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John D, Gottwald W, Berthe D, Wirtensohn S, Hickler J, Heck L, Herzen J. X-ray dark-field computed tomography for monitoring of tissue freezing. Sci Rep 2024; 14:5599. [PMID: 38454107 PMCID: PMC10920745 DOI: 10.1038/s41598-024-56201-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
Accurately monitoring the extent of freezing in biological tissue is an important requirement for cryoablation, a minimally invasive cancer treatment that induces cell death by freezing tissue with a cryoprobe. During the procedure, monitoring is required to avoid unnecessary harm to the surrounding healthy tissue and to ensure the tumor is properly encapsulated. One commonly used monitoring method is attenuation-based computed tomography (CT), which visualizes the ice ball by utilizing its hypoattenuating properties compared to unfrozen tissue. However, the contrast between frozen and unfrozen tissue remains low. In a proof-of-principle experiment, we show that the contrast between frozen and unfrozen parts of a porcine phantom mimicking breast tissue can be greatly enhanced by acquiring X-ray dark-field images that capture the increasing small-angle scattering caused by the ice crystals formed during the procedure. Our results show that, compared to X-ray attenuation, the frozen region is detected significantly better in dark-field radiographs and CT scans of the phantom. These findings demonstrate that X-ray dark-field imaging could be a potential candidate for improved monitoring of cryoablation procedures.
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Affiliation(s)
- Dominik John
- Research Group Biomedical Imaging Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany.
- Chair of Biomedical Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany.
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany.
- Institute of Materials Physics, Helmholtz-Zentrum hereon, 21502, Geesthacht, Germany.
| | - Wolfgang Gottwald
- Research Group Biomedical Imaging Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Chair of Biomedical Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
| | - Daniel Berthe
- Research Group Biomedical Imaging Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Chair of Biomedical Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
| | - Sami Wirtensohn
- Research Group Biomedical Imaging Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Chair of Biomedical Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
- Institute of Materials Physics, Helmholtz-Zentrum hereon, 21502, Geesthacht, Germany
| | - Julia Hickler
- Research Group Biomedical Imaging Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Chair of Biomedical Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
| | - Lisa Heck
- Research Group Biomedical Imaging Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Chair of Biomedical Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
| | - Julia Herzen
- Research Group Biomedical Imaging Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Chair of Biomedical Physics, Department of Physics, TUM School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
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Afandy AN, Tori MB, Bintalib SO, Soh BLP. Threshold in breast compression reduction for full-field digital mammography and digital breast tomosynthesis. Radiography (Lond) 2024; 30:217-225. [PMID: 38035436 DOI: 10.1016/j.radi.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Breast compression is essential in mammography to improve image quality and reduce radiation dose. However, it can cause discomfort or even pain in women which could discourage them from attending future mammography examinations. Therefore, this study aims to explore the maximum reduction in breast compression in full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) that is achievable without impacting on image quality and dose. METHODS Ten compression force (CF) levels (20N-110N, with 10N intervals) were assessed on Siemens MAMMOMAT Inspiration with Nuclear Associates 18-228 phantom. Imaging was carried out in craniocaudal projection using Automatic Exposure Control at 28 kVp with a Tungsten/Rhodium anode/filter combination, and at 50° sweep angle for DBT. Using ImageJ software, image quality of the acquired mammograms and central tomosynthesis slices were examined based on mass conspicuity (MC) and microcalcification conspicuity (MicroC). Entrance skin dose (ESD) and mean glandular dose (MGD) were recorded from Digital Imaging and Communication in Medicine image header. Linear regression was performed to examine the relationship between CF with ESD, MGD, MC and MicroC. Differences in image quality and radiation dose were assessed with one-way analysis of variance and Kruskal-Wallis H test. RESULTS Significant correlations were noted between CF with ESD and MicroC for FFDM and DBT, with DBT also demonstrating associations with MGD and MC. No significant differences were observed for ESD, MGD, MC and MicroC when CF was reduced to 40N and 80N in FFDM and DBT respectively. CONCLUSION This study demonstrated that CF can be reduced as low as 40N and 80N in FFDM and DBT respectively, without significant impact on image quality and radiation dose. IMPLICATIONS FOR PRACTICE Reduced mammographic compression may reduce discomfort or pain in women, which may improve attendance rate in breast screening programmes. Findings from this study will provide reference for future work examining breast compression in mammography.
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Affiliation(s)
- A N Afandy
- Department of Radiology, Ng Teng Fong General Hospital, Singapore.
| | - M B Tori
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - S O Bintalib
- Division of Oncologic Imaging, National Cancer Centre Singapore, Singapore
| | - B L P Soh
- Health and Social Sciences, Singapore Institute of Technology, Singapore
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Regression Analysis between the Different Breast Dose Quantities Reported in Digital Mammography and Patient Age, Breast Thickness, and Acquisition Parameters. J Imaging 2022; 8:jimaging8080211. [PMID: 36005454 PMCID: PMC9409844 DOI: 10.3390/jimaging8080211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 12/04/2022] Open
Abstract
Breast cancer is the leading cause of cancer death among women worldwide. Screening mammography is considered the primary imaging modality for the early detection of breast cancer. The radiation dose from mammography increases the patients’ risk of radiation-induced cancer. The mean glandular dose (MGD), or the average glandular dose (AGD), provides an estimate of the absorbed dose of radiation by the glandular tissues of a breast. In this paper, MGD is estimated for the craniocaudal (CC) and mediolateral–oblique (MLO) views using entrance skin dose (ESD), X-ray spectrum information, patient age, breast glandularity, and breast thickness. Moreover, a regression analysis is performed to evaluate the impact of mammography acquisition parameters, age, and breast thickness on the estimated MGD and other machine-produced dose quantities, namely, ESD and organ dose (OD). Furthermore, a correlation study is conducted to evaluate the correlation between the ESD and OD, and the estimated MGD per image view. This retrospective study was applied to a dataset of 2035 mammograms corresponding to a cohort of 486 subjects with an age range of 28–86 years who underwent screening mammography examinations. Linear regression metrics were calculated to evaluate the strength of the correlations. The mean (and range) MGD for the CC view was 0.832 (0.110–3.491) mGy and for the MLO view was 0.995 (0.256–2.949) mGy. All the mammography dose quantities strongly correlated with tube exposure (mAs): ESD (R2 = 0.938 for the CC view and R2 = 0.945 for the MLO view), OD (R2 = 0.969 for the CC view and R2 = 0.983 for the MLO view), and MGD (R2 = 0.980 for the CC view and R2 = 0.972 for the MLO view). Breast thickness showed a better correlation with all the mammography dose quantities than patient age, which showed a poor correlation. Moreover, a strong correlation was found between the calculated MGD and both the ESD (R2 = 0.929 for the CC view and R2 = 0.914 for the MLO view) and OD (R2 = 0.971 for the CC view and R2 = 0.972 for the MLO view). Furthermore, it was found that the MLO scan views yield a slightly higher dose compared to CC scan views. It was also found that the glandular absorbed dose is more dependent on glandularity than size. Despite being more reflective of the dose absorbed by the glandular tissue than OD and ESD, MGD is considered labor-intensive and time-consuming to estimate.
