Dianne Georgian-Smith MD, Presenter: Nothing to Disclose

Elizabeth Ann Rafferty MD, Abstract Co-Author: Nothing to Disclose

Richard H. Moore AB, Abstract Co-Author: Nothing to Disclose

Janie M. Lee MD, Abstract Co-Author: Nothing to Disclose

Eren D. Yeh MD, Abstract Co-Author: Nothing to Disclose

Daniel Benjamin Kopans MD, Abstract Co-Author: Nothing to Disclose

Mary Staffa MD, Abstract Co-Author: Nothing to Disclose

Deborah A. Hall MD, Abstract Co-Author: Nothing to Disclose

Elkan F. Halpern PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

It is thought that one of the advantages of digital mammograms is that they can be obtained at lower doses without compromising image quality. We noted that noise levels were high using the default exposure values. We sought to determine how changes in kVp affected clinical image quality using spot magnification of calcifications from GE and Hologic full-field breast digital systems.

After obtaining IRB approval, we recruited 30 patients who presented diagnostically for evaluation of calcifications. Following informed consent, they agreed to undergo imaging using both standard (kVp’s 26-28) and low-noise techniques kVp >,= 35).A reader study was conducted using soft copy evaluation. Readers were blinded to image technique and were asked to determine on which views the calcifications was more conspicuous, better determined the extent and morphology, and if one view detected calcifications not apparent on the other.

In all of the cases, the readers commented on the marked reduction in noise in the high-dose images by greater conspicuity of the calcifications and extent more clearly defined. In general, the radiologists were more confident in their impressions on the high Kv images, whereas there were more instances of questionable calcifications vs. noise artifact on the standard images.

Although the dose is higher with the higher kVp technique, there is a dramatic increase in the ability to visualize calcifications using this modified technical factor. The clinical risks and history of a given patient may outweigh the risks involved with dose exposure. Radiologists, using digital imaging, now have the ability and choice to vary dose to expedite clinical decision making. Further studies are planned to evaluate the clinical usefulness of higher kVp magnification views (at least 35 kVp or higher) to offset the inherent noise that is present at the current standard technical parameters. We believe that this will result in improved sensitivity and the earlier detection of suspicious calcifications, and possibly the improved specificity by more accurate morphologic analysis of calcifications

Georgian-Smith, D, Rafferty, E, Moore, R, Lee, J, Yeh, E, Kopans, D, Staffa, M, Hall, D, Halpern, E, et al, , Clinical Evaluation Microcalcifications Using Low-noise, High Kv Digital Magnification.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4411503.html