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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
An authoritative and up-to-date discussion of digital mammography fundamentals
The newly revised second edition of Digital Mammography: Physics and Instrumentation delivers an expert discussion of all things digital mammography. From an explanation of how mammography plays an important role in cancer detection and treatment to practical discussions of mammography image formation, you’ll find analysis of the most recent advances in digital breast tomosynthesis and photon counting mammography.
Readers will also discover:
- Complete treatments of mammographic instrumentation and physics
- A thorough introduction to image quality optimization techniques
- Comprehensive explorations of new artificial intelligence applications in mammography
- Valuable information about how radiation dose is relevant to patient safety and diagnostics
Perfect for mammography radiologic technologists and diagnostic radiographers, Digital Mammography: Physics and Instrumentation will also benefit breast clinicians, trainee radiologists, and students of medical imaging and radiography.
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Seitenzahl: 201
Veröffentlichungsjahr: 2025
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Table of Contents
Cover
Table of Contents
Title Page
Copyright Page
Dedication Page
Author Biography
Contributor
Series Editor’s Foreword
Acknowledgments
1 Why Mammography?
Why Mammography? The Clinical Reasons, by Liz Bowey
Why Digital Mammography? An Overview of the Technical Reasons, by Rob Davidson
Bibliography
2 Mammographic Instrumentation and Physics
Introduction
Instrumentation
X‐ray Generator
High‐Frequency Generator Technology
Mammography X‐ray Tube, Filter, and Collimator
Bibliography
3 Mammography Image Formation
Introduction
Interaction of X‐rays with Breast Tissue
Attenuation of X‐rays
Controlling Scattered Radiation
Compression/Breast Thickness
Collimation
Grids
Air Gap
Exposure Selection
Automatic Exposure Control
Image Recording
Current Image Recording Systems
In‐Direct Flat Panel Detectors
Direct Flat Panel Detectors
Flat Panel Detectors Arrays
Image Generation
DICOM Image File
Image Display
Display Monitors
Conclusion
Bibliography
4 Digital Breast Tomosynthesis and Advanced Techniques
Introduction
Stereotactic Digital Imaging Biopsies
Contrast Enhanced Mammography
Digital Breast Tomosynthesis
Photon‐Counting Mammography
Breast Computed Tomography
Conclusions
Bibliography
5 Radiation Exposure and Patient Dose
Introduction
Basic Concepts of Radiation Measurement
Putting Radiation Dose in Perspective
Bibliography
6 Mammographic Image Quality
Introduction
Clinical Image Quality Requirements
Image Quality in Mammography
Spatial Resolution
Image Contrast
Noise
Relationships Among Spatial Resolution, Image Contrast, and Noise
Artifacts
Quality Control and Quality Assurance
Personnel Knowledge and Experience/Accreditation
Bibliography
7 Artificial Intelligence in Mammography
Introduction to Artificial Intelligence
Computer Vision in Medical Imaging
Conclusions
Bibliography
Index
End User License Agreement
List of Tables
Chapter 1
Table 1.1 X‐ray Mammography Unit Development Timetable.
Chapter 2
Table 2.1 Voltage Ripple of Various X‐ray Generator Waveforms.
Table 2.2 International Electrotechnical Commission (IEC) Focal Spot Tolera...
Table 2.3 Typical Mammography X‐Ray Tube Target Specifications.
Table 2.4 Typical Mammography X‐ray Filter Materials and Specifications.
Table 2.5 Typical Mammography Target/Filter Combinations.
Chapter 3
Table 3.1 The Number of X‐ray Photons and Percentage of Transmission from a...
Chapter 5
Table 5.1 Tissue Weighting Factors (w
T
) of Organs/Body Parts as Some Organs...
Table 5.2 US National Academy of Sciences Biologic Effects of Ionizing Radi...
List of Illustrations
Chapter 1
Figure 1.1 An example of a digital mammographic examination of the right bre...
Figure 1.2 A plot of linear attenuation coefficients of breast fibroglandula...
