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Albeshan SM, Alhulail AA, Almuqbil MM. Glandular doses and diagnostic reference levels (DRLs) for Saudi breast cancer screening programme (2012-2021). RADIATION PROTECTION DOSIMETRY 2024; 200:467-472. [PMID: 38324508 DOI: 10.1093/rpd/ncae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 12/28/2023] [Accepted: 01/07/2024] [Indexed: 02/09/2024]
Abstract
The aim of this study was to report the diagnostic reference levels (DRLs) corresponding to different compressed breast thickness (CBT) ranges. To achieve this, mammographic examinations with 187,788 exposures were analysed. The mean average glandular (AGD) dose was calculated per view, examination, and center. Moreover, the DRL values corresponding to different CBT ranges were reported. The result of the mean AGD per view was found to be 1.36 mGy for craniocaudal (CC) and 1.54 mGy for Mediolateral oblique (MLO), while the mean AGD per examination for all women was 1.45 mGy. The DRL values corresponding to CBTs between 20 to 79 mm ranges were below 2 mGy. These results were from a population of mean age = 49 ± 8 years and mean CBT = 58 ± 8 mm, and was imaged with mean exposures of 29 ± 1 kVp and 74 ± 31 mAs, and a mean compression force of 135±37 N. In conclusion, good mammography practice has been shown, as DRL values are within the limits suggested by the international organizations.
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Affiliation(s)
- Salman M Albeshan
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia
| | - Ahmad A Alhulail
- Department of Radiology and Medical Imaging, Prince Sattam Bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia
| | - Maha M Almuqbil
- Ministry of Health, General Directorate for Health Programs and Chronic Diseases, Riyadh 12628, Saudi Arabia
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2
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Patidar D, Yap LBC, Begum H, Soh BP. Manual or auto-mode: Does this affect radiation dose in digital mammography without compromising image quality? Radiography (Lond) 2022; 28:1064-1070. [PMID: 35994975 DOI: 10.1016/j.radi.2022.08.004] [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: 05/18/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION In current practice, auto-filter exposure mode is used for most screening mammography examinations. However, with better understanding of the side effects of radiation, it is important to examine exposure parameters and practises to minimise radiation dose to patients. The purpose of this phantom study is to investigate the impact that different exposure modes (manual, auto-time and auto-filter) have on radiation dose, while maintaining images of diagnostic quality. METHODS This study was conducted in three stages. In the first stage, 125 images were taken using a Gammex 156 phantom with polymethyl methacrylate blocks to reflect varying thicknesses (4.5, 5.0, 5.5, 6.0 and 6.5 cm). In the second stage, three mammographers independently assessed image quality and assigned scores based on the number of distinct fibers, masses and speck groups visible. Images with acceptable quality were further investigated in the third stage by comparing their average glandular dose (AGD) using the Kruskal-Wallis H test and Dunn's post-hoc pairwise analysis. RESULTS Significant differences in AGD were shown between the auto-filter mode and manual mode techniques for 6.0 cm, and between auto-time mode and manual mode techniques for 6.5 cm (p < 0.05). CONCLUSION For 4.5, 5.0 and 5.5 cm phantoms, as AGD was not significantly different among the different modes, the auto-filter may remain the most practical option. However, significant reductions in AGD were obtained for the 6.0 and 6.5 cm phantoms when manual mode techniques were used. IMPLICATIONS FOR PRACTICE Manual mode techniques can potentially provide dose-saving opportunity in 6.0 and 6.5 cm breast thickness though future work on human breast should be done to confirm this. Results from this study will support future research based on patient data.
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Affiliation(s)
- D Patidar
- Health and Social Sciences, Singapore Institute of Technology, 10 Dover Drive, 138683, Singapore.
| | - L B C Yap
- Radiography Department, Singapore General Hospital, 31 Third Hospital Avenue, 168753, Singapore
| | - H Begum
- Health and Social Sciences, Singapore Institute of Technology, 10 Dover Drive, 138683, Singapore
| | - B P Soh
- Health and Social Sciences, Singapore Institute of Technology, 10 Dover Drive, 138683, Singapore
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Loveland J, Young KC, Oduko JM, Mackenzie A. Radiation doses in the United Kingdom breast screening programmes 2016-2019. Br J Radiol 2022; 95:20211400. [PMID: 35604717 PMCID: PMC10996325 DOI: 10.1259/bjr.20211400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To record the radiation doses involved in UK breast screening and to identify any changes since previous publications related to technical factors and the population screened. METHODS Mammographic exposure factors for 68,998 women imaged using 411 X-ray sets spread across the UK were compiled. Local output and half value layer measurements for each X-ray set were used to estimate mean glandular dose (MGD) using the standard UK method. RESULTS Mean MGDs in digital mammography have increased by 11% since 2010-12 for both medio-lateral oblique (MLO) and cranio-caudal (CC) views. The mean compressed breast thickness (CBT) has increased (4.8% CC, 5.2% MLO) over the same period. The mean MLO CBT value of 62.4 ± 0.1 mm is outside the 50 to 60 mm range used for diagnostic reference levels. The increase in MGD is consistent with the CBT changes. The mean MGD in the 50 to 60 mm CBT range is 1.44 ± 0.03 mGy for MLO views. CBT varies with age and peaks at 51. CONCLUSIONS Mean CBT has increased with time, and this has increased mean MGDs for digital mammography. CBT also varies with age. ADVANCES IN KNOWLEDGE Updated average MGDs in the UK are provided. There is evidence that breast size is increasing in the UK and that mean CBT is affected by age-related changes in the breast.
