Implications of using high contrast mammography X-ray film-screen combinations

The objective of this study was to determine the implications of using Fuji AD-M and Kodak min-R 2000, two high contrast X-ray film types developed fo r mammography. Evaluation of the Fuji AD-M film was divided into two parts. The first part was a contralateral comparison between mammograms using Fuj i AD-M and Fuji UM-MA HC film-screen combinations. Fuji AD-M contrast was a bout 25% higher than that of Fuji UM-MA HC. The effect of increased contras t on image quality was investigated by visually grading the quality of info rmation in different parts of each mammogram. Fuji AD-M film was generally judged to be better for overall diagnosis. However, 2.3% of mammograms prod uced using Fuji AD-M film were not acceptable and might have led to a techn ical recall of the patient. In the second part of this study, sets of mammo grams from women attending mobile screening units were reviewed. One unit u sed Fuji AD-M film and the other used Kodak min-R 2000 film. Both samples o f mammograms were digitized and analysed. The average film gradients betwee n an optical density (OD) of 0.25 and 2.00 above base plus fog were 4.38 fo r Fuji AD-M film and 3.77 for Kodak min-R 2000 film. The main breast region s of the mammograms were judged to be satisfactorily displayed when breast tissues were above ODs of approximately 0.6 for Fuji AD-M film and 0.8 for Kodak min-R 2000 film.