Mammographic compression – A need for mechanical standardization

Branderhorst, Woutjan; Groot, Jerry E. de; Highnam, Ralph; Chan, Ariane; Böhm-Vélez, Marcela; Broeders, Mireille J. M.; Heeten, Gerard J. den; Grimbergen, C.A.

doi:10.1016/j.ejrad.2014.12.012

Cited by 62 publications

(101 citation statements)

References 16 publications

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“…These results show that the accuracy and precision of both methods are adequate to study compression pressure in large retrospective data sets from daily practice, where standard deviations of 43.1% and 50.6% are typical. 1 The capacitive method is sufficiently accurate and precise to be employed in real-time breast compression pressure feedback and standardization systems. …”

Section: Discussionmentioning

confidence: 99%

“…Compared to the current force-based guidelines, guidelines based on pressure have much more potential to improve the breast compression procedure in terms of reproducibility, image quality, radiation dose, and patient comfort. 1 …”

Section: E Clinical Applicationmentioning

confidence: 99%

“…This effect could (partly) explain the significant dependence of variance on contact area reported in a prior study. 1 The uncertainty in P = F/A depends also on the error in the force measurement. Since the force is in the nominator, the percentage error in force translates directly to the percentage error in pressure.…”

Section: A Accuracy Of Calculated Pressurementioning

confidence: 99%

“…1 The goal of this study was to assess the accuracy and the precision of these two methods. Both methods are increasingly often employed to establish the average compression pressure in mammography, for standardization, quality control, and scientific research in a growing number of research groups.…”

Section: Introductionmentioning

confidence: 99%

“…Recent publications point out that controlling pressure can be beneficial in terms of reproducibility, pain, radiation dose, image quality, and detectability of breast cancer. [1][2][3][4][5][6][7][8][9][10][11][12][13] For many years, breast compression has been susceptible to subjectivity and thus large variations in the applied pressure. With mammography systems indicating only the force applied by the paddle, but not the area over which the force is distributed, 14 the exerted pressure (force divided by area) could only be estimated based on subjective cues, such as skin tautness or the patient's perceived pain experience.…”

Section: Introductionmentioning

confidence: 99%

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Technical Note: Validation of two methods to determine contact area between breast and compression paddle in mammography

et al. 2017

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Purpose: To assess the accuracy of two methods of determining the contact area between the compression paddle and the breast in mammography. An accurate method to determine the contact area is essential to accurately calculate the average compression pressure applied by the paddle. Methods: For a set of 300 breast compressions, we measured the contact areas between breast and paddle, both capacitively using a transparent foil with indium-tin-oxide (ITO) coating attached to the paddle, and retrospectively from the obtained mammograms using image processing software (Volpara Enterprise, algorithm version 1.5.2). A gold standard was obtained from video images of the compressed breast. During each compression, the breast was illuminated from the sides in order to create a dark shadow on the video image where the breast was in contact with the compression paddle. We manually segmented the shadows captured at the time of x-ray exposure and measured their areas. Conclusions:The size of the contact area between the paddle and the breast can be determined accurately and precisely, both in real-time using the capacitive method, and retrospectively using image processing software. This result is beneficial for scientific research, data analysis and quality control systems that depend on one of these two methods for determining the average pressure on the breast during mammographic compression.

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Section: Discussionmentioning

confidence: 99%

Section: E Clinical Applicationmentioning

confidence: 99%

Section: A Accuracy Of Calculated Pressurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Technical Note: Validation of two methods to determine contact area between breast and compression paddle in mammography

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Mammographic compression practices of force‐ and pressure‐standardisation protocol: A scoping review

Serwan

Matthews

Davies

et al. 2020

J of Medical Radiation Sci

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Introduction As an efficient, effective and moderately inexpensive modality, mammography has been implemented as a cancer screening tool and in diagnostic management. However, appropriate breast compression is necessary for optimal outcomes. Current key measures of compression force are subjective and variable, giving rise to the concept of a ‘personalised’ pressure‐standardisation protocol. Methods A scoping review of the literature was performed using the Arksey and O’Malley framework to explore the existing force‐ and pressure‐standardisation protocols in clinical application. A comprehensive search strategy and standardised study selection and evaluation were completed. This synthesis of existing knowledge can lead to the implementation of mechanically standardised mammographic compression pressure as a feasible tailored approach to clinical practice. Four databases (PubMed, MEDLINE, Embase and Scopus) were searched from the databases’ inception to 13 December 2019 for relevant information, and eighteen articles were selected for analysis. Results In addition to current protocol comparison, emerging key concepts include the reasoning behind standardisation, the benefits of improved diagnostic outcomes/decreased pain with negligible change in image quality and average glandular dose (AGD), and the recommendation of a 10kPa (approximate) pressure‐standardisation protocol. Research to date is largely based abroad (Netherlands), with a strong focus on screening practices. Consequently, several gaps in the current literature were identified as potential directions for future investigation. Conclusions As a suggested mammographic guideline, compression pressures of approximately 10kPa aid in image acquisition reproducibility both within and between women; pain levels decrease, with minimal variations to breast thickness, AGD and image quality.

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Improvements of an objective model of compressed breasts undergoing mammography: Generation and characterization of breast shapes

et al. 2017

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Purpose To develop a set of accurate 2D models of compressed breasts undergoing mammography or breast tomosynthesis, based on objective analysis, to accurately characterize mammograms with few linearly independent parameters, and to generate novel clinically realistic paired cranio-caudal (CC) and medio-lateral oblique (MLO) views of the breast. Methods We seek to improve on an existing model of compressed breasts by overcoming detector size bias, removing the nipple and non-mammary tissue, pairing the CC and MLO views from a single breast, and incorporating the pectoralis major muscle contour into the model. The outer breast shapes in 931 paired CC and MLO mammograms were automatically detected with an in-house developed segmentation algorithm. From these shapes three generic models (CC-only, MLO-only, and joint CC/MLO) with linearly independent components were constructed via principal component analysis (PCA). The ability of the models to represent mammograms not used for PCA was tested via leave-one-out cross-validation, by measuring the average distance error (ADE). Results The individual models based on six components were found to depict breast shapes with accuracy (mean ADE-CC=0.81 mm, ADE-MLO=1.64 mm, ADE-Pectoralis=1.61 mm), outperforming the joint CC/MLO model (p≤0.001). The joint model based on 12 principal components contains 99.5% of the total variance of the data, and can be used to generate new clinically realistic paired CC and MLO breast shapes. This is achieved by generating random sets of 12 principal components, following the Gaussian distributions of the histograms of each component, which were obtained from the component values determined from the images in the mammography database used. Conclusion Our joint CC/MLO model can successfully generate paired CC and MLO view shapes of the same simulated breast, while the individual models can be used to represent with high accuracy clinical acquired mammograms with a small set of parameters. This is the first step towards objective 3D compressed breast models, useful for dosimetry and scatter correction research, among other applications.

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Mammographic compression – A need for mechanical standardization

Cited by 62 publications

References 16 publications

Technical Note: Validation of two methods to determine contact area between breast and compression paddle in mammography

Technical Note: Validation of two methods to determine contact area between breast and compression paddle in mammography

Mammographic compression practices of force‐ and pressure‐standardisation protocol: A scoping review

Improvements of an objective model of compressed breasts undergoing mammography: Generation and characterization of breast shapes

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