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Affiliation(s)
- John Loveland
- National Coordinating Centre for the Physics in Mammography
(NCCPM), Level B, St Luke’s Wing, Royal Surrey NHS Foundation
Trust, Guildford,
UK
| | - Kenneth C Young
- National Coordinating Centre for the Physics in Mammography
(NCCPM), Level B, St Luke’s Wing, Royal Surrey NHS Foundation
Trust, Guildford,
UK
| | - Jennifer M Oduko
- National Coordinating Centre for the Physics in Mammography
(NCCPM), Level B, St Luke’s Wing, Royal Surrey NHS Foundation
Trust, Guildford,
UK
| | - Alistair Mackenzie
- National Coordinating Centre for the Physics in Mammography
(NCCPM), Level B, St Luke’s Wing, Royal Surrey NHS Foundation
Trust, Guildford,
UK
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Liu Q, Suleiman ME, McEntee MF, Soh BP. Diagnostic reference levels in digital mammography: a systematic review. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:011503. [PMID: 34891143 DOI: 10.1088/1361-6498/ac4214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/10/2021] [Indexed: 06/13/2023]
Abstract
Diagnostic reference levels (DRLs) in digital mammography (DM) serve as a useful benchmark for dose monitoring and optimisation, allowing comparison amongst countries, institutions and mammography units. A systematic review of DRLs in DM, published in 2014, reported a lack of consistent and internationally accepted protocol in DRLs establishment, thereby resulting in wide variations in methodologies which complicates comparability between studies. In 2017, the International Commission of Radiation Protection (ICRP) published additional guidelines and recommendations to provide clarity in the protocol used in DRLs establishment. With the continuing evolvement of technology, optimisation of examinations and updates in guidelines and recommendations, DRLs should be revised at regular intervals. This systematic review aims to provide an update and identify a more consistent protocol in the methodologies used to establish DRLs. Searches were conducted through Web of Science, PubMed-MEDLINE, ScienceDirect, CINAHL and Google Scholar, which resulted in 766 articles, of which 19 articles were included after screening. Relevant data from the included studies were summarised and analysed. While the additional guidelines and recommendations have provided clarifications in the methodologies used in DRLs establishment, such as data source (i.e. the preference to use data derived from patient instead of phantoms to establish DRLs), protocol (i.e. stratification of DRLs by compressed breast thickness and detector technology, and the use of median value for DRLs quantity instead of mean) and percentiles used to establish DRLs (i.e. set at the 75th percentile with a minimum sample size of 50 patients), other differences such as the lack of a standard dose calculation method used to estimate mean glandular dose continues to complicate comparisons between studies and different DM systems. This systematic review update incorporated the updated guidelines and recommendations from ICRP which will serve as a useful resource for future research efforts related to DRLs, dose monitoring and optimisation.
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Affiliation(s)
- Qiumei Liu
- Health and Social Sciences, Singapore Institute of Technology, Dover Road, Singapore
| | - Moayyad E Suleiman
- Faculty of Medicine and Health, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Mark F McEntee
- The Discipline of Medical Imaging and Radiation Therapy, School of Medicine, UGF 12, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - BaoLin P Soh
- Health and Social Sciences, Singapore Institute of Technology, Dover Road, Singapore
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Avramova-Cholakova S, Kulama E, Daskalov S, Loveland J. PERFORMANCE COMPARISON OF SYSTEMS WITH FULL-FIELD DIGITAL MAMMOGRAPHY, DIGITAL BREAST TOMOSYNTHESIS AND CONTRAST-ENHANCED SPECTRAL MAMMOGRAPHY. RADIATION PROTECTION DOSIMETRY 2021; 197:212-229. [PMID: 34977945 DOI: 10.1093/rpd/ncab172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/12/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
The purpose is to compare full-field digital mammography (FFDM), digital breast tomosynthesis (DBT) and contrast-enhanced spectral mammography (CESM) technologies on three mammography systems in terms of image quality and patient dose. Two Senographe Essential with DBT and CESM (denoted S1 and S2) and one Selenia Dimensions (S3) with FFDM and DBT were considered. Dosimetry methods recommended in the European protocol were used. Image quality was tested with CDMAM in FFDM and DBT and with ideal observer method in FFDM. Mean values of mean glandular dose (MGD) from whole patient samples on S1, S2 and S3 were as follows: FFDM 1.65, 1.84 and 2.23 mGy; DBT 2.03, 1.96 and 2.87 mGy; CESM 2.65 and 3.16 mGy, respectively. S3 exhibited better low-contrast detectability for the smallest sized discs of CDMAM and ideal observer in FFDM, and for the largest sized discs in DBT, at similar dose levels.
