Dose and diagnostic performance comparison between phase-contrast mammography with synchrotron radiation and digital mammography: a clinical study report

Abstract

Two dosimetric quantities [mean glandular dose (MGD) and entrance surface air kerma (ESAK)] and the diagnostic performance of phase-contrast mammography with synchrotron radiation (MSR) are compared to conventional digital mammography (DM). Seventy-one patients (age range, 41 to 82 years) underwent MSR after a DM examination if questionable or suspicious breast abnormalities were not clarified by ultrasonography. The MGD and the ESAK delivered in both examinations were evaluated and compared. Two on-site radiologists rated the images in consensus according to the Breast Imaging Reporting and Data System assessment categories, which were then correlated with the final diagnoses by means of statistical generalized linear models (GLMs). Receiver operating characteristic curves were also used to assess the diagnostic performance by comparing the area under the curve (AUC). An important MGD and ESAK reduction was observed in MSR due to the monoenergetic beam. In particular, an average 43% reduction was observed for the MGD and a reduction of more than 50% for the ESAK. GLM showed higher diagnostic accuracy, especially in terms of specificity, for MSR, confirmed by AUC analysis ([Formula: see text]). The study design implied that the population was characterized by a high prevalence of disease and that the radiologists, who read the DM images before referring the patient to MSR, could have been influenced in their assessments. Within these limitations, the use of synchrotron radiation with the phase-contrast technique applied to mammography showed an important dose reduction and a higher diagnostic accuracy compared with DM. These results could further encourage research on the translation of x-ray phase-contrast imaging into the clinics.

Monochromatic breast computed tomography with synchrotron radiation: phase-contrast and phase-retrieved image comparison and full-volume reconstruction

“…In this framework, the first x-ray PhC mammographic clinical study performed with SR, involving more than 70 patients, has demonstrated an improvement in the image quality and diagnostic performance when compared with the conventional state-of-the-art mammography. [7][8][9] The transition of PhC mammography from synchrotron to hospitals is a research topic for several groups. [10][11][12][13][14][15] At the same time, the advent of more efficient digital detectors and powerful reconstruction algorithms allowed the realization of three-dimensional (3-D) mammographic systems, such as tomosynthesis and tomographic scanners.…”

Comparison of a personalized breast dosimetry method with standard dosimetry protocols

“…3c) are in good agreement with Fedon et al . 29 . The difference in skin layer models between Dance and Wu also leads to slightly higher AGD for thin breasts with the Dance model 29 .…”

Radiochromic film dosimetry in synchrotron radiation breast computed tomography: a phantom study

“…The SYRMA-3D collaboration was established to set up the first clinical trial of phase-contrast breast CT with synchrotron radiation (SR) at the Elettra synchrotron light source facility in Trieste, Italy, based on the previous clinical trial for SR mammography using phase-contrast techniques; that study highlighted an increase of image quality with respect to standard digital mammography (Castelli et al, 2011;Fedon et al, 2018;Longo et al, 2014). Breast imaging with SR may also be compatible with K-edge subtraction imaging with iodine contrast medium (Thomlinson et al, 2018) for enhanced visibility of tumor masses.…”