Radiology Unit, Veneto Institute of Oncology IOV- IRCCS, via Gattamelata, 64, 35128, Padua, Italy.
U.O. Senologia Clinica e Screening Mammografico, Department of Diagnostics, Azienda Provinciale Servizi Sanitari (APSS), Trento, Italy.
Eur Radiol. 2018 Feb;28(2):573-581. doi: 10.1007/s00330-017-5024-4. Epub 2017 Aug 17.
To compare radiation dose delivered by digital mammography (FFDM) and breast tomosynthesis (DBT) for a single view.
4,780 FFDM and 4,798 DBT images from 1,208 women enrolled in a screening trial were used to ground dose comparison. Raw images were processed by an automatic software to determine volumetric breast density (VBD) and were used together with exposure data to compute the mean glandular dose (MGD) according to Dance's model. DBT and FFDM were compared in terms of operation of the automatic exposure control (AEC) and MGD level.
Statistically significant differences were found between FFDM and DBT MGDs for all views (CC: MGD=1.366 mGy, MGD=1.858 mGy; p<0.0001; MLO: MGD=1.374 mGy, MGD=1.877 mGy; p<0.0001). Considering the 4,768 paired views, Bland-Altman analysis showed that the average increase of DBT dose compared to FFDM is 38 %, and a range between 0 % and 75 %.
Our findings show a modest increase of radiation dose to the breast by tomosynthesis compared to FFDM. Given the emerging role of DBT, its use in conjunction with synthetic 2D images should not be deterred by concerns regarding radiation burden, and should draw on evidence of potential clinical benefit.
• Most studies compared tomosynthesis in combination with mammography vs. mammography alone. • There is some concern about the dose increase with tomosynthesis. • Clinical data show a small increase in radiation dose with tomosynthesis. • Synthetic 2D images from tomosynthesis at zero dose reduce potential harm. • The small dose increase should not be a barrier to use of tomosynthesis.
比较数字乳腺摄影术（FFDM）和乳腺断层合成术（DBT）单次成像的辐射剂量。
使用来自参加筛查试验的 1208 名女性的 4780 张 FFDM 和 4798 张 DBT 图像进行基础剂量比较。原始图像由自动软件处理，以确定体积乳腺密度（VBD），并与曝光数据一起根据 Dance 模型计算平均腺体剂量（MGD）。从自动曝光控制（AEC）的操作和 MGD 水平两方面对 DBT 和 FFDM 进行比较。
所有视图的 FFDM 和 DBT MGD 之间均存在统计学差异（CC：MGD=1.366 mGy，MGD=1.858 mGy；p<0.0001；MLO：MGD=1.374 mGy，MGD=1.877 mGy；p<0.0001）。考虑到 4768 对配对视图，Bland-Altman 分析显示 DBT 剂量比 FFDM 平均增加 38%，范围在 0%至 75%之间。
我们的研究结果表明，与 FFDM 相比，断层合成术会使乳房辐射剂量略有增加。鉴于 DBT 的出现，其与合成 2D 图像联合使用不应因对辐射负担的担忧而受阻，而应利用潜在临床获益的证据。
大多数研究比较了断层合成术与单独的乳腺摄影术。
对断层合成术的剂量增加存在一些担忧。
临床数据显示，断层合成术的辐射剂量略有增加。
从断层合成术的零剂量获取的合成 2D 图像可降低潜在危害。
小剂量增加不应成为使用断层合成术的障碍。