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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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Procz S, Roque G, Avila C, Racedo J, Rueda R, Santos I, Fiederle M. Investigation of CdTe, GaAs, Se and Si as Sensor Materials for Mammography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:3766-3778. [PMID: 32746121 DOI: 10.1109/tmi.2020.3004648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Despite the benefits of mammography investigations, some studies have shown that X-ray exposure from the mammography screening itself can statistically cause breast cancer in a small fraction of women. Therefore, a dose reduction in mammography is desirable. At the same time, there is a demand for a higher spatial resolution in mammographic imaging. The most promising way to achieve these goals is the use of advanced photon-processing semiconductor X-ray detectors with optimum sensor materials. This study addresses the investigation of the optimum semiconductor sensor material for mammography in combination with the photon-processing detector Medipix3RX. The influence of K-shell fluorescence from the sensor material on the achievable contrast-to-noise ratio is investigated, as well as the attenuation efficiency. The three different sensor materials, CdTe, GaAs, and Si are studied, showing advances of CdTe-sensors for mammography. Furthermore, a comparison of the contrast-to-noise ratio between a clinical Se-detector and Medipix3RX detectors with Si- and CdTe-sensors is shown using a self-produced mammography phantom that is based on real human tissue.
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8
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Dosimetric and Contrast Noise Ratio Comparison of Three Different Digital Imaging Technologies in Mammography. J Med Imaging Radiat Sci 2020; 51:88-94. [DOI: 10.1016/j.jmir.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 11/20/2022]
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9
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Development and validation of a bespoke phantom to test accuracy of Cobb angle measurements. Radiography (Lond) 2020; 26:e78-e87. [PMID: 32052769 DOI: 10.1016/j.radi.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Adolescent idiopathic scoliosis (AIS) is a spinal deformity that causes the spine to bend laterally. Patients with AIS undergo frequent X-ray examinations to monitor the progression of the disorder by through the measurement of the Cobb angle. Frequent exposure of adolescents poses the risk of radiation-induced cancer. The aim of this research was to design and build a bespoke phantom representing a 10-year-old child with AIS to allow optimisation of imaging protocols for AIS assessment through the accuracy of Cobb angle measurements. METHODS Poly-methyl methacrylate (PMMA) and plaster of Paris (PoP) were used to represent human soft tissue and bone tissue, respectively, to construct a phantom exhibiting a 15° lateral curve of the spine. The phantom was validated by comparing the Hounsfield unit (HU) of its vertebrae with that of human and sheep. Additionally, comparisons of signal-to-noise ratio (SNR) to those from a commercially available phantom. An assessment of the accuracy of the radiographic assessment of the Cobb angle measurement was performed. RESULTS The HU of the PoP vertebrae was 628 (SD = 56), human vertebrae was 598 (SD = 79) and sheep vertebra was 605 (SD = 83). The SNR values of the two phantoms correlated strongly (r = 0.93 (p = 0.00)). The measured scoliosis angle was 14°. CONCLUSION The phantom has physical characteristics (in terms of spinal deformity) and radiological characteristics (in terms of HU and SNR values) of the spine of a 10-year-old child with AIS. This phantom has utility for the optimisation of x-ray imaging techniques in 10 year old children. IMPLICATIONS FOR PRACTICE A phantom to investigate new x-ray imaging techniques and technology in the assessment of scoliosis and to optimise currently used protocols.
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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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Sá Dos Reis C, Fartaria MJ, Garcia Alves JH, Pascoal A. PORTUGUESE STUDY OF MEAN GLANDULAR DOSE IN MAMMOGRAPHY AND COMPARISON WITH EUROPEAN REFERENCES. RADIATION PROTECTION DOSIMETRY 2018; 179:391-399. [PMID: 29342291 DOI: 10.1093/rpd/ncx300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 12/19/2017] [Indexed: 06/07/2023]
Abstract
To characterise the mean glandular dose (MGD) in a sample of healthcare providers for digital mammography in Portugal. To compare the achieved values with European references. The MGD was measured on a poly-methyl-methacrylate phantom (45 mm) for each system using dosimeters. In addition, MGD was estimated using exposure settings collected from mammography exams in clinical context. Data were collected from 25 computed-radiography systems (CR) and 13 integrated digital (DR). For both measurements (phantom and clinical exposures), the average MGD for CR was higher compared to the DR. For CR the mean MGD was 1.85 mGy (CC projection) and 2.10 mGy (MLO projection). For DR systems the corresponding values were 1.54 mGy (CC) and 1.68 mGy (MLO). The average MGD obtained using both methods and for both technologies is within the acceptable reference range proposed by European guidelines (<2.5 mGy). Dose Reference Levels implementation should be the next step to optimise mammography practice in Portugal.