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Comparison of Mean Glandular Dose between Full-Field Digital Mammography and Digital Breast Tomosynthesis. Healthcare (Basel) 2021; 9:healthcare9121758. [PMID: 34946484 PMCID: PMC8700789 DOI: 10.3390/healthcare9121758] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/02/2021] [Accepted: 12/12/2021] [Indexed: 11/23/2022] Open
Abstract
Early detection of breast cancer is diagnosed using mammography, the gold standard in breast screening. However, its increased use also provokes radiation-induced breast malignancy. Thus, monitoring and regulating the mean glandular dose (MGD) is essential. The purpose of this study was to determine MGD for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in the radiology department of a single centre. We also analysed the exposure factors as a function of breast thickness. A total of 436 patients underwent both FFDM and DBT. MGD was auto calculated by the mammographic machine for each projection. Patients’ data included compressed breast thickness (CBT), peak kilovoltage (kVp), milliampere-seconds (mAs) and MGD (mGy). Result analysis showed that there is a significant difference in MGD between the two systems, namely FFDM and DBT. However, the MGD values in our centre were comparable to other centres, as well as the European guideline (<2.5 mGy) for a standard breast. Although DBT improves the clinical outcome and quality of diagnosis, the risk of radiation-induced carcinogenesis should not be neglected. Regular quality control testing on mammography equipment must be performed for dose monitoring in women following a screening mammography in the future.
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Evaluation of Breast Galactography Using Digital Breast Tomosynthesis: A Clinical Exploratory Study. Diagnostics (Basel) 2021; 11:diagnostics11112060. [PMID: 34829407 PMCID: PMC8622426 DOI: 10.3390/diagnostics11112060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives: To compare the application value of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in breast galactography. Materials and Methods: A total of 128 patients with pathological nipple discharge (PND) were selected to undergo galactography. DBT and FFDM were performed for each patient after injecting the contrast agent; the radiation dose of DBT and FFDM was calculated, and the image quality was evaluated in consensus by two senior breast radiologists. Histopathologic data were found in 49 of the 128 patients. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for both FFDM- and DBT-galactography were calculated using histopathologic results as a reference standard. Data were presented as percentages along with their 95% confidence intervals (CI). Results: The average age of the 128 patients was 46.53 years. The average glandular dose (AGD) of DBT-galactography was slightly higher than that of FFDM-galactography (p < 0.001). DBT-galactography was 30.7% higher than FFDM-galactography in CC view, while DBT-galactography increased by 21.7% compared with FFDM-galactography in ML view. Regarding catheter anatomic distortion, structure detail, and overall image quality groups, DBT scores were higher than FFDM scores, and the differences were significant for all measures (p < 0.05). In 49 patients with pathological nipple discharge, we found that the DBT-galactography had higher sensitivity, specificity, PPV, and NPV (93.3%, 75%, 97.7%, and 50%, respectively) than FFDM-galactography (91.1%, 50%, 95.3%, and 33.3%, respectively). Conclusions: Compared to FFDM-galactography, within the acceptable radiation dose range, DBT-galactography increases the sensitivity and specificity of lesion detection by improving the image quality, providing more confidence for the diagnosis of clinical ductal lesions.
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Tamam N, Salah H, Rabbaa M, Abuljoud M, Sulieman A, Alkhorayef M, Bradley D. Evaluation of patients radiation dose during mammography imaging procedure. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Barbosa da Silveira Gatto L, Braz D, Pacifico L, Travassos PC, Goncalves Magalhaes LA. Comparison of spectra and mean glandular dose (MGD) with tube voltage used in digital mammography for simulated, metrological and clinical cases. Appl Radiat Isot 2021; 176:109862. [PMID: 34385091 DOI: 10.1016/j.apradiso.2021.109862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/02/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022]
Abstract
Mammography has a crucial role in breast cancer detection. The National Cancer Institute (INCA) estimates that 29.7% of the cancer cases in Brazil are related specifically to the breast. It is necessary to evaluate the mean glandular dose with a new solid-state detector in a digital radiography system, utilizing PMMA phantoms and spacers for different thicknesses. The Selenia Dimensions (Hologic, Bedford) direct radiography (DR) system can perform full-field digital mammographies through digital detectors. This system uses new technologies, such as the digital breast tomosynthesis system (DBT), and employs a sequence of projections acquired over the breast, resulting in images with low contrast. The estimation of breast dose is an important part of mammographic quality control for x-ray mammography. Nevertheless, there are currently no standard protocols for the dosimetry of breast imaging in 3D. Additionally, a x-ray spectra function is crucial to measure a considerable output in x-ray spectrometry. The purpose of this work was to assess the mean glandular dose (MGD) and the spectra in slabs of polymethyl methacrylate (PMMA) and breast equivalent thickness through digital mammography using four experiments: a Hologic Selenia Dimensions mammograph with a solid-state detector; a spectrometer (only for the spectra, in this case); a clinical COMET x-ray tube with a solid-state detector; and the MCNPX code. References recommend that the real environments that work well with digital mammography are in the following tube voltages: 25 kVp; 26 kVp; 28 kVp; 31 kVp and 33 kVp. Taking into account several thicknesses of PMMA, the results of both the MGD in metrological, clinical and simulated cases were in accordance with the references, from 30 mm of PMMA. All the spectra for all cases have indicated good agreement with the references.
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Affiliation(s)
- Leandro Barbosa da Silveira Gatto
- COPPE - Rio de Janeiro Federal University (UFRJ), Av. Horácio Macedo, 2030, Bloco G, Cidade Universitária, Ilha do Fundão, CEP 221941-914, Rio de Janeiro, Brazil
| | - Delson Braz
- COPPE - Rio de Janeiro Federal University (UFRJ), Av. Horácio Macedo, 2030, Bloco G, Cidade Universitária, Ilha do Fundão, CEP 221941-914, Rio de Janeiro, Brazil
| | - Leonardo Pacifico
- Radiological Sciences Laboratory (LCR) - Rio de Janeiro State University (UERJ), Rua São Francisco Xavier, PHLC, 524, s136, CEP 20550-900, Rio de Janeiro, Brazil
| | - Paulo Cesar Travassos
- Radiological Sciences Laboratory (LCR) - Rio de Janeiro State University (UERJ), Rua São Francisco Xavier, PHLC, 524, s136, CEP 20550-900, Rio de Janeiro, Brazil
| | - Luis Alexandre Goncalves Magalhaes
- Radiological Sciences Laboratory (LCR) - Rio de Janeiro State University (UERJ), Rua São Francisco Xavier, PHLC, 524, s136, CEP 20550-900, Rio de Janeiro, Brazil.
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Local diagnostic reference levels for digital mammography: Two hospitals study in northwest, Nigeria. J Med Imaging Radiat Sci 2021; 52:435-442. [PMID: 33896746 DOI: 10.1016/j.jmir.2021.03.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/20/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Mammography involves the use of low energy X-rays to image the breast tissue. Although low dose radiation is used, the use of ionising radiation implies the risk of inducing breast cancer. Thus, the study established local DRLs for digital mammography for in-house dose optimisation. METHODS This was a retrospective study that had a total of 240 women that presented for mammography at the two tertiary institutions located in the Northwest region of Nigeria. Patient demographic information including compressed breast thickness (CBT), which is the breast tissue thickness across the imaging plate, and mean glandular dose (MGD) were recorded. Data were analysed based on descriptive and inferential statistics using SPSS statistical software. The DRLs based on MGD and CBT were established and compared with the relevant data in the literature. RESULTS Local DRLs based on MGD and CBT were established at the 75th percentile (craniocaudal (CC): 1.50 mGy; 57 mm; mediolateral (MLO): 1.60 mGy; 63 mm) and 95th percentile (CC: 3.74 mGy; 69 mm; MLO: 3.61 mGy; 76 mm). The MGD based on manual exposure was significantly (p < 0.005) higher compared to the automatic optimisation parameter (AOP) mode which suggests the need to continuously adhere to the use of AOP mode for in-house dose optimisation. CONCLUSION The study established local DRLs for the digital mammography systems at the 75th and 95th percentiles which compared well with the values established in the literature. Manual selection of parameters should only be employed where there are legitimate indications as it is associated with high exposure. Also, manual selection of parameters should be based on preset tables as a function of compressed breast thickness.
