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Direct Radiography Photon-Counting Systems Detect More Breast Cancers


Direct radiography photon-counting systems detect more smaller breast cancers and DCIS, but also cause more recalls.

Direct radiography photon-counting systems provide higher detection rates of small invasive cancers and ductal carcinoma in situ (DCIS) than statewide screening with different digital technologies, according to a study published in the journal Radiology.

Researchers from Germany undertook a retrospective study of prospectively acquired data from a German mammography screening program from 2009 to 2010. The purpose was to determine the efficacy of direct radiography (DR) photon-counting systems in breast cancer screening.

A total of 13,312 women underwent scanning with the DR photon-counting system and 993,822 women underwent alternate digital screening examinations by either computed radiography mammography or DR. The researchers assessed cancer detection rate, recall rate and proportion of small invasive cancers and DCIS.

The findings showed that the cancer detection rate was higher with the photon-counting system:


DR photon counting


Cancer detection rate



(0.76 percent)


(0.58 percent)

Recall rate


(5.4 percent)


3.3 percent

Detection of invasive cancers up to 10 mm

Patients, initial screening

40 percent

31.6 percent

Patients, subsequent screening

42 percent

32.5 percent


Patients, subsequent screening

0.23 percent

0.12 percent

The researchers concluded that the DR photon-counting technique for breast cancer screening detected more small cancers than did other DR imaging, but also produced higher recall rates.

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