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The Mammography system – Siemens Mammomat 3000
Sensitive techniques to diagnose breast cancer are of importance for two main reasons.
There is strong evidence indicating that early diagnoses and treatment increases the
chance of completely curing the disease.
In addition, the possibility of performing a breast-preserving operation is greater if the
disease is detected at an early stage.
Mammography is a specific type of imaging that uses a low-dose x-ray system to examine
breasts. A mammography exam, called a mammogram, is used to aid in the early detection and
diagnosis of breast diseases in women.
A detailed assessment of the breast tissue by the use of low dose radiation. This investigation is
used specifically to detect masses in the breast tissue. Mammography is a tool used to assess
both non-symptomatic and symptomatic women. The first mammogram that a woman
undergoes will provide baseline information. Even when the result of this mammogram
demonstrates no abnormalities it is an invaluable tool to compare later mammograms against.
Mammograms are generally offered as a screening tool by individual countries health
departments to coincide with the ages at which a woman becomes most vulnerable to
developing breast cancer. However the tool of mammography exists so that any woman, at
whatever age, who develop a breast abnormality that would benefit from the further scrutiny
that a mammogram would offer, can undergo the procedure. Breast tissue which is under the
influence of the sex hormones. Whether these are ones produced by the body itself or those
given in the form of drugs such as hormone replacement therapy (HRT), may make the
appearance of the mammographic images denser, and consequently be more difficult to
interpret from the radiologists point of view.
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The Mammography system – Siemens Mammomat 3000
Tumor deep
in breast
Calcified tumor
Tumor in mammary duct
Fig26. Mammographic images
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat
medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of
ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most
frequently used form of medical imaging.
Two recent advances in mammography include digital mammography and computer-aided
detection.
Computer-aided detection (CAD) systems use a digitized mammographic image that can be
obtained from either a conventional film mammogram or a digitally acquired mammogram. The
computer software then searches for abnormal areas of density, mass, or calcification that may
indicate the presence of cancer. The CAD system highlights these areas on the images, alerting
the radiologist to the need for further analysis.
Diagnostic Mammography
Diagnostic mammography is used to evaluate a patient with abnormal clinical findings—such as
a breast lump or lumps—that have been found by the woman or her doctor. Diagnostic
mammography may also be done after an abnormal screening mammography in order to
evaluate the area of concern on the screening exam.
Fig30. A Mammogram
Mammogram:
A mammography unit is a rectangular box that houses the tube in which x-rays are produced.
The unit is used exclusively for x-ray exams of the breast, with special accessories that allow
only the breast to be exposed to the x-rays. Attached to the unit is a device that holds and
compresses the breast and positions it so images can be obtained at different angles.
Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a
small burst of radiation that passes through the body, recording an image on photographic film
or a special digital image recording plate.
Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of
the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass
through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of
gray and air appears black.
Until recently, x-ray images were maintained as hard film copy (much like a photographic
negative). Today, most images are digital files that are stored electronically. These stored
images are easily accessible and are sometimes compared to current x-ray images for diagnosis
and disease management.
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The Mammography system – Siemens Mammomat 3000
Examination Technique
Positioning
Compression
No of projections
Patient factors
Ratio fact / fibro glandular tissue
Morphology of carcinoma
Observer factors
Knowledge
Experience
Fig35. Stand
Stand:
• The stand of the mammography machine is the unit where the patient is in direct
contact with the machine for undergoing the scan. The stand is available in 2 versions:
-With pivoted object table arm for two different object tables and Mo X-ray tube
-Same as above, but with Mo/W X-ray tube
Stand consists of:
Swivel arm system:-
-X-ray tube assembly
-Collimator unit
-Compression device
-Pivoted object-table arm with two different object tables (18x24 cm or 24x30 cm).
Latero-Medial:
o Permits correct localization of lesion when used with the cranio-caudal
projection.
Cranio-Caudal:
o Complements other projection
o Best for visualizing the medial half of the breast.
Hence there are two sets of labels on the object table as
L-cc R-cc
L-mlo R-mlo
L-ml R-ml
The object table can be replaced with a magnification table for viewing an enlarged image of
the lesion. Magnification table reduces the distance between the x ray source and the breast,
thus providing us with more prominent image. It includes AEC detector, locking mechanism for
the object table & a connector for electronics. The object table functions as a beam stopper
also.
Compression Devices:
The swivel arm system does compression using various compression plates. The compression
plate can be controlled by:
Manual compression and decompression by the knob.
Electronically by two sets of motorized foot switches.
Breast compression is necessary in order to:
Even out the breast thickness so that all of the tissue can be visualized.
Spread out the tissue so that small abnormalities are less likely to be obscured by
overlying breast tissue.
Allow the use of a lower x-ray dose since a thinner amount of breast tissue is being
imaged.
Hold the breast still in order to minimize blurring of the image caused by motion.
Reduce x-ray scatter to increase sharpness of picture.
Control Panel:
1. Mammomat 3000 ON/OFF
2. Exposure release buttons with green lights. Both buttons must be pressed during the
entire exposure. This is to ensure that the operator is standing behind the radiation
shield during the exposure.
3. +/- kV selection and display
4. +/- mAs selection and display. In AEC mode, the display remains dark before the
exposure. After the exposure, the mAs value reached during radiography is indicated.
5. +/- Film density adjustment and display.
6. AEC. These buttons are used to activate AEC mode and to select screen /film systems. H
stands for high speed and D for detailed screen.
7. Button for selection of anode/filter combination in manual mode.
8. Button for selection of one of four pre-programmed exposure parameter setting
9. Button for storing exposure parameters
10. Button to select/deselect Auto mode
11. Button to select/deselect automatic decompression after exposure. When OFF, use foot
switch or the knobs for manual decompression
12. Limit button (Acknowledgement). Serves to reset the system after errors, indicated by
an error code, or faulty exposures (limit errors), indicated also by the limit lamp and
acoustic signal
13. Limit lamp. Flashing- Tube is temperature is above normal
14. Cassette is missing or needs to be replaced (it has already been exposed)
15. Object table or object table arm is not locked in position
16. Risk of collision between tube head and floor. In stereotactic mode: the tube head is not
in 0° or +/- 10° position
17. AEC detector not in chest wall position (only in stereotactic mode)
18. Diaphragm not in correct position. In stereotactic mode: external diaphragm not in
position
19. Focal spot indication. Indicates focus in operation. Small focus is automatically selected,
when a magnification table is used.
20. Green light indicates that the unit is ready for exposure. This indicator has the same
function as the green light on the stand display and the exposure release buttons.
21. Yellow light and an acoustic signal indicate radiation ON.
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The Mammography system – Siemens Mammomat 3000
Stand display:
Operating Modes:
Mammomat 3000 works in 5 different modes:
1. Manual mode-
The kV values are set manually
The mAs values are set manually
The anode/filter combination is already set
2. AEC mode
AEC stands for Automatic exposure control mode.
Desired kV is set.
High speed screen or detail screen is selected.
The mAs is already set.
Anode/filter combination is set
3. Program mode
In this particular mode there are four different programs for different intervals
of breast thickness.
There are pre-programmed values stored in each button.
H or D is also included. I.e. high speed and detail screen.
There is a store button is used to store the desired values.
4. Automatic program selection mode
In this mode the kV, density ,anode/filter, H/D combination are automatically
selected according to breast thickness.
Still adjustments can be made.
5. Stereotactic mode
There is a Knob used to push to tilt the swivel arm.
The needle-syringe is placed to take the specimen of the lump.
This process is also known as Biopsy.
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The Mammography system – Siemens Mammomat 3000