title: Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme.
abstract: OBJECTIVE
  To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM).
  
  
  METHODS
  Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme.
  
  
  RESULTS
  Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30% in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR.
  
  
  CONCLUSIONS
  No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR.
  
  
  CONCLUSIONS
  • Performance parameters showed no major differences after digitalisation to CR or DR. • Transition from SFM to CR results in a higher mean glandular dose. • Transition from SFM to DR results in a lower mean glandular dose.
authors.affiliation: Department of Basic Medical Sciences, QCC-Gent, Ghent University, Ghent, Belgium, Lore.Timmermans@UGent.be.
authors.forename: Lore
authors.initials: L
authors.lastname: Timmermans
authors.forename: An
authors.initials: A
authors.lastname: De Hauwere
authors.forename: Klaus
authors.initials: K
authors.lastname: Bacher
authors.forename: Hilde
authors.initials: H
authors.lastname: Bosmans
authors.forename: Kim
authors.initials: K
authors.lastname: Lemmens
authors.forename: Luc
authors.initials: L
authors.lastname: Bleyen
authors.forename: Erik
authors.initials: E
authors.lastname: Van Limbergen
authors.forename: Patrick
authors.initials: P
authors.lastname: Martens
authors.forename: Andre
authors.initials: A
authors.lastname: Van Steen
authors.forename: Griet
authors.initials: G
authors.lastname: Mortier
authors.forename: Koen
authors.initials: K
authors.lastname: Van Herck
authors.forename: Hubert
authors.initials: H
authors.lastname: Thierens
mesh_terms: D000368:Aged; D001530:Belgium; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015397:Program Evaluation; D011856:Radiographic Image Enhancement / Q000379:methods*; D011874:Radiometry; D015203:Reproducibility of Results; D012189:Retrospective Studies