Department of Radiology, Albany Medical Center South Clinical Campus, 25 Hackett Blvd, Albany, NY 12208; Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215.
Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215.
Acad Radiol. 2014 Jan;21(1):99-103. doi: 10.1016/j.acra.2013.10.005.
When using mammographic detectors of different sizes, it can be difficult to match patient breast size to optimal detector size. We studied whether a mismatch between breast size and optimal detector size resulted in increased radiation exposure.
All screening and diagnostic (Dx) mammography patients during a 6-week period in November-December 2009 (864 patients) were evaluated (institutional review board exemption for quality assurance studies). Data gathered included breast size (large or small), detector size used, number of views obtained, mean glandular dose (MGD) per breast, and patient waiting time. Average MGD and average waiting time was calculated for imaging performed on appropriately matched or mismatched breast size-detector size pairs.
Screening mammography patients with large breasts imaged on a small detector received a significantly higher radiation dose (4.9 vs. 3.3 mGy, P < .05) and a greater number of views (5.9 vs. 4.6, P < .05) compared to optimally matched breast-detector pairs. Dx mammography patients with large breasts imaged on a small detector received a higher radiation dose (8.2 vs. 6.7 mGy, P < .05) compared to optimally matched breast-detector pairs, although without an increased number of views. Waiting times were longer for a large detector.
A mismatch in breast-detector sizes results in a significantly greater radiation dose to patients with large breasts imaged on a small detector. Pressure to minimize patient waiting time may inadvertently result in increased radiation dose. Detector size should be matched to breast size whenever possible, but particularly for patients with larger breast sizes.
使用不同尺寸的乳腺探测器时，可能难以将患者乳房大小与最佳探测器尺寸相匹配。我们研究了乳房大小与最佳探测器尺寸不匹配是否会导致辐射暴露增加。
在 2009 年 11 月至 12 月的 6 周期间，对所有筛查和诊断（Dx）乳腺摄影患者（机构审查委员会豁免质量保证研究）进行了评估。收集的数据包括乳房大小（大或小）、使用的探测器尺寸、获得的视图数量、每只乳房的平均腺体剂量（MGD）和患者等待时间。为适当匹配或不匹配的乳房大小-探测器尺寸对进行成像计算平均 MGD 和平均等待时间。
与最佳匹配的乳房-探测器对相比，大乳房在小探测器上成像的筛查乳腺摄影患者接受的辐射剂量显著更高（4.9 比 3.3 mGy，P <.05），且获得的视图更多（5.9 比 4.6，P <.05）。与最佳匹配的乳房-探测器对相比，大乳房在小探测器上成像的 Dx 乳腺摄影患者接受的辐射剂量更高（8.2 比 6.7 mGy，P <.05），尽管视图数量没有增加。大探测器的等待时间更长。
乳房-探测器尺寸不匹配会导致在小探测器上对大乳房进行成像的患者接受的辐射剂量显著增加。为尽量减少患者等待时间的压力可能会无意中导致辐射剂量增加。应尽可能将探测器尺寸与乳房大小相匹配，但对于乳房较大的患者尤其如此。