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Application of DQE for quantitative assessment of detectors to estimate AEC efficiency in digital mammography. POLISH JOURNAL OF MEDICAL PHYSICS AND ENGINEERING 2021. [DOI: 10.2478/pjmpe-2021-0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Optimisation of the detector’s exposure parameters settings for image quality and patient dose is an important task in digital mammography. Assessment of a digital detector’s performance can be done objectively and without operator bias by determining the Detective Quantum Efficiency (DQE). The authors of this article aim to prove that the performance of the AEC system can be objectively portrayed through DQE. The results were examined for influence of KAD changes on DQE values and to determine if it was possible to obtain similar DQE values for different exposures. While analysing the effect of the operation of the AEC system described with DQE, the doses received by women during mammography examinations were considered, as well.
The AEC system’s exposure control mechanism cannot guarantee the same DQE value for different object thicknesses. When the object thickness increases, the AEC system should increase the KAD value to obtain the same DQE value. The result of increasing KAD would be the increase of mean glandular dose for some women. However, assuming that DQE is a good indicator of image quality, introducing the proposed changes to the AEC system’s operation would result in the same image quality for all breast thicknesses.
This approach to DQE use for AEC system evaluation is independent of the image processing procedure and can be the basis for changes to system calibration done by the manufacturer’s technical support team.
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Niroshani HS, Jeyasugiththan J, Senanayake G, Negishi T. Establishment of regional diagnostic reference levels for digital mammography in Western Province of Sri Lanka. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2021; 41:79-96. [PMID: 33271512 DOI: 10.1088/1361-6498/abd075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Abstract
The radiation dose to the breasts should be kept to a minimum as breast tissues are highly sensitive to radiation. In mammography, the mean glandular dose (MGD) is used to specify the patient dose. In this study, data on the MGD during diagnostic mammographic examinations was collected using the database from six digital mammography facilities available in the Western Province in Sri Lanka. Examinations involving breast pathology, breast implants, or compressed breast thicknesses (CBT) outside the range of 20-110 mm were excluded in this study. The mean MGD per breast was 3.50 mGy, with a mean CBT of 57 mm. The mean MGD per facility varies from 1.58 to 2.27 mGy, with overall 75th and 95th percentiles of 2.15 and 2.82 mGy, respectively. The 75th and 95th percentile MGD per image, for the average CBT of 57 ± 12 mm, were 2.00 and 2.65 mGy respectively. The 75th percentile value of the MGD is suggested for the Western Province and it depends on the specific CBT.
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Affiliation(s)
- H S Niroshani
- Department of Nuclear Science, University of Colombo, Colombo, Sri Lanka
- Department of Radiography & Radiotherapy, General Sir John Kotelawala Defence University, Werahera, Sri Lanka
- Department of Radiological Sciences, Graduate school of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | | | - G Senanayake
- Department of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Werahera, Sri Lanka
| | - Toru Negishi
- Department of Radiological Sciences, Graduate school of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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AlNaemi H, Aly A, J Omar A, AlObadli A, Ciraj-Bjelac O, Kharita MH, Rehani MM. EVALUATION OF RADIATION DOSE FOR PATIENTS UNDERGOING MAMMOGRAPHY IN QATAR. RADIATION PROTECTION DOSIMETRY 2020; 189:354-361. [PMID: 32342104 DOI: 10.1093/rpd/ncaa049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 02/06/2020] [Accepted: 02/25/2020] [Indexed: 06/11/2023]
Abstract
In the absence of information on radiation doses in mammography in the Gulf countries, this study was designed to assess patient dose in terms of entrance surface air kerma and average glandular dose (AGD) in three mammography units in Qatar that covers 21% of all mammography systems in the country. The study of 150 patients involving 600 projections indicated that the average value of AGD in patients was 2.2 mGy for cranio-caudal and 2.5 mGy for mediolateral-oblique views, respectively. Dose assessment was also performed for polymethyl methacrylate phantoms of thicknesses, ranging from 20 to 80 mm. Comparing the patient dose values with several other publications in literature for full-field digital mammography, our values are typically higher, which can be likely attributed to the larger compressed breast thickness.
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Affiliation(s)
| | - Antar Aly
- Hamad Medical Corporation, Doha, Qatar
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Fusco R, Raiano N, Raiano C, Maio F, Vallone P, Mattace Raso M, Setola SV, Granata V, Rubulotta MR, Barretta ML, Petrosino T, Petrillo A. Evaluation of average glandular dose and investigation of the relationship with compressed breast thickness in dual energy contrast enhanced digital mammography and digital breast tomosynthesis. Eur J Radiol 2020; 126:108912. [PMID: 32151787 DOI: 10.1016/j.ejrad.2020.108912] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/20/2020] [Accepted: 02/14/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To quantitatively assess the dose of Dual energy contrast enhanced digital mammography (CEDM) and digital breast tomosynthesis (DBT) and to investigate the relationship between average absorbed glandular dose (AGD), compressed breast thickness (CBT) and compression force (CF). MATERIALS AND METHODS All CEDM and DBT examinations were performed in cranio-caudal (CC) and medio-lateral oblique (MLO) view. Exposure parameters of 135 mammographic procedures that using AEC (automatic exposure control) mode were recorded. AGDs were calculated. Kruskal Wallis test was performed. RESULTS CBT population ranged from 23 to 94 mm with a thickness median value of 52 mm in CC view and of 57 mm in MLO views. CEDM AGD median value was significatively lower than DBT AGD in each views (p << 0.01). AGD showed a positive correlation and linear regression with CBT for both CEDM and DBT while CF did not show a correlation and linear regression with AGD. The highest values were found for MLO view: R2 of 0.74 for CEDM and R2 of 0.61 for DBT. Kruskal Wallis test shows that there was a difference statistically significant between AGD values of CEDM and DBT in CC view respect to MLO views (p < 0.01). CONCLUSIONS Dose values of both techniques meet the recommendations for maximum dose in mammography. The results of the present study indicated that there was significant difference between AGD for CEDM and DBT exposure in different views (AGD in CC views had the lowest value) and that CBT could influence the AGD while CF was not correlated to AGD.
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Affiliation(s)
- Roberta Fusco
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Nicola Raiano
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Concetta Raiano
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Francesca Maio
- Radiology Division, "UNIVERSITA' DEGLI STUDI DI NAPOLI FEDERICO II", Via Pansini, Naples, Italy
| | - Paolo Vallone
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Mauro Mattace Raso
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Sergio Venanzio Setola
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Vincenza Granata
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Maria Rosaria Rubulotta
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Maria Lusia Barretta
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Teresa Petrosino
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Antonella Petrillo
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy.
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13
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Lekatou A, Metaxas V, Messaris G, Antzele P, Tzavellas G, Panayiotakis G. INSTITUTIONAL BREAST DOSES IN DIGITAL MAMMOGRAPHY. RADIATION PROTECTION DOSIMETRY 2019; 185:239-251. [PMID: 30753684 DOI: 10.1093/rpd/ncz005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/11/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
The objective of this study was to survey breast dose in screening mammography, establish institutional doses and compare them with the corresponding dose values. Three hundred women between the ages of 40 and 80 years old participated in the study. All mammographic examinations were performed with a digital mammography system. The women characteristics (age, weight, height, BMI), technical and exposure parameters (anode/filter material, projection, compressed breast thickness (CBT), compression force, tube voltage, tube load), the entrance surface dose (ESD) and the average glandular dose (AGD) were recorded. The mean, median, 75th and 95th percentiles of the AGD and ESD distributions were estimated for all examinations, for right and left breast, as well as for CBT within 55-65 mm, for Cranio-Caudal (CC) and Medio-Lateral Oblique (MLO) projections. A statistical analysis was also performed, to investigate the impact of the recorded parameters on the ESD and AGD. The mean/median values of the ESD and AGD for all examinations, for CC and MLO projections were 4.60/4.29 and 5.42/5.25 mGy and 1.18/1.13 and 1.32/1.30 mGy, respectively. The mean/median values of the ESD and AGD for CC and MLO projections at CBT range 55-65 mm were 5.29/5.08 and 5.56/5.42 mGy and 1.30/1.24 and 1.36/1.32 mGy, respectively. The 75th percentile for CC and MLO projections were estimated 5.79 and 6.17 mGy, as well as 1.41 and 1.48 mGy in terms of ESD and AGD values, respectively. The 95th percentile of the ESD and AGD for CC and MLO projections were also 7.40 and 7.53 mGy and 1.76 and 1.78 mGy, respectively. The tube voltage, tube load, age and CBT had a significant influence on the dose values. The estimated values were found to be comparable, or in most cases lower, than the corresponding 75th and 95th percentile values from previous studies.
