The problem of the choice of a luminescent screen for screen-film and
digital mammography is considered. It is shown that high efficiency ph
osphors must be used in both cases. By comparing the quantum noise and
the threshold contrast of a human eye an upper limit for the sensitiv
ity of an imaging system is determined. It is also demonstrated that d
igital mammography systems, based either on CCD detectors or on storag
e phosphors, do not allow for essential reduction of the X-ray dose.