mammography- related to imaging technology.pptx

This ppt is related to mammography.

1. Mammography

2. A mammogram is an x-ray picture of the breasts. It is used to find tumors and to help tell the difference between non-cancerous ( benign ) and cancerous (malignant) disease. Mammography uses low dose x-ray; high contrast, high-resolution film; and an x-ray system designed specifically for imaging the breasts.

3. Early detection of breast cancers. To help the radiologist or surgeon guide the needle to the correct area in the breast during biopsy.

4. Basic Physics of Mammography: X-ray images depend on differences in x-ray stopping power (attenuation) to separate tissues. In general, a clear separation between normal functioning tissue, and abnormal cancerous tissues is not possible since their attenuation is very similar. However both functional tissue and cancer can be separated from fatty storage tissues which normally surround active breast tissue, even in lean persons. This is due to a substantially lower attenuation caused by fat. In older women, the functional glandular tissue diminishes, leaving only thin supporting tissues clearly outlined by fatty tissues. Mammography in these "mature" breasts is very effective, since even small cancers are well outlined by fat. In addition, many cancers develop calcium deposits which strongly stop X-rays and are easily seen on mammograms.

5. Dedicated mammography equipment consists of: Generator Xray tube Automatic exposure control Secondary radiation grid Compression Film screen comination processing

6. Basic Limitations of Mammography: Since mammography cannot separate normal gland tissue from tumors, it is much more effective when gland tissue diminishes with age. Many women retain glandular tissue as they "mature", and it camouflages tumors until they are large. As you might expect, the young women's breast normally contains more active tissue, which again interferes with detection of small cancers.

7. Types of Mammography Screening Diagnostic Ductgram/Galactogram (imaging the breast ducts)

8. Screening mammography Screening mammography is an x-ray examination of the breasts in a woman who is asymptomatic (has no complaints or symptoms of breast cancer). The goal of screening mammography is to detect cancer when it is still too small to be felt by a woman or her physician. Early detection of small breast cancers by screening mammography greatly improves a woman's chances for successful treatment. Screening mammography is recommended every one to two years for women once they reach 40 years of age and every year once they reach 50 years of age . In some instances, physicians may recommend beginning screening mammography before age 40 (i.e. if the woman has a strong family history of breast cancer).

9. Diagnostic mammography Diagnostic mammography is an x-ray examination of the breast in a woman who either has a breast complaint (for example, a breast lump or nipple discharge is found during self-exam ) or has had an abnormality found during screening mammography. It is more involved and time-consuming than screening mammography and is used to determine exact size and location of breast abnormalities and to image the surrounding tissue and lymph nodes. Typically, several additional views of the breast are imaged and interpreted during diagnostic mammography. Thus, diagnostic mammography is more expensive than screening mammography.

10. Mammography equipment

11. How is Mammography Performed? During mammography, the technologist will position the patient and image each breast separately. One at a time, each breast is carefully positioned on a special film cassette and then gently compressed with a paddle (often made of clear Plexiglas or other plastic). This compression flattens the breast so that the maximum amount of tissue can be imaged and examined.

12. Cont… At some facilities, mammography technologists may place adhesive markers to the breast skin prior to taking images of the breast. The purpose of the adhesive markers is twofold: first , to identify areas with moles, blemishes or scars so that they are not mistaken for abnormalities, and secondly, to identify areas that may be of concern (e.g. a lump was felt during physical examination). Some centers routinely mark the nipple with a small dot to provide a clear "landmark" for the radiologist on the mammogram images.

13. Breast compression is necessary in order to: Even out the breast thickness so that all of the tissue can be visualized. Spread out the tissue so that small abnormalities are less likely to be obscured by overlying breast tissue. Allow the use of a lower x-ray dose since a thinner amount of breast tissue is being imaged. Hold the breast still in order to minimize blurring of the image caused by motion. Reduce x-ray scatter to increase sharpness of picture.

14. Mammo app of normal breast Different tissues in the breast absorb different amounts of x-rays, producing different shades of black, gray, and white on the film: Fatty tissue absorbs a small amount of x-rays and appears black or dark gray. Normal fibrous and glandular tissues (milk glands, lymph nodes) contain water fluid and absorb a moderate amount of x-rays, and appear light gray. Fibrous and glandular tissues may contain calcium and appear nearly white or white.

15. Breast comp & mammo app..

16. Mammographic views Standard views Supplemental views

17. Standard views CC (cranio-caudal) view MLO (medio-lateral oblique) view

18. Supplemental Views Lateromedial, LM: Mediolateral view, ML Exaggerated cranial-caudal, Magnification views, Spot compression view