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Affiliation(s)
- Aristea Lekatou
- Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece
| | - Vasileios Metaxas
- Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece
| | - Gerasimos Messaris
- Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece
| | - Penelope Antzele
- Department of Radiology, University Hospital of Patras, Patras, Greece
| | - George Tzavellas
- Department of Radiology, University Hospital of Patras, Patras, Greece
| | - George Panayiotakis
- Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece
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14
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Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC, Sperling L, Virani SS, Yeboah J. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2019; 139:e1082-e1143. [PMID: 30586774 PMCID: PMC7403606 DOI: 10.1161/cir.0000000000000625] [Citation(s) in RCA: 1129] [Impact Index Per Article: 225.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Scott M Grundy
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Neil J Stone
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Alison L Bailey
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Craig Beam
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Kim K Birtcher
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Roger S Blumenthal
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Lynne T Braun
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Sarah de Ferranti
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Joseph Faiella-Tommasino
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Daniel E Forman
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Ronald Goldberg
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Paul A Heidenreich
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Mark A Hlatky
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Daniel W Jones
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Donald Lloyd-Jones
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Nuria Lopez-Pajares
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Chiadi E Ndumele
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Carl E Orringer
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Carmen A Peralta
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Joseph J Saseen
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Sidney C Smith
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Laurence Sperling
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Salim S Virani
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
| | - Joseph Yeboah
- ACC/AHA Representative. †AACVPR Representative. ‡ACC/AHA Task Force on Clinical Practice Guidelines Liaison. §Prevention Subcommittee Liaison. ‖PCNA Representative. ¶AAPA Representative. **AGS Representative. ††ADA Representative. ‡‡PM Representative. §§ACPM Representative. ‖‖NLA Representative. ¶¶APhA Representative. ***ASPC Representative. †††ABC Representative
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15
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Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC, Sperling L, Virani SS, Yeboah J. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. J Am Coll Cardiol 2019; 73:e285-e350. [DOI: 10.1016/j.jacc.2018.11.003] [Citation(s) in RCA: 1113] [Impact Index Per Article: 222.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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16
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Quality Controls in Digital Mammography protocol of the EFOMP Mammo Working group. Phys Med 2018; 48:55-64. [DOI: 10.1016/j.ejmp.2018.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 03/22/2018] [Accepted: 03/24/2018] [Indexed: 11/24/2022] Open
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17
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Suleiman ME, McEntee MF, Cartwright L, Diffey J, Brennan PC. Diagnostic reference levels for digital mammography in New South Wales. J Med Imaging Radiat Oncol 2016; 61:48-57. [DOI: 10.1111/1754-9485.12540] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/31/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Moayyad E Suleiman
- Faculty of Health Sciences; The University of Sydney; Lidcombe New South Wales Australia
| | - Mark F McEntee
- Faculty of Health Sciences; The University of Sydney; Lidcombe New South Wales Australia
| | | | - Jennifer Diffey
- Hunter New England Imaging; John Hunter Hospital; New Lambton Heights New South Wales Australia
| | - Patrick C Brennan
- Faculty of Health Sciences; The University of Sydney; Lidcombe New South Wales Australia
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18
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Pasicz K, Fabiszewska E, Grabska I, Skrzyński W. Mean glandular doses in mammography: a comparison of values displayed by a mammography unit with in-house values, both using the method proposed by Dance. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:709-715. [PMID: 27556917 DOI: 10.1088/0952-4746/36/3/709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this work is to compare the mean glandular dose (MGD) displayed by the mammography system and the MGD calculated according to the method proposed by Dance for women. This study also attempts to analyse whether the relationship between the calculated and the displayed values is constant and what factors influence this relationship. Material for this study included data from 1200 exposures (i.e. six series; each series consisting of 200 exposures) performed with one full-field digital mammography unit. Based on collected parameters of exposures, values of the MGD for individual mammography examinations were calculated according to the methods proposed by Dance. Obtained values of the MGD were compared with the values displayed by the mammography system. The MGD displayed by the mammography system and the MGD calculated according to the method proposed by Dance for women are significantly different. This result emphasises the importance of verifying MGD values for patient radiation protection, particularly after machine servicing.
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Affiliation(s)
- Katarzyna Pasicz
- Medical Physics Department, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, W Roentgena 5, 02-781 Warsaw, Poland
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19
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Paixão L, Oliveira BB, Viloria C, de Oliveira MA, Teixeira MHA, Nogueira MDS. Monte Carlo derivation of filtered tungsten anode X-ray spectra for dose computation in digital mammography. Radiol Bras 2016; 48:363-7. [PMID: 26811553 PMCID: PMC4725397 DOI: 10.1590/0100-3984.2014.0108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Derive filtered tungsten X-ray spectra used in digital mammography systems by means of Monte Carlo simulations. MATERIALS AND METHODS Filtered spectra for rhodium filter were obtained for tube potentials between 26 and 32 kV. The half-value layer (HVL) of simulated filtered spectra were compared with those obtained experimentally with a solid state detector Unfors model 8202031-H Xi R/F & MAM Detector Platinum and 8201023-C Xi Base unit Platinum Plus w mAs in a Hologic Selenia Dimensions system using a direct radiography mode. RESULTS Calculated HVL values showed good agreement as compared with those obtained experimentally. The greatest relative difference between the Monte Carlo calculated HVL values and experimental HVL values was 4%. CONCLUSION The results show that the filtered tungsten anode X-ray spectra and the EGSnrc Monte Carlo code can be used for mean glandular dose determination in mammography.
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Affiliation(s)
- Lucas Paixão
- M.Sc., Post-graduation in Science and Technology of Radiations, Minerals and Materials - Centro de Desenvolvimento da Tecnologia Nuclear / Comissão Nacional de Energia Nuclear (CDTN/CNEN), Belo Horizonte, MG, Brazil
| | - Bruno Beraldo Oliveira
- M.Sc., Post-graduation in Science and Technology of Radiations, Minerals and Materials - Centro de Desenvolvimento da Tecnologia Nuclear / Comissão Nacional de Energia Nuclear (CDTN/CNEN), Belo Horizonte, MG, Brazil
| | - Carolina Viloria
- M.Sc., Post-graduation in Nuclear Sciences and Techniques - Departamento de Engenharia Nuclear da Universidade Federal de Minas Gerais (DEN-UFMG), Belo Horizonte, MG, Brazil
| | - Marcio Alves de Oliveira
- M.Sc., Professor, Department of Anatomy and Imaging, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Maria do Socorro Nogueira
- D.Sc., Titular Researcher-Professor, Centro de Desenvolvimento da Tecnologia Nuclear / Comissão Nacional de Energia Nuclear (CDTN/CNEN), Departamento de Engenharia Nuclear da Universidade Federal de Minas Gerais (DEN-UFMG), Belo Horizonte, MG, Brazil
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20
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Suleiman ME, Brennan PC, McEntee MF. Diagnostic reference levels in digital mammography: a systematic review. RADIATION PROTECTION DOSIMETRY 2015; 167:608-619. [PMID: 25543130 DOI: 10.1093/rpd/ncu365] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/03/2014] [Indexed: 06/04/2023]
Abstract
This study aims to review the literature on existing diagnostic reference levels (DRLs) in digital mammography and methodologies for establishing them. To this end, a systematic search through Medline, Cinahl, Web of Science, Scopus and Google scholar was conducted using search terms extracted from three terms: DRLs, digital mammography and breast screen. The search resulted in 1539 articles of which 22 were included after a screening process. Relevant data from the included studies were summarised and analysed. Differences were found in the methods utilised to establish DRLs including test subjects types, protocols followed, conversion factors employed, breast compressed thicknesses and percentile values adopted. These differences complicate comparison of DRLs among countries; hence, an internationally accepted protocol would be valuable so that international comparisons can be made.
