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Dr. Vigeland is particularly impressed with the Selenia system’s ability to visualize microcalcifications. “For microcalcifications, digital is clearly superior to analog.” The center receives analog images from many referrers, enabling an easy comparison with digitally captured pictures. “We cannot see anything on film better than we can with digital,” he said.

In August 2007, Dr. Vigeland and his colleagues published the results of their analysis of cancer detection and recall rates for 18,239 women screened with their Selenia systems to the results of 324,763 women screened with film elsewhere in Norway in European Radiology.

While prior studies have compared the performance of digital mammography to screen-film in high volume screening, until this study, few researchers had looked at the performance of this specific digital mammography technology exclusively. The detector characteristics and way the various digital mammography systems operate is considerably different. The pixel size of the system studied, the Hologic Selenia system, is smaller, the system uses direct capture (selenium) technology, and the image-processing algorithms are unique, resulting in a sharp, high contrast image.

The researchers found that the detection rate for ductal carcinoma in situ (DCIS) and the positive predictive value for cancer (PPV) were statistically significantly higher and the technical recall rate was statistically lower for Selenia over film.

Image quality and dose aside, image archival and presentation are less labor intensive with the digital systems. The one or two medical professionals who used to hang images on light boxes can now concentrate their efforts on other crucial duties. In fact, the entire system runs more smoothly when the light box shortage inherent to analog systems in busy departments is circumvented. “Overall,” Dr. Vigeland said, “the digital systems enable radiologists to make a more flexible use of their time.”

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