Mammography Positioning Technique for Additional Views
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This document discusses additional views that can be performed in mammography, including magnification views, spot compression views, and views for patients with breast implants. Magnification views use a smaller focal spot size and elevated breast position to provide higher resolution of areas of interest, though at the cost of increased radiation dose and potential for motion blur. Spot compression views apply targeted compression over areas of concern to spread overlapping tissues and better define lesion features. Views for implants displace the implant posteriorly during compression to exclude it from the image and allow improved visualization of breast tissue.
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This document provides information on breast oncoplastic surgery techniques:
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- Key factors in determining the appropriate OPS approach are excision volume, tumor location, breast density, and glandular composition. Excisions over 20% of breast volume or from certain locations risk deformity. OPS allows excision of up to 1000g compared to 80g for standard surgery.
- OPS techniques are classified into Level I involving reshaping and Level II involving skin excision and reshaping using
Mammoplasty surgery
Mammoplasty is a surgical procedure to alter the size or shape of the breasts. There are several types of mammoplasty procedures, including breast augmentation to enlarge the breasts using implants, breast reduction to reduce large breasts, and breast reconstruction after mastectomy or other breast surgery. Mammoplasty procedures carry risks like scarring or uneven results, but can provide physical and psychological benefits by improving breast contour and size. Recovery times vary by procedure but generally involve a week or more of rest and limiting strenuous activity.
recentadvancesinmammography-150410103808-conversion-gate01.pdf
Recent advances in mammography include the transition to digital technologies like full-field digital mammography (FFDM) and breast tomosynthesis. FFDM provides higher contrast resolution than film screen mammography, reducing missed cancers. New techniques like contrast-enhanced digital mammography and breast tomosynthesis further improve detection by reducing tissue overlap and enhancing lesion conspicuity. These digital technologies allow for improved cancer screening while maintaining or reducing radiation dose compared to conventional mammography.
Digital breast tomosynthesis
Digital breast tomosynthesis (DBT) is an emerging 3D breast imaging technique that involves acquiring low-dose X-ray images of the stationary breast from multiple angles to create tomographic slices. The first DBT system was introduced in 2011. DBT provides improved visualization of lesions and reduced call back rates compared to 2D digital mammography. While DBT exposes patients to a higher radiation dose than 2D mammography alone, combining DBT with a synthesized 2D mammogram can achieve a radiation dose similar to standard mammography alone. DBT is being widely adopted for breast cancer screening due to its superior performance over conventional digital mammography.
mammographyfull-210721111323 (1).pptx
Mammography uses low-dose x-rays to image the breast and is the primary screening tool for breast cancer. It requires specialized equipment to produce high-quality images of breast tissue, including a high-frequency generator, focal spot sizes as small as 0.1-0.15mm for magnification, appropriate anode targets and filtration. Multiple views of each breast are taken during an exam, and supplementary views may be needed. Mammography finds masses, calcifications, and asymmetries that could indicate breast cancer requiring biopsy for diagnosis. It plays a crucial role in early cancer detection when treatment is most effective.
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- 1. Additional Views in Mammography & Basic Implant/Prosthesis Imaging Ms Selin Prasad Radiographer/Sonographer
- 2. Additional Views Performed in Mammography Magnification View Spot Compression View Tangential Views( refer to CC module) Lateral View ( refer to Lateral View module) Cleavage View ( refer to CC module) Rolled CC View ( refer to CC module)
- 3. Magnification View • Magnification mammography is most used for the analysis of morphology and distribution of micro-calcifications. However, it can also be used in the analysis of the margins and internal architecture of masses. • The breast is elevated off the normal platform to obtain 1.5–2x magnification of the area of concern. Standard mammography uses a small focal spot size (traditionally, a nominal 0.4 mm focal spot). By using a smaller focal spot size (specifically, a 0.2 mm for 1.5× magnification and smaller) and elevating the breast above the receptor, magnification mammography can be performed. • This allows for improved resolution due to a reduction in scatter and noise. This improved resolution comes at a cost, which are a higher patient dose as well as the exposure time. This can result in increased motion blur, which degrades the examination. Therefore, magnification views should be used appropriately realizing that what is obtained in increased resolution may be nullified by motion artefact from the longer exposure time. • The smaller round spot device provides better resolution of the area of interest
- 5. Spot Compression • Using a spot compression paddle will increase compression over the area of interest allowing the tissue to spread more evenly and effectively eliminating the pseudomass/overlapping breast tissue • If the abnormality is evident on both views, then image in both projections • When a smaller compression paddle is used, the pressure is then applied over a smaller area. This serves a dual purpose: (1) it spreads overlapping structures that may form a “pseudomass” on the original images, and (2) it helps to better define the morphological features of the lesion of interest. • The preferred compression device is the round spot compression paddle. This device is utilized for mid to large masses and small area of asymmetries . The larger square spot compression devices are best utilized for mid to large areas of asymmetry and very large masses. The smaller round spot compression device provides better compression with better resolution of the area of interest.
- 6. Technique for Breast Implant/Prosthesis • CC and MLO views without applying compression are done to assess the integrity of the implant ( to assess for extra capsular rupture) • Additionally Eklund views are done to image portion of breast tissue that is not superimposed by implants. The method suggests displacing the implant posteriorly to exclude it from view Increased compression and lack of superimposition of the implant is possible showing an improvement in breast tissue visualization in 99% of patients The modified compression technique is possible regardless of whether the implant is posterior or anterior to the pectoral muscle, as long as the implant remains soft and free of encapsulation. • Routine View for implants include: - routine CC ( without compression) - routine MLO ( without compression) - CC with implant displaced ( Eklund View) - MLO with implant displaced ( Eklund View)
- 7. Technique for Breast Implant/Prosthesis • Position the patient as usual for the intended view (CC or MLO). • Lift the breast and feel for the anterior portion of the implant. Place the thumb and forefinger between the breast tissue and the implant. Bring this portion of the breast to rest on the image receptor. • Encourage the patient to relax her upper torso to encourage the breast tissue to fall forward. Still holding the breast between the thumb and forefinger, lower the compression paddle while pulling the breast tissue forward and outward, allowing the implant to be displaced posteriorly. • Compress as usual. If the breast tissue is over the AEC detector, automatic exposure control is possible; if the implant rests over the detector, manual technique should be used.
- 8. Technique for Eklund View