Screen-film versus full-field digital mammography: Radiation dose and image quality in a large teaching hospital

The objective of this paper is to measure the radiation dose and image quality in conventional screen-film mammography and full-field digital mammography in women referred to mammography examination. Participants underwent bilateral, two-view screen-film mammography or full-field digital mammography. The visibility of anatomical regions and overall clinical image quality was rated by experienced radiologists. Total of 387 women and 1548 mammograms were enrolled in the study. Image quality was assessed in terms of image quality score, whereas patient dose assessment was performed in terms of mean glandular dose. Average mean glandular dose for cranio-caudal projection was 1.5 mGy and 2.1 mGy in full-field digital mammography and screen-film mammography, respectively. For medio-lateral oblique projection, corresponding values were 2.3 and 2.1 mGy. Overall image quality criteria scoring was 0.82 and 0.99 for screen-film and digital systems, respectively. The scores were in the range from 0.11 to 1.0 for different anatomical structures. Overall, full-field digital mammography was superior both in terms of image quality and dose over the screen-film mammography. The results have indicated that phantom dose values can assist in setting the optimisation activities in mammography and for comparison between mammography units. To obtain accurate diagnostic information with an acceptable radiation dose to breast, it is necessary to periodically perform patient dose and image quality surveys in all mammography units.