From the *Departments of Radiology and Nuclear Medicine, †GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht; and ‡Dutch Reference Center for Screening, Nijmegen, the Netherlands.
Invest Radiol. 2015 Oct;50(10):679-85. doi: 10.1097/RLI.0000000000000168.
Our study aim was to assess the radiation dose of digital breast tomosynthesis (DBT) in comparison to full-field digital mammography (FFDM) in a clinical setting.
Two-hundred four patients were consecutively included, of which 236 complementary DBT and FFDM examinations were available. All acquisitions were performed on a single commercially available mammography system capable of FFDM and DBT acquisitions using an antiscatter grid. The average glandular dose (AGD) was calculated for each examination using the Dance method. For this, tube output and half-value layer were measured, and the required exposure parameters (target/filter material, tube voltage, tube load, compressed breast thickness) were retrieved from the DICOM metadata. The DBT and FFDM AGD values were pairwise tested, and a subanalysis with respect to breast thickness was performed.
The mean (SD) AGD values for a single-view DBT and FFDM were 1.49 (0.36) mGy and 1.62 (0.55) mGy, respectively, which are small but statistically significant differences. This difference may be partially attributed to the small difference in the mean breast thickness between FFDM and DBT (3 mm). In this patient population, the AGD was lower for DBT than for FFDM in 61% of the patients. When patients were categorized according to breast thickness, the AGD of DBT was only significantly smaller than the AGD of FFDM for breast thickness categories larger than 50 mm, indicating that the dose reduction for DBT compared with FFDM was more pronounced in thick breasts.
The radiation dose of patients undergoing a single-view DBT was comparable to a single-view FFDM. For patients with thicker breasts, the radiation dose of DBT was slightly lower than FFDM.
本研究旨在评估数字乳腺断层摄影术(DBT)与全视野数字化乳腺摄影术(FFDM)在临床环境中的辐射剂量。
连续纳入 204 例患者,其中 236 例补充 DBT 和 FFDM 检查均可用。所有采集均在单台商业可用的乳腺摄影系统上进行,该系统能够使用散射栅格进行 FFDM 和 DBT 采集。使用 Dance 法计算每次检查的平均腺体剂量(AGD)。为此,测量管输出和半价层,并从 DICOM 元数据中检索所需的曝光参数(靶/滤光材料、管电压、管负载、压缩乳腺厚度)。对 DBT 和 FFDM 的 AGD 值进行了两两比较,并进行了关于乳腺厚度的亚分析。
单次 DBT 和 FFDM 的平均(SD)AGD 值分别为 1.49(0.36)mGy 和 1.62(0.55)mGy,差异虽小但具有统计学意义。这种差异部分归因于 FFDM 和 DBT 之间平均乳腺厚度的微小差异(3mm)。在该患者人群中,61%的患者 DBT 的 AGD 低于 FFDM。当根据乳腺厚度对患者进行分类时,仅在乳腺厚度大于 50mm 的类别中,DBT 的 AGD 明显小于 FFDM 的 AGD,这表明与 FFDM 相比,DBT 的剂量降低在厚乳房中更为明显。
接受单次 DBT 的患者的辐射剂量与单次 FFDM 相当。对于乳腺较厚的患者,DBT 的辐射剂量略低于 FFDM。