基于软件的散射校正模式对乳腺X射线检查中辐射剂量的影响

Effect of software-based scatter correction on radiation dose in mammography

目的:这项研究探讨了基于软件的散射校正(PRIME)模式中平均腺体剂量与压缩厚度和腺体类型的关系,以及PRIME模式与全视野数字化乳腺X射线摄影(FFDM)相比平均腺体剂量(AGD)减少的程度和影响因素。资料与方法:收集在同一压缩厚度下对左右侧乳腺分别行PRIME模式、FFDM的女性患者515例,分析共1030幅乳腺头尾位和1030幅内外侧斜位的图像。结果:乳腺压缩厚度与AGD_(PRIME)呈正向较强相关(r=0.698,P<0.001),乳腺腺体类型和压迫力与AGD_(PRIME)呈正向较弱相关(r=0.227,r=0.228,P<0.001),年龄与AGD_(PRIME)呈负相关(r=-0.327,P<0.001)。乳腺压缩厚度、腺体类型、压迫力和年龄是AGD PRIME的独立影响因素(B_(压缩厚度)=0.025,B_(腺体类型)=0.238,B_(压迫力)=0.001,B_(年龄)=-0.007,P<0.001)。压缩厚度、腺体类型、压迫力和年龄的标准化系数分别为0.735、0.229、0.106、-0.244,乳腺压缩厚度对AGD_(PRIME)的影响较腺体类型大。乳腺压缩厚度和年龄与△AGD(AGD_(FFDM)减去AGD_(PRIME))呈负相关(r=-0.565,r=-0.127,P<0.001),腺体类型与△AGD呈正相关(r=0.159,P<0.001)。乳腺压缩厚度和年龄分别是△AGD的独立影响因素(B_(压缩厚度)=-0.011,B_(年龄)=-0.002,标准化系数分别为-0.558、-0.104)。PRIME模式下乳腺压缩厚度与剂量减少率呈负相关,线性拟合显示较薄的乳房剂量降低幅度更高。结论:AGD PRIME与乳腺压缩厚度、腺体类型和压迫力呈正相关,压缩厚度对AGD_(PRIME)的影响更大。△AGD与压缩厚度及年龄呈负相关,乳腺压缩厚度较小时和在年轻患者乳腺中PRIME采集模式降低腺体剂量的效果越明显。

Purpose:This study investigated the relationship between average glandular dose and compressed thickness and gland type in the software-based Progressive Reconstruction Intelligently Minimizing Exposure(PRIME)model.The extent of average glandular dose reduction(AGD)in PRIME mode is compared to full field digital mammography(FFDM)and influencing factors.Materials and Methods:515 female patients who underwent PRIME mode and FFDM on the left and right breast under the same compressed thickness were collected respectively.A total of 1030 breast craniocaudal view images and 1030 breast mediolateral oblique view images were analyzed.Results:Breast compressed thickness was positively and strongly correlated with AGD_(PRIME)(r=0.698,P<0.001),gland type and compressed force were positively and weakly correlated with AGD_(PRIME)(r=0.227,r=0.228,P<0.001),and age was negatively correlated with AGD_(PRIME)(r=-0.327,P<0.001).Breast compressed thickness,gland type,compressed force and age were independent factors for AGD_(PRIME)(B compressed thickness=0.025,B_(gland type)=0.238,B_(compressed force)=0.001,B_(age)=-0.007,P<0.001).The standardized coefficients of compressed thickness,gland type,compressed force and age were 0.735,0.229,0.106 and-0.244,respectively.The effect of compressed thickness on AGD_(PRIME)was greater than that of gland type.Breast compressed thickness and age were negatively correlated with△AGD(AGD_(FFDM)minus AGD_(PRIME))(r=-0.565,r=-0.127,P<0.001),while gland type was positively correlated with△AGD(r=0.159,P<0.001).Breast compressed thickness and age were independent factors of△AGD(B_(compressed thickness)=-0.011,B_(age)=-0.002,the standardization coefficients were-0.558 and-0.104,respectively).Breast compressed thickness was negatively correlated with the rate of dose-reduction in PRIME mode,and linear fitting showed a higher dose reduction in thinner breasts.Conclusions:AGD_(PRIME)is positively correlated with breast compressed thickness,gland type and compressed force,and compressed thickness has a greater effect on AGD_(PRIME).△AGD is negatively correlated with compressed thickness and age,and the effect of PRIME acquisition mode on reducing glandular dose in young patients with small breast compressed thickness is more obvious.