Radiation Dose Reduction for Augmentation Mammography

Smathers, Ralph L.; Boone, John M.; Lee, Lisa J.; Berns, Eric A.; Miller, Robert A.; Wright, Allison

doi:10.2214/ajr.06.0998

Cited by 25 publications

(22 citation statements)

References 20 publications

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“…Sechopoulos 126 has developed Monte Carlo techniques for the evaluation of glandular dose in tomosynthesis. A number of investigators have studied other dosimetry issues in breast imaging, including magnification mammography, [127][128][129] dual energy mammography, 130-133 the use of monoenergetic x-ray beams, 132,134 iodine imaging, 135 imaging the augmented breast, 136,137 and breast CT. 138 .…”

Section: Ivd Dosimetry For Breast Imaging Beyond Mammographymentioning

confidence: 99%

Overview of patient dosimetry in diagnostic radiology in the USA for the past

2008

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This review covers the role of medical physics in addressing issues directly related to patient dosimetry in radiography, fluoroscopy, mammography, and CT. The sections on radiography and fluoroscopy radiation doses review the changes that have occurred during the last 50 to 60 years. A number of technological improvements have contributed to both a significant reduction in patient and staff radiation doses and improvements to the image quality during this period of time. There has been a transition from film-screen radiography with hand dip film processing to electronic digital imaging utilizing CR and DR. Similarly, fluoroscopy has progressed by directly viewing image intensifiers in darkened rooms to modern flat panel image receptor systems utilizing pulsed radiation, automated variable filtration, and digitally processed images. Mammography is one of the most highly optimized imaging procedures performed, because it is a repetitive screening procedure that results in annual radiation exposure. Mammography is also the only imaging procedure in the United States in which the radiation dose is regulated by the federal government. Consequently, many medical physicists have studied the dosimetry associated with screen-film and digital mammography. In this review, a brief history of mammography dose assessment by medical physicists is discussed. CT was introduced into clinical practice in the early 1970s, and has grown into one of the most important modalities available for diagnostic imaging. CT dose quantities and measurement techniques are described, and values of radiation dose for different types of scanner are presented. Organ and effective doses to adult patients are surveyed from the earliest single slice scanners, to the latest versions that include up to two x-ray tubes and can incorporate as many as 256 detector channels. An overview is provided of doses received by pediatric patients undergoing CT examinations, as well as methods, and results, of studies performed to assess the radiation absorbed by the conceptus of pregnant patients.

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Section: Ivd Dosimetry For Breast Imaging Beyond Mammographymentioning

confidence: 99%

Overview of patient dosimetry in diagnostic radiology in the USA for the past

2008

Self Cite

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“…This means the radiation dose of augmented women during MMG is double that of non-augmented women. Moreover, the standard implant compression technique has a high mean glandular dose to the breast because the average compressed breast thickness for implant compression technique (7.7 cm) is more than double that for the implant displacement technique (3.5 cm) and non-augmented breast (3.5 cm) [17]. The guidelines for screening MMG for augmented women must balance the risk of radiation-induced breast cancer associated with an increase in the number of views and the merit of complete imaging of an augmented breast.…”

Section: Mammography (Mmg)mentioning

confidence: 99%

“…However, obtaining four views may be appropriate for diagnostic MMG, not for screening MMG. Smathers et al [17] recommended a three-view augmentation mammogram consisting of craniocaudal implant displacement, lateromedial implant displacement, and mediolateral oblique standard implant compression views to reduce the radiation dose of screening MMG. The significant radiation dose reduction achieved by eliminating one of the standard implant compression views should translate over a lifetime into a reduction in the rate of MMG-induced breast cancer, and this fact cannot be easily dismissed [17].…”

Section: Mammography (Mmg)mentioning

confidence: 99%

Screening and diagnosis of breast cancer in augmented women

Uematsu

2008

Breast Cancer

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Cosmetic breast enlargement surgery has become common in Japan. There are some reports suggesting that implants can interfere with mammography (MMG) and may lead to delayed breast cancer diagnosis, even when implant-displaced MMG (Eklund technique) is performed. Screening MMG was recommended in a notification issued by the Japanese Ministry of Health, Labor and Welfare in 1999, and MMG is just coming into widespread use in Japanese breast cancer screening. Recent reports suggest that screening MMG may not be appropriate in augmented women, but breast self-examination may be effective in these women. Ultrasonography (US) may be useful in screening augmented women without risk of rupturing the implant. In appropriate cases, magnetic resonance imaging should be considered as an adjunct to MMG and US. The question of whether augmented women should not undergo core needle biopsy because of the possibility of damage to the implant should be considered. This review discusses diagnostic methods for augmented women and suggests the optimal screening method for augmented women. The challenge of the screening and diagnosis of breast cancer in augmented women is important in order to detect more of their cancer at a preclinical stage, because we can expect to see breast cancer in augmented women with increasing frequency over the next decade.

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“…Insufficient compression during mammography, as well as the additional views for a better evaluation of the breast tissue (Eklund technique) lead to an increased dose of irradiation in this group of patients [5][6][7]. Moreover, mammography is insufficient to assess the pathology related to the implant, especially the intracapsular rupture [8].…”

Section: Mammographymentioning

confidence: 99%

The role of ultrasound in the imaging assessment of the augmented breast. A pictorial review

et al. 2014

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The imaging evaluation of the augmented breast is becoming more and more frequent in daily practice. Even if mammography remains the golden standard for breast cancer screening, ultrasound is used as a first step investigation in young symptomatic patients or as a screening tool in detecting pathology related to the implants. This pictorial essay reviews the indications and limitations of the imaging methods and illustrates the normal and pathological ultrasound findings in the augmented breast.

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Radiation Dose Reduction for Augmentation Mammography

Cited by 25 publications

References 20 publications

Overview of patient dosimetry in diagnostic radiology in the USA for the past

Overview of patient dosimetry in diagnostic radiology in the USA for the past

Screening and diagnosis of breast cancer in augmented women

The role of ultrasound in the imaging assessment of the augmented breast. A pictorial review

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