Radiation Dose of Contrast-Enhanced Mammography: A Two-Center Prospective Comparison

Gennaro, Gisella; Cozzi, Andrea; Schiaffino, Simone; Sardanelli, Francesco; Caumo, Francesca

doi:10.3390/cancers14071774

Cited by 29 publications

(15 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a result, its use in a screening context of high-risk patients could be a good compromise between cost and benefit. However, few studies have compared the AGD between CEM and tomosynthesis [14][15][16][17]. As far as we know, only one study has compared AGD in the same patients [14].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Breast Digital Tomosynthesis versus Contrast-Enhanced Mammography: Comparison of Diagnostic Application and Radiation Dose in a Screening Setting

Nicosia

Bozzini

Pesapane

et al. 2023

Cancers

View full text Add to dashboard Cite

This study aims to evaluate the Average Glandular Dose (AGD) and diagnostic performance of CEM versus Digital Mammography (DM) as well as versus DM plus one-view Digital Breast Tomosynthesis (DBT), which were performed in the same patients at short intervals of time. A preventive screening examination in high-risk asymptomatic patients between 2020 and 2022 was performed with two-view Digital Mammography (DM) projections (Cranio Caudal and Medio Lateral) plus one Digital Breast Tomosynthesis (DBT) projection (mediolateral oblique, MLO) in a single session examination. For all patients in whom we found a suspicious lesion by using DM + DBT, we performed (within two weeks) a CEM examination. AGD and compression force were compared between the diagnostic methods. All lesions identified by DM + DBT were biopsied; then, we assessed whether lesions found by DBT were also highlighted by DM alone and/or by CEM. We enrolled 49 patients with 49 lesions in the study. The median AGD was lower for DM alone than for CEM (3.41 mGy vs. 4.24 mGy, p = 0.015). The AGD for CEM was significantly lower than for the DM plus one single projection DBT protocol (4.24 mGy vs. 5.55 mGy, p < 0.001). We did not find a statistically significant difference in the median compression force between the CEM and DM + DBT. DM + DBT allows the identification of one more invasive neoplasm one in situ lesion and two high-risk lesions, compared to DM alone. The CEM, compared to DM + DBT, failed to identify only one of the high-risk lesions. According to these results, CEM could be used in the screening of asymptomatic high-risk patients.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In particular, as far as we know, only one study focused on the same group of patients undergoing both tomosynthesis and CEM at short intervals [14]. The dose can be affected by total breast thickness, breast density, and the age of patients [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Breast Digital Tomosynthesis versus Contrast-Enhanced Mammography: Comparison of Diagnostic Application and Radiation Dose in a Screening Setting

Nicosia

Bozzini

Pesapane

et al. 2023

Cancers

View full text Add to dashboard Cite

show abstract

“…This could be particularly useful when studying the ratio of the total dose that is distributed between the low-energy and high-energy acquisitions,since this fraction can vary between protocols and in a population. 54,55 Although the values chosen for the variations between spectra are beyond the limits found in clinics, this extrapolation is useful to understand the physics behind the dose distribution within the breast due to the combination of two spectra in dual-energy techniques.…”

Section: Discussionmentioning

confidence: 99%

“…For the combination of a low energy, and high energy spectrum, under the conditions studied in this work, we observed an approximate linear behavior in the spread of the GDD as a function of the total MGD proportions used between both spectra. This could be particularly useful when studying the ratio of the total dose that is distributed between the low‐energy and high‐energy acquisitions, since this fraction can vary between protocols and in a population 54,55 . Although the values chosen for the variations between spectra are beyond the limits found in clinics, this extrapolation is useful to understand the physics behind the dose distribution within the breast due to the combination of two spectra in dual‐energy techniques.…”

Section: Discussionmentioning

confidence: 99%

Multiscale Monte Carlo simulations for dosimetry in x‐ray breast imaging: Part I ‐ Macroscopic scales

