Comparison of Image Acquisition and Radiologist Interpretation Times in a Diagnostic Mammography Center

Rationale and Objectives

The purpose of this study was to determine the acquisition and interpretation times of screen-film mammography and soft-copy digital mammography in a diagnostic mammography center.

Materials and Methods

The study was conducted in three phases for patients presenting for clinical diagnostic workup to a mammography clinic. In the first phase, technologist acquisition and processing times and radiologist interpretation time were measured for patients imaged with a screen-film mammographic system. During the second phase of the study, times were measured for patients imaged with a direct radiographic digital mammographic system, with interpretation performed on a soft-copy display system. During the third phase, 3 months after installation of the soft-copy display system, times were measured again for patients imaged on the same direct radiographic digital mammographic system, with interpretation with the same soft-copy system. The same four experienced breast imaging radiologists and seven technologists participated in all phases of the study. All data were entered into a database, and statistical analysis was conducted using weighted linear models and logarithmic transformation.

Results

Times were obtained for 295 patients. There were 100 patients each for phases 1 and 2 and 95 patients for phase 3. Diagnostic mammographic acquisition times with processing were 13.02 min/case for screen film (phase 1), 8.16 min/case for digital (phase 2), and 10.66 min/case for digital (phase 3) ( P < .001 and P < .0001, respectively). In addition, the radiologist interpretation time for digital mammography in both phases was not significantly different from that for film mammography ( P = .2853 and P = .2893, respectively). There was no significant difference between phases 2 and 3 ( P = 1.0000). The mean interpretation times were 3.75 min/case for screen film, 2.14 min/case for digital (phase 2), and 2.26 min/case for digital (phase 3).

Conclusions

Digital mammography significantly shortened the acquisition time for diagnostic mammography. There was no significant difference in interpretation time compared to screen-film mammography in a diagnostic mammography setting.

Full-field digital mammography (FFDM) continues to increase in clinical use in the United States since its US Food and Drug Administration approval in 2000. As of December 2009, approximately 53% of US mammography facilities had one or more full-field digital mammographic units . This is a significant increase from 2005, when approximately 7% of US facilities used digital units .

For mammography centers that are currently considering whether to convert to FFDM, the initial impact on work flow continues to be a concern. FFDM offers the advantages of decoupling image acquisition, display, and storage , in addition to the elimination of wet chemical processing over screen-film mammography (SFM). The latter was the primary reason that led to a decrease in the acquisition time of FFDM compared to SFM in a screening mammography setting, as reported by Berns et al . However, they also reported an increase in interpretation time with FFDM .

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Materials and methods

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Results

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Table 1

Reason for Diagnostic Mammography for Each Phase

Reason for Diagnostic Mammography Phase 1: SFM Phase 2: FFDM Phase 3: FFDM Total cases 100 100 95 Callback 18 (18.0%) 15 (15.0%) 13 (13.7%) Physical finding 39 (39.0%) 35 (35.0%) 41 (43.2%) Lumpectomy 22 (22.0%) 24 (24.0%) 25 (26.3%) Mastectomy 8 (8.0%) 9 (9.0%) 7 (7.4%) High risk 5 (5.0%) 7 (7.0%) 5 (5.2%) 6-mo follow-up 8 (8.0%) 10 (10.0%) 4 (4.2%)