Comparation of image quality in the different exposure modes of mammography
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摘要:
目的 探讨乳腺X线下不同曝光模式的图像质量和辐射剂量，总结不同受检者最佳曝光模式和曝光参数。 方法 回顾性分析南方医院2020年5~12月行乳腺X线摄影90例女性患者临床资料及12例模体（MPW-01体模）的拍摄资料，将其分为受检者组和模体组，分别对比两组在高对比度模式（CNT）、标准模式（STD）和低剂量模式（DOSE）3种曝光模式下的曝光技术参数、平均腺体剂量。由多名不同年资医师对图像质量进行评估打分，总结不同受检者的最佳曝光模式和曝光参数。 结果 受检者在不同曝光模式下，图像质量没有明显差异，但其中DOSE模式下的剂量最低，为0.99±0.18 mGy；其次STD模式剂量增加约22.2%，为1.21±0.18 mGy；CNT模式剂量增加约108%，为2.06±0.42 mGy。模体在不同曝光模式下，其中DOSE模式下的剂量最低，约为0.9 mGy；STD模式剂量增加约50%，为1.35±0.01 mGy；CNT模式剂量增加约127%，为2.05±0.01mGy；模体的不同曝光模式对纤样病变和肿物样病变的评分差异有统计学意义，其中CNT模式下对这两种病变显示最佳，其次是STD模式，最后是DOSE模式。 结论 在保证图像质量的前提下，可根据受检者腺体情况，尽可能选择最优化曝光组合，以降低受检者的辐射剂量、重检率和召回率。 Abstract:Objective To investigate the quality of image and the radiation dose in different exposure mode by mammography, so as to summarize the most suitable exposure mode and exposure parameters in different patients. Methods Retrospective analysis clinical data of 90 female mammography patients and 12 phantoms (MPW- 01) in Nanfang Hospital from May to December 2020 were collected, dividing into two groups as patients group and phantoms group. The technical parameters, average glandular dose and image quality score with high contrast mode (CNT), standard mode (STD) and low dose mode (DOSE) of the two groups were compared and summarize the most suitable exposure mode and exposure parameters in different patients were summarized. Results The image quality of patients at different exposure mode was no significant difference, but the DOSE mode have the lowest dosed (0.99±0.18 mGy); secondly STD mode increased about 22.2% (1.21±0.18 mGy), and finally CNT mode increased about 108% (2.06±0.42 mGy). Phantoms in different exposure mode, have the lowest dosed in DOSE mode (about 0.9 mGy); secondly STD mode increased about 50% (1.35 ± 0.01 mGy); and finally CNT mode increased about 127% (2.05±0.01 mGy). The different exposure modes of phantoms was statistically different between in fiber and mass lesions. CNT mode was the best mode which can display the two kinds of lesions, the second was the STD mode, and the last one was DOSE mode. Conclusion On the premise of guarantee the quality of image, the optimal exposure combination can be selected as much as possible based on the glandular condition of the subject, in order to reduce the radiation dose of client, reinspection rate and recall rate. -
Key words:
- mammography /
- exposure mode /
- dose /
- image quality
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表 1 不同曝光模式的技术参数、AGD和评价总分
Table 1. The technical parameters, AGD and evaluation score in different exposure mode (Mean±SD)
Exposure mode Tube voltage (kV) Tube current (mAs) Thickness（mm） Force（daN） AGD (mGy) Score RCC (CNT） 28.3±1.0 111.4±32.2 48±10.2 11.2±2.6 2.06±0.42 11.88±1.895 LCC (DOSE) 28.7±1.1 47.9±9.4 49.0±9.9 11.58±2.8 0.99±0.18 12.17±1.516 RMLO (CNT) 28.4±1.1 110.1±29.9 49.6±9.7 12.6±2.3 2.06±0.38 11.82±1.911 LMLO (STD) 28.8±1.0 59.67±11.3 50.2±9.7 12.8±2.1 1.21±0.18 12.14±1.518 F 295.198 0.964 P ＜0.001 0.410 AGD: Average glandular dose; RCC: Right cranio candal view; LCC: Left cranio candal view; RMLO: Right medial lateral oblique view; LMLO: Left medial lateral oblique view; CNT: Contrast; STD: Standard. 
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表 2 不同曝光模式AGD的配对t检验
Table 2. The paired t-test of AGD in different exposure mode (Mean±SD)
Exposure mode AGD (mGy) t P RCC(CNT)-LCC(DOSE) 1.073±0.369 27.624 ＜0.001 RCC(CNT)-RMLO(CNT) 0.003±0.366 0.072 0.943 RCC(CNT)-LMLO(STD) 0.853±0.377 21.436 ＜0.001 LMLO(STD)-LCC(DOSE) 0.221±0.155 13.517 ＜0.001
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表 3 模体不同曝光模式下的技术参数
Table 3. The phantoms' technical parameters in different exposure mode
Exposure mode Tube voltage (kV) Tube current (mAs) Thickness（mm） Force（daN） CNT 29 103.1±0.7 48 10 STD 28.3±0.7 72.05±6 48 10 DOSE 29 43.7 48 10
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表 4 模体不同曝光模式下AGD、各种类型病变平均得分及总分
Table 4. The phantoms' AGD, evaluation score of difference lesions in different exposure mode(Mean±SD)
Exposure mode AGD (mGy) Fiber lesions Calcification lesions Mass lesions Score CNT 2.05±0.01 3.46±0.13 3.92±0.09 5.92±0.26 13.3±0.2 STD 1.35±0.01 3.08±0.25 3.86±0.14 5.86±0.3 12.8±0.2 DOSE 0.9±0 2.92±0.26 3.86±0.14 5.17±0.33 12±0.33 F 669.107 9.279 0.30 14.619 51.717 P ＜0.001 0.007 0.748 0.01 ＜0.001
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