1 Department of Radiology, The University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 4032, Kansas City, KS 66160.
2 Department of Radiology, Piedmont Athens Regional Medical Center, Athens, GA.
AJR Am J Roentgenol. 2017 Dec;209(6):1419-1425. doi: 10.2214/AJR.16.17522. Epub 2017 Sep 5.
The objective of our study was to evaluate positioning of full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) compared with film-screen (FS) mammography positioning standards.
A retrospective study was conducted of consecutive patients who underwent screening FFDM in 2010-2012 and DBT in 2012-2013 at an academic institution. Examinations were performed by five experienced technologists who underwent updated standardized positioning training. Positioning criteria were assessed by consensus reads among three breast radiologists and compared with FS mammography data from a 1993 study by Bassett and colleagues.
One hundred seventy patients (n = 340 examinations) were analyzed, showing significant differences between FFDM and DBT examinations (p < 0.05) for medial or inferior skin folds (FFDM vs DBT: craniocaudal [CC] view, 16% [n = 56] vs 23% [n = 77]; mediolateral oblique [MLO] view, 35% [n = 118] vs 45% [n = 154]), inclusion of lateral glandular tissue on CC view (FFDM vs DBT, 73% [n = 247] vs 81% [n = 274]), and concave pectoralis muscle shape (FFDM vs DBT, 36% [n = 121] vs 28% [n = 95]). In comparison with Bassett et al. data, all positioning criteria for both FFDM and DBT examinations were significantly different (p < 0.05). The largest differences were found in visualization of the pectoralis muscle on CC views and the inframammary fold on MLO views, inclusion of posterior or lateral glandular tissue, and inclusion of skin folds, with DBT and FFDM more frequently exhibiting all criteria than originally reported Bassett et al.
DBT and FFDM mammograms more frequently include posterior or lateral tissue, the inframammary fold on MLO views, the pectoralis muscle on CC views, and skin folds than FS mammograms. Inclusion of more breast tissue with newer technologies suggests traditional positioning standards, in conjunction with updated standardized positioning training, are still applicable at the expense of including more skin folds.
本研究的目的是评估全数字化乳腺摄影（FFDM）和数字乳腺断层摄影（DBT）与屏片乳腺摄影（FS）的定位标准相比的定位情况。
回顾性分析了 2010 年至 2012 年在学术机构行筛查 FFDM 及 2012 年至 2013 年行 DBT 的连续患者。检查由 5 名经验丰富的技师进行，他们接受了更新的标准化定位培训。三位乳腺放射科医生通过共识阅读评估了定位标准，并与 Bassett 及其同事在 1993 年进行的 FS 乳腺摄影数据进行了比较。
共分析了 170 例患者（n = 340 次检查），FFDM 和 DBT 检查之间存在显著差异（p < 0.05），包括内侧或下侧皮肤褶皱（FFDM 与 DBT：头尾位[CC]视图，16%[n = 56]比 23%[n = 77]；内外斜位[MLO]视图，35%[n = 118]比 45%[n = 154]）、CC 视图上包含外侧腺组织（FFDM 与 DBT，73%[n = 247]比 81%[n = 274]）和胸大肌凹陷形状（FFDM 与 DBT，36%[n = 121]比 28%[n = 95]）。与 Bassett 等人的数据相比，FFDM 和 DBT 检查的所有定位标准均有显著差异（p < 0.05）。最大的差异出现在 CC 视图上胸大肌和 MLO 视图上的乳房下皱襞、包含后外侧腺组织和皮肤褶皱的显示上，DBT 和 FFDM 比 Bassett 等人最初报告的更频繁地表现出所有标准。
与 FS 乳腺摄影相比，DBT 和 FFDM 乳腺摄影更频繁地包括后外侧组织、MLO 视图上的乳房下皱襞、CC 视图上的胸大肌和皮肤褶皱。新技术包含更多的乳腺组织，提示传统的定位标准，结合更新的标准化定位培训，仍然适用，代价是包含更多的皮肤褶皱。
