RESUMEN
Modulation transfer functions (MTFs) and test object radiographs were used to study the effect of geometric and recording system unsharpness in mammography with the CGR Senographe x-ray unit. Results show that geometric unsharpness can be a significant factor in the detection of microcalcifications within the breast, depending on the size and shape of the focal spot, the focal spot-to-recording system distance, and the object-to-recording system distance (o.r.d.). A new recording system for mammography, the DuPont Lo-dose system, requires approximately 1/15th the exposure of a direct x-ray film, such as Kodak RP/M, to provide mammograms with comparable photographic density. With the Lo-dose system, geometric unsharpness can be reduced by use of a specially designed long cone with an increased focal spot-to-recording system distance. This cannot be accomplished with direct x-ray films because the x-ray unit is operating at near-maximum output conditions even when short cones are used. Although direct x-ray films have a higher resolution than the Lo-dose system, at certain o.r.d.s total resolution is found to be affected more significantly by geometric unsharpness than by the Lo-dose recording system. In several cases, clinical results show improved detection of microcalcifications at larger o.r.d.s by the Lo-dose system with a long one, combined with a reduction by a factor of 15 in patient exposure.