series ◽

Screening Mammography ◽

Compression Force ◽

Limits Of Agreement ◽

Improve Image Quality ◽

Series Design ◽

Interrupted Time Series Design ◽

Paired T Test

Abstract Objective This study sought to determine if a mammogram performed in a multi-sensory environmental upgraded room (UR) is associated with improved image quality when compared to a standard room (SR). Methods A retrospective analysis (interrupted time series design) of compression force and posterior nipple line (PNL) measurements was performed on 303 women (mean age 60.9 years) who underwent screening mammography for 2 consecutive years (year 1 in SR, year 2 in UR) at a single outpatient facility. Using the Picture Archiving Communication System (PACS), craniocaudal (CC) and mediolateral oblique (MLO) images for the two years were reviewed. The PNL was measured for the CC and MLO images bilaterally using the embedded tools in the PACS software. Posterior nipple line and compression force were analyzed using a paired t-test. Bland–Altman plots were used to obtain 95% limits of agreement (LOA) between the UR and SR. Results Image quality as determined by PNL measurement distance was greater in the UR (P < 0.001) when compared with the SR, with similar compression force (P ≥ 0.14). Mean PNL measurement differences ranged from 5.0 to 6.2 mm greater in the UR, whereas mean compression force differences ranged from -2.4 to 1.5 newtons. The 95% LOA suggest that PNL measurement differences between the UR and SR can vary by -11.0 to 27.0 mm. Conclusion Environmentally modifying mammography rooms may improve image quality with regard to PNL measurements without increasing compression force.

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A practical approach on non-regular sampling and universal demosaicing of raw image sensor data

London Imaging Meeting ◽

10.2352/issn.2694-118x.2020.lim-17 ◽

2020 ◽

Vol 2020 (1) ◽

pp. 91-95

Author(s):

Philipp Backes ◽

Jan Fröhlich

Keyword(s):

Image Quality ◽

Source Code ◽

Image Sensor ◽

Sensor Data ◽

Color Filter ◽

Lowpass Filter ◽

Sampling Errors ◽

Regular Sampling ◽

Single Sensor ◽

Similar Image Quality

Non-regular sampling is a well-known method to avoid aliasing in digital images. However, the vast majority of single sensor cameras use regular organized color filter arrays (CFAs), that require an optical-lowpass filter (OLPF) and sophisticated demosaicing algorithms to suppress sampling errors. In this paper a variety of non-regular sampling patterns are evaluated, and a new universal demosaicing algorithm based on the frequency selective reconstruction is presented. By simulating such sensors it is shown that images acquired with non-regular CFAs and no OLPF can lead to a similar image quality compared to their filtered and regular sampled counterparts. The MATLAB source code and results are available at: http://github. com/PhilippBackes/dFSR

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Faculty Opinions recommendation of Effect of screening mammography on breast-cancer mortality in Norway.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.5324957.5337058 ◽

2010 ◽

Author(s):

Susan Davis

Keyword(s):

Breast Cancer ◽

Cancer Mortality ◽

Breast Cancer Mortality ◽

Screening Mammography

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Impact on dose and image quality of a software-based scatter correction in mammography

Acta Radiologica ◽

10.1177/0284185117730100 ◽

2017 ◽

Vol 59 (6) ◽

pp. 649-656 ◽

Cited By ~ 1

Author(s):

Teresa Monserrat ◽

Elena Prieto ◽

Benigno Barbés ◽

Luis Pina ◽

Arlette Elizalde ◽

...

Keyword(s):

