title: Image quality of digital direct flat-panel mammography versus an indirect small-field CCD technique using a high-contrast phantom.
abstract: 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).
  
  
  METHODS
  Randomly distributed silica beads (diameter 100-1400 μm) 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 μm 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 μm in diameter. The greatest agreement with the gold standard was observed for beads >400 μm in diameter across all methods.
  
  
  CONCLUSIONS
  Stereotactic spot images taken by 1024 matrix CCD technique are diagnostically equivalent to direct digital flat-panel mammograms for visualizing simulated microcalcifications >400 μm in diameter.
authors.affiliation: Department of Radiology, Medical School, University of Cologne, Kerpenerstraße 62, 50924 Cologne, Germany. barbara.krug@uk-koeln.de
authors.forename: Kathrin Barbara
authors.initials: KB
authors.lastname: Krug
authors.forename: Hartmut
authors.initials: H
authors.lastname: Stützer
authors.forename: Peter
authors.initials: P
authors.lastname: Frommolt
authors.forename: Julia
authors.initials: J
authors.lastname: Boecker
authors.forename: Henning
authors.initials: H
authors.lastname: Bovenschulte
authors.forename: Volker
authors.initials: V
authors.lastname: Sendler
authors.forename: Klaus
authors.initials: K
authors.lastname: Lackner