Breast radiation dose with contrast-enhanced mammography-guided biopsy : a retrospective comparison with stereotactic and tomosynthesis guidance
Alcántara Souza, Rodrigo (Universitat Autònoma de Barcelona. Departament de Medicina)
Azcona, Javier (Hospital del Mar (Barcelona, Catalunya))
Pitarch Diago, Mireia (Hospital del Mar (Barcelona, Catalunya))
Arenas, Natalia (Hospital del Mar (Barcelona, Catalunya))
Castells, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina)
Milioni, Pablo (GE Healthcare)
Iotti, Valentina (IRCCS Azienda Unità Sanitaria Locale di Reggio Emilia (Itàlia))
Besutti, Giulia (IRCCS Azienda Unità Sanitaria Locale di Reggio Emilia (Itàlia))

Data:	2024
Resum:	Objectives: This retrospective study aimed to compare the average glandular dose (AGD) per acquisition in breast biopsies guided by contrast-enhanced mammography (CEM), conventional stereotactic breast biopsy (SBB), and digital breast tomosynthesis (DBT). The study also investigated the influence of compressed breast thickness (CBT) and density on AGD. Furthermore, the study aimed to estimate the AGD per procedure for each guidance modality. Methods: The study included 163 female patients (mean age 57 ± 10 years) who underwent mammography-guided biopsies using SBB (9%), DBT (65%), or CEM (26%) guidance. AGD and CBT data were extracted from DICOM headers, and breast density was visually assessed. Statistical analyses included two-sample t-tests and descriptive statistics. Results: Mean AGD per acquisition varied slightly among CEM (1. 48 ± 0. 22 mGy), SBB (1. 49 ± 0. 40 mGy), and DBT (1. 55 ± 0. 47 mGy), with CEM presenting higher AGD at lower CBTs and less dose escalation at higher CBTs. For CBT > 55 mm, CEM showed reduced AGD compared to SBB and DBT (p < 0. 001). Breast density had minimal impact on AGD, except for category A. The estimated AGD per procedure was approximately 11. 84 mGy for CEM, 11. 92 mGy for SBB, and 6. 2 mGy for DBT. Conclusion: The study found mean AGD per acquisition to be similar for CEM and SBB, with DBT slightly higher. CEM demonstrated higher AGD at lower CBT but lower AGD at higher CBT, indicating reduced dose escalation with increasing thickness. While breast density had minimal overall impact, variations were noted in category A. DBT was more dose-efficient per procedure due to fewer acquisitions required. Clinical relevance statement: CEM guidance provides effective lesion visualization within safe radiation limits, improving the precision of percutaneous image-guided breast interventions and supporting its potential consideration in a wider range of breast diagnostic procedures.
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Breast neoplasms ; Mammography ; Contrast media ; Biopsy ; Radiation dosage
Publicat a:	European radiology, 2024 , ISSN 1432-1084

DOI: 10.1007/s00330-024-10920-3
PMID: 39143245

11 p, 1.1 MB

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