Commercially available direct digital (DR) and computerized radiography (CR) mammography systems vary greatly in terms of physical performance and cost. Some large clinical trials have provided insight on the clinical performance of various detectors.1,2 One of these, the ACRIN DMIST study1 was a large prospective study in which patients were imaged on both screen-film and digital systems. This study found the overall diagnostic accuracy for screen-film and digital to be similar, but digital mammography was more accurate in women under the age of 50 yr, women with radiographically dense breasts, and pre- or perimenopausal women.