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Affiliation(s)
- Cláudia Sá Dos Reis
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia
- Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa (ESTeSL/IPL), Lisbon, Portugal
- Universidade Católica Portuguesa, Faculdade de Engenharia, Estrada Octávio Pato, 2635-631 Rio de Mouro, Portugal
| | - Mário João Fartaria
- Universidade Católica Portuguesa, Faculdade de Engenharia, Estrada Octávio Pato, 2635-631 Rio de Mouro, Portugal
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Instituto Superior Técnico (IST), Universidade de Lisboa (UL), Laboratório de Proteção e Segurança Radiológica (LPSR), Estrada Nacional 10 (ao km 139,7), 2986-066 Bobadela, Portugal
| | - João H Garcia Alves
- Instituto Superior Técnico (IST), Universidade de Lisboa (UL), Laboratório de Proteção e Segurança Radiológica (LPSR), Estrada Nacional 10 (ao km 139,7), 2986-066 Bobadela, Portugal
- Centro de Ciências e Tecnologias Nucleares (C2TN) do IST, UL, EN 10 (ao km 139,7), 2986-066 Bobadela, Portugal
| | - Ana Pascoal
- Universidade Católica Portuguesa, Faculdade de Engenharia, Estrada Octávio Pato, 2635-631 Rio de Mouro, Portugal
- Guy's & St Thomas NHS Foundation Trust, London, UK
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Nguyen TL, Choi YH, Aung YK, Evans CF, Trinh NH, Li S, Dite GS, Kim MS, Brennan PC, Jenkins MA, Sung J, Song YM, Hopper JL. Breast Cancer Risk Associations with Digital Mammographic Density by Pixel Brightness Threshold and Mammographic System. Radiology 2018; 286:433-442. [DOI: 10.1148/radiol.2017170306] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Tuong L Nguyen
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Yoon-Ho Choi
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Ye K Aung
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Christopher F Evans
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Nhut H Trinh
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Shuai Li
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Gillian S Dite
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Myeong-Seong Kim
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Patrick C Brennan
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Mark A Jenkins
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Joohon Sung
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - Yun-Mi Song
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
| | - John L Hopper
- From the Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC 3053, Australia (T.L.N., Y.K.A., C.F.E., N.H.T., S.L., G.S.D., M.A.J., J.L.H.); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.H.C..); Department of Radiology, National Cancer Center, Goyang-si, South Korea (M.S.K.); Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia (P.C.B.); Department of Epidemiology School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea (J.S., J.L.H.); and Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.M.S.)
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13
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Acho SN, Boonzaier WPE, Nel IF. EXPOSURE PARAMETERS OF MAMMOGRAMS WITH AND WITHOUT MASS LESIONS FROM A SOUTH AFRICAN BREAST CARE CENTRE. RADIATION PROTECTION DOSIMETRY 2017; 177:348-355. [PMID: 28444247 DOI: 10.1093/rpd/ncx053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 04/04/2017] [Indexed: 06/07/2023]
Abstract
In South African breast care centres, full-field digital mammography units provide breast imaging services to symptomatic and asymptomatic women simultaneously. This study evaluated the technical exposure parameters of 800 mammograms of which 100 mammograms had obvious mass lesions in the fibroglandular tissue. The average breast compression force of mammograms with mass lesions in the fibroglandular tissue was 18.4% less than the average breast compression force of mammograms without mass lesions. The average mean glandular dose (MGD), tube potential (kVp) and compressed breast thickness (CBT) values were 2.14 mGy, 30.5 kVp and 63.9 mm, respectively, for mammograms with mass lesions, and 1.45 mGy, 29.6 kVp and 56.9 mm, respectively, for mammograms without mass lesions. Overall, the average MGD and mean CBT of mammograms with mass lesion were significantly higher compared to those without mass lesions (p < 0.05), although there was no significant difference in their tube potentials (p > 0.05).
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Affiliation(s)
- Sussan N Acho
- Department of Medical Physics, University of the Free State, Bloemfontein 9300, South Africa
| | - Willem P E Boonzaier
- Department of Medical Physics, University of the Free State, Bloemfontein 9300, South Africa
| | - Ina F Nel
- Department of Clinical Imaging Services, University of the Free State, Bloemfontein 9300, South Africa
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14
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Suleiman ME, Brennan PC, McEntee MF. Mean glandular dose in digital mammography: a dose calculation method comparison. J Med Imaging (Bellingham) 2017; 4:013502. [PMID: 28149921 DOI: 10.1117/1.jmi.4.1.013502] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 12/27/2016] [Indexed: 11/14/2022] Open
Abstract
Our objective was to analyze the agreement between organ dose estimated by different digital mammography units and calculated dose for clinical data. Digital Imaging and Communication in Medicine header information was extracted from 52,405 anonymized mammograms. Data were filtered to include images with no breast implants, breast thicknesses 20 to 110 mm, and complete exposure and quality assurance data. Mean glandular dose was calculated using methods by Dance et al., Wu et al., and Boone et al. Bland-Altman analysis and regression were used to study the agreement and correlation between organ and calculated doses. Bland-Altman showed statistically significant bias between organ and calculated doses. The bias differed for different unit makes and models; Philips had the lowest bias, overestimating Dance method by 0.03 mGy, while general electric had the highest bias, overestimating Wu method by 0.20 mGy, the Hologic organ dose underestimated Boone method by 0.07 mGy, and the Fujifilm organ dose underestimated Dance method by 0.09 mGy. Organ dose was found to disagree with our calculated dose, yet organ dose is potentially beneficial for rapid dose audits. Conclusions drawn based on the organ dose alone come with a risk of over or underestimating the calculated dose to the patient and this error should be considered in any reported results.
