This book offers a single publication to be utilised comprehensively as a reference manual within current mammographic clinical practice for use by assistant practitioners and practitioners as well as trainees in radiography and related disciplines. In recent years mammographic clinical practice and technology have evolved rapidly and become increasingly sophisticated, this book will cover these issues. The public feel increasingly empowered to ‘have a say’ in their care and expectations of their mammography experience is high. Consequently a well-trained, well-informed practitioner is of paramount importance in clinical practice today. This book addresses patient/client-related issues in the form of psychological and emotional support they may require. This will enable the reader to gain insight into the patient/client perspective and thereby assist in meeting their needs.

Digital Radiography has been ? rmly established in diagnostic radiology during the last decade. Because of the special requirements of high contrast and spatial resolution needed for roentgen mammography, it took some more time to develop digital m- mography as a routine radiological tool. Recent technological progress in detector and screen design as well as increased ex- rience with computer applications for image processing have now enabled Digital Mammography to become a mature modality that opens new perspectives for the diag- sis of breast diseases. The editors of this timely new volume Prof. Dr. U. Bick and Dr. F. Diekmann, both well-known international leaders in breast imaging, have for many years been very active in the frontiers of theoretical and translational clinical research, needed to bring digital mammography ? nally into the sphere of daily clinical radiology. I am very much indebted to the editors as well as to the other internationally rec- nized experts in the ? eld for their outstanding state of the art contributions to this v- ume. It is indeed an excellent handbook that covers in depth all aspects of Digital Mammography and thus further enriches our book series Medical Radiology. The highly informative text as well as the numerous well-chosen superb illustrations will enable certi? ed radiologists as well as radiologists in training to deepen their knowledge in modern breast imaging.

Bogen er en grundlæggende lærebog om digital mammografi, hvori digital mammografi og traditionel mammografi også sammenlignes i forhold til screening, diagnoser og radiografisk billedteknik. Der er en komplet billedsamling af cases indenfor digital mammografi.

In June 1998 the Fourth International Workshop on Digital Mammography was held in Nijmegen, The Netherlands, where it was hosted by the department of Radiology of the University Hospital Nijmegen. This series of meetings was initiated at the 1993 SPIE Biomedical Image Processing Conference in San Jose, USA, where a number of sessions were entirely devoted to mammographic image analysis. At very successful subsequent workshops held in York, UK (1994) and Chicago, USA (1996), the scope of the conference was broadened, establishing a platform for presentation and discussion of new developments in digital mammog raphy. Topics that are addressed at these meetings are computer-aided diagnosis, image processing, detector development, system design, observer performance and clinical evaluation. The goal is to bring researchers from universities, breast cancer experts, and engineers together, to exchange information and present new scientific developments in this rapidly evolving field. This book contains all the scientific papers and posters presented at the work shop in Nijmegen. Contributions came from as many as 20 different countries and 190 participants attended the meeting. At a technical exhibit companies demon strated new products and work in progress. Abstracts of all papers were reviewed by members of the scientific committee. Many of the accepted papers had excellent quality, but due to limited space not all of them could be included as full papers in these proceedings. Papers that were rated high by the reviewers are included as long or short papers, others appear as extended abstracts in the last chapter.

