Siemens MAMMOMAT 1000 Nova Benutzerhandbuch

Mammography Applications

for MAMMOMAT 1000/3000 Nova

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.

There are also instructions on the use of Opcomp®

and Opdose®.

This handbook with helpful hints and directions is

a complement to the operator’s manual. It should

be noted that this is not a textbook and that we

make no claim of complete coverage of the subjects

discussed. The responsibility for medical judge-

ments and directions remains with the attending

physician.

For information on other questions relating to the

operation of your MAMMOMAT 1000/3000 Nova,

please refer to the Operating Instructions.

Contents

General advice 5

Positioning 6

Compression 6

AEC-detector 8

Choice of exposure 9

Opdose 10

Image quality 13

Radiation quality 14

Film/screen combinations 15

Processing 16

Positioning 17

Mediolateral oblique view, MLO 17

Cranio-caudal projection, CC 20

Lateral projection 22

Medio lateral, ML 23

Latero medial, LM 24

Specialized mammographic technique 25

Spot compression 25

Magnification 26

Biopsy methods 27

Biopsy hole plate 27

Shadow cross 27

Stereo 28

General advice

It is always important to inform the patient how

the examination will be performed. It should be

explained why it is necessary to compress the breast

and that it will be uncomfortable for a short time.

Always keep the patient under observation. If the

patient is very sensitive to pain or very nervous, it is

recommended that two radiographers attend in

the room. 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

found on the lateral side of the breast.

GENERAL ADVICE

Positioning

Correct positioning of the breast is extremely important. If the

entire breast is not in the X-ray field, or there is something block-

ing the X-ray field, the whole diagnosis can be incorrect. It is also

easier to apply good compression when the positioning is correct.

Compression

Proper and adequate compression is necessary in order to reduce

the radiation dose, displace the tissue apart and avoid blurring

due to motion. Inadequate compression can, for example, mean

that small micro-calcifications do not appear on the X-ray image,

as a result of which the patient risks getting an incorrect diagnosis.

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. Opcomp is purely an aid. It

is always the operator who decides if the compression is to stop

before, after or on the Opcomp value.

When using Opcomp, the foot switch is to be kept pressed down

during the whole compression process. Using a pumping techni-

que on the foot switch can result in the Opcomp indication failing

to appear.

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.

When using Opcomp:

Begin by applying

compression until the

compression plate comes

into contact with the

skin (3-5 kg). Smooth out

any folds in the skin.

Press the foot switch all the way down, continue compression

until the plate stops and the green OC lamp on the stand display is

lit. Keep the patient under observation.

Studies have shown that the Opcomp value on average is 9-12 kg

for the CC view and 13-16 kg for the MLO view. However, some

breasts may require up to 20 kg. This is not harmful. The breasts

withstand this temporary deformation, but pay attention to the

patient. Do not override the patients pain-treshold.

More information on Opcomp can be found in the operating

instructions.

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. Do not forget to

return the detector to the chestwall-close position after each patient.

The image on the left demonstrates the

cassettes turbo release function. The text

does not mention this aspect of the unit.

Should this image be removed or should

text be added.

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.

If desired, both kV and mAs can also be

chosen manually. When the mAs button is

first activated, a value of 100 mAs is shown

on the display. Continue to press the mAs

button until the desired value is shown,

then make the exposure.

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). That is, the larger the breast the more

the high-energy radiation, which enables the dose and exposure

time to be kept down. The user must confirm the values before an

exposure is made.

Make sure that the

“Auto” button is pressed in.

Position the patient and

apply the compression.

The compression force must

be at least 6 kg for the Opdose

to activate.

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