Direct radiography photon-counting systems detect more smaller breast cancers and DCIS, but also cause more recalls.
Direct radiography photon-counting systems provide higher detection rates of small invasive cancers and ductal carcinoma in situ (DCIS) than statewide screening with different digital technologies, according to a study published in the journal Radiology.
Researchers from Germany undertook a retrospective study of prospectively acquired data from a German mammography screening program from 2009 to 2010. The purpose was to determine the efficacy of direct radiography (DR) photon-counting systems in breast cancer screening.
A total of 13,312 women underwent scanning with the DR photon-counting system and 993,822 women underwent alternate digital screening examinations by either computed radiography mammography or DR. The researchers assessed cancer detection rate, recall rate and proportion of small invasive cancers and DCIS.
The findings showed that the cancer detection rate was higher with the photon-counting system:
DR photon counting
Statewide
Cancer detection rate
Patients
76/8,842
(0.76 percent)
3,108/527,194
(0.58 percent)
Recall rate
475/8,872
(5.4 percent)
17,656/527,194
3.3 percent
Detection of invasive cancers up to 10 mm
Patients, initial screening
40 percent
31.6 percent
Patients, subsequent screening
42 percent
32.5 percent
DCIS
Patients, subsequent screening
0.23 percent
0.12 percent
The researchers concluded that the DR photon-counting technique for breast cancer screening detected more small cancers than did other DR imaging, but also produced higher recall rates.
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