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Affiliation(s)
- Moayyad E Suleiman
- The University of Sydney , Faculty of Health Sciences, M205, Cumberland Campus, 75 East Street, Lidcombe, New South Wales 2141, Australia
| | - Patrick C Brennan
- The University of Sydney , Faculty of Health Sciences, M205, Cumberland Campus, 75 East Street, Lidcombe, New South Wales 2141, Australia
| | - Mark F McEntee
- The University of Sydney , Faculty of Health Sciences, M205, Cumberland Campus, 75 East Street, Lidcombe, New South Wales 2141, Australia
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15
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Young KC, Oduko JM. Radiation doses received in the United Kingdom breast screening programme in 2010 to 2012. Br J Radiol 2015; 89:20150831. [PMID: 26654386 DOI: 10.1259/bjr.20150831] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To review the radiation doses received by women attending the UK breast-screening programme between 2010 and 2012. To compare doses with previous years and to quantify the impact on dose of changing from analogue to digital imaging and to analyse doses by type of imaging system. METHODS Measurements of doses to samples of about 50-100 women attending for screening were collected across the whole of the UK breast-screening programme. RESULTS Data were collected for 87,122 exposures, using 449 X-ray sets, for 25,408 women. The average mean glandular dose (MGD) was 1.79 mGy for mediolateral oblique images and 1.58 mGy for craniocaudal images. The average MGD per two-view examination was 4.01 mGy for film-screen imaging and 3.03 mGy for direct digital radiography (DR) and 4.69 mGy for computed radiography. CONCLUSION The MGD to women attending breast screening has been reduced on average by about 25% where DR systems have replaced film-screen systems. The dose reduction was greatest for breasts with the largest compressed thickness. There are large variations in dose between the different models of DR system provided by different manufacturers. There should be further work to ensure that all DR systems are operated at the optimal dose level to ensure the best cancer detection while balancing the detriment caused by using radiation. ADVANCES IN KNOWLEDGE Changes in the radiation dose in breast screening over time have been determined. Specifically, the impact on radiation dose of introducing different types of DR and computed radiography system into breast screening has been quantified.
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Affiliation(s)
- Kenneth C Young
- 1 National Co-ordinating Centre for the Physics of Mammography, Medical Physics Department, Royal Surrey County Hospital, Guildford, UK.,2 Physics Department, University of Surrey, Guildford, UK
| | - Jennifer M Oduko
- 1 National Co-ordinating Centre for the Physics of Mammography, Medical Physics Department, Royal Surrey County Hospital, Guildford, UK
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16
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Kamal I, Chelliah KK, Mustafa N. Estimates of Average Glandular Dose with Auto-modes of X-ray Exposures in Digital Breast Tomosynthesis. Sultan Qaboos Univ Med J 2015; 15:e292-e296. [PMID: 26052465 PMCID: PMC4450795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 11/10/2014] [Accepted: 12/07/2014] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES The aim of this research was to examine the average glandular dose (AGD) of radiation among different breast compositions of glandular and adipose tissue with auto-modes of exposure factor selection in digital breast tomosynthesis. METHODS This experimental study was carried out in the National Cancer Society, Kuala Lumpur, Malaysia, between February 2012 and February 2013 using a tomosynthesis digital mammography X-ray machine. The entrance surface air kerma and the half-value layer were determined using a 100H thermoluminescent dosimeter on 50% glandular and 50% adipose tissue (50/50) and 20% glandular and 80% adipose tissue (20/80) commercially available breast phantoms (Computerized Imaging Reference Systems, Inc., Norfolk, Virginia, USA) with auto-time, auto-filter and auto-kilovolt modes. RESULTS The lowest AGD for the 20/80 phantom with auto-time was 2.28 milliGray (mGy) for two dimension (2D) and 2.48 mGy for three dimensional (3D) images. The lowest AGD for the 50/50 phantom with auto-time was 0.97 mGy for 2D and 1.0 mGy for 3D. CONCLUSION The AGD values for both phantoms were lower against a high kilovolt peak and the use of auto-filter mode was more practical for quick acquisition while limiting the probability of operator error.
