Siemens MAMMOMAT 1000 Nova Application Handbook
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Siemens MAMMOMAT 1000 Nova Application Handbook

Mammography applications
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  • Page 1 Mammography Applications for MAMMOMAT 1000/3000 Nova...
  • Page 2 Introduction This booklet is intended as an application handbook for use with Siemens MAMMOMAT® 1000 and 3000 Nova. The booklet contains advice on positioning, instruc- tions for choice of exposure and proper positioning of the Automatic Exposure Control (AEC) detector.

  • Page 3: Table Of Contents

    Contents General advice Positioning Compression AEC-detector Choice of exposure Opdose Image quality Radiation quality Film/screen combinations Processing Positioning Mediolateral oblique view, MLO Cranio-caudal projection, CC Lateral projection Medio lateral, ML Latero medial, LM Specialized mammographic technique Spot compression Magnification Biopsy methods Biopsy hole plate Shadow cross Stereo...

  • Page 5: General Advice

    Begin each setting by chosing the correct slide marker for the desired projection. With Siemens fixed markings, the risk of faulty marking is limited. The marking for a cranio-caudal projection is always...

  • Page 6: Positioning

    Opcomp Siemens MAMMOMAT 1000/3000 Nova are fitted with Opcomp. Opcomp senses for each individual breast when the compression force is sufficient for optimal image quality. The force can be increased but this only adds to the discomfort and does not provide any improvement in image quality.
  • Page 7 Set the maximum value for the compression force – 20 kg – unless your facility has other guidelines. Select automatic decompression (however, not when biopsies and localizations are to be performed). Apply compression until the breast is evenly and firmly compressed. Ensure that no folds form in the skin.

  • Page 8: Aec-Detector

    GENERAL ADVICE AEC-detector In order to obtain the correct density on the images, the AEC detector should be moved to the densest area in the breast. Move the AEC-detector lever to the marking, which corresponds with the marking in the compression plate. Ensure that the breast com- pletely covers the position of the AEC detector with a 2 cm margin, otherwise the chamber will be measuring air.

  • Page 9: Choice Of Exposure

    GENERAL ADVICE Choice of exposure Both Siemens MAMMOMAT 1000 and Siemens MAMMOMAT 3000 Nova are equipped with automatic exposure control (AEC). Only the kV value is set manually. After exposure, the mAs value obtained can be read on the generator control panel.

  • Page 10: Opdose

    GENERAL ADVICE Opdose Siemens MAMMOMAT 1000 and 3000 Nova are equipped with an automatic exposure system - Opdose. Opdose suggests the exposure parameters depending on the thickness of the breast. Both kV and an anode/ filter combination are suggested in accordance with what has been preset for the respective thickness interval (see program table on page 12).
  • Page 11 GENERAL ADVICE On the control panel, an indicator lamp will now be flas- hing over the program which is suggested. Confirm by pressing the program button for the suggested program. Make the exposure. It is recommended that the same program is kept for the entire examination.
  • Page 12 GENERAL ADVICE The program values as preset from the factory are, for Mo/W tube: Program Compression kV-value Anode/Filter- thickness combination 0 - 29 mm Mo / Mo 30 - 44 mm Mo / Mo 45 - 59 mm Mo / Rh ≈...

  • Page 13: Image Quality

    IMAGE QUALITY Image quality Several factors affect the image quality. In addition to the pre- viously mentioned factors such as positioning, compression and the position of the detector, the cooperation between the doctor, radiographer and patient is of greatest importance.

  • Page 14: Radiation Quality

    (28-30) in order to keep the contrast down. At 25 kV and large focal spot, the tube current for a Siemens mammography-X-ray tube with a molybdenum anode is 150 mA.

  • Page 15: Film/Screen Combinations

    IMAGE QUALITY Film/screen combinations Mammography film and screens are made to provide high reso- lution and high contrast. For normal mammography, screens with the highest possible resolution should be used. Faster screens can be used for magnification, to reduce the exposure time. The resolution will be maintained through the small focal spot.

  • Page 16: Processing

    IMAGE QUALITY Processing Even a picture which has been properly exposed and skillfully executed can easily lose in quality in a poor development process. The film processing machine is the heart of the mammography department. Deterioration in image quality can often be traced to a disorder in the development process.