Chapter 2
Figure 2.1 The five essential steps in producing quality mammograms.
Figure 2.2 Diagram of a mammography unit showing the relationship among the ...
Figure 2.3 (a) Single‐phase voltage waveform over a number of 50/60 Hz cycle...
Figure 2.4 Diagrammatic representation of a mammography X‐ray tube showing i...
Figure 2.5 Orientation of the cathode and anode in the X‐ray tube to the pat...
Figure 2.6 (a) A conventional X‐ray tube focusing cup and (b) a mammography‐...
Figure 2.7 A plot of the number of photons versus their energy, in kilo‐elec...
Figure 2.8 (a) X‐ray spectrum from a molybdenum target, unfiltered as it exi...
Figure 2.9 Attenuation curves comparison from a molybdenum filter (solid lin...
Figure 2.10 (a) X‐ray spectrum from a molybdenum target, unfiltered as it ex...
Figure 2.11 X‐ray spectrum from a tungsten target, using a silver filter (K‐...
Figure 2.12 A diverging beam approach showing missed anatomy at the chest wa...
Chapter 3
Figure 3.1 Photoelectric and Compton interactions at differing photon energi...
Figure 3.2 A diagrammatic representation of a linear grid. (a) The front vie...
Figure 3.3 A diagrammatic representation of a High Transmission Cellular (HT...
Figure 3.4 Primary and secondary (scattered) radiations either transmitting ...
Figure 3.5 The air gap method increases the object‐to‐image distance creatin...
Figure 3.6 A xeromammography image. Note the inherent edge enhancement seen ...
Figure 3.7 Diagram of a thin film array used in flat panel detectors.
Figure 3.8 Flat panel detector processes. Left: The in‐direct conversion met...
Figure 3.9 Shifting the 18 × 24 cm field area within the 24 × 30 cm flat pan...
Figure 3.10 A raw image, a positive image, of the pixel values directly take...
Figure 3.11 A histogram of the raw image seen in Figure 3.10. The X‐axis sca...
Figure 3.12 Left: Three sigmoid‐shaped look‐up‐table (LUT) curves with diffe...
Figure 3.13 DICOM file attributes and associated data for this mammographic ...
Figure 3.14 Side‐by‐side and magnified display of the right and left lateral...
Chapter 4
Figure 4.1 (a) Digital stereotactic methods showing the angle of the X‐ray t...
Figure 4.2 Tomography principles. The X‐ray tube and image plate move in syn...
Figure 4.3 Digital breast tomosynthesis principles. The X‐ray tube moves in ...
Figure 4.4 Digital breast tomosynthesis reconstruction process of simple bac...
Figure 4.5 A 2D mammogram (a) and digital breast tomosynthesis (b) mediolate...
Chapter 6
Figure 6.1 The image quality triangle showing three of the main factors of i...
Figure 6.2 A line‐pair phantom with line‐pair sizes from 0.5 to 14 lp/mm.
Figure 6.3 A diagram of an ACR‐approved phantom, the CIRS Model 015. In the ...
Figure 6.4 A line‐pair phantom (top) and corresponding transect histogram of...
Figure 6.5 A modulation transfer function (MTF) plot of the MTF versus objec...
Figure 6.6 Image of a contrast‐detail phantom, the Artinis CDMAM 3.4 phantom...
Guide
Cover Page
Table of Contents
Title Page
Copyright Page
Dedication Page
Author Biography
Contributor
Series Editor’s Foreword
Acknowledgments
Begin Reading
Index
Wiley End User License Agreement
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Digital Mammography
Physics and Instrumentation
Second Edition
Rob Davidson, PhD., MAppSc(MI), BBus, FASMIRT
University of Canberra Bruce, Australia
Series Editor
Euclid Seeram, PhD., MSc., BSc., FCAMRT
Medical Imaging Advanced StudiesBritish Columbia Institute of TechnologyBurnaby, British Columbia, Canada
This edition first published 2026© 2026 John Wiley & Sons Ltd
Edition HistoryJohn Wiley & Sons Ltd (1e, 2002)
All rights reserved, including rights for text and data mining and training of artificial intelligence technologies or similar technologies. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.
