Safe and sound: Full-field digital mammography, Low-dose screening
Every year in Germany alone 48,000 women are diagnosed with breast cancer. Therefore, the German government and the health funds have initiated a screening programme for women between 50 and 69 years. They are entitled to a breast exam – free of charge – every two years. The objective of this programme is to detect breast tumors before they have reached a critical size. In her Frankfurt-based screening unit Professor Jutta Peters offers her patients state-of-the-art technology which generates high quality images with low radiation exposure. Full-field digital mammography systems by Sectra mean more safety for the women.
Only the counter in the reception area of the breast centre at Opernplatz in Frankfurt indicates that this is a medical facility. The welcoming design of the lounge, sophisticated lighting, warm colours and elegant lines – they all say “home” rather than “doctor’s office”. Nothing in this pleasant atmosphere hints at the fact that this one the most
modern and best equipped mammography screening centres in Germany.
Professor Jutta Peters has scheduled up to 150 women per day for her two fullfield
mammo screening systems. “We consciously opted for the MicroDose mammography systems by Sectra since screening means that women without previous diagnosis are being x-rayed. In our opinion, women are entitled to be examined with devices that ensure lowest possible radiation exposure“, says Professor Peters. The participation rate in her catchment area is well above 70 percent, on peak days it reaches even 90 percent.
Every photon is being counted
Unlike other systems the innovative detector by the Swedish company Sectra converts x-rays directly into digital electronic signals. The complicated process of converting photons into light and light via a scintillator into analogue electric signals can be bypassed.
Every single photon is turned into a pixel. This technology enables Sectra’s MicroDose mammography system to apply the lowest possible radiation dose of all available mammography devices. A total of nine physicians are available to interpret the images generated on seven identically equipped Sectra mammography workstations.
Professor Peters designed the breast centre from the very beginning with the idea in mind to avoid potential sources of error. Thus the radiologist took great care to ensure that every physician can rely on an identical work environment, no matter which workstation he or she is using: “Identical diagnostic workstations contribute to high quality. Every colleague will be instantly familiar with the work environment and decisions are made under identical circumstances.”
Not only the physicians but also the medical staff benefit from the modern work environment. The number of steps in the workflow has been substantially reduced in full-field digital mammography. Fetching cassettes, inserting the cassettes, developing the film, reading the film – all these things have become obsolete in the Frankfurt screening centre.
At the touch of a button all digital images with all imaging parameters can be viewed at the workstation. And very soon, Sectra will offer complete integration of the MASC software (MAmmographie SCreening). As soon as the first image has been completed, the device moves the entire tube-detector unit automatically by 90° into MLO position (medio-lateraloblique). This seemingly banal detail, however, is another unique selling point
of the Sectra system as it relieves the staff from the exhausting task of moving the device manually.
Professor Peters: “In the screening programme the assistants suffer from extreme physical and psychological stress. Therefore I consider providing optimal working conditions very important.”
Efficient workflows
In the near future Professor Peters will also be able to organize the multi-disciplinary conferences in an entirely new fashion. Currently, the physicians flock around a workstation with a high resolution 5 megapixel screen, but shortly a beamer will project the enlarged mammography images onto a wall. “Screening units have to use the same
technology for at least three years. Therefore state-of-the-art digital technology was the only way to go. Technological advances will come and I still want to be technologically up-to-date in three years time”, Profess Peters explains her futureoriented investment decision.
The diagnostic workstation can store RIS data and display them in a separate information window. The most important functions of the diagnostic workstation are only a keystroke away and the scroll ball offers additional flexibility. Thus the radiologist can effectively control the diagnostic process with one hand and a few mouse clicks. The workstation supports different user profiles with user-specific settings, digital dictation systems and computeraided detection (CAD) software. Both the archive and the workstations follow
Sectra’s open architecture philosophy and fully support DICOM, HL7, IHE and HIPAA.
Unique breastcentre
In Professor Peters’ fully digital screening unit mammography images are no longer printed. She provides images exclusively on CD. “Printing images is not compatible with a digital unit”, Professor Peters insists. For surgeons who base their interventions
on Professor Peters’ images, she marks the tumors in the digital files with bold arrows in all planes. The surgeons instantly know where to look for the tumor and can navigate the tissue easily during the procedure.
Professor Peters: “Full-field digital mammography offers several post-processing
options providing the physician with enhanced diagnostic safety.” The radiologist is also convinced that microcalcifications can be more easily detected in digital systems than on conventional films. On the workstation she can enlarge the images at any time or change
the contrast in order to visualize details that before literally remained in the dark. In Frankfurt this committed radiologist founded a competence centre which is unmatched throughout Germany: with four state-of-the-art digital systems that perform approximately 15,000 mammographies for about 7,500 patients this breast centre is a nation-wide leader in mamma-diagnostics. And most importantly: it offers thousands of women in Hesse more safety.
On September 1, 2011, Philips acquired the MicroDose operations from Sectra and hence all questions regarding photon-counting, low-dose mammography, MicroDose etc are referred to Philips. For more information on MicroDose Mammography or on the acquisition please go to www.philips.com/microdose
