Comparison of radiation dose between 2D digital stereotactic versus digital breast tomosynthesis-guided breast biopsies.

RATIONALE AND OBJECTIVE

Use of digital breast tomosynthesis (DBT) in breast imaging has necessitated DBT-guided biopsy, however, a single DBT acquisition may result in a greater radiation dose than a single DM acquisition. Our objective was to compare the number of images acquired and the resulting radiation dose of DBT versus DM-guided breast biopsies.

METHOD

All biopsies performed on our DM unit from 8/2016 to 1/2017 and on our DM-DBT unit from 8/2017 to 1/2018 were retrospectively reviewed. The number of image acquisitions, average glandular dose (AGD) per acquisition and per procedure were computed and stratified by guidance modality and lesion type.

RESULTS

25 DM-guided biopsies were performed on the DM-only unit, 58 biopsies were performed with DM guidance on the dual unit (DM-DU) and 29 were performed with DBT. The average number of images acquisitions was 10.9 for DM-only unit biopsies, 9.3 images for DM-DU biopsies and 4.3 images for DBT-guided biopsies. Mean procedure AGD for DM-only unit biopsies was 28.77 mGy, versus 22.06 mGy for DM-DU and 10.18 mGy for DBT biopsies. Mean procedure AGD for biopsied calcification-only lesions was 22.3 mGy for DM-DU versus 10.7 mGy for DBT guidance (p < 0.001), with an average of 8.1 images per procedure for DM-DU versus 4.2 for DBT.

CONCLUSION

Fewer image acquisitions were obtained with DBT compared with DM guidance, therefore, the overall dose of DBT-guided procedures was less. The dose reduction obtained with DBT is possible across all lesion types, even for calcification-only lesions.