Current Status of and Future Directions for Digital Mammography

─ 179 ─ Screen-film mammography has certain technical limitations which reduce its effectiveness: the film gradient must be balanced against the need for wide latitude, detection of microcalcifications and portrayal of the clarity of the margins of breast masses are reduced due to the presence of film noise in the displayed image, film processing artifacts can degrade the mammographic image, and the day-to-day variability inherent in automated film processors can produce suboptimal image quality. The principal theoretical advantage of digital mammography comes from decoupling image display from the image receptor. This permits the digital image to be captured, stored electronically, and then manipulated, analyzed, and displayed however, whenever, and wherever it is needed. Numerous practical applications are being developed to take advantage of these intrinsic capabilities of digital mammography. Some of these applications have already gained clinical acceptance; others have not because of current hardware limitations. The following paragraphs describe the several practical applications of full-field digital mammography that can be expected to define its future roles.