The objective of this research is to develop an improved screen-film mammography system which provides improved breast lesion and microcalcification sensitivity in dense fibroglandular tissue without compromising diagnostic sensitivity for the "average" breasts. The essential novelty of the approach lies in recognizing that 50% of the light produced in the phosphor screen is wasted in the current mammography screen-film technology. The proposed approach uses that light by exposing a second film which is faster than the first film, thereby permitting a wider exposure latitude imaging system. In Phase I, the feasibility of achieving this goal was demonstrated. That system has been shown in Phase I to be adequate to meet the general objectives. In this proposed work, the prototype cassettes which accommodate several new screen-film combinations with the required characteristics will be developed. In collaboration with Eastman Kodak Company and Sterling Diagnostic Imaging, Inc., screens and films will be optimized to achieve high resolution (>20 lp/mm on the first film and equal to or > 15 lp/mm on the second film) and low image noise. The commercial application of this new technology is to provide a superior alternative to the existing screen-film technology. The proposed technique could be the dominant approach to improve mammography in small hospitals for the next decade and provide cost- effective health care in the rural areas. PROPOSED COMMERCIAL APPLICATIONS: There is a substantial world wide market for breast cancer screening devices which can provide improved diagnostic accuracy in a population of patients with dense breasts. The proposed screen-film combinations provide a cost-effective solution to dense breast problems, and can be used in every mammography center with negligible added capital cost. Success in mammography may also be expanded to other areas of medical and industrial radiography.