EDR Advance: Influence of patient position is reduced

Advantage 2: No saturation on high-contrast images despite the type of breast.

X-ray tube anode material of the Amulet Innovality mammography system is tungsten (W) only, because studies have found that a tungsten x-ray tube allows for dose reductions.

In Europe a tungsten x-ray tube is widely used and accepted.

But, in some countries, tungsten x-ray tube is not used because of its lower contrast image.

ISC provides diagnostic tungsten images with high image quality and contrast similar to Mo.

ISC Technology enables to correct the contrast change which is occurred by the difference between X-ray spectrum and the quantity of both mammary grand and fat by image processing technology.

Our image processing technology to detect the mammary gland area correctly and analyze it realized ISC technology.

Adaptive Contrast Management” and handle local densities as part of dynamic imaging.

FSC analyzes exposed images using artificial intelligence technology. This technology offers high quality images by allowing proper recognition of breast structure patterns and optimizing sharpness and contrast of fine structures (such as mammary gland and calcification) important for mammography interpretation. Simultaneously, noise suppression is added to enable low-dose exposure.

Structure pattern recognition processing

Using the information on mammary glands and calcification contained in images, FSC recognizes complicated structural patterns in each pixel such as straight, curved and intersecting lines that are created with locally populated similar pixel values. Based on the information of the recognized structural patterns, sharpness/contrast is improved for normal structures and lesions of the subject, while it prevents noise from increasing by decreasing the information in which random pixel values are locally populated. Structure pattern recognition is executed with a technology to recognize structures closer to those of the human body.

We provide the image to easily detect the lesion at first sight regardless of breast thickness and breast density.

Providing consistent optical density of glandular and adipose tissue in all breast types.

• The contrast of thick breast and dense breast is improved.

Providing high contrast and no saturation in breast region.

• Setting non-conventional high contrast parameter is possible.

With Dynamic Visualization II, the entirety of the breast can be visible with better contrast and with no saturation.

• WW/WL adjustment is unnecessary.

Dynamic Visualization II enables calcifications in the glandular tissue to be seen.

Dynamic Visualization II additionally enhances the dense breast images so that the lesion in the glandular tissue can be seen.

• Tungsten tubes are preferred to molybdenum purely because the dose can be significantly reduced. Roughly 40% lower from traditional Molybdenum
• But the higher energies reduce Radiographic contrast
• The radiographic contrast is also affected by the thickness of the compressed breast.
• 2 cm thick 20% higher than average
• 10 cm thick 20% lower than average
• A ± 20% change in the contrast corresponds to a ± 50% relative increase or decrease in dose
• Optimum choice of beam quality is different for different breasts
• A contrast increase is at the cost of increased dose and vice versa.

Clinical Significance/ Quality

• A Tungsten x-ray target allows for dose reduction over the use of Molybdenum (~40%)
• But results in an inherent contrast reduction
• Fujifilm’s ISC (Image based Spectral Conversion) processing allows the higher levels of Inherent Contrast of Breast tissue as seen with molybdenum (especially smaller thicknesses) with benefit of lower dose tungsten
• A more natural contrast enhancement

• 50µm images using HCP: Hexagonal Close Packing TFT

Hexagonal pixels collect image information from the interpixel space more effectively

Clinical Significance/ Quality

• Greater X-ray capture with (FUJIFILM developed) a-Se layer, improving dose requirements
• Sharper representation of detail using direct acquisition and Hexagonal pixel
• 50µm Image pixel (68µm acquisition pixel)

50 micron pixel

Intelligent AEC (iAEC)

• Analysis of Breast shape and construction by pixel data

Clinical relevance/ Quality

• Consistent dose for different breast types (Fatty, Glandular, Implant)
• Variations in Breast morphology and positioning are compensated to maintain consistent exposures
• Reduced user variation in selected dose values for difficult examinations (i.e Implants)
• Improved workflow for Mammographer/ Technician

Clinical Significance/Quality

• High diagnostic confidence:
  • Overall breast evaluation
  • Comparison with priors (2D/3D)
• Workflow and patient care:
  • One single compression
  • Fast acquisition
• Dose optimization:
  • One single acquisition required

Innovative Technology- Compression

• More than 40% of the women who fail to re-attend screening mammography appointments confirm pain as the main cause
• It can be easily determined that for most women pain is directly related to the compression which is applied to the breast during mammography examinations
• Given the fact that it is not possible to eliminate the necessity for breast compression, several advances have been recently made from manufacturers, in order to improve patients’ comfort while maintaining an adequate breast compression and position

“Fit Sweet” Adaptive compression paddles

• 3 way adaptive compression paddles
• Reduce pain in sensitive areas (Chest wall)
• Encapsulate Breast instead of pushing it away

Comfort Comp functionality*

• Using “Hysteresis” effect to reduce discomfort during examination
• Compression force is reduced prior to exposure
• Clinical evaluation reports no change in AGD or IQ
• Patient feedback positive

Clinical Significance/ Quality

• Improved distribution of compression force across the breast
  • Improved IQ
• Reduced discomfort at Chest wall edge leading to reduced movement and blurring
  • Improved IQ and reduced technical recalls
• Patient experience improved
  • 70% of women reported pain reduction with Fit Sweet
  • 67% of the subjects who felt pain was reduced with Comfort comp

Innovative Technology- Breast Density measurement

The AMULET Innovality’s AWS workstation can measure breast density in two ways:

• Entire Breast area (BI-RADS Ed.4 [1-4])
• Within the Glandular area (BI-RADS Ed.5 [a-d])

Clinical Significance/ Quality

• Provides indication of possible requirement for supplemental imaging
• Provides improved analysis of risk factors connected to Breast cancer
• Some evidence suggests that breast density is one of the strongest, if not the strongest, predictor of the failure of mammographic screening to detect cancer.
• Breast cancer detected in the interval after a negative mammogram

Innovative Technology- CEDM – Contrast Enhanced Digital Mammography

• Angiogenesis is a normal and vital process in growth and development.
• However, it is also a fundamental step in the transition of tumours from  benign to malignant
• Breast MRI overtakes FFDM and US limitations with regards to neo-angiogenesis detection
• Sensitivity 94%
• Specificity 60-70%
• Problem with Accessibility
• Expensive
• Contraindications