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Affiliation(s)
- Moayyad E Suleiman
- Faculty of Health Sciences, The University of Sydney, M205, Cumberland Campus, 75 East St, Lidcombe, Sydney, NSW 2141, Australia
| | - Patrick C Brennan
- Faculty of Health Sciences, The University of Sydney, M205, Cumberland Campus, 75 East St, Lidcombe, Sydney, NSW 2141, Australia
| | - Mark F McEntee
- Faculty of Health Sciences, The University of Sydney, M205, Cumberland Campus, 75 East St, Lidcombe, Sydney, NSW 2141, Australia
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21
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Ten JI, Vano E, Sánchez R, Fernandez-Soto JM. Automatic patient dose registry and clinical audit on line for mammography. RADIATION PROTECTION DOSIMETRY 2015; 165:346-349. [PMID: 25809108 DOI: 10.1093/rpd/ncv068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The use of automatic registry systems for patient dose in digital mammography allows clinical audit and patient dose analysis of the whole sample of individual mammography exposures while fulfilling the requirements of the European Directives and other international recommendations. Further parameters associated with radiation exposure (tube voltage, X-ray tube output and HVL values for different kVp and target/filter combinations, breast compression, etc.) should be periodically verified and used to evaluate patient doses. This study presents an experience in routine clinical practice for mammography using automatic systems.
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Affiliation(s)
- J I Ten
- Servicio de Diagnóstico por la imagen, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - E Vano
- Servicio de Física Médica, Hospital Clínico San Carlos, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos, Madrid, Spain Departamento de Radiología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - R Sánchez
- Servicio de Física Médica, Hospital Clínico San Carlos, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - J M Fernandez-Soto
- Servicio de Física Médica, Hospital Clínico San Carlos, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos, Madrid, Spain Departamento de Radiología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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22
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Kelaranta A, Toroi P, Timonen M, Komssi S, Kortesniemi M. Conformance of mean glandular dose from phantom and patient data in mammography. RADIATION PROTECTION DOSIMETRY 2015; 164:342-353. [PMID: 25114321 DOI: 10.1093/rpd/ncu261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 07/18/2014] [Indexed: 06/03/2023]
Abstract
In mammography dosimetry, phantoms are often used to represent breast tissue. The conformance of phantom- and patient-based mean glandular dose (MGD) estimates was evaluated mainly from the aspect of diagnostic reference levels. Patient and phantom exposure data were collected for eight diagnostic and three screening mammography devices. More extensive assessments were performed for two devices. The average breast thickness was close to the nationally used reference of 50 mm in diagnostic (50 mm, SD = 13 mm, n = 5342) and screening (47 mm, SD = 13 mm, n = 395) examinations. The average MGD for all breasts differed by 2% from the MGD determined for breasts in the limited compressed thickness range of 40-60 mm. The difference between phantom- and patient-based MGD estimations was up to 30%. Therefore, phantom measurements cannot replace patient dose data in MGD determination.
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Affiliation(s)
- A Kelaranta
- STUK-Radiation and Nuclear Safety Authority, Laippatie 4, PO Box 14, Helsinki FI-00881, Finland Helsinki Medical Imaging Center, University Hospital of Helsinki, PO Box 340, Helsinki FI-00290, Finland Department of Physics, University of Helsinki, PO Box 64, Helsinki FI-00014, Finland
| | - P Toroi
- STUK-Radiation and Nuclear Safety Authority, Laippatie 4, PO Box 14, Helsinki FI-00881, Finland
| | - M Timonen
- Helsinki Medical Imaging Center, University Hospital of Helsinki, PO Box 340, Helsinki FI-00290, Finland
| | - S Komssi
- Suomen Terveystalo Ltd., Jaakonkatu 3B, Helsinki FI-00100, Finland
| | - M Kortesniemi
- Helsinki Medical Imaging Center, University Hospital of Helsinki, PO Box 340, Helsinki FI-00290, Finland
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23
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Oliveira BB, de Oliveira MA, Paixão L, Teixeira MHA, Nogueira MDS. Dosimetry and image quality assessment in a direct radiography system. Radiol Bras 2015; 47:361-7. [PMID: 25741119 PMCID: PMC4341379 DOI: 10.1590/0100-3984.2013.1876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 04/10/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the mean glandular dose with a solid state detector and the image quality in a direct radiography system, utilizing phantoms. MATERIALS AND METHODS Irradiations were performed with automatic exposure control and polymethyl methacrylate slabs with different thicknesses to calculate glandular dose values. The image quality was evaluated by means of the structures visualized on the images of the phantoms. RESULTS Considering the uncertainty of the measurements, the mean glandular dose results are in agreement with the values provided by the equipment and with internationally adopted reference levels. Results obtained from images of the phantoms were in agreement with the reference values. CONCLUSION The present study contributes to verify the equipment conformity as regards dose values and image quality.
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Affiliation(s)
- Bruno Beraldo Oliveira
- Masters, Fellow PhD degree, Course of Science and Technology of Radiations, Minerals and Materials - Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/ CNEN), Belo Horizonte, MG, Brazil
| | - Marcio Alves de Oliveira
- Master, Teacher, Department of Anatomy and Imaging, School of Medicine - Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Lucas Paixão
- Masters, Fellow PhD degree, Course of Science and Technology of Radiations, Minerals and Materials - Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/ CNEN), Belo Horizonte, MG, Brazil
| | | | - Maria do Socorro Nogueira
- PhD, Titular Researcher-Professor, Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG, Brazil
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de Groot JE, Broeders MJM, Branderhorst W, den Heeten GJ, Grimbergen CA. A novel approach to mammographic breast compression: Improved standardization and reduced discomfort by controlling pressure instead of force. Med Phys 2013; 40:081901. [DOI: 10.1118/1.4812418] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tsai CJ, Chen RC, Peng HL, Hsu WL, Lee JJS. Improved microcalcification visualization using dual-energy digital mammography. Acta Radiol 2013; 54:614-21. [PMID: 23528569 DOI: 10.1177/0284185113481017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dual-energy digital mammography (DEDM), involving a combination of high-energy (HE) and low-energy (LE) images, has been investigated as offering a potential improvement in microcalcification detection obscured by overlapping tissue structures. PURPOSE To explore the possibility to improve detection of microcalcifications using the DEDM technique. MATERIAL AND METHODS Three DEDM protocols were performed by adjusting the effective tube current time product (mAs) of LE image at the same (100%), one half (50%), and one-quarter (25%) of that used in HE image acquisition, named DEDM100%, DEDM50%, and DEDM25%, respectively. A single-energy digital mammography (SEDM) method was also used as a control. A total of 525 regions of interest (ROIs) were used to compare the performance of the DEDM to that of SEDM using free-response receiver-operating characteristic (FROC) and areas under the FROC curve (Az). RESULTS All DEDM protocols ranked significantly higher than the SEDM method (P < 0.001). The true-positive fraction was 0.90 for an average of 0.017-0.042 false-positive per image using the DEDM100%, 0.017-0.114 using the DEDM50%, 0.021-0.148 using the DEDM25%, and 0.134-0.422 using the SEDM. The estimated Az values were 0.915-0.940, 0.867-0.935, 0.824-0.930, and 0.567-0.673, respectively. CONCLUSION The DEDM50% protocol provided a trade-off benefit between accurate microcalcification detectability and radiation dose for any tissue density. Therefore, the DEDM50% has the potential to minimize excess radiation dose without a negative impact on image quality which could improve earlier diagnosis of breast cancer.
