Medical Physics Unit - University Hospital of Parma, Parma, Italy.
Medical Physics Unit - University Hospital of Parma, Parma, Italy.
Phys Med. 2024 Apr;120:103334. doi: 10.1016/j.ejmp.2024.103334. Epub 2024 Mar 22.
Contrast-enhanced digital mammography (CEDM) is a relatively new imaging technique recombining low- and high-energy mammograms to emphasise iodine contrast. This work aims to perform a multicentric physical and dosimetric characterisation of four state-of-the-art CEDM systems.
We evaluated tube output, half-value-layer (HVL) for low- and high-energy and average glandular dose (AGD) in a wide range of equivalent breast thicknesses. CIRS phantom 022 was used to estimate the overall performance of a CEDM examination in the subtracted image in terms of the iodine difference signal (S). To calculate dosimetric impact of CEDM examination, we collected 4542 acquisitions on patients.
Even if CEDM acquisition strategies differ, all the systems presented a linear behaviour between S and iodine concentration. The curve fit slopes expressed in PV/mg/cm were in the range [92-97] for Fujifilm, [31-32] for GE Healthcare, [35-36] for Hologic, and [114-130] for IMS. Dosimetric data from patients were matched with AGD values calculated using equivalent PMMA thicknesses. Fujifilm exhibited the lowest values, while GE Healthcare showed the highest.
The subtracted image showed the ability of all the systems to give important information about the linearity of the signal with the iodine concentrations. All the patient-collected doses were under the AGD EUREF 2D Acceptable limit, except for patients with thicknesses ≤35 mm belonging to GE Healthcare and Hologic, which were slightly over. This work demonstrates the importance of testing each CEDM system to know how it performs regarding dose and the relationship between PV and iodine concentration.
对比增强数字乳腺摄影术（CEDM）是一种将低能和高能乳腺摄影术相结合以强调碘对比的相对较新的成像技术。本工作旨在对四种最先进的 CEDM 系统进行多中心物理和剂量学特性评估。
我们在广泛的等效乳房厚度范围内评估了管输出、低能和高能的半价层（HVL）以及平均腺体剂量（AGD）。使用 CIRS phantom 022 来估计 CEDM 检查在减去图像中的总体性能，以碘差信号（S）表示。为了计算 CEDM 检查的剂量学影响，我们在患者身上收集了 4542 次采集。
即使 CEDM 采集策略不同，所有系统在 S 和碘浓度之间均呈现线性关系。以 PV/mg/cm 表示的曲线拟合斜率范围为 Fujifilm [92-97]、GE Healthcare [31-32]、Hologic [35-36]和 IMS [114-130]。从患者收集的剂量数据与使用等效 PMMA 厚度计算的 AGD 值匹配。Fujifilm 表现出最低的值，而 GE Healthcare 表现出最高的值。
减去的图像显示出所有系统都能够提供关于信号与碘浓度之间线性关系的重要信息。除了厚度≤35mm 的患者属于 GE Healthcare 和 Hologic 系统，其 AGD 值略高于 EUREF 2D 可接受限值外，所有患者采集的剂量均低于 AGD EUREF 2D 可接受限值。这项工作证明了测试每个 CEDM 系统以了解其在剂量和 PV 与碘浓度之间的关系方面的性能的重要性。
