Future Developments

Database of digital images of screen detected cancers

One of the outcomes of the OPTIMAM project is the collection of unprocessed images of screen detected cancers. These are being stored as part of a database which includes information on the location and extent of the cancer and its radiographic features. Currently images are being collected from the two clinical sites in OPTIMAM. However, we plan to extend this soon to include the Jarvis Centre in Guildford which will soon be all digital. Although the primary purpose in assembling these images is for the OPTIMAM project it is clear that such a collection could be useful for a variety of other purposes including further research, training, reader evaluation and CAD evaluation. A specific application would be to provide digital images for PERFORMS. It is planned to discuss with the wider NHSBSP the development of this database into a national resource. This would involve adding more provider clinical sites as they adopt digital equipment. One issue to be addressed is the need to save both unprocessed and processed image files. Another issue is the resource implications of building the database which will involve some additional work and possibly resources at each clinical site and centrally to validate and store the images in the database.

Analysis of cancer detection data by system type

The change from analogue to digital technology has been shown recently to affect cancer detection in screening and that the results are different for different types of digital system. It is proposed to study the link between system type and cancer detection statistics for digital systems in the NHSBSP.

Evaluation of Image processing

Until now the technical evaluations conducted by NCCPM have been limited to the acquisition phase of digital imaging which does not include the image processing incorporated into all digital mammography systems. Experience in the OPTIMAM project and recent publications both suggest that variations in the image processing used by different manufacturers may in some cases have a detrimental impact on cancer detection. From now on it is proposed to ask manufacturers to make their software available for separate evaluation as part of routine evaluations by NCCPM on behalf of the NHSBSP.

Remote Quality Control of Digital mammography Systems

NCCPM is preparing to pilot a procedure for implementing remote QC on digital mammography systems in the NHSBSP.

Evaluation of Digital Breast Tomosynthesis (DBT)

Several manufacturers have developed commercial DBT systems. NCCPM will be involved in managing and developing technical quality control procedures for the TOMMY trial and it is planned that formal technical evaluations are conducted on all new systems and published as NHSBSP Equipment reports. This will involve the development of a new protocol as well as specially designed phantoms.