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The potential use of ultra-low radiation dose images in digital mammography-a clinical proof-of-concept study in craniocaudal views

机译：超低辐射剂量图像在数字乳腺X线摄影中的潜在用途-颅尾视图中的临床概念验证研究

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Objective: To estimate the potential of low-dose images in digital mammography by analysing the effect of substantial dose reduction in craniocaudal (CC) views on clinical performance. Methods: At routine mammography, additional CC views were obtained with about 10% of the standard dose. Five radiologists retrospectively read the standard [mediolateral oblique (MLO) + CC] and combination low-dose mammograms (standard MLO + low-dose CC). If present, lesion type, conspicuity and suggested work-up were recorded. Final diagnoses were made by histology or follow up. A t-test or chi(2) test was used to compare results. Results: 421 cases were included, presenting 5 malignancies, 66 benign lesions and multiple non-specific radiologic features. Using MLO with low-dose CC, all lesions were detected by at least one reader, but altogether less often than with standard mammography (sensitivity, 73.9% vs 81.5%). Missed lesions concerned all types. Lesions detected with both protocols were described similarly (p = 0.084) with comparable work-up recommendations (p = 0.658). Conclusion: Mammography with ultra-low-dose CC images particularly influences detection. While sensitivity decreased, specificity was unaffected. In this proof-of-concept study a lower limit was to be determined that is not intended nor applicable for clinical practice. This should facilitate further research in optimization of a low-dose approach, which has potential in a relatively young and largely asymptomatic population. Advances in knowledge: Tungsten/silver-acquired mammography images might facilitate substantial dose reduction. Ultra-low-dose CC images reduce sensitivity, but not specificity. Low-dose images have potential in a largely young and asymptomatic population; a baseline is set for further research in optimization of a low-dose approach
机译：目的：通过分析大幅减少颅尾（CC）视图的剂量对临床表现的影响，估计数字化乳腺摄影中低剂量图像的潜力。方法：在常规乳腺摄影中，以标准剂量的约10％获得额外的CC图像。五名放射科医师回顾性阅读了标准[内侧斜肌（MLO）+ CC]和组合的低剂量乳腺X线照片（标准MLO +低剂量CC）。如果存在，则记录病变类型，明显程度和建议的检查。最终诊断是通过组织学或随访进行的。使用t检验或chi（2）检验比较结果。结果：共纳入421例，表现为5例恶性肿瘤，66例良性病变和多个非特异性放射学特征。使用低剂量CC的MLO，至少由一个阅读器可以检测到所有病变，但与标准的乳房X线照相术相比，检出的频率更低（敏感性分别为73.9％和81.5％）。丢失的病变涉及所有类型。两种方案检测到的病变均进行了类似的描述（p = 0.084），并具有相似的后处理建议（p = 0.658）。结论：带有超低剂量CC图像的乳腺摄影特别影响检测。虽然敏感性降低，但特异性不受影响。在此概念验证研究中，将确定一个既不打算也不适用于临床实践的下限。这应有助于进一步研究优化低剂量方法，这种方法在相对年轻且无症状的人群中具有潜力。知识进步：钨/银乳腺摄影图像可能有助于减少剂量。超低剂量CC图像会降低灵敏度，但不会降低特异性。低剂量图像在大部分年轻且无症状的人群中具有潜力。为优化低剂量方法的进一步研究设定了基线

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