Mathew Thomas BS, Presenter: Nothing to Disclose

Yohei Matsutani, Abstract Co-Author: Nothing to Disclose

Emily F. Conant MD, Abstract Co-Author: Scientific Advisory Board, Hologic, Inc

Andrew D.A. Maidment PhD, Abstract Co-Author: Research support, Hologic, Inc Research support, Barco nv Spouse, Employee, Real-Time Radiography, Inc Spouse, Stockholder, Real-Time Radiography, Inc

To compare the cumulative mean glandular dose (MGD) in digital mammography (DM) and digital breast tomosynthesis (DBT) in a prospective breast cancer screening trial.

This trial compared cumulative dose per breast from two imaging scenarios: standard of care DM versus an image set of low-dose 2-view DM combined with 2-view DBT (Hologic Selenia Dimensions). A paired design was used so that each patient underwent both types of imaging. Low-dose 2-view DM and DBT was conducted at 15% reduced dose. The cumulative MGD was calculated in 495 women from exposure parameters of 2262 standard-DM and 1980 low-dose DM/DBT acquisitions. Extra views in standard-DM were obtained in some patients at clinical discretion. No additional low-dose DM/DBT views were obtained. To adjust for additional views in the standard-DM group, the mean dose of all standard-DM views was used for cumulative dose comparison. The following screening paradigms were defined: Standard DM (CC/MLO) vs. low-dose ACRIN-Limited (DM—MLO; DBT—MLO+CC), and low-dose ACRIN-Complete (DM—MLO+CC; DBT—MLO+CC). Comparison of MGD per breast between protocols was made by 2-sided paired t-test.

The ACRIN-Limited MGD at Site A and Site B were 4.94 mGy and 5.29 mGy, respectively. The ACRIN-Complete MGD was 6.35 mGy and 6.56 mGy at Site A and B, respectively. The standard-DM MGD was 4.81 mGy and 3.52 mGy at Site A and B, respectively. An additional 23.9% and 6.7% standard-DM views were obtained at site A and B, respectively. After adjusting for extra views, the standard-DM MGD was 3.85 mGy and 3.28 mGy at Site A and B, respectively. The ACRIN-limited MGD did not differ significantly from standard-DM at Site A (p=0.10) but was greater than standard-DM at Site B (p<0.01). After adjusting for additional standard-DM views, ACRIN-limited dose was greater than standard-DM at both sites (p<0.01).

Three-view, low-dose combination-DM/DBT screening is achievable at MGD comparable to the dose of routine screening mammography. The clinical use of additional standard-DM views significantly affects the cumulative MGD during routine breast cancer screening.

Prospective 3-view combination DM/DBT screening can be achieved at cumulative mean glandular dose comparable to those in standard mammography screening.

Thomas, M, Matsutani, Y, Conant, E, Maidment, A, ACRIN PA 4006: Comparison of Dose in Digital Breast Tomosynthesis and Standard Two-View Mammography for Prospective Breast Cancer Screening.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13023753.html