Agasthya Greeshma A, D'Orsi Ellen, Kim Yoon-Jin, Handa Priyanka, Ho Christopher P, D'Orsi Carl J, Sechopoulos Ioannis
1 Department of Radiology and Imaging Sciences, Winship Cancer Institute, Emory University, Atlanta, GA.
2 Department of Radiology and Nuclear Medicine, Radboud University Medical Center and Dutch Reference Centre for Screening, P.O. Box 9101, 6500 HB Nijmegen 766, The Netherlands.
AJR Am J Roentgenol. 2017 Nov;209(5):W322-W332. doi: 10.2214/AJR.16.17615. Epub 2017 Sep 20.
The objective of this study was to investigate the impact of decreasing breast compression during digital mammography and breast tomosynthesis (DBT) on perceived pain and image quality.
In this two-part study, two groups of women with prior mammograms were recruited. In part 1, subjects were positioned for craniocaudal (CC) and mediolateral oblique (MLO) views, and four levels of compression force were applied to evaluate changes in breast thickness, perceived pain, and relative tissue coverage. No imaging was performed. In part 2, two MLO DBT images of one breast of each patient were acquired at standard and reduced compression. Blurring artifacts and tissue coverage were judged by three breast imaging radiologists, and compression force, breast thickness, relative tissue coverage, and perceived pain were recorded.
Only the first reduction in force was feasible because further reduction resulted in inadequate breast immobilization. Mean force reductions of 48% and 47% for the CC and MLO views, respectively, resulted in a significantly reduced perceived pain level, whereas the thickness of the compressed breast increased by 0.02 cm (CC view) and 0.09 (MLO view, part 1 of the study) and 0.38 cm (MLO view, part 2 of the study), respectively, with no change in tissue coverage or increase in motion blurring.
Mammography and DBT acquisitions may be possible using half of the compression force used currently, with a significant and substantial reduction in perceived pain with no clinically significant change in breast thickness and tissue coverage.
本研究的目的是调查在数字乳腺摄影和乳腺断层合成（DBT）过程中降低乳房压迫对感知疼痛和图像质量的影响。
在这项分为两部分的研究中，招募了两组曾进行过乳腺摄影的女性。在第一部分中，让受试者摆好头尾位（CC）和内外斜位（MLO）的姿势，并施加四种压迫力水平，以评估乳房厚度、感知疼痛和相对组织覆盖度的变化。未进行成像。在第二部分中，对每位患者的一侧乳房在标准压迫和降低压迫的情况下采集两张MLO DBT图像。由三位乳腺影像放射科医生判断模糊伪影和组织覆盖情况，并记录压迫力、乳房厚度、相对组织覆盖度和感知疼痛。
只有第一次降低压迫力是可行的，因为进一步降低会导致乳房固定不充分。CC位和MLO位的平均压迫力分别降低48%和47%，导致感知疼痛水平显著降低，而受压乳房的厚度分别增加了0.02厘米（CC位）和0.09厘米（MLO位，研究的第一部分）以及0.38厘米（MLO位，研究的第二部分），组织覆盖度无变化，运动模糊也未增加。
乳腺摄影和DBT采集可能使用目前压迫力的一半，同时感知疼痛显著大幅降低，而乳房厚度和组织覆盖度无临床显著变化。
