Mammography positioning technique for Lateral Views (LM/ML)
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This document provides instructions for performing lateral mammography views. It discusses: - The ALARA (As Low As Reasonably Achievable) principle of using low radiation doses. Repeats should only be done if necessary. - Lateral mediolateral (LM) and mediolateral (ML) views provide orthogonal views to the craniocaudal projection. They can help localize and triangulate lesions. - Proper positioning techniques are described for the LM and ML views, including patient positioning, breast positioning, compression, and centering of the breast on the image receptor. Rotating the breast brings the nipple into profile for localization.
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105723.ppt, mammography examinationradio
This document provides an overview of radiology and imaging of the mammary gland. It describes the normal anatomy of the breast including lobes, ducts, connective tissue, fat, lymph nodes, veins and arteries. It discusses mammography techniques including standard views, compression, magnification and localization. It outlines indications for screening and diagnostic mammography and patient preparation.
MAMMOGRAPHY VIEWS .ppt
1. Mammography is specialized medical imaging that uses A low dose x-ray system to see inside the breast.
A mammography exam, called as mammogram, aids in the early detection and diagnosis of breast diseases generally in women.
Mammogram is an x-ray picture of breast.
Breast cancer accounts for 32% of cancer incidence and 18% of cancer deaths in women in the United States .
Approximately 1 in 8 or 9 women in US will develop breast cancer over her lifetime.
A mammogram can find breast cancer when it is very small ---2 to 3 years before we can feel it.
In 1913, radiographic appearance of breast cancer was first reported.
2. TYPES OF MAMMOGRAPHY: Screening mammography
Screening mammograms are performed for asymptomatic patients, who have no symptoms or signs of breast cancer and are considered at average risk of breast cancer.
Usually involves 2 x-rays of each breast.
Screening mammogram considered a baseline mammogram against which all future tests will be compared to look changes in breast tissue.
Organizations such as the national comprehensive cancer network recommend that women get a screening mammogram each starting at the age of 40. Diagnostic mammograms are performed for symptomatic patients, who have symptoms such as lump, pain, nipple thickening or discharge. Or after suspicious results on a screening mammogram.
Usually involves more x-ray exposures.
3. INDICATIONS: Post menopausal women
Post hysterectomy women
Gynaecomastia
Symptomatic women :
Lump , Tenderness , Nipple discharge , Pain , Change in shape and texture , Nipple retraction.
4. CONTRA - INDICATIONS: Pregnancy
Lactating women
Post FNAC or FNAB
5. PATIENT PREPARATION: Describe the mammographic procedure to the patient.
Schedule mammogram in a week after the end of menstrual period.
Ask the patient to bring previous mammogram if any.
Ask the patient to avoid caffeine containing foods and drinks.
Ask the patient to take an over-the counter pain reliever one hour before the procedure (after consulting the doctor).
Ask the patient do not apply grooming products.
Ask the patient to wear green open gown before the mammogram.
Ask about any breast related medical history.
Ask about any physical limitations.
6. POSITIONING:
Compress the breast firmly in between the two plates to spread the dense tissue of the breast.
Compression makes it easier for radiologist to see through the breast tissue and to hold it away from the chest wall.
Breast compression optimizes breast quality by reducing breast thickness.
Compression unit in mammography machine consist adjustable plate on top and a fixed plate on bottom which holds the x-ray film and detector that makes the image.
7. STANDARD PROJECTIONS: Cranio - caudal view
Medio – lateral oblique view
Typically, the routine 4-projection series in mammography involves imaging in the craniocaudal (CC) and the mediolateral oblique (MLO) of both breasts. The CC and MLO projections are complementary
Similar to Mammography positioning technique for Lateral Views (LM/ML) (20)
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Mammography positioning technique for Lateral Views (LM/ML)
- 1. Mammography Positioning Technique for Lateral View( LM/ML) Ms Selin Prasad Radiographer/Sonographer
- 2. ALARA Principle As Low As Reasonably Achievable (ALARA) Mammography uses low dose protocols in accordance with ALARA, however, all precaution should be taken not to take unnecessary images/repeats Repeats should be kept to a very minimum and ONLY done if absolutely necessary Repeat of an image should ONLY be done if it serves a diagnostic purpose, will aid in final diagnosis
- 4. Application ML& LM Completing the ML with the nipple in profile provides a true representation of breast structures to the nipple, and is useful for localization of non-palpable lateral abnormalities (use the LM lateral for localization of medial abnormalities). Additionally, the ML projection is useful as a third view to open structural overlap. The ML projection is poor at visualizing the most posterior and lateral aspect of the breast and is not useful as a third projection to image breast tissue that was missed on the MLO. Gives a better visualization of abnormalities located in the medial half of the breast Both LM & ML show the effects gravity of on air fluid levels- assessment of ‘tea-cupping’ Provides an orthogonal view of the cranio-caudal projection
- 5. Application ML& LM Can be used to triangulate lesions: Triangulation involves lining up the mammographic views from largest angle (lateral – 90 degrees) to the lowest angle (CC – 0 degrees). The order should be from left to right: Lateral –- MLO –- CC (as shown above.) The common saying, “Muffins rise and Lead falls” refers to the expected location of a lesion on the lateral view. A lateral lesion will move inferiorly on the lateral view compared to the MLO view, while a medial lesion will move superiorly on the lateral view compared to the MLO view.
- 6. Positioning for LM Turn the C-arm to 90 so that the medial aspect of the breast will rest against the image receptor. The path of the x-ray beam will then be horizontal
- 7. Positioning for LM The patient should face the unit with her feet forward, with sternum against the edge of the detector
- 8. Positioning for LM Have the patient raise her arm to shoulder level , letting the upper humerus ret on the superior aspect of the image receptor and lean forward from the waist to facilitate compression. Place the edge of the image receptor posterolateral to the breast tissue. Adjust the height of the C-arm to centre the mid-breast to the detector.
- 9. Positioning for LM Lift the breast and pull upward and outward. For localization purposes, rotate the breast or patient to bring the nipple into profile. Lower the compression as the breast is held in place
- 10. Positioning for LM Hold the breast from below and pull it away from the chest wall
- 11. Positioning for LM Rotate the patient toward the detector and while simultaneously applying compression. During this rotation the compression paddle is used to capture and bring in as much of the extreme lateral breast tissue as possible to the field of view
- 12. Positioning for LM The hand supporting the breast from below moves forward and upward, coordinated with the application of compression. Maintain the proper position of the breast as this function is gradually taken over by the compression table.
- 13. Positioning for ML Turn the C-arm to 90 so that the lateral aspect of the breast will rest against the image receptor The rest of the positioning is same as positioning for LM projection , except with ML positioning the patient has to hold the ipsilateral breast away to avoid overlapping the region of interest
- 14. Comparison of ML and LM projection
Editor's Notes
- Schematic of the amount of the “glandular island” usually evident with this projection.