Sechopoulos Ioannis, Dance David R, Boone John M, Bosmans Hilde T, Caballo Marco, Diaz Oliver, van Engen Ruben, Fedon Christian, Glick Stephen J, Hernandez Andrew M, Hill Melissa L, Hulme Katie W, Longo Renata, Rabin Carolina, Sanderink Wendelien B G, Seibert J Anthony
Radboud University Medical Center, Nijmegen, The Netherlands.
Dutch Expert Centre for Screening (LRCB), Nijmegen, The Netherlands.
Med Phys. 2024 Feb;51(2):712-739. doi: 10.1002/mp.16842. Epub 2023 Nov 29.
Currently, there are multiple breast dosimetry estimation methods for mammography and its variants in use throughout the world. This fact alone introduces uncertainty, since it is often impossible to distinguish which model is internally used by a specific imaging system. In addition, all current models are hampered by various limitations, in terms of overly simplified models of the breast and its composition, as well as simplistic models of the imaging system. Many of these simplifications were necessary, for the most part, due to the need to limit the computational cost of obtaining the required dose conversion coefficients decades ago, when these models were first implemented. With the advancements in computational power, and to address most of the known limitations of previous breast dosimetry methods, a new breast dosimetry method, based on new breast models, has been developed, implemented, and tested. This model, developed jointly by the American Association of Physicists in Medicine and the European Federation for Organizations of Medical Physics, is applicable to standard mammography, digital breast tomosynthesis, and their contrast-enhanced variants. In addition, it includes models of the breast in both the cranio-caudal and the medio-lateral oblique views. Special emphasis was placed on the breast and system models used being based on evidence, either by analysis of large sets of patient data or by performing measurements on imaging devices from a range of manufacturers. Due to the vast number of dose conversion coefficients resulting from the developed model, and the relative complexity of the calculations needed to apply it, a software program has been made available for download or online use, free of charge, to apply the developed breast dosimetry method. The program is available for download or it can be used directly online. A separate User's Guide is provided with the software.
目前，全球范围内有多种用于乳腺钼靶摄影及其变体的乳腺剂量测定估算方法。仅这一事实就带来了不确定性，因为通常无法区分特定成像系统内部使用的是哪种模型。此外，所有当前模型都受到各种限制的困扰，包括对乳房及其组成的过度简化模型以及成像系统的简单化模型。在很大程度上，这些简化中的许多都是必要的，这是由于几十年前首次实施这些模型时，需要限制获取所需剂量转换系数的计算成本。随着计算能力的进步，为了解决先前乳腺剂量测定方法的大多数已知限制，一种基于新的乳房模型的新乳腺剂量测定方法已经开发、实施并经过测试。该模型由美国医学物理学家协会和欧洲医学物理组织联合会联合开发，适用于标准乳腺钼靶摄影、数字乳腺断层合成及其对比增强变体。此外，它包括头尾位和内外斜位两种视角下的乳房模型。特别强调所使用的乳房和系统模型是基于证据的，这些证据要么来自对大量患者数据的分析，要么来自对一系列制造商的成像设备进行的测量。由于所开发模型产生的剂量转换系数数量众多，以及应用该模型所需计算的相对复杂性，现已提供一个软件程序供免费下载或在线使用，以应用所开发的乳腺剂量测定方法。该程序可供下载，也可直接在线使用。软件随附单独的用户指南。