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Affiliation(s)
- Izdihar Kamal
- Diagnostic Imaging & Radiotherapy Programme, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kanaga K. Chelliah
- Diagnostic Imaging & Radiotherapy Programme, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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17
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O'Brien KM, Dwane F, Kelleher T, Sharp L, Comber H. Interval cancer rates in the Irish national breast screening programme. J Med Screen 2015; 22:136-43. [PMID: 25917389 DOI: 10.1177/0969141315580386] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 03/11/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare interval cancer rates from the Irish breast screening programme, BreastCheck, for the period 2000-2007 with those from other European countries. METHODS Data from BreastCheck was linked to National Cancer Registry breast cancer registrations, to calculate numbers of women screened, screen-detected cancers, and interval cancers, by year of screening, in the first and second years after screening, and by initial or subsequent screen. Estimated underlying cancer incidence from the period 1996-1999 inclusive was used to calculate proportionate incidence. We calculated the interval cancer ratio as an alternative measure of the burden of interval cancers. RESULTS There were 372,658 screening records for 178,147 women in the period 2000-2007. The overall interval rate was 9.6 per 10,000 screens. In the first year after screening, the interval cancer rate was 5.8 per 10,000 screens and this increased to 13.4 in the second year after screening. The screen detection rate for the period was 53.6 per 10,000 screened for all screens combined. Initial screens produced a higher detection rate at 66.9 per 10,000 screened compared with subsequent screens with a screen-detected rate of 41.4 per 10,000 screens. CONCLUSION Interval breast cancer rates for the first years of the programme are within acceptable limits and are comparable with those in other European programmes. Nationwide roll-out together with the adoption of digital mammography may have an impact on interval cancer rates in future years.
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Affiliation(s)
- Katie M O'Brien
- National Cancer Registry, Building 6800, Airport Business Park, Kinsale Rd, Cork, Ireland
| | - Fiona Dwane
- National Cancer Registry, Building 6800, Airport Business Park, Kinsale Rd, Cork, Ireland
| | - Tracy Kelleher
- National Cancer Registry, Building 6800, Airport Business Park, Kinsale Rd, Cork, Ireland
| | - Linda Sharp
- National Cancer Registry, Building 6800, Airport Business Park, Kinsale Rd, Cork, Ireland
| | - Harry Comber
- National Cancer Registry, Building 6800, Airport Business Park, Kinsale Rd, Cork, Ireland
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18
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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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19
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Damases CN, Brennan PC, McEntee MF. Mammographic density measurements are not affected by mammography system. J Med Imaging (Bellingham) 2015; 2:015501. [PMID: 26158085 DOI: 10.1117/1.jmi.2.1.015501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/05/2015] [Indexed: 01/22/2023] Open
Abstract
Mammographic density (MD) is a significant risk factor for breast cancer and has been shown to reduce the sensitivity of mammography screening. Knowledge of a woman's density can be used to predict her risk of developing breast cancer and personalize her imaging pathway. However, measurement of breast density has proven to be troublesome with wide variations in density recorded using radiologists' visual Breast Imaging Reporting and Data System (BIRADS). Several automated methods for assessing breast density have been proposed, each with their own source of measurement error. The use of differing mammographic imaging systems further complicates MD measurement, especially for the same women imaged over time. The purpose of this study was to investigate whether having a mammogram on differing manufacturer's equipment affects a woman's MD measurement. Raw mammographic images were acquired on two mammography imaging systems (General Electric and Hologic) one year apart and processed using VolparaDensity™ to obtain the Volpara Density Grade (VDG) and average volumetric breast density percentage (AvBD%). Visual BIRADS scores were also obtained from 20 expert readers. BIRADS scores for both systems showed strong positive correlation ([Formula: see text]; [Formula: see text]), while the VDG ([Formula: see text]; [Formula: see text]) and AvBD% ([Formula: see text]; [Formula: see text]) showed stronger positive correlations. Substantial agreement was shown between the systems for BIRADS ([Formula: see text]; [Formula: see text]), however, the systems demonstrated an almost perfect agreement for VDG ([Formula: see text]; [Formula: see text]).
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Affiliation(s)
- Christine N Damases
- University of Sydney , Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Research Institute, M205, Cumberland Campus, East Street, Lidcombe, New South Wales 2141, Sydney ; University of Namibia , Faculty of Health Sciences, Department of Allied Sciences, M-Block, Room M-105, Mandume Ndemufayo Avenue, Private bag 13310, Windhoek 9000, Namibia
| | - Patrick C Brennan
- University of Sydney , Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Research Institute, M205, Cumberland Campus, East Street, Lidcombe, New South Wales 2141, Sydney
| | - Mark F McEntee
- University of Sydney , Faculty of Health Sciences, Discipline of Medical Radiation Sciences and Brain and Mind Research Institute, M205, Cumberland Campus, East Street, Lidcombe, New South Wales 2141, Sydney
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20
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Abstract
Despite controversy regarding mammography's efficacy, it continues to be the most commonly used breast cancer-screening modality. With the development of digital mammography, some improved benefit has been shown in women with dense breast tissue. However, the density of breast tissue continues to limit the sensitivity of conventional mammography. We discuss the development of some derivative digital technologies, primarily digital breast tomosynthesis, and their strengths, weaknesses, and potential patient impact.
