Sheng Meihong, Ji Juan, Zhang Chenying, Zhang Zirui, Gong Shenchu, Lu Yihua
Department of Radiology, Affiliated Hospital 2 of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, 226001, People's Republic of China.
Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China.
Int J Gen Med. 2021 Mar 30;14:1147-1154. doi: 10.2147/IJGM.S300584. eCollection 2021.
Full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) are used separately or in combination to identify small breast lesions. The dose of the examination depends on the density of the breast and the imaging (FFDM or DBT) performed. We have performed a retrospective review of FFDM and DBT in women with denser breasts in order to demonstrate how varying the combination of FFDM and DBT in CC and MLO views affects lesion detection and the average gland dose.
Eighty-one patients with dense breast received both full-field digital mammography (FFDM) and DBT bilateral screening. The recorded data included the display rates for small lesions or other positive lesions, the type of breast gland, the average gland dose (AGD), and the compression thickness of different collection methods. ANOVA was used to compare the AGD among different collection combinations, and -test was used to perform pairwise comparison between groups with the same gland type. The relationship between AGD and compression thickness was analyzed by Pearson linear correlation, and the lesion display rates were compared using Chi-square test.
We found that AGDs were significantly different among the 6 collection methods (F = 119.06, p<0.01), but were not obviously different between groups with the same gland type (F = 0.848, p>0.05). The types of dense glands were correlated with compression thickness, and the thickness was moderately to strongly correlated with AGD (r=0.596-0.736). The combination of single-view DBT(CC-DBT) and FFDM showed significantly higher mass display rates than the two-view FFDM (p<0.05), while the display rates for other positive lesions were similar (p>0.05).
Our study showed that in opportunistic screening of patients with small breast masses that can be easily detected by ultrasound, MLO-FFDM+CC-DBT or CC-FFDM+MLO-DBT combinations can better balance the individual average gland dose and detection accuracy. The study result cannot be applied to the detection of non-mass lesions as the numbers are too small.
全视野数字化乳腺摄影（FFDM）和数字乳腺断层合成（DBT）可单独使用或联合使用以识别小的乳腺病变。检查剂量取决于乳腺密度和所进行的成像（FFDM或DBT）。我们对乳腺密度较高的女性进行了FFDM和DBT的回顾性研究，以证明在CC位和MLO位视图中改变FFDM和DBT的组合如何影响病变检测和平均腺体剂量。
81例乳腺致密的患者接受了全视野数字化乳腺摄影（FFDM）和双侧DBT筛查。记录的数据包括小病变或其他阳性病变的显示率、乳腺腺体类型、平均腺体剂量（AGD）以及不同采集方法的压迫厚度。采用方差分析比较不同采集组合之间的AGD，采用t检验对相同腺体类型的组间进行两两比较。通过Pearson线性相关分析AGD与压迫厚度之间的关系，采用卡方检验比较病变显示率。
我们发现6种采集方法之间的AGD存在显著差异（F = 119.06，p<0.01），但相同腺体类型的组间差异不明显（F = 0.848，p>0.05）。致密腺体类型与压迫厚度相关，且压迫厚度与AGD呈中度至高度相关（r = 0.596 - 0.736）。单视图DBT（CC-DBT）和FFDM的组合显示肿块的显示率显著高于双视图FFDM（p<0.05），而其他阳性病变的显示率相似（p>0.05）。
我们的研究表明，可以通过超声轻松检测出小乳腺肿块的患者进行机会性筛查时，MLO-FFDM+CC-DBT或CC-FFDM+MLO-DBT组合可以更好地平衡个体平均腺体剂量和检测准确性。由于数量过少，该研究结果不适用于非肿块性病变的检测。