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Library of Congress Cataloging‐in‐Publication Data Applied for:
Paperback ISBN: 9781119520818
Cover Design: WileyCover Image: © andresr/Getty Images
This book is dedicated to all mammographers/mammography technologists, mammography radiologists, and breast clinicians. Every day you help save lives of the 1 in 8 women in the world who will develop breast cancer and other breast diseases, yet most people do not know of your important role. On their behalf, I offer my sincere and grateful thanks.
Author Biography
Author:
Rob Davidson, PhD, MAppSc(MI), BBus, FASMIRT
Emeritus Professor, University of Canberra, Australia
Adjunct Research Professor, Fiji National University, Fiji
Professor Rob Davidson retired from the University of Canberra (UC) in February 2022 and was awarded the esteemed title of Emeritus Professor of the University of Canberra. In 2015, Professor Davidson developed and established the Medical Imaging and Ultrasound programs at UC. During Professor Davidson's appointment at UC, he was also the Head, School of Health Science and Discipline Lead, Medical Radiation Sciences. Rob is also an Adjunct Research Professor in Medical Imaging, College of Medicine, Nursing & Health Sciences at Fiji National University and has held an adjunct appointment at RMIT University.
Rob was the second person to be appointed as a Full Professor in Medical Imaging/Medical Radiation Sciences in Australia. He has previously held roles as a Professor at Charles Sturt University (CSU), Associate Professor at RMIT University and at Curtin University, and Senior Lecturer at CSU. Prior to becoming an academic, Rob was employed as a Medical Imaging Clinician for approximately 10 years, followed by a further 9 years in sales/marketing roles.
In 2003, Rob completed his Master's in Medical Imaging; in 2006, he received his PhD in Medical Imaging/Physics; and in 2008, he gained Fellowship of the Australian Society for Medical Imaging and Radiation Therapy (ASMIRT). Early in his academic career, he was awarded the 2001 UniServe Science National Science Teaching Award as the best university science lecturer in Australia.
Rob has been the Editor‐in‐Chief of The Radiographer, the then journal of the Australian Institute of Radiographer/ASMIRT; was Deputy Editor of the Canadian journal, Journal of Medical Imaging and Radiation Sciences; and is currently on the Board of the Journal of Medical Radiation Sciences.
Rob's research focus is on dose/image quality in mammography, planar radiography, and CT; digital image processing in medical imaging; and is currently part of an international team looking at new imaging methods for the improved detection of prostate cancer. He has been a chief investigator on multiple research grants, has over 70 peer‐reviewed publications, authored/coauthored six book chapters. Rob has also been the keynote speaker at multiple international conferences, supervised/cosupervised approximately 20 PhD and Master’s by research students, and examined multiple higher degree by research theses. Professor Davidson has established international research colleagues in the United States, Canada, Kuwait, Fiji, Saudi Arabia, The Netherlands, and Taiwan. PhD students have come to Australia to be supervised by Rob from Singapore, China, Saudi Arabia, and Fiji.