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Affiliation(s)
- Stephanie K Patterson
- Division of Breast Imaging, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Marilyn A Roubidoux
- Division of Breast Imaging, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA
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21
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Weigel S, Berkemeyer S, Girnus R, Sommer A, Lenzen H, Heindel W. Digital Mammography Screening with Photon-counting Technique: Can a High Diagnostic Performance Be Realized at Low Mean Glandular Dose? Radiology 2014; 271:345-55. [DOI: 10.1148/radiol.13131181] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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22
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Vedantham S, Shi L, Karellas A, O'Connell AM, Conover DL. Personalized estimates of radiation dose from dedicated breast CT in a diagnostic population and comparison with diagnostic mammography. Phys Med Biol 2013; 58:7921-36. [PMID: 24165162 DOI: 10.1088/0031-9155/58/22/7921] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study retrospectively analyzed the mean glandular dose (MGD) to 133 breasts from 132 subjects, all women, who participated in a clinical trial evaluating dedicated breast CT in a diagnostic population. The clinical trial was conducted in adherence to a protocol approved by institutional review boards and the study participants provided written informed consent. Individual estimates of MGD to each breast from dedicated breast CT was obtained by combining x-ray beam characteristics with estimates of breast dimensions and fibroglandular fraction from volumetric breast CT images, and using normalized glandular dose coefficients. For each study participant and for the breast corresponding to that imaged with breast CT, an estimate of the MGD from diagnostic mammography (including supplemental views) was obtained from the DICOM image headers for comparison. This estimate uses normalized glandular dose coefficients corresponding to a breast with 50% fibroglandular weight fraction. The median fibroglandular weight fraction for the study cohort determined from volumetric breast CT images was 15%. Hence, the MGD from diagnostic mammography was corrected to be representative of the study cohort. Individualized estimates of MGD from breast CT ranged from 5.7 to 27.8 mGy. Corresponding to the breasts imaged with breast CT, the MGD from diagnostic mammography ranged from 2.6 to 31.6 mGy. The mean (± inter-breast SD) and the median MGD (mGy) from dedicated breast CT exam were 13.9 ± 4.6 and 12.6, respectively. For the corresponding breasts, the mean (± inter-breast SD) and the median MGD (mGy) from diagnostic mammography were 12.4 ± 6.3 and 11.1, respectively. Statistical analysis indicated that at the 0.05 level, the distributions of MGD from dedicated breast CT and diagnostic mammography were significantly different (Wilcoxon signed ranks test, p = 0.007). While the interquartile range and the range (maximum-minimum) of MGD from dedicated breast CT was lower than diagnostic mammography, the median MGD from dedicated breast CT was approximately 13.5% higher than that from diagnostic mammography. The MGD for breast CT is based on a 1.45 mm skin layer and that for diagnostic mammography is based on a 4 mm skin layer; thus, favoring a lower estimate for MGD from diagnostic mammography. The median MGD from dedicated breast CT corresponds to the median MGD from four to five diagnostic mammography views. In comparison, for the same 133 breasts, the mean and the median number of views per breast during diagnostic mammography were 4.53 and 4, respectively. Paired analysis showed that there was approximately equal likelihood of receiving lower MGD from either breast CT or diagnostic mammography. Future work will investigate methods to reduce and optimize radiation dose from dedicated breast CT.
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Affiliation(s)
- Srinivasan Vedantham
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655, USA
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McCullagh J, Keavey E, Egan G, Phelan N. Experience with the European quality assurance guidelines for digital mammography systems in a national screening programme. RADIATION PROTECTION DOSIMETRY 2013; 153:223-226. [PMID: 23173219 DOI: 10.1093/rpd/ncs297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The transition to a fully digital breast screening programme, utilising three different full-field digital mammography (FFDM) systems has presented many challenges to the implementation of the European guidelines for physico-technical quality assurance (QA) testing. An analysis of the QA results collected from the FFDM systems in the screening programme over a 2-y period indicates that the three different systems have similar QA performances. Generally, the same tests were failed by all systems and failure rates were low. The findings provide some assurance that the QA guidelines are being correctly implemented. They also suggest that there is more scope for the development of the relevance of the guidelines with respect to modern FFDM systems. This study has also shown that a summary review of the QA data can be achieved by simple organisation of the QA data storage and by automation of data query and retrieval using commonly available software.
