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了解乳腺成像中电离辐射的风险:概念与量值、临床重要性及未来方向。

Understanding the risk of ionizing radiation in breast imaging: Concepts and quantities, clinical importance, and future directions.

作者信息

Di Maria S, van Nijnatten T J A, Jeukens C R L P N, Vedantham S, Dietzel M, Vaz P

机构信息

Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7 2695-066, Bobadela LRS, Portugal.

Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands.

出版信息

Eur J Radiol. 2024 Dec;181:111784. doi: 10.1016/j.ejrad.2024.111784. Epub 2024 Oct 12.

Abstract

BACKGROUND

Conventional mammography remains the primary imaging modality for state-of-the-art breast imaging practice and its benefit (both on diagnostic and screening) was largely reported. In mammography, the typical Mean Glandular Dose (MGD) from X-ray radiation to the breast spans, on average, from 1 to 10 mGy, depending on breast thicknesses, percentage of fibroglandular tissue, and on the examination purpose.

METHODS

The aim of this narrative review is to describe the extent of radiation risk in X-ray breast imaging and discuss the main steps and parameters (e.g. MGD, screening frequency and number of examination views) that may have an influence on the radiation risk assessment.

RESULTS

Even though the radiation doses used with these examinations are very low, as compared to other medical or natural radiation exposures, there is a non-negligible associated risk of radiation-induced cancer. Accurate radiation risk assessment permits to better balance the overall estimation of the benefit-to-risk ratio in X-ray breast imaging.

CONCLUSIONS

It is expected that a better knowledge about radiation-induced cancer risk among population could improve the communications skills between patients and clinicians and could help to increase the awareness in women about radiation risk perception for a transparent and proper informed choice of imaging exam.

摘要

背景

传统乳腺钼靶摄影仍然是当前先进乳腺成像实践的主要成像方式,其益处(包括诊断和筛查方面)已有大量报道。在乳腺钼靶摄影中,根据乳房厚度、纤维腺体组织百分比以及检查目的,X射线辐射至乳房的典型平均腺体剂量(MGD)平均范围为1至10毫戈瑞。

方法

本叙述性综述的目的是描述X射线乳腺成像中的辐射风险程度,并讨论可能影响辐射风险评估的主要步骤和参数(如MGD、筛查频率和检查视图数量)。

结果

尽管与其他医疗或自然辐射暴露相比,这些检查所使用的辐射剂量非常低,但存在不可忽视的辐射诱发癌症风险。准确的辐射风险评估有助于更好地平衡X射线乳腺成像中效益风险比的总体评估。

结论

预计公众对辐射诱发癌症风险有更深入的了解,可改善患者与临床医生之间的沟通技巧,并有助于提高女性对辐射风险认知的意识,以便她们做出透明且恰当的影像检查知情选择。

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Radiation Doses and Risks in Breast Screening.乳腺筛查中的辐射剂量与风险
J Breast Imaging. 2020 Jun 3;2(3):188-200. doi: 10.1093/jbi/wbaa016.

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