  • Page 17: Positioning

    Positioning Mediolateral oblique view MLO For routine examinations, the MLO projec- tion is to be preferred over the 90° lateral projection. More of the breast tissue can be seen in the upper outer quadrant and the axilla. Furthermore, it is easier to carry out the application with this setting.
  • Page 18 POSITIONING Set the angle for the desired projection (30°- 60°). It is best to adapt the angle to each patient. The object table should be parallel with the pectoral muscle. Many clinics want to use the same pro- jection angle for all patients, in order to be able to reproduce the image on the next occasion.
  • Page 19 POSITIONING Place the patient’s hand on the lower part of the handle. Turn the patient 45° or more in towards the stand. Ask the patient to stand steadi- ly and not to move her feet. Instruct the patient to lift her elbow but still keep her hand in the same position.

  • Page 20: Cranio-Caudal Projection Cc

    POSITIONING Cranio-caudal projection Criteria: The whole breast parenchyma should be depicted. The fatty tissue closest to the breast muscle should appear as a dark stripe on the X-ray and behind that it should be possible to discern the pectoral muscle. The nipple should be depicted in profile. Lift the breast approximately 2 cm and adjust the height so that the object table touches your...
  • Page 21 POSITIONING Stand on the medial side of the breast which is to be X-rayed (or behind the patient). Ask the patient to turn her head in your direction (good to have eye con- tact). Take hold of the patient’s back and shoulder in order to press her closer to the table.

  • Page 22: Lateral Projection

    POSITIONING Lateral projection The lateral projection can be taken either from the medial side (mediolateral, ML) or from the lateral side (lateromedial, LM). If no oblique projection is taken, the mediolateral projection may be preferable since the lateral side of the breast, where pathological changes are most commonly found, is then closest to the film.

  • Page 23: Medio Lateral Ml

    90° POSITIONING Medio lateral mediolateral Set the X-ray tube in a 90° lateral projection. Ensure that the correct slide marker is used. Set the height to the axillary fold. Ask the patient to put up her arm along the object table and stretch it well forward. Grasp the breast from below and draw it out while applying compression.

  • Page 24: Latero Medial Lm

    POSITIONING Latero medial 90° lateromedial Set the tube in a 90° lateral projection. Ensure that the correct slide marker is used. Set the height to the uppermost point of the sternum. Position the patient with the object table between her breasts. Ask the patient to lift her arm and place her hand on the handle while keeping the elbow lifted.

  • Page 25: Specialized Mammographic Technique

    SPECIALIZED MAMMOGRAPHIC TECHNIQUES Specialized mammographic technique Spot compression Spot compression images are valuable when improved compression is desired over a small area and overlapping structures need to be separated. Since scattered radiation is reduced with this technique, it is possible to obtain high contrast and detailed images. Set the tube at the angle desired.

  • Page 26: Magnification

    SPECIALIZED MAMMOGRAPHIC TECHNIQUES Magnification When making exposures with a magnification table, the same positioning methods are used as for normal images or spot compression images. There are two different compression plates available, a flat plate used without a aperture and a spot compression plate with a corresponding aperture.

  • Page 27: Biopsy Methods

    BIOPSY METHODS Biopsy and localization methods Mammography is a superior method for early detection of breast cancer. Many pathological changes that are discovered are so small that it is not possible to carry out palpation guided biopsies. X-ray guided biopsies can be carried out in various ways and with different means.

  • Page 28: Stereo

    BIOPSY METHODS Stereo On the Siemens MAMMOMAT 3000 Nova, there is the possibility of connecting up a stereo biopsy attachment. With the aid of this stereo attachment, biopsies can be performed both with fine needle and core-gun technique. Instructions on how the attach- ment is mounted and used is described in the separate Operating Instructions “Stereotactic Biopsy Attachment”.
  • Page 29 BIOPSY METHODS Position and compress. Note the compression thickness so that you can make an adjustment if the compression value changes. Mark on the breast with a felt-tip pen the inner corners of the compression plate. In this way, you have control over the positioning and you will notice at once if the patient has moved.
  • Page 30 Siemens reserves the right to modify the design, packaging, specifications and options described herein without prior notice. Please contact your local Siemens sales representative for the most current information.

This manual is also suitable for:

Mammomat 3000 nova

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