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International Journal of Breast Cancer
Volume 2011, Article ID 701054, 9 pages
Research Article

Image Quality of Digital Direct Flat-Panel Mammography Versus an Indirect Small-Field CCD Technique Using a High-Contrast Phantom

1Department of Radiology, Medical School, University of Cologne, Kerpenerstraße 62, 50924 Cologne, Germany
2Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, 50931 Cologne, Germany
3Testing Office for Radiation Protection, Deisterstraße 9, 30974 Wennigsen, Germany

Received 23 May 2010; Revised 1 August 2010; Accepted 11 August 2010

Academic Editor: Owen A. Ung

Copyright © 2011 Kathrin Barbara Krug et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To compare the detection of microcalcifications on mammograms of an anthropomorphic breast phantom acquired by a direct digital flat-panel detector mammography system (FPM) versus a stereotactic breast biopsy system utilizing CCD (charge-coupled device) technology with either a 1024 or 512 acquisition matrix (1024 CCD and 512 CCD). Materials and Methods. Randomly distributed silica beads (diameter 100–1400  𝜇 m) and anthropomorphic scatter bodies were applied to 48 transparent films. The test specimens were radiographed on a direct digital FPM and by the indirect 1024 CCD and 512 CCD techniques. Four radiologists rated the monitor-displayed images independently of each other in random order. Results. The rate of correct positive readings for the “number of detectable microcalcifications” for silica beads of 100–199  𝜇 m in diameter was 54.2%, 50.0% and 45.8% by FPM, 1024 CCD and 512 CCD, respectively. The inter-rater variability was most pronounced for silica beads of 100–199  𝜇 m in diameter. The greatest agreement with the gold standard was observed for beads > 400  𝜇 m in diameter across all methods. Conclusion. Stereotactic spot images taken by 1024 matrix CCD technique are diagnostically equivalent to direct digital flat-panel mammograms for visualizing simulated microcalcifications > 400  𝜇 m in diameter.