Contributor
Liz Bowey, CCPM, ABIC, GCertMR (Breast Ultrasound)
Retired Mammographer/Breast Sonographer
Liz, after graduating in 1973 from the then South Australian Institute of Technology, now UniSA, worked in several places in various states of Australia. Once she moved back to Adelaide, her interest in mammography grew. Liz worked for Dr Jones & Partners, now Jones Radiology, which placed a high value and gave support for top‐level breast imaging. Liz earned her first Certificate of Clinical Proficiency in Mammography (CCPM) in 1997, which she kept renewed until her retirement. In 1998–1999, Liz studied for and attained the Graduate Certificate in Medical Imaging (Breast Ultrasound), the first person in the Jones Radiology to achieve this qualification. Liz was part of a team that helped set up the Breast Centre of Excellence at Burnside Hospital, where the X‐ray department worked closely with a team of breast surgeons and pathologists. In 2001, Liz was appointed Chief of Mammography. Her role included setting up a mammography training program; organizing and supervising basic and advanced training for staff; organizing attendance at BreastScreen SA (BSSA) training programs/conferences; organizing site accreditation for the Australian/New Zealand RANZCR MQAP standards; QA/QC program; CPD programs; purchasing new equipment; liaising with referrers; giving presentations to staff at BSSA professional development days and also to referrers; and serving as guest lecturer for breast ultrasound at UniSA. In 2005, Liz was awarded the Advanced Breast Imaging Certificate (ABIC) by the Australian Institute of Radiography (AIR), now the Australian Society for Medical Imaging and Radiation Therapy (ASMIRT).
Liz also worked concurrently for BreastScreen SA on a casual basis for about 12 years in the assessment clinics, doing breast ultrasound, biopsies, etc. This work gave her a valuable insight into the workings of BreastScreen and was helpful in her role in Jones Radiology.
Liz retired from radiography in 2017. She was very proud of what was achieved in her time at Jones Radiology and BSSA. At these organizations, she worked with many dedicated and caring staff to ensure the standard of mammography remained high, giving a great service to their clients.
Series Editor’s Foreword
Wiley's Rad Tech’s Guides Series in radiologic technology is intended to provide clear and comprehensive coverage of a wide range of topics and prepare students to write their entry‐to‐practice registration examination. Additionally, this series can be used by working technologists to review essential and practical concepts and principles and to use them as tools to enhance their daily skills during the examination of patients in the radiology department.
The Rad Tech’s Guides Series features short books covering the fundamental core curriculum topics for radiologic technologists at both the diploma and the specialty levels, as well as acting as knowledge sources for continuing education as defined by the American Registry for Radiologic Technologists (ARRT).
Titles in the series include books on radiologic physics, equipment operation, patient care, radiographic technique, radiologic procedures, radiation protection, image production and evaluation, and quality control. You may have noticed that this book lacks the Rad Tech’s Guides title on the front cover. Thematically and structurally, this is very much a Rad Tech’s Guide, but we felt that the readership extended beyond radiologic technologists and made the decision to broaden the scope by removing the series title.
In Digital Mammography: Physics and Instrumentation, Dr. Rob Davidson, a renowned educator and expert in radiologic sciences and technology from the University of Canberra and other universities in Australia, presents clear and concise coverage of the physics and instrumentation of digital mammography. More details of his academic activities are provided in his biography included in this book. He has coauthored Chapter 1with Liz Bowey, CCPM, ABIC, G Cert MR (Breast Ultrasound), and her biography is also listed in this book.
Topics include why mammography? Fundamental physics of mammography, equipment components, image quality, dose consideration, digital breast tomosynthesis, quality control issues of primary significance to quality mammography, and finally artificial intelligence in mammography.
Dr. Davidson has done an excellent job in explaining significant concepts that are mandatory for the successful performance of quality digital mammography in clinical practice. Students, technologists, clinicians, and educators alike will find this book a worthwhile addition to their libraries.
Enjoy the pages that follow; remember, your patients will benefit from your wisdom.
Euclid Seeram, PhD, MSc. BSc, FCAMRT
Series Editor
British Columbia, Canada
Acknowledgments
First, I thank the author of the first edition of this textbook, Donald R. Jacobson, PhD, DABMP, who has provided an excellent template for this second edition. His knowledge of mammography physics and instrumentation, which shone through in that text, I am sure has guided many potential and current clinical people in the breast imaging field of the medical radiation sciences.
Next, my thanks go to Euclid Seeram, PhD, MSc, BSc, FCAMRT, for inviting me to revise and update Donald's textbook. Euclid is a great colleague and friend, and I have had the privilege to be a part of his supervising team for his PhD candidature; we have undertaken research together and have coauthored chapters and a book. Euclid, you are a great mate.