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Affiliation(s)
- Chia-Jung Tsai
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung
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Bosmans H, De Hauwere A, Lemmens K, Zanca F, Thierens H, Van Ongeval C, Van Herck K, Van Steen A, Martens P, Bleyen L, Vande Putte G, Kellen E, Mortier G, Van Limbergen E. Technical and clinical breast cancer screening performance indicators for computed radiography versus direct digital radiography. Eur Radiol 2013; 23:2891-8. [PMID: 23689308 DOI: 10.1007/s00330-013-2876-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 03/19/2013] [Accepted: 03/21/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare technical and clinical screening performance parameters between computed radiography (CR) and direct digital radiography (DR) systems. METHODS The number of women screened with CR was 73,008 and with DR 116,945. Technical and patient dose survey data of 25 CR and 37 DR systems were available. Technical performance was expressed by threshold thickness values at the mean glandular dose (MGD) level of routine practice. Clinical indicators included recall rate (RR), cancer detection rate (CDR), percentage of ductal carcinoma in situ (DCIS), percentage of cancers with T-scores smaller than 1 cm and positive predictive value (PPV). RESULTS Contrast threshold values for the 0.1-mm gold disk were 1.44 μm (SD 0.13 μm) for CR and 1.20 μm (SD 0.13 μm for DR). MGD was 2.16 mGy (SD 0.36 mGy) and 1.35 mGy (SD 0.32 mGy) for CR and DR respectively. We obtained for CR, respectively DR, the following results: RR in the first round of 5.48 % versus 5.61 %; RR in subsequent rounds of 2.52 % versus 2.65 %; CDR of 0.52 % versus 0.53 %; DCIS of 0.08 % versus 0.11 %; a rate of cancers with T-scores smaller than 1 cm of 0.11 % versus 0.11 %; PPV of 18.45 % versus 18.64 %; none of them was significantly different. CONCLUSION Our screening indicators are reassuring for the use of CR and DR, with CR operating at 60 % higher MGD. KEY POINTS • Breast cancer screening can employ both computed (CR) and direct digital radiography (DR). • Screening performance parameters for CR and DR technology are not significantly different. • Screening parameters are in accordance with European Guidelines. • Radiation doses employed for CR are generally 60 % greater than for DR.
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Affiliation(s)
- Hilde Bosmans
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium,
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Experience With Patient Dosimetry and Quality Control Online for Diagnostic and Interventional Radiology Using DICOM Services. AJR Am J Roentgenol 2013; 200:783-90. [DOI: 10.2214/ajr.12.10179] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Chen B, Wang Y, Sun X, Guo W, Zhao M, Cui G, Hu L, Li P, Ren Y, Feng J, Yu J. Analysis of patient dose in full field digital mammography. Eur J Radiol 2012; 81:868-72. [DOI: 10.1016/j.ejrad.2011.02.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2011] [Accepted: 02/10/2011] [Indexed: 11/16/2022]
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Thierry-Chef I, Simon SL, Weinstock RM, Kwon D, Linet MS. Reconstruction of absorbed doses to fibroglandular tissue of the breast of women undergoing mammography (1960 to the present). Radiat Res 2012; 177:92-108. [PMID: 21988547 PMCID: PMC3876279 DOI: 10.1667/rr2241.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The assessment of potential benefits versus harms from mammographic examinations as described in the controversial breast cancer screening recommendations of the U.S. Preventive Task Force included limited consideration of absorbed dose to the fibroglandular tissue of the breast (glandular tissue dose), the tissue at risk for breast cancer. Epidemiological studies on cancer risks associated with diagnostic radiological examinations often lack accurate information on glandular tissue dose, and there is a clear need for better estimates of these doses. Our objective was to develop a quantitative summary of glandular tissue doses from mammography by considering sources of variation over time in key parameters, including imaging protocols, X-ray target materials, voltage, filtration, incident air kerma, compressed breast thickness, and breast composition. We estimated the minimum, maximum and mean values for glandular tissue dose for populations of exposed women within 5-year periods from 1960 to the present, with the minimum to maximum range likely including 90% to 95% of the entirety of the dose range from mammography in North America and Europe. Glandular tissue dose from a single view in mammography is presently about 2 mGy, about one-sixth the dose in the 1960s. The ratio of our estimates of maximum to minimum glandular tissue doses for average-size breasts was about 100 in the 1960s compared to a ratio of about 5 in recent years. Findings from our analysis provide quantitative information on glandular tissue doses from mammographic examinations that can be used in epidemiological studies of breast cancer.
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McCullagh JB, Baldelli P, Phelan N. Clinical dose performance of full field digital mammography in a breast screening programme. Br J Radiol 2011; 84:1027-33. [PMID: 21586506 PMCID: PMC3473710 DOI: 10.1259/bjr/83821596] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 06/03/2010] [Accepted: 07/06/2010] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE BreastCheck, the Irish Breast Screening Programme, has employed three different models of a full field digital mammography (FFDM) system since its transition to a digital service in 2007. The three models from GE Healthcare, Hologic and Sectra exhibit differences in their design and function, the most significant of which include anode target/filter choice, detector technology and the type of exposure automation. METHODS The aim of this study was to use the results from a clinical breast dose survey to examine the differences between three different FFDM models in terms of exposure selection, breast mean glandular dose (MGD) and automatic exposure control (AEC) dose contribution. RESULTS The accuracy of the dose estimation was improved by inclusion of the AEC pre-exposure dose contribution. The photon-counting system demonstrated the lowest average MGD. The GE Healthcare and Hologic flat-panel detector systems demonstrated a small but statistically significant dose difference. The pre-exposure dose contribution did not exceed 13% of the total exposure dose for any system in the survey. A comparison of the system calculated organ dose estimate from each machine with the corresponding MGD calculated from medical physics measurements indicated reasonably accurate organ dose estimates for most systems in the survey. CONCLUSION The results of this study provide a comprehensive assessment of the breast dose performance of current digital mammography systems in a clinical screening setting.
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Affiliation(s)
- J B McCullagh
- BreastCheck, The National Cancer Screening Service, Infirmary Road, Cork, Ireland.
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Tsalafoutas IA, Metallidis SI. A method for calculating the dose length product from CT DICOM images. Br J Radiol 2010; 84:236-43. [PMID: 21081566 DOI: 10.1259/bjr/37630380] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The dosimetric calculations in CT examinations are currently based on two quantities: the volume weighted CT dose index (CTDI(vol)) and the dose-length product (DLP). The first quantity is dependent on the exposure factors, scan field of view, collimation and pitch factor selections, whereas the second is additionally dependent on the scan length. METHODS In this study a method for the calculation of these quantities from digital imaging and communication in medicine (DICOM) CT images is presented that allows an objective audit of patient doses. This method was based on software that has been developed to enable the automatic extraction of the DICOM header information of each image (relating to the parameters that affect the aforementioned quantities) into a spreadsheet with embedded functions for calculating the contribution of each image to the CTDI(vol) and DLP values. The applicability and accuracy of this method was investigated using data from actual examinations carried out in three different multislice CT scanners. These examinations have been performed with the automatic exposure control systems activated, and therefore the tube current and tube loading values varied during the scans. RESULTS The calculated DLP values were in good agreement (±5%) with the displayed values. The calculated average CDTI(vol) values were in similar agreement with the displayed CTDI(vol) values but only for two of the three scanners. In the other scanner the displayed CTDI(vol) values were found to be overestimated by about 25%. As an additional application of this method the differences among the tube modulation techniques used by the three CT scanners were investigated. CONCLUSION This method is a useful tool for radiation dose surveys.
