From the *Department of Radiology, Maastricht University Medical Center, Maastricht; †Department of Clinical Physics, Màxima Medical Center, Veldhoven; and ‡GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands.
Invest Radiol. 2014 Oct;49(10):659-65. doi: 10.1097/RLI.0000000000000068.
Contrast-enhanced spectral mammography (CESM) shows promising initial results but comes at the cost of increased dose as compared with full-field digital mammography (FFDM). We aimed to quantitatively assess the dose increase of CESM in comparison with FFDM.
Radiation exposure-related data (such as kilovoltage, compressed breast thickness, glandularity, entrance skin air kerma (ESAK), and average glandular dose (AGD) were retrieved for 47 CESM and 715 FFDM patients. All examinations were performed on 1 mammography unit. Radiation dose values reported by the unit were validated by phantom measurements. Descriptive statistics of the patient data were generated using a statistical software package.
Dose values reported by the mammography unit were in good qualitative agreement with those of phantom measurements. Mean ESAK was 10.5 mGy for a CESM exposure and 7.46 mGy for an FFDM exposure. Mean AGD for a CESM exposure was 2.80 mGy and 1.55 mGy for an FFDM exposure.
Compared with our institutional FFDM, the AGD of a single CESM exposure is increased by 1.25 mGy (+81%), whereas ESAK is increased by 3.07 mGy (+41%). Dose values of both techniques meet the recommendations for maximum dose in mammography.
与全视野数字乳腺摄影术（FFDM）相比，对比增强光谱乳腺摄影术（CESM）显示出有希望的初步结果，但代价是剂量增加。我们旨在定量评估 CESM 与 FFDM 相比的剂量增加。
为 47 例 CESM 和 715 例 FFDM 患者检索了与辐射暴露相关的数据（如千伏、压缩乳房厚度、腺体、入射皮肤空气比释动能（ESAK）和平均腺体剂量（AGD）。所有检查均在 1 台乳腺摄影机上进行。通过体模测量验证了设备报告的辐射剂量值。使用统计软件包生成患者数据的描述性统计数据。
设备报告的剂量值与体模测量值具有良好的定性一致性。CESM 曝光的平均 ESAK 为 10.5 mGy，FFDM 曝光的平均 ESAK 为 7.46 mGy。CESM 曝光的平均 AGD 为 2.80 mGy，FFDM 曝光的平均 AGD 为 1.55 mGy。
与我们机构的 FFDM 相比，单次 CESM 曝光的 AGD 增加了 1.25 mGy（增加 81%），而 ESAK 增加了 3.07 mGy（增加 41%）。两种技术的剂量值均符合乳腺摄影术最大剂量的建议。
