Universitätsklinikum Augsburg, Klinik für Diagnostische Radiologie und Neuroradiologie, Stenglinstr. 2, 86156 Augsburg, Deutschland.
DONAUISAR Klinikum, Institut für Radiologie, Perlasberger Str. 41, 94469 Deggendorf.
Eur J Radiol. 2020 Aug;129:109140. doi: 10.1016/j.ejrad.2020.109140. Epub 2020 Jun 19.
Conventional mammography is a decisive tool in detecting breast cancer. Continuous efforts are undertaken in order to further improve the image quality as well as to reduce the applied doses. The purpose of our study was to compare diagnostic image quality of dose reduced computed mammography with a new needle-based detector system to full dose powder imaging plates.
We retrospectively compared 360 randomly chosen mammographies performed on a GE Senographe DMR running the Agfa DX-M needle-based imaging plate system (NIP) with their preliminary examinations which were acquired at standard dose with the same GE mammography device and an Agfa CR85-X powdered storage phosphor imaging plate system (PIP). NIP-based mammographies were about 29.8 % dose-reduced. The preliminary examinations had to be performed not earlier than 2 years before the recent investigations. Exclusion criteria were changes in ACR level and appearance of the scored targets and not optimally positioned and exposed mammographies. The images were blinded and read separately twice by 2 mammography experts according to a 3-point score on diagnostic image quality and the visualization of parenchyma, cysts, fibroadenomas, physiologic lymph nodes, solitary microcalcifications and macrocalcifications.
Dose reduced NIPs showed a significantly better visualization of parenchyma at ACR II/III and solitary microcalcifications at ACR I-III mammographies (p < 0.001) whereas the difference in scoring macrocalcifications, cysts, fibroadenomas and physiologic lymph nodes was not significant. The reading showed an excellent intra- (r = 0.97/0.94) and interobserver agreement (r = 0.92).
With computed mammography using the needle-based detector system a significant dose reduction is possible without loss of diagnostic image quality.
传统乳腺 X 线摄影是检测乳腺癌的决定性工具。为了进一步提高图像质量并降低所应用的剂量，人们一直在进行持续的努力。我们研究的目的是比较剂量降低的计算机乳腺 X 线摄影与新型基于针的探测器系统与全剂量粉末成像板的诊断图像质量。
我们回顾性地比较了在运行 Agfa DX-M 基于针的成像板系统（NIP）的 GE Senographe DMR 上进行的 360 次随机选择的乳腺 X 线摄影及其初步检查，这些初步检查是在相同的 GE 乳腺 X 线摄影设备和 Agfa CR85-X 粉末存储磷光体成像板系统（PIP）上以标准剂量获得的。NIP 乳腺 X 线摄影的剂量降低了约 29.8％。初步检查必须在最近的研究之前至少 2 年进行。排除标准是 ACR 水平的变化和评分目标的出现以及未最佳定位和曝光的乳腺 X 线摄影。图像是盲目的，并由 2 位乳腺 X 线摄影专家根据诊断图像质量的 3 分评分和对实质，囊肿，纤维腺瘤，生理性淋巴结，孤立微钙化和大钙化的可视化情况分别进行了两次单独阅读。
剂量降低的 NIP 在 ACR II/III 级和 ACR I-III 级乳腺 X 线摄影中显示出明显更好的实质可视化效果（p<0.001），而在评分大钙化，囊肿，纤维腺瘤和生理性淋巴结方面的差异无统计学意义。阅读显示出极好的内部（r=0.97/0.94）和观察者间一致性（r=0.92）。
使用基于针的探测器系统的计算机乳腺 X 线摄影可以在不降低诊断图像质量的情况下显著降低剂量。