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Affiliation(s)
- I A Tsalafoutas
- Medical Physics Department, Agios Savvas Hospital, 171 Alexandras Avenue, 115 22, Athens, Greece.
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Palma BA, Rosado-Méndez I, Villaseñor Y, Brandan ME. Phantom study to evaluate contrast-medium-enhanced digital subtraction mammography with a full-field indirect-detection system. Med Phys 2010; 37:577-89. [PMID: 20229866 DOI: 10.1118/1.3276733] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
This phantom study simulates contrast-medium-enhanced digital subtraction mammography (CEDM) and compares subtracted image quality and total mean glandular dose for two alternative spectral combinations available in a GE Senographe DS mammography unit. The first choice takes advantage of large iodine attenuation at low photon energies and uses traditionally available spectra (anode/filter combinations Mo/Mo at 25 kV and Rh/Rh at 40 kV, "Mo25-Rh40"). The second choice, selected from a previous analytical optimization, includes harder spectra obtained by adding external filtration to traditional beams (Rh/Rh at 34 kV and Rh/Rh+5 mm of Al at 45 kV, "Rh34-Rh45H"). Individual images of a custom-made phantom containing tubes of various diameters filled with water- or iodine-based contrast agent were acquired with both spectral combinations. The total breast entrance air kerma, considering subtraction of two images, was limited to 8.76 mGy (1 R). The results were compared to predictions obtained through an analytical formalism that assumes noise of stochastic origin. Individual images were evaluated and subtracted under five combinations of temporal and dual-energy modalities. Signal variance analysis in individual raw images showed important contributions of nonstochastic origin, associated with the software applied to raw images, the curved geometry, and strong attenuation of the phantom cylindrical iodine-filled tubes, causing experimental SNR to vary from 2.2 to 0.8 times the predictions from low to high values of SNR. Iodine contrast in the subtracted images was found to be mainly defined by the spectra, independent of exposure, and linearly dependent on the iodine mass thickness. The highest contrast was obtained with the combined dual-energy temporal subtraction with Rh34-Rh45H, its value was 7% larger than the highest value measured with Mo25-Rh40. As expected, temporal modalities (single and dual energy, any spectral choice) led to higher contrast-over-noise ratio (CNR) than nontemporal dual-energy subtraction, the latter being negligibly small with Mo25-Rh40. CNR for 4 mg iodine/cm2 imaged temporally in a dual-energy fashion with Rh34-Rh45H (iodine imaged at high energy) is about 1.7 times the optimum for Mo25-Rh40 (iodine imaged at low energy). Iodine thicknesses needed to fulfill Rose's criterion were 0.78 +/- 0.02 mg iodine/cm2 for Mo25-Rh40 and 0.54 +/- 0.17 mg iodine/cm2 for Rh34-Rh45H, both lower than the proposed biological concentration of iodine in breast tumors after contrast medium administration. Although similar dose levels were obtained with both spectral choices under dual-energy (temporal and nontemporal) subtraction, the dose obtained in single-energy temporal subtraction with the Mo25 spectrum was 1.2 mGy lower than the dose from the modality offering the highest CNR. In all results considered, the spectral choice Mo25-Rh40 was found to represent an interesting alternative to the use of high-energy hardened spectra for CEDM, particularly when performing dynamic studies of the contrast-agent uptake in breast lesions.
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Affiliation(s)
- B A Palma
- Instituto de Fisica, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico
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Das M, Gifford HC, O'Connor JM, Glick SJ. Evaluation of a variable dose acquisition technique for microcalcification and mass detection in digital breast tomosynthesis. Med Phys 2009; 36:1976-84. [PMID: 19610286 PMCID: PMC2832061 DOI: 10.1118/1.3116902] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 03/19/2009] [Accepted: 03/20/2009] [Indexed: 11/07/2022] Open
Abstract
In this article the authors evaluate a recently proposed variable dose (VD)-digital breast tomosynthesis (DBT) acquisition technique in terms of the detection accuracy for breast masses and microcalcification (MC) clusters. With this technique, approximately half of the total dose is used for one center projection and the remaining dose is split among the other tomosynthesis projection views. This acquisition method would yield both a projection view and a reconstruction view. One of the aims of this study was to evaluate whether the center projection alone of the VD acquisition can provide equal or superior MC detection in comparison to the 3D images from uniform dose (UD)-DBT. Another aim was to compare the mass-detection capabilities of 3D reconstructions from VD-DBT and UD-DBT. In a localization receiver operating characteristic (LROC) observer study of MC detection, the authors compared the center projection of a VD acquisitioh scheme (at 2 mGy dose) with detector pixel size of 100 microm with the UD-DBT reconstruction (at 4 mGy dose) obtained with a voxel size of 100 microm. MCs with sizes of 150 and 180 microm were used in the study, with each cluster consisting of seven MCs distributed randomly within a small volume. Reconstructed images in UD-DBT were obtained from a projection set that had a total of 4 mGy dose. The current study shows that for MC detection, using the center projection alone of VD acquisition scheme performs worse with area under the LROC curve (AL) of 0.76 than when using the 3D reconstructed image using the UD acquisition scheme (AL=0.84). A 2D ANOVA found a statistically significant difference (p=0.038) at a significance level of 0.05. In the current study, although a reconstructed image was also available using the VD acquisition scheme, it was not used to assist the MC detection task which was done using the center projection alone. In the case of evaluation of detection accuracy of masses, the reconstruction with VD-DBT (AL=0.71) was compared to that obtained from the UD-DBT (AL=0.78). The authors found no statistically significant difference between the two (p-value=0.22), although all the observers performed better for UD-DBT.
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Affiliation(s)
- Mini Das
- Department of Radiology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, USA.
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35
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Arvanitis CD, Bohndiek SE, Royle G, Blue A, Liang HX, Clark A, Prydderch M, Turchetta R, Speller R. Empirical electro-optical and x-ray performance evaluation of CMOS active pixels sensor for low dose, high resolution x-ray medical imaging. Med Phys 2008; 34:4612-25. [PMID: 18196789 DOI: 10.1118/1.2804744] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Monolithic complementary metal oxide semiconductor (CMOS) active pixel sensors with high performance have gained attention in the last few years in many scientific and space applications. In order to evaluate the increasing capabilities of this technology, in particular where low dose high resolution x-ray medical imaging is required, critical electro-optical and physical x-ray performance evaluation was determined. The electro-optical performance includes read noise, full well capacity, interacting quantum efficiency, and pixels cross talk. The x-ray performance, including x-ray sensitivity, modulation transfer function, noise power spectrum, and detection quantum efficiency, has been evaluated in the mammographic energy range. The sensor is a 525 x 525 standard three transistor CMOS active pixel sensor array with more than 75% fill factor and 25 x 25 microm pixel pitch. Reading at 10 f/s, it is found that the sensor has 114 electrons total additive noise, 10(5) electrons full well capacity with shot noise limited operation, and 34% interacting quantum efficiency at 530 nm. Two different structured CsI:Tl phosphors with thickness 95 and 115 microm, respectively, have been optically coupled via a fiber optic plate to the array resulting in two different system configurations. The sensitivity of the two different system configurations was 43 and 47 electrons per x-ray incident on the sensor. The MTF at 10% of the two different system configurations was 9.5 and 9 cycles/mm with detective quantum efficiency of 0.45 and 0.48, respectively, close to zero frequency at approximately 0.44 microC/kg (1.72 mR) detector entrance exposure. The detector was quantum limited at low spatial frequencies and its performance was comparable with high resolution a: Si and charge coupled device based x-ray imagers. The detector also demonstrates almost an order of magnitude lower noise than active matrix flat panel imagers. The results suggest that CMOS active pixel sensors when coupled to structured CsI:Tl can be used for conventional and advanced digital mammography due to their low noise, high resolution performance.