ThisbookcomprisesthescientificproceedingsoftheInternationalWorkshop onDigitalMammography(IWDM),heldinBremen,Germany,fromJune22 toJune25,2002. Sinceitsinceptionin1992,IWDMhasgrownintotheIn­ ternationalForumonDigitalMammography. TheuniquenessofIWDMisits attractivenesstoresearchers,medicalpractitioners,andindustrialdevelopers. F6rmerworkshopswereheldinSanJose,USA(1992),York,UK(1994), Chicago,USA(1996),Nijmegen,NL(1998),andToronto,Canada(2000). Each ofthesescientificeventshasbeencombinedwithverysuccessfulandfocused industrialandresearchexhibits,whichdemonstratedthemilestonesofdigital mammographyhard-andsoftware. Now,thatdigitalmammographyisenteringroutineclinicaluse,wewitness itsstrongimpactonscreeninganddiagnosticmammography,computeraided detection,minimallyinvasiveprocedures,andthedevelopmentofsystemicand integrateddisease-orientedbreastcare. Inviewofthis,the2002workshoppro­ videdawindowtogiveusaglanceatthefuture,andtheworkwhichwas presentedintalks,postersandexhibitshasdemonstratedthatIWDM2002will takeaspecialplaceintheverysuccessfulsequenceofIWDMevents. Finally,asconferencechair,Iwouldliketothankallwhohavehelpedtopre­ pareandrunIWDM2002:theScientificAdvisoryBoardforitsexcellentworkin guaranteeingscientificsignificance,theOrganizationalBoardforitshardworkto accomplishanappropriateframeworkfortheevent,andtheindustrialexhibitors andsponsorsfortheirgeneroussupport. Bremen,January2003 Heinz-Otto Peitgen ConferenceChair ProfessorofMathematicsand BiomedicalSciences VI Scientific Committee SusanAstley UniversityofManchester,UK UlrichBick CharitBerlin,Germany/UniversityofChicago,USA MichaelBrady OxfordUniversity,UK HiroshiFujita GifuUniversity,Japan MaryellenGiger UniversityofChicago,USA NicoKarssemeijer UniversityHospitalNijmegen,TheNetherlands Heinz-OttoPeitgenUniversityofBremen,Germany EttaD. Pisano UniversityofNorthCarolina,USA MartinYaffe UniversityofToronto,Canada IWDM 2002 was supported by (MeViS SIEMENS BreastCare medical I'' General Electric ARC-0 Fllmle. . Perfection for DI I JMammography Table of Contents Imaging Systems and Detectors. . . . . . . . . . . . . . . . . . . . . . . . . . . 1 DigitalMammographicApplicationofaSinglePhotonCountingPixel Detector. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Amendolia SR, Bisogni MG, Delogu P, Fantacci ME, Novelli M, Quattrocchi M, Rosso V, Stefanini A, Zucca S BreastCancerScreeningUsingaDedicatedBreastCTScanner:A FeasibilityStudy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Boone JM, Lindfors KK, Seibert JA, Nelson TR PhysicalEvaluationofaPrototypefortheSectraMicrodose MammographySystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Lundqvist M, Bergstrom D, Cederstrom B, Chmill V, Chuntonov A, Danielsson M, Aslund M DoseMeasurementsonaScanningMulti-slitDigitalMammography System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Hansson B, Cederstrom B, Danielsson M, Aslund M DigitalMammographyvs. toScreen-FilmMammography:aPhantom Study. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Heid P, PagliuchiC, Seradour B, Motte N, Langlois L, Kurkdjian S, Piana L MammographyTaxonomyforImprovementofLesionDetectionRates. . . 27 Howard D, Roberts SC, Tabar L AHighResolution(25 p. m)HybridSelenium/CCDSlotScanDetector forDigitalMammography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Hunter DM, De CrescenzoG, Mainprize JG, Mawdsley GE, SmithC, Kasap SO, Rowlands JAR, Tumer T, Yin S, Yaffe MJ Co-registeredBreastImagingwith3DX-Raysand3DUltrasound. . . . . . 38 Kapur A, Eberhard JW, Abdalmajeid AM, Thomenius K ImagingCharacteristicsofaDirectConversionFull-FieldDigital MammographyDetectorusingSelenium. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Lee DL, Yorker lG, ling Z, leromin LS SimultaneousAcquisitionofDiffraction,ScatteringandPhase-Contrast ImagesbyMeansofaMulti-LayerEdge-OnMicrostripDetector 48 Olivo A, Arfelli P, Bergamaschi A, Dreossi D, Longo R, Menk RH, Montanari F, Pani S, Poropat P, Rigon L, Vallazza E, Castelli E VIII FullFieldDigitalMammographywithaCCDBasedSlot-Scanned Detector. PhysicalCharacteristicsMeasurements. . . . . . . . . . . . . . . . . . . . . .

Each year more than 180,000 new cases of breast cancer are diagnosed in women in the U.S. If cancer is detected when small and local, treatment options are less dangerous, intrusive, and costly-and more likely to lead to a cure. Yet those simple facts belie the complexity of developing and disseminating acceptable techniques for breast cancer diagnosis. Even the most exciting new technologies remain clouded with uncertainty. Mammography and Beyond provides a comprehensive and up-to-date perspective on the state of breast cancer screening and diagnosis and recommends steps for developing the most reliable breast cancer detection methods possible. This book reviews the dramatic expansion of breast cancer awareness and screening, examining the capabilities and limitations of current and emerging technologies for breast cancer detection and their effectiveness at actually reducing deaths. The committee discusses issues including national policy toward breast cancer detection, roles of public and private agencies, problems in determining the success of a technique, availability of detection methods to specific populations of women, women's experience during the detection process, cost-benefit analyses, and more. Examining current practices and specifying research and other needs, Mammography and Beyond will be an indispensable resource to policy makers, public health officials, medical practitioners, researchers, women's health advocates, and concerned women and their families.

This book offers a comprehensive, practical resource entirely devoted to Contrast-Enhanced Digital Mammography (CEDM), a state-of-the-art technique that has emerged as a valuable addition to conventional imaging modalities in the detection of primary and recurrent breast cancer, and as an important preoperative staging tool for women with breast cancer. CEDM is a relatively new breast imaging technique based on dual energy acquisition, combining mammography with iodine-based contrast agents to display contrast uptake in breast lesions. It improves the sensitivity and specificity of breast cancer detection by providing higher foci to breast-gland contrast and better lesion delineation than digital mammography. Preliminary results suggest that CEDM is comparable to breast MRI for evaluating the extent and size of lesions and detecting multifocal lesions, and thus has the potential to become a readily available, fast and cost-effective examination. With a focus on the basic imaging principles of CEDM, this book takes a practical approach to breast imaging. Drawing on the editors’ and authors’ practical experience, it guides the reader through the basics of CEDM, making it especially accessible for beginners. By presenting the key aspects of CEDM in a straightforward manner and supported by clear images, the book represents a valuable guide for all practicing radiologists, in particular those who perform breast imaging and have recently incorporated or plan to incorporate CEDM into their diagnostic arsenal.