Siemens MAMMOMAT 1000 Nova User guide

Mammography Applications
for MAMMOMAT 1000/3000 Nova

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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.

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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

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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
6
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.

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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.
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GENERAL ADVICE
8
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
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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
10
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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