分子乳腺成像、二维全视野数字化乳腺摄影与断层合成及合成乳腺断层摄影的辐射风险与获益比比较。
Comparative Benefit-to-Radiation Risk Ratio of Molecular Breast Imaging, Two-Dimensional Full-Field Digital Mammography with and without Tomosynthesis, and Synthetic Mammography with Tomosynthesis.
机构信息
Sections of Nuclear Medicine (M.B., M.F.C.) and Breast Imaging (M.F.C.), Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110.
出版信息
Radiol Imaging Cancer. 2019 Sep 27;1(1):e190005. doi: 10.1148/rycan.2019190005. eCollection 2019 Sep.
PURPOSE
To apply previously published benefit-to-risk ratio methods for mammography and molecular breast imaging (MBI) risk estimates to an expanded range of mammographic screening techniques, compressed breast thicknesses, and screening views.
MATERIALS AND METHODS
Only previously published estimates were used; therefore, this study was exempt from the requirement to obtain institutional review board approval. Benefit-to-risk ratios were calculated as the ratio of breast cancer deaths averted and lives lost to screening over 10-year intervals starting at age 40 years for MBI, two-dimensional (2D) full-field digital mammography (FFDM) alone, 2D FFDM with synthetic mammography, and 2D FFDM with tomosynthesis for two-, four-, and five-view screening mammography and compressed breast thicknesses of 20-29 mm, 50-59 mm, and 80-89 mm.
RESULTS
Central estimates of the benefit-to-risk ratios ranged from 3 to 179 for screening mammography and from 5 to 9 for MBI. Benefit-to-risk ratios for MBI were inferior to those for mammography for most scenarios, but MBI may be performed at an equal or superior benefit-to-risk ratio for women aged 40-59 years with a compressed breast thickness of at least 80 mm and for those undergoing mammographic screening examinations with four or five views per breast. The benefit-to-risk ratios across all ages with use of tomosynthesis plus 2D FFDM as a screening examination were 45% lower than those for tomosynthesis plus synthetic mammography.
CONCLUSION
Benefit-to-risk ratios for MBI are within the lower range of those for mammography when accounting for variation in mammography technique, compressed breast thickness, and age. Benefit-to-risk ratios of synthetic mammography plus tomosynthesis are superior to those of tomosynthesis plus 2D FFDM. Breast, Mammography, Molecular Imaging, Molecular Imaging-Cancer, Radiation Safety, Radionuclide Studies, Screening, Tomosynthesis© RSNA, 2019See also the commentary by Hruska in this issue.
目的
将先前发表的用于乳房 X 线摄影和分子乳腺成像（MBI）风险评估的获益-风险比方法应用于更广泛的乳腺 X 线筛查技术、压缩乳腺厚度和筛查视图。
材料和方法
仅使用先前发表的估计值；因此，本研究无需获得机构审查委员会的批准。获益-风险比计算为从 40 岁开始，在 10 年的间隔内，每 10 年通过 MBI、二维（2D）全数字乳腺摄影（FFDM）单独、2D FFDM 加合成乳腺摄影和 2D FFDM 加断层合成摄影，以及每侧乳腺进行 2 视图、4 视图和 5 视图筛查的乳腺癌死亡人数和筛查导致的死亡人数与筛查人数之比，压缩乳腺厚度为 20-29 mm、50-59 mm 和 80-89 mm。
结果
筛查乳腺 X 线摄影的获益-风险比中值范围为 3 至 179，MBI 的获益-风险比中值范围为 5 至 9。在大多数情况下，MBI 的获益-风险比低于乳房 X 线摄影，但对于压缩乳腺厚度至少为 80 mm 的 40-59 岁女性和接受每侧乳腺 4 或 5 次视图的乳腺 X 线筛查检查的女性，MBI 可能具有相等或更高的获益-风险比。在使用断层合成加 2D FFDM 作为筛查检查的所有年龄段中，其获益-风险比比断层合成加合成乳腺摄影低 45%。
结论
在考虑乳腺 X 线摄影技术、压缩乳腺厚度和年龄的变化时，MBI 的获益-风险比处于乳腺 X 线摄影的较低范围。合成乳腺摄影加断层合成的获益-风险比优于断层合成加 2D FFDM。乳房、乳房 X 线摄影、分子成像、分子成像-癌症、辐射安全、放射性核素研究、筛查、断层合成术© RSNA，2019 也可参见本期 Hruska 的评论。
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