Image Quality ◽

Scatter Correction ◽

Inverse Image ◽

Clinical Image ◽

Air Kerma ◽

Average Glandular Dose ◽

Standard Mode ◽

Entrance Surface Air Kerma ◽

Clinical Cases

Background In 2014, Siemens developed a new software-based scatter correction (Progressive Reconstruction Intelligently Minimizing Exposure [PRIME]), enabling grid-less digital mammography. Purpose To compare doses and image quality between PRIME (grid-less) and standard (with anti-scatter grid) modes. Material and Methods Contrast-to-noise ratio (CNR) was measured for various polymethylmethacrylate (PMMA) thicknesses and dose values provided by the mammograph were recorded. CDMAM phantom images were acquired for various PMMA thicknesses and inverse Image Quality Figure (IQFinv) was calculated. Values of incident entrance surface air kerma (ESAK) and average glandular dose (AGD) were obtained from the DICOM header for a total of 1088 pairs of clinical cases. Two experienced radiologists compared subjectively the image quality of a total of 149 pairs of clinical cases. Results CNR values were higher and doses were lower in PRIME mode for all thicknesses. IQFinv values in PRIME mode were lower for all thicknesses except for 40 mm of PMMA equivalent, in which IQFinv was slightly greater in PRIME mode. A mean reduction of 10% in ESAK and 12% in AGD in PRIME mode with respect to standard mode was obtained. The clinical image quality in PRIME and standard acquisitions resulted to be similar in most of the cases (84% for the first radiologist and 67% for the second one). Conclusion The use of PRIME software reduces, in average, the dose of radiation to the breast without affecting image quality. This reduction is greater for thinner and denser breasts.

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Image Quality of Screening Mammography

American Journal of Roentgenology ◽

10.2214/ajr.178.4.1780805 ◽

2002 ◽

Vol 178 (4) ◽

pp. 805-807 ◽

Cited By ~ 22

Author(s):

Stephen A. Feig

Keyword(s):

Image Quality ◽

Screening Mammography

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Enhancing Patient Experience With Internet Protocol Addressable Digital LED Lighting in Imaging Environments: A Phase I Study (Preprint)

10.2196/preprints.11839 ◽

2018 ◽

Author(s):

Melanie U Knopp ◽

Katherine Binzel ◽

Chadwick L Wright ◽

Jun Zhang ◽

Michael V Knopp

Keyword(s):

Image Quality ◽

Patient Experience ◽

Patient Comfort ◽

Patient Specific ◽

Diagnostic Image Quality ◽

Imaging Studies ◽

Diagnostic Image ◽

Clinical Imaging ◽

Ambient Lighting ◽

Led Lights

BACKGROUND Conventional approaches to improve the quality of clinical patient imaging studies focus predominantly on updating or replacing imaging equipment; however, it is often not considered that patients can also highly influence the diagnostic quality of clinical imaging studies. Patient-specific artifacts can limit the diagnostic image quality, especially when patients are uncomfortable, anxious, or agitated. Imaging facility or environmental conditions can also influence the patient’s comfort and willingness to participate in diagnostic imaging studies, especially when performed in visually unesthetic, anxiety-inducing, and technology-intensive imaging centers. When given the opportunity to change a single aspect of the environmental or imaging facility experience, patients feel much more in control of the otherwise unfamiliar and uncomfortable setting. Incorporating commercial, easily adaptable, ambient lighting products within clinical imaging environments allows patients to individually customize their environment for a more personalized and comfortable experience. OBJECTIVE The aim of this pilot study was to use a customizable colored light-emitting diode (LED) lighting system within a clinical imaging environment and demonstrate the feasibility and initial findings of enabling healthy subjects to customize the ambient lighting and color. Improving the patient experience within clinical imaging environments with patient-preferred ambient lighting and color may improve overall patient comfort, compliance, and participation in the imaging study and indirectly contribute to improving diagnostic image quality. METHODS We installed consumer-based internet protocol addressable LED lights using the ZigBee standard in different PET/CT scan rooms within a clinical imaging environment. We recruited healthy volunteers (n=35) to generate pilot data in order to develop a subsequent clinical trial. The visual perception assessment procedure utilized questionnaires with preprogrammed light/color settings and further assessed how subjects preferred ambient light and color within a clinical imaging setting. RESULTS Technical implementation using programmable LED lights was performed without any hardware or electrical modifications to the existing clinical imaging environment. Subject testing revealed substantial variabilities in color perception; however, clear trends in subject color preference were noted. In terms of the color hue of the imaging environment, 43% (15/35) found blue and 31% (11/35) found yellow to be the most relaxing. Conversely, 69% (24/35) found red, 17% (6/35) found yellow, and 11% (4/35) found green to be the least relaxing. CONCLUSIONS With the majority of subjects indicating that colored lighting within a clinical imaging environment would contribute to an improved patient experience, we predict that enabling patients to customize environmental factors like lighting and color to individual preferences will improve patient comfort and patient satisfaction. Improved patient comfort in clinical imaging environments may also help to minimize patient-specific imaging artifacts that can otherwise limit diagnostic image quality. CLINICALTRIAL ClinicalTrials.gov NCT03456895; https://clinicaltrials.gov/ct2/show/NCT03456895

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