UniSA Allied Health and Human Performance, University of South Australia, 108 North Terrace, Adelaide, SA, 5001, Australia.
South Australia Medical Imaging, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, Australia.
Radiography (Lond). 2021 Aug;27(3):789-794. doi: 10.1016/j.radi.2020.12.009. Epub 2021 Jan 6.
Although breast compression is required in routine mammographic practices, current subjective protocols enforcing 'breast tautness' have minimal clinical reproducibility. Whilst objective guidelines of target force (daN) do not consider breast volumes, new measures of pressure (kPa) account for associated variations. The study aims to determine characteristic compressive forces applied at an Australian diagnostic breast clinic, thereby establishing performance success in achieving ideal pressures of 10 kPa.
Parameters of 1972 mammograms were analysed retrospectively from a South Australian diagnostic breast clinic. Raw data were processed using VolparaDensity software; applied compression (force/pressure), breast thickness, breast volume, breast density and average glandular dose estimates were investigated based on breast/paddle contact areas.
Distributions of applied average forces is large, yet distributions of applied average pressures are larger; this is internationally comparable. Regarding force-compressions, 98.6% are >5 daN, 16.6% are >10 daN, and 0.0% are >15 daN. Regarding pressure-compressions, 94.5% are >5 kPa, 36.0% are >10 kPa, and 6.3% are >15 kPa. Measures of average breast thickness, volume and density show anatomically consistent trends, with average glandular dose values constant, albeit high.
There was a high level of variation of applied compression forces in relation to breast/paddle contact area and an even higher variation in applied pressure. This is comparable with existing literature. Real-time compression pressure standardisation may benefit examination consistency. The relationship between breast volume, contact area, compression force and resultant compression pressure may aid in developing an objective compression protocol for clinical practice.
Practical guidelines may increase the reproducibility of image acquisition, whilst optimizing patient discomfort and additional radiation dose from image repeats. Patient compliance may increase in accordance with perceived advantages of mechanical standardisation, ultimately aiding in the detection of early-stage breast cancer.
尽管在常规乳腺 X 线摄影实践中需要进行乳房压迫，但目前强制执行“乳房紧绷度”的主观方案在临床再现性方面几乎没有作用。虽然目标力（daN）的客观指南不考虑乳房体积，但新的压力（kPa）测量方法考虑了相关变化。该研究旨在确定澳大利亚诊断性乳房诊所应用的特征性压缩力，从而确定实现理想压力 10kPa 的性能成功。
从南澳大利亚诊断性乳房诊所回顾性分析了 1972 张乳房 X 光片的参数。使用 VolparaDensity 软件对原始数据进行处理；根据乳房/垫板接触面积研究了应用压缩力（力/压力）、乳房厚度、乳房体积、乳房密度和平均腺体剂量估计值。
应用平均力的分布很大，但应用平均压力的分布更大；这在国际上是可比的。就力压缩而言，98.6%的力大于 5daN，16.6%的力大于 10daN，0.0%的力大于 15daN。就压力压缩而言，94.5%的压力大于 5kPa，36.0%的压力大于 10kPa，6.3%的压力大于 15kPa。平均乳房厚度、体积和密度的测量值显示出解剖一致的趋势，平均腺体剂量值保持不变，尽管很高。
与乳房/垫板接触面积相关的应用压缩力变化很大，应用压力的变化更大。这与现有文献一致。实时压缩压力标准化可能有益于检查一致性。乳房体积、接触面积、压缩力和产生的压缩压力之间的关系可能有助于为临床实践开发客观的压缩协议。
实用指南可能会提高图像采集的再现性，同时优化患者的不适和因图像重复而增加的额外辐射剂量。随着对机械标准化的感知优势的提高，患者的依从性可能会提高，最终有助于早期乳腺癌的检测。