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Affiliation(s)
- C D Arvanitis
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, United Kingdom.
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36
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Mettler FA, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology 2008; 248:254-63. [PMID: 18566177 DOI: 10.1148/radiol.2481071451] [Citation(s) in RCA: 1312] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Medical uses of radiation have grown very rapidly over the past decade, and, as of 2007, medical uses represent the largest source of exposure to the U.S. population. Most physicians have difficulty assessing the magnitude of exposure or potential risk. Effective dose provides an approximate indicator of potential detriment from ionizing radiation and should be used as one parameter in evaluating the appropriateness of examinations involving ionizing radiation. The purpose of this review is to provide a compilation of effective doses for radiologic and nuclear medicine procedures. Standard radiographic examinations have average effective doses that vary by over a factor of 1000 (0.01-10 mSv). Computed tomographic examinations tend to be in a more narrow range but have relatively high average effective doses (approximately 2-20 mSv), and average effective doses for interventional procedures usually range from 5-70 mSv. Average effective dose for most nuclear medicine procedures varies between 0.3 and 20 mSv. These doses can be compared with the average annual effective dose from background radiation of about 3 mSv.
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Affiliation(s)
- Fred A Mettler
- Department of Radiology and Nuclear Medicine, New Mexico Veterans Administration Healthcare System, 1501 San Pedro Blvd, Albuquerque, NM 87108, USA.
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Michielsen K, Jacobs J, Lemmens K, Nens J, Zoetelief J, Faulkner K, Bosmans H. Results of a European dose survey for mammography. RADIATION PROTECTION DOSIMETRY 2008; 129:199-203. [PMID: 18430718 DOI: 10.1093/rpd/ncn152] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
For the dose study, a semi-automated method of data collection is used in this study. The participating centres were asked to fill out a spreadsheet with all necessary data and return it. For direct digital (DR) systems, the relevant data available in the DICOM header were used. All data is automatically added to a database and processed. The data were used to calculate the mean glandular dose for every image and for different thicknesses of polymethyl methacrylate phantoms using available conversion factors. Second-degree polynomials were fitted to the patient dose data and a reference dose curve was constructed for a range of thicknesses instead of a dose reference level at a single point. The dose reference curve rises from 1.57 mGy for a thickness of 30 mm to 2.50 mGy for 55 mm and 3.83 mGy for 75 mm. The results show centres that exceed this curve lie only in the lower or higher range of thicknesses and would remain undetected using a dose reference value in a single point. This gives better information to radiographers on where there is room for improvement of the dose levels in their system.
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Affiliation(s)
- K Michielsen
- Leuven University Centre for Medical Physics in Radiology, Leuven, Belgium.
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Lu LJW, Nishino TK, Khamapirad T, Grady JJ, Leonard MH, Brunder DG. Computing mammographic density from a multiple regression model constructed with image-acquisition parameters from a full-field digital mammographic unit. Phys Med Biol 2007; 52:4905-21. [PMID: 17671343 PMCID: PMC2691417 DOI: 10.1088/0031-9155/52/16/013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Breast density (the percentage of fibroglandular tissue in the breast) has been suggested to be a useful surrogate marker for breast cancer risk. It is conventionally measured using screen-film mammographic images by a labor-intensive histogram segmentation method (HSM). We have adapted and modified the HSM for measuring breast density from raw digital mammograms acquired by full-field digital mammography. Multiple regression model analyses showed that many of the instrument parameters for acquiring the screening mammograms (e.g. breast compression thickness, radiological thickness, radiation dose, compression force, etc) and image pixel intensity statistics of the imaged breasts were strong predictors of the observed threshold values (model R(2) = 0.93) and %-density (R(2) = 0.84). The intra-class correlation coefficient of the %-density for duplicate images was estimated to be 0.80, using the regression model-derived threshold values, and 0.94 if estimated directly from the parameter estimates of the %-density prediction regression model. Therefore, with additional research, these mathematical models could be used to compute breast density objectively, automatically bypassing the HSM step, and could greatly facilitate breast cancer research studies.
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Affiliation(s)
- Lee-Jane W. Lu
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX 77555-1109
| | - Thomas K. Nishino
- Department of Radiology, The University of Texas Medical Branch, Galveston, TX 77555-1109
| | - Tuenchit Khamapirad
- Department of Radiology, The University of Texas Medical Branch, Galveston, TX 77555-1109
| | - James J Grady
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX 77555-1109
| | | | - Donald G. Brunder
- Address correspondence to Donald G. Brunder, Ph.D., at Academic Computing/Academic Resources, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1035; Tel: (409) 772-8423; E-mail
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Gennaro G, di Maggio C. Dose comparison between screen/film and full-field digital mammography. Eur Radiol 2006; 16:2559-66. [PMID: 16733678 DOI: 10.1007/s00330-006-0314-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2006] [Revised: 04/05/2006] [Accepted: 04/24/2006] [Indexed: 11/26/2022]
Abstract
The study purpose was the comparison between doses delivered by a full-field digital mammography system and a screen/film mammography unit, both using the same type of X-ray tube. Exposure parameters and breast thickness were collected for 300 screen/film (GE Senographe DMR) and 296 digital mammograms (GE Senographe 2000D). The entrance surface air kerma (ESAK) was calculated from anode/filter combination, kV(p) and mAs values and breast thickness, by simulating spectra through a program based on a catalogue of experimental X-ray spectra. The average glandular dose (AGD) was also computed. Results showed an overall reduction of average glandular dose by 27% of digital over screen/film mammography. The dose saving was about 15% for thin and thick breasts, while it was between 30% and 40% for intermediate thicknesses. Full-field digital mammography dose reduction is allowed by wider dynamic range and higher efficiency of digital detector, which can be exposed at higher energy spectra than screen/film mammography, and by the separation between acquisition and displaying processes.
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Affiliation(s)
- Gisella Gennaro
- Department of Oncological and Surgical Sciences, Padua University, via Gattamelata 64, 35128, Padua, Italy.
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Gennaro G, Katz L, Souchay H, Alberelli C, di Maggio C. Are phantoms useful for predicting the potential of dose reduction in full-field digital mammography? Phys Med Biol 2005; 50:1851-70. [PMID: 15815100 DOI: 10.1088/0031-9155/50/8/015] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A phantom study was performed in full-field digital mammography to investigate the opportunity and the magnitude of a possible dose reduction that would leave the image quality above the accepted thresholds associated with some classical phantoms. This preliminary work is intended to lay the groundwork for a future clinical study on the impact of dose reduction on clinical results. Three different mammography phantoms (ACR RMI 156, CIRS 11A and CDMAM 3.4) were imaged by a full-field digital mammography unit (GE Senographe 2000D) at different dose levels. Images were rated by three observers with softcopy reading and scoring methods specific to each phantom. Different types of data analysis were applied to the ACR (American College of Radiology) and the other two phantoms, respectively. With reference to the minimum acceptance score in screen/film accreditation programmes, the ACR phantom showed that about 45% dose reduction could be applied, while keeping the phantom scores above that threshold. A relative comparison was done for CIRS and CDMAM, for which no threshold is defined. CIRS scoring remained close to the reference level down to 40% dose reduction, the inter- and intra-observer variability being the main source of uncertainty. Contrast-detail curves provided by CDMAM overlapped down to 50% dose reduction, at least for object contrast values ranging between 30% and 3%. This multi-phantom study shows the potential of further reducing the dose in full-field digital mammography beyond the current values. A common dose reduction factor around 50% seems acceptable for all phantoms. However, caution is required before extrapolating the results for clinical use, given the limitations of these widely used phantoms, mainly related to their limited dynamic range and uniform background.
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Affiliation(s)
- Gisella Gennaro
- Department of Oncological and Surgical Sciences, University of Padua, Italy
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