ABSTRACT
AIM: To investigate the effect of image processing on cancer detection in mammography. METHODS AND MATERIALS: An observer study was performed using 349 digital mammography images of women with normal breasts, calcification clusters, or soft-tissue lesions including 191 subtle cancers. Images underwent two types of processing: FlavourA (standard) and FlavourB (added enhancement). Six observers located features in the breast they suspected to be cancerous (4,188 observations). Data were analysed using jackknife alternative free-response receiver operating characteristic (JAFROC) analysis. Characteristics of the cancers detected with each image processing type were investigated. RESULTS: For calcifications, the JAFROC figure of merit (FOM) was equal to 0.86 for both types of image processing. For soft-tissue lesions, the JAFROC FOM were better for FlavourA (0.81) than FlavourB (0.78); this difference was significant (p=0.001). Using FlavourA a greater number of cancers of all grades and sizes were detected than with FlavourB. FlavourA improved soft-tissue lesion detection in denser breasts (p=0.04 when volumetric density was over 7.5%) CONCLUSIONS: The detection of malignant soft-tissue lesions (which were primarily invasive) was significantly better with FlavourA than FlavourB image processing. This is despite FlavourB having a higher contrast appearance often preferred by radiologists. It is important that clinical choice of image processing is based on objective measures.
Subject(s)
Breast Neoplasms/diagnostic imaging , Calcinosis/diagnostic imaging , Diagnostic Errors , Mammography/methods , Radiographic Image Interpretation, Computer-Assisted/methods , Aged , Breast Neoplasms/pathology , Calcinosis/pathology , Female , Humans , Middle AgedABSTRACT
Use of ceiling-mounted radiographic equipment in an emergency room for management of the multiply injured patient is described. The protocol of the Advanced Trauma and Life Support manual is followed and three plain radiographs (lateral cervical spine, anteroposterior views of the chest and pelvis) are obtained by the radiographers, who are members of the trauma team. Abnormalities were diagnosed on 7 per cent of the cervical radiographs, 31 per cent of the chest and 28 per cent of the pelvis in 108 patients during the first year of use. With full integration of the radiographers into the trauma team these three initial films are obtained within 10 min. Subsequent films can be taken of skeletal injuries found clinically or incidentally on the first three plain radiographs. It is recommended that all emergency rooms should have a ceiling-mounted radiographic unit with an automatic daylight processor to provide the best service for patients with major trauma.
Subject(s)
Emergency Service, Hospital , Multiple Trauma/therapy , Radiography/instrumentation , Trauma Centers , Cervical Vertebrae/diagnostic imaging , Humans , Pelvis/diagnostic imaging , Radiography, Thoracic/instrumentation , Tomography, X-Ray Computed/instrumentationABSTRACT
We report the details of a young woman in whom pericardial tamponade developed acutely following preparation for allogeneic bone marrow transplantation for acute lymphoblastic leukaemia. The aetiology of the effusion, though uncertain, probably relates to the cumulative cardiotoxicity of cyclophosphamide and irradiation upon a myocardium previously sensitised by anthracycline therapy. As the number of transplant procedures increases, this complication may become more common, and might be avoided by a more critical assessment of cardiac function prior to transplantation, with radionuclide angiography.
