Digital mammography system developed, incorporating opinions and impressions from Patient, Doctor, and Technologist

As a base hospital in the western Owari region of Aichi Prefecture, Ichinomiya Nishi Hospital provides a wide range of healthcare services, from local emergency and acute care to subacute rehabilitation, home care, and palliative care, including medical checkups, which are important for preventive care, under the philosophy of “May the city and its people stay healthy and happy.”

We asked users about the usability and benefits of the AMULET SOPHINITY digital mammography system that has been introduced at the Medical Support Center, a provider of various types of complete personal and corporate health checkup services.

What we expected from the system included the availability of the Comfort Comp^*1 automatic decompression control function to improve image quality and reduce pain; easy positioning; and its compact size. In addition, since we use AMULET Innovality, which is the previous model, for outpatient care, it is easier for diagnosing doctors to compare images.

In addition to the thinness of the exposure table​, the breast is held firmly on the table, making positioning easier and making it easier to identify the greater pectoral muscle, especially in MLO view. Regarding image quality, we feel FADs and calcifications are clearly delineated and extramammary glands are quite visible. The overall rounded design of the system and its back being low and compact may help reduce the tightness the patient may feel.

In MLO view, for example, the use of dominant hand can cause certain effects. In such a situation, however, I find that it is good to use the easier projection for shooting the opposite side as a guideline, which makes it easier to understand how far the lens is inserted and whether it should go further. In addition, the use of the projection function is a good way to understand your own shooting habits, helping you to check the position to some extent before shooting, so I think it will be especially helpful for Technologist who have little experience in imaging. Although we currently use the projection function for right-side images after shooting the right side and when shooting the left side, in the future we would like to use past images to minimize differences in positioning from the previous image.

When I first saw it, I was surprised at how the pressure plate rises during decompression, but I heard that it has no effect on image quality, so I use it as appropriate while monitoring the paitient’s condition. Specifically, we may use it on the spot if the patient is in pain from compression, or we may use it only for CC and MLO views. For those who we know are very susceptible to pain, just telling them in advance“, now I’m going to use this function to reduce your pain” before applying the pressure often helps them feel less stressful. In fact, I explained Comfort Comp before shooting to an patient who had felt sick during the previous mammography examination. The examination was successfully completed, and the patient said“, I had no problem this time.” Since I think compression is also a psychological burden, the presence of Comfort Comp may help reduce the stress not only of patients but also of technologist.

During busy seasons, there were times when we did not have time to review the images that we took by ourselves. We now all make use of the positioning analysis function to perform a review after we finish our work. I would like to use the analysis function when selecting images during the Image quality evaluation as a mammography facility. I would also like to adjust the evaluation criteria for the analysis function to levels close to those of the Image quality evaluation as a mammography facility.

In addition to the evaluation, the system enables the user to record the ease of shooting, presence or absence of pain, and any freely provided comments, which allows the user to review the information about previous imaging examinations at the next examination, so I would like to continue to accumulate information for the future.

The changes we have seen include information used for shooting, such as compression pressure and breast thickness, being projected on the compression plate, as well as the Comfort Comp function being easily accessed for manipulation, allowing imaging to be performed with minimal movement and resulting in time reduction.

• *1 The function developed for the aim of reducing the pain.
• *2 The extraction of the reference point of the pectoralis major muscle and nipple position for positioning was designed using an AI technique called deep learning.
  There is no automatic change in performance or accuracy of the system after installation