(HealthDay News) — Digital mammography screening with a direct radiography (DR) photon-counting system has good diagnostic performance, according to a study published online Feb. 4 in Radiology.

Stefanie Weigel, MD, from the University Hospital Muenster in Germany, and colleagues examined screening performance of a DR photon-counting system (13,312 women) compared with statewide screening units with different digital technologies (993,822 women) using data from the North Rhine-Westphalian mammography screening program (2009 to 2010). Diagnostic performance was evaluated and included cancer detection rate, recall rate, and proportion of small invasive cancers and ductal carcinoma in situ (DCIS).

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The researchers found that, for DR photon counting, the cancer detection rate for subsequent screenings was higher than statewide rates (0.76% vs. 0.59%; P = 0.05), with a higher rate of recall (5.4% vs. 3.3%; P = 0.001).

For invasive cancers up to 10 mm, detection was high for initial and subsequent DR photon-counting screenings (40% and 42%, respectively), but the rates were not significantly different from statewide rates (initial: 31.6%; P = 0.50 and subsequent: 32.5%; P = 0.25). 

For DCIS, the subsequent screening rate was higher for DR photon counting (0.23%) than statewide screening (0.12%) and conventional DR (0.12%; P = 0.01 and 0.025, respectively). 

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Compared with conventional DR, the mean glandular dose was significantly lower for DR photon counting (P = 0.0001 for craniocaudal and mediolateral oblique views).

“The higher cancer detection resulting from the use of the DR photon-counting scan system is due to high detection of both small, invasive cancers and ductal carcinoma in situ,”Walter Heindel, MD, one of the study coauthors, said in a statement.


  1. Weigel S, Berkemeyer S, Girnus R, et al. Digital Mammography Screening with Photon-counting Technique: Can a High Diagnostic Performance Be Realized at Low Mean Glandular Dose? Radiology. 2014;doi:10.1148/radiol.13131181.