Technical Repeats in Mammography Practices

Purpose	Reduction of Technical Recalls in Mammography Practices
Tag(s)
Panel	Breast Imaging
Define-AI ID	19060008
Originator	Bhavika Patel
Lead	Bhavika Patel
Panel Chair	Beth Burnside
Panel Reviewers	Breast Imaging Panel
License	Creative Commons 4.0
Status	Public Comment
RadElement Set	RDES140

Clinical Implementation

Value Proposition

BI technologists would instantly know if patient imaging is technically inadequate, thus saving time where you may have waited for the radiologist to call the patient back for additional imaging.

Narrative(s)

Motion/blur artifact or inadequate positionion on screening mammography imaging requires a patient to return for additional imaging. The technologist would be instantly notified of the suboptimal quality via AI recognition and repeat imaging would be performed onsite. This would lead to a reduction in mammography recalls and improve overall quality of BI examinations.

Workflow Description

Training cases fed into system, rules implemented such as retropectoral fat plane must be seen on CC, nipple in profile on one view etc. Once trained, the program will alert the technologist at time of imaging that additional view is necessary due to improper positioning, blur artifact from motion etc.

Considerations for Dataset Development

Procedure	Screening mammography and screening tomosynthesis
Views	Bilateral CC and MLO mammography views; bilateral CC and MLO tomosynthesis views from the entire 3D dataset.
Age	over 40 years
Breast Anatomy	No exclusion criteria

Technical Specifications

Inputs

DICOM Study

Procedure	Diagnostic Mammography
Views	CC, MLO, LM, XCCM, XCCL, Cleavage view, etc.
Data Type	DICOM
Modality	MAMMO
Body Region	Chest
Anatomic Focus	Breast

Primary Outputs

Retropectoral Fat Plane Visible on CC

RadElement ID	RDE929
Definition	Identify whether retropectoral fat plane is visible on CC. One criteria for an adequate image.
Data Type	Categorical
Value Set	Retropectoral fat plane not visible Retropectoral fat plane partially in view nipple partially identified but inappropriately positioned Retropectoral fat plane fully in view Unknown
Units	N/A

Nipple in Profile

RadElement ID	RDE930
Definition	Identify whether nipple is in profile on one view. This is one criteria for an adequate image.
Data Type	Categorical
Value Set	Nipple not visible Nipple visible Unknown
Units	N/A

Motion Blur

RadElement ID	RDE931
Definition	Identify whether image contains blur. Blur in the image may require further imaging.
Data Type	Categorical
Value Set	No motion blur Image contains motion blur Unknown
Units	N/A

Adequate visualization of posterior breast tissue

RadElement ID	RDE932
Definition	Adequate visualization of posterior breast tissue.
Data Type	Categorical
Value Set	Inadequate visualization Adequate visualization Unknown
Units	N/A

Sagging of the breast on MLO view

RadElement ID	RDE933
Definition	Excessive sagging of the breast on MLO view
Data Type	Categorical
Value Set	Acceptable position Excessive sagging Unknown
Units	N/A

Inframammary Fold on MLO

RadElement ID	RDE934
Definition	inframammary fold visible on the MLO view
Data Type	Categorical
Value Set	Inframammary fold not visible Inframammary fold visible Unknown
Units	N/A

Breast height on image receptor

RadElement ID	RDE935
Definition	breast height on image receptor for MLO view
Data Type	Categorical
Value Set	Acceptable breast height Breast too high Unknown
Units	N/A

Posterior nipple line on the CC view

RadElement ID	RDE936
Definition	posterior nipple line on the CC view. Should measure less than 1 cm of the same measurement on the MLO view
Data Type	Numeric
Value Set	N/A
Units	cm

Skin folds obscuring visualization

RadElement ID	RDE937
Definition	skin folds from breast positioning that may obscure visualization
Data Type	Categorical
Value Set	no skin folds skin folds may obscure visualization unknown
Units	N/A

Excessive Exaggeration

RadElement ID	RDE938
Definition	excessive exaggeration of the breast on CC view
Data Type	Categorical
Value Set	no excessive exaggeration excessive exaggeration unknown
Units	N/A

Other body parts obscuring image

RadElement ID	RDE939
Definition	determine if other body parts projected over the breast on the image obscure visualization of breast tissue
Data Type	Categorical
Value Set	no other body part other body parts present unknown
Units	N/A

Breast Cut off

RadElement ID	RDE940
Definition	Identify if any portion of the breast is cut off
Data Type	Categorical
Value Set	No breast cut off in image Breast cutoff in image Unknown
Units	N/A

Additional view necessary

RadElement ID	RDE941
Definition	Identify whether further imaging should be taken based on the adequacy of previous imaging.
Data Type	Categorical
Value Set	No further imaging necessary Further imaging necessary Unknown
Units	N/A