Rationale and Objectives
The aim of this retrospective study is to compare the radiation dose received during
CEDM, short and long protocol (CEDM SP and CEDM LP), with dose received during DM
and DBT on patients with varying breast thickness, age and density.
Materials and Methods
Between January 2019 and December 2019, patients having 6214 DM, 3662 DBT and 173
CEDM examinations in our department were analyzed. Protocol total single breast AGD
has been evaluated for all clinical imaging protocols, extracting AGD values and exposure
data from the dose DICOM Structured Report (SR) information stored in the hospital
PACS system. Protocol AGD was calculated as the sum of single projection AGDs carried
out in every exam for each clinical protocol. A total amount of 23,383 exams for each
breast were analyzed. Protocol AGDs, stratified as a function of patient breast compression
thickness, age, and breast density were assessed.
Results
The total protocol AGD median values for each protocol are: 2.8 mGy for DM, 3.2 mGy
for DBT, 6.0 mGy for DM+DBT, 4.5 mGy for CEDM SP, 7.4 mGy for CEDM SP_DBT (CEDM SP
protocol with DBT), 8.4 mGy for CEDM LP and 11.6 mGy for CEDM LP_DBT (CEDM LP protocol
with DBT). CEDM SP AGD median value is 59% higher than DM AGD median value and 40%
lesser than DM+DBT AGD median; this last difference was statistically confirmed with
a p-value <0.001. AGD value for each standard breast CEDM SP projection results to be
below 3-mGy limit.
AGD value for each standard breast CEDM SP projection results to be below 3 mGy, as
required by international legislation.
For dense breasts, the AGD median value is 4.2 mGy, with the first and third quartile
of 3.3 mGy and 6.0 mGy respectively; for non-dense breasts, the AGD median value is
4.7 mGy, with first and third quartile of 3.5 mGy and 6.3 mGy respectively. The difference
between the two groups was statistically tested and confirmed, with a p-value of 0.039.
Conclusion
CEDM SP results in higher radiation exposure compared with conventional DM and DBT
but lower than the Combo mode. The dose administered during the CEDM SP is lower in
patients with dense breasts regardless of their size. An interesting outcome, considering
the ongoing studies on CEDM screening in patients with dense breasts.
Key Words
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Article Info
Publication History
Published online: January 19, 2022
Accepted:
December 22,
2021
Received in revised form:
December 17,
2021
Received:
November 2,
2021
Footnotes
Institution from which the work originated: Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Largo G. A. Brambilla 3, 50134, Florence, Italy.
Identification
Copyright
© 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