Importantly, thank you to the people who have allowed me to use their images in this book. We all belong to the medical imaging community, and I think the old adage of “an image says a thousand words” is an understatement in our field. By providing these images, you have saved the readers much time.
I also thank Liz Bowey, my sister, for writing the clinical part of Chapter 1. Liz and I belong to a medical family, and as such, I think our career directions were easy to choose. Liz has been a dedicated mammography/breast sonographer for many years, and I am sure her patients have benefited from her clinical skills and calming manner. Thanks, sis!
Finally, I thank Debbie and the rest of my family for giving me the time to focus on writing this textbook. You all have supported and encouraged me in doing this when I could have spent more time with you.
1Why Mammography?
Why Mammography? The Clinical Reasons, by Liz Bowey
When first considering the topic of “Why mammography?”, any instinctive reaction should be “Why not?” Mammography can be used as a screening tool in asymptomatic women, or as a diagnostic tool to investigate lumps or changes to the breast. In both cases, it is a really important part of caring for women's health and well‐being. Mammography is currently the best way to discover early breast cancers. It can detect breast cancer before it shows physical symptoms. Mammograms have also been proven to reduce the risk of dying from breast cancer which affects up to one in eight women in their lifetime. Early detection of cancers and precancerous lesions has increased with continual improvements in mammography. Early detection/early diagnosis is still the best way of ensuring a good outcome, so why would we not make use of mammography?
Most women in developed countries have access to free screening mammography. Those who have symptoms that need close follow‐up, or are following up on a suspicious area, will need diagnostic mammography which is often accompanied by breast ultrasound and other breast image modalities as needed to assist in making the diagnosis. The mammogram, whether screening or diagnostic, is a low‐dose X‐ray examination, and both use the same type of equipment and require well‐trained staff.
Good mammography is a combination of many things. Digital mammographic image examples are shown in Figure 1.1. Having access to state‐of‐the‐art equipment is paramount. The importance of this will be covered in the rest of this book. Well‐trained mammographers and radiologists are the other essential requirements to produce good mammography. A good mammographer/mammography technologist will put the client at ease. This is essential as it is easier to position a breast and get really good coverage if the client is relaxed. Getting a few more millimeters of breast tissue into the field of view can mean seeing a cancer that may have been missed. It is a real skill to achieve the best positioning possible for each client. Breast shape and size, body habitus, and client maneuverability are just a few of the issues to deal with. The procedure is also much less uncomfortable for the relaxed client than a tense one!
Figure 1.1 An example of a digital mammographic examination of the right breast. (a) A cranio‐caudal view and (b) a mediolateral oblique view.
Source: With permission of BreastScreen ACT, Canberra, Australia.
Why Digital Mammography? An Overview of the Technical Reasons, by Rob Davidson
Currently, planar X‐ray imaging, including mammography and general X‐ray imaging, uses digital radiography (DR) recording methods. DR imaging requires the anatomy of interest to have differing amounts of X‐ray attenuation, also known as subject contrast, so the X‐ray exit intensities from those anatomical regions differ by at least 5%. In general X‐ray DR imaging, anatomical regions, for example, of the chest and bones, the attenuation difference in that anatomical region is significantly greater than 5%. If the attenuation differences are less than 5%, the detectors will not be able to detect differences in the X‐ray beam's exit intensities and there will be no differences in gray levels and image contrast in the displayed image.
One of the main advantages of computed tomography, arguably the main advantage, is CT's low contrast resolution of around 0.25%. In other words, there needs to be an anatomical subject contrast of greater than 0.25%. The advantage of this is seen in CT imaging of the brain and abdomen, where general planar X‐ray imaging cannot visualize gray matter/white matter differences and has difficulty in visualizing different abdominal organs.
The breast tissue is composed of fibroglandular, adipose, blood vessel, and ductal tissues. These tissues and breast cancers have very similar X‐ray attenuation characteristics. Figure 1.2