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Affiliation(s)
- J McCullagh
- Southern Unit, BreastCheck, Infirmary Road, Cork, Ireland
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25
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Judge MA, Keavey E, Phelan N. Scatter radiation intensities around full-field digital mammography units. Br J Radiol 2013; 86:20120130. [PMID: 23239693 PMCID: PMC3615403 DOI: 10.1259/bjr.20120130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 09/03/2012] [Accepted: 09/10/2012] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to investigate the scatter radiation intensity around digital mammography systems and apply these data to standard shielding calculations to reveal whether shielding design of existing breast screening rooms is adequate for the use of digital mammography systems. Three digital mammography systems from GE Healthcare, Hologic and Philips were employed in the study. A breast-equivalent phantom was imaged under clinical workload conditions and scatter radiation intensities around the digital mammography systems were measured for a range of angles in three planes using an ionisation chamber. The results were compared with those from previous studies of film-screen systems. It may be deduced from the results that scattering in the backward direction is significant for all three systems, while scattering in the forward direction can be significant for some planes around the GE and Hologic systems. Measurements at typical clinical settings on each system revealed the Philips system to have markedly lower scatter radiation intensities than the other systems. Substituting the measured scattered radiation intensity into shielding calculations yielded barrier requirements similar to those already in place at the screening centres operating these systems. Current radiation protection requirements based on film-screen technology remain sufficient when applied to rooms with digital mammography installations and no alteration is required to the structural shielding.
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Affiliation(s)
- M A Judge
- BreastCheck, The National Cancer Screening Service, Galway, Ireland.
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Cole EB, Toledano AY, Lundqvist M, Pisano ED. Comparison of radiologist performance with photon-counting full-field digital mammography to conventional full-field digital mammography. Acad Radiol 2012; 19:916-22. [PMID: 22537503 DOI: 10.1016/j.acra.2012.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 03/06/2012] [Accepted: 03/06/2012] [Indexed: 11/17/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to assess the performance of a MicroDose photon-counting full-field digital mammography (PCM) system in comparison to full-field digital mammography (FFDM) for area under the receiver-operating characteristic (ROC) curve (AUC), sensitivity, specificity, and feature analysis of standard-view mammography for women presenting for screening mammography, diagnostic mammography, or breast biopsy. MATERIALS AND METHODS A total of 133 women were enrolled in this study at two European medical centers, with 67 women who had a pre-existing 10-36 months FFDM enrolled prospectively into the study and 66 women who underwent breast biopsy and had screening PCM and diagnostic FFDM, including standard craniocaudal and mediolateral oblique views of the breast with the lesion, enrolled retrospectively. The case mix consisted of 49 cancers, 17 biopsy-benign cases, and 67 normal cases. Sixteen radiologists participated in the reader study and interpreted all 133 cases in both conditions, separated by washout period of ≥4 weeks. ROC curve and free-response ROC curve analyses were performed for noninferiority of PCM compared to FFDM using a noninferiority margin Δ value of 0.10. Feature analysis of the 66 cases with lesions was conducted with all 16 readers at the conclusion of the blinded reads. Mean glandular dose was recorded for all cases. RESULTS The AUC for PCM was 0.947 (95% confidence interval [CI], 0.920-0.974) and for FFDM was 0.931 (95% CI, 0.898-0.964). Sensitivity per case for PCM was 0.936 (95% CI, 0.897-0.976) and for FFDM was 0.908 (95% CI, 0.856-0.960). Specificity per case for PCM was 0.764 (95% CI, 0.688-0.841) and for FFDM was 0.749 (95% CI, 0.668-0.830). Free-response ROC curve figures of merit were 0.920 (95% CI, 0.881-0.959) and 0.903 (95% CI, 0.858-0.948) for PCM and FFDM, respectively. Sensitivity per lesion was 0.903 (95% CI, 0.846-0.960) and 0.883 (95% CI, 0.823-0.944) for PCM and FFDM, respectively. The average false-positive marks per image of noncancer cases were 0.265 (95% CI, 0.171-0.359) and 0.281 (95% CI, 0.188-0.374) for PCM and FFDM, respectively. Noninferiority P values for AUC, sensitivity (per case and per lesion), specificity, and average false-positive marks per image were all statistically significant (P < .001). The noninferiority P value for free-response ROC was <.025, from the 95% CI for the difference. Feature analysis resulted in PCM being preferred to FFDM by the readers for ≥70% of the cases. The average mean glandular dose for PCM was 0.74 mGy (95% CI, 0.722-0.759 mGy) and for FFDM was 1.23 mGy (95% CI, 1.199-1.262 mGy). CONCLUSIONS In this study, radiologist performance with PCM was not inferior to that with conventional FFDM at an average 40% lower mean glandular dose.
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Affiliation(s)
- Elodia B Cole
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, 29425, USA.
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Karellas A. Photon-counting digital mammography: evaluation of performance under clinically relevant conditions. Acad Radiol 2012; 19:913-5. [PMID: 22770464 DOI: 10.1016/j.acra.2012.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 05/21/2012] [Accepted: 05/21/2012] [Indexed: 10/28/2022]
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