Massera,

Tomal,

Thomson

2023

Medical Physics

View full text Add to dashboard Cite

BackgroundX‐ray breast imaging modalities are commonly employed for breast cancer detection, from screening programs to diagnosis. Thus, dosimetry studies are important for quality control and risk estimation since ionizing radiation is used.PurposeTo perform multiscale dosimetry assessments for different breast imaging modalities and for a variety of breast sizes and compositions. The first part of our study is focused on macroscopic scales (down to millimeters).MethodsNine anthropomorphic breast phantoms with a voxel resolution of 0.5 mm were computationally generated using the BreastPhantom software, representing three breast sizes with three distinct values of volume glandular fraction (VGF) for each size. Four breast imaging modalities were studied: digital mammography (DM), contrast‐enhanced digital mammography (CEDM), digital breast tomosynthesis (DBT) and dedicated breast computed tomography (BCT). Additionally, the impact of tissue elemental compositions from two databases were compared. Monte Carlo (MC) simulations were performed with the MC‐GPU code to obtain the 3D glandular dose distribution (GDD) for each case considered with the mean glandular dose (MGD) fixed at 4 mGy (to facilitate comparisons).ResultsThe GDD within the breast is more uniform for CEDM and BCT compared to DM and DBT. For large breasts and high VGF, the ratio between the minimum/maximum glandular dose to MGD is 0.12/4.02 for DM and 0.46/1.77 for BCT; the corresponding results for a small breast and low VGF are 0.35/1.98 (DM) and 0.63/1.42 (BCT). The elemental compositions of skin, adipose and glandular tissue have a considerable impact on the MGD, with variations up to 30% compared to the baseline. The inclusion of tissues other than glandular and adipose within the breast has a minor impact on MGD, with differences below 2%. Variations in the final compressed breast thickness alter the shape of the GDD, with a higher compression resulting in a more uniform GDD.ConclusionsFor a constant MGD, the GDD varies with imaging modality and breast compression. Elemental tissue compositions are an important factor for obtaining MGD values, being a source of systematic uncertainties in MC simulations and, consequently, in breast dosimetry.

show abstract

“…CEM does have some disadvantages, which include (i) use of ionizing radiation when compared to ultrasound and MRI, or a higher radiation dose to the patient when compared to standard digital mammography [17], and (ii) possible adverse effects from the iodinated contrast agent. Recent surveys on the additional radiation dose burden of CEM compared to standard mammography indicate the magnitude of increase is a less than double (ranging from 20-80% increase) in mean glandular dose, and less than 50% increase in entrance skin dose compared to standard mammogram [21,27,28].…”

Section: Introductionmentioning

confidence: 99%

The verification of the utility of a commercially available phantom combination for quality control in contrast-enhanced mammography

Kim,

Kessell,

Taylor

et al. 2024

Preprint

View full text Add to dashboard Cite

Contrast-enhanced mammography (CEM) is being increasingly implemented clinically, providing much improved contrast between tumour and background structures, particularly in dense breasts. Although CEM is similar to conventional mammography it differs via an additional exposure with high energy X-rays (≥ 40 kVp) and subsequent image subtraction. Because of its special operational aspects, the CEM aspect of a CEM unit needs to be uniquely characterised and evaluated. This study aims to verify the utility of a commercially available phantom set (BR3D model 020 and CESM model 022 phantoms (CIRS, Norfolk, Virginia, USA)) in performing key CEM performance tests (linearity of system response with iodine concentration and background subtraction) on two models of CEM units in a clinical setting. The tests were successfully performed, yielding results similar to previously published studies. Further, similarities and differences in the two systems from different vendors were highlighted, knowledge of which may potentially facilitate optimisation of the systems.

show abstract

Radiation Dose of Contrast-Enhanced Mammography: A Two-Center Prospective Comparison

Cited by 29 publications

References 32 publications

Breast Digital Tomosynthesis versus Contrast-Enhanced Mammography: Comparison of Diagnostic Application and Radiation Dose in a Screening Setting

Breast Digital Tomosynthesis versus Contrast-Enhanced Mammography: Comparison of Diagnostic Application and Radiation Dose in a Screening Setting

Multiscale Monte Carlo simulations for dosimetry in x‐ray breast imaging: Part I ‐ Macroscopic scales

The verification of the utility of a commercially available phantom combination for quality control in contrast-enhanced mammography

Contact Info

Product

Resources

About