Full-field digital mammography: A phantom study for the detectability of simulated microcalcifications.

Objectives: The study compares direct full-field digital mammography (FFDM) to the state-of-the-art conventional screen-film mammography (SFM) concerning the detectability of simulated microcalcifications. Materials and Methods: The investigations were performed with a FFDM system (Senographe 2000D, GEMS) and a SFM system (Senographe DMR, GEMS, Fuji UM MA film with Fuji UM MAMMO FINE screen). An anthropomorphic breast phantom with superimposed microcalcifications (50-200 mu m) was used to evaluate the detectability of microcalcifications with a confidence level ranging from 1 to 5. Contact mammograms and magnification spot views (m = 1.8) of the FFDM and SFM systems were compared. A receiver operating characteristic (ROC) analysis was performed by three well-experienced readers. Results: The ROC analysis revealed a higher performance of the digital images compared to the conventional screen-film mammograms. The area under the ROC-curve (AZ) in the digital contact mammograms was 0.68 versus 0.63 in the conventional technique. The results were not significantly different. In digital spot views, A(Z) was 0.79 versus 0.70 in the conventional spot views. Conclusions: The results suggest that FFDM is at least equivalent or - as far as spot views are concerned - may be superior to conventional SFM in the detection of microcalcifications.