James Judy R, Pavlicek William, Hanson James A, Boltz Thomas F, Patel Bhavika K
1 Department of Radiology, Diagnostic Physics Division, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054.
2 Department of Radiology, Breast Imaging Division, Mayo Clinic Arizona, Phoenix, AZ.
AJR Am J Roentgenol. 2017 Feb;208(2):362-372. doi: 10.2214/AJR.16.16743.
We aimed to compare radiation dose received during contrast-enhanced spectral mammography (CESM) using high- and low-energy projections with radiation dose received during 2D full field digital mammography (FFDM) and 3D tomosynthesis on phantoms and patients with varying breast thickness and density.
A single left craniocaudal projection was chosen to determine the doses for 6214 patients who underwent 2D FFDM, 3662 patients who underwent 3D tomosynthesis, and 173 patients who underwent CESM in this retrospective study. Dose measurements were also collected in phantoms with composition mimicking nondense and dense breast tissue.
Average glandular dose (AGD) ± SD was 3.0 ± 1.1 mGy for CESM exposures at a mean breast thickness of 63 mm. At this thickness, the dose was 2.1 mGy from 2D FFDM and 2.5 mGy from 3D tomosynthesis. The nondense phantom had a mean AGD of 1.0 mGy with 2D FFDM, 1.3 mGy with 3D tomosynthesis, and 1.6 mGy with CESM. The dense breast phantom had a mean AGD of 1.3 mGy with 2D FFDM, 1.4 mGy with 3D tomosynthesis, and 2.1 mGy with CESM. At a compressed thickness of 4.5 cm, radiation exposure from CESM was approximately 25% higher in dense breast phantoms than in nondense breast phantoms. The dose in the dense phantom at a compressed thickness of 6 cm was approximately 42% higher than the dose in the nondense phantom at a compressed thickness of 4.5 cm.
CESM was found to increase AGD at a mean breast thickness of 63 mm by approximately 0.9 mGy and 0.5 mGy compared with 2D FFDM and 3D tomosynthesis, respectively. Of note, CESM provides a standard image (similar to 2D FFDM) that is obtained using the low-energy projection. Overall, the AGD from CESM falls below the dose limit of 3 mGy set by Mammography Quality Standards Act regulations.
我们旨在比较在不同乳房厚度和密度的体模及患者中，使用高能和低能投影的对比增强光谱乳腺摄影（CESM）所接受的辐射剂量与二维全场数字化乳腺摄影（FFDM）和三维断层合成所接受的辐射剂量。
在这项回顾性研究中，选择单个左侧头尾位投影来确定6214例接受二维FFDM、3662例接受三维断层合成以及173例接受CESM的患者的剂量。还在模拟非致密和致密乳腺组织成分的体模中收集剂量测量数据。
在平均乳房厚度为63毫米时，CESM曝光的平均腺体剂量（AGD）±标准差为3.0±1.1毫戈瑞。在此厚度下，二维FFDM的剂量为2.1毫戈瑞，三维断层合成的剂量为2.5毫戈瑞。非致密体模中，二维FFDM的平均AGD为1.0毫戈瑞，三维断层合成的为1.3毫戈瑞，CESM的为1.6毫戈瑞。致密乳腺体模中，二维FFDM的平均AGD为1.3毫戈瑞，三维断层合成的为1.4毫戈瑞，CESM的为2.1毫戈瑞。在压缩厚度为4.5厘米时，致密乳腺体模中CESM的辐射暴露比非致密乳腺体模高约25%。在压缩厚度为6厘米时，致密体模中的剂量比压缩厚度为4.5厘米时非致密体模中的剂量高约42%。
发现在平均乳房厚度为63毫米时，与二维FFDM和三维断层合成相比，CESM使AGD分别增加约0.9毫戈瑞和0.5毫戈瑞。值得注意的是，CESM提供了一个使用低能投影获得的标准图像（类似于二维FFDM）。总体而言，CESM的AGD低于《乳腺摄影质量标准法案》规定的3毫戈瑞剂量限值。
