Mean glandular dose in the mammary gland and dose of radiation in the thyroid gland and lens in women with and without breast implants during different modalities of mammography

Pérez Fuentes, J.A.; Roldán Sánchez, V.S.; Gordillo Ledesma, A.K.; Mena, A.F.; Brito, S.; Soteldo, C.

doi:10.1016/j.rxeng.2020.10.013

Article information

Abstract

Full Text

Bibliography

Download PDF

Statistics

Special issue

This article is part of special issue:

Vol. 64. Issue S1

Breast radiology: New horizons in times of pandemics

More info

Abstract

There have always been concerns about the secondary effects of diagnostic methods that use ionizing radiation. During mammography, the parameters to be concerned about are the mean glandular dose and the scatter dose. We evaluated the dose of radiation to the breast, thyroid gland, and lens in digital mammography in women with and without implants, in tomosynthesis in women with and without implants, and in contrast-enhanced mammography.

Materials and methods

The study included 212 women with and without disease who were attended at the Centro Clínico de Estereotaxia, CECLINES, in Caracas, Venezuela, between June 2017 and August 2017; the women were classified into five groups according to the mammographic modality used to evaluate them and whether or not they had implants. The statistical analysis included descriptive statistics for the study population. We used the Mann-Whitney U to compare the mean glandular dose and dose in the thyroid gland and lens between groups.

Results

The mean glandular dose and the dose of radiation received in the thyroid and lens were within the acceptable range. In a few exceptions, the mean glandular dose per view was slightly higher than 3 mGy. The scatter dose to the thyroid gland and the lens during mammography has a very small contribution to the annual dose equivalent.

Conclusion

The mean glandular dose and the scatter dose to the thyroid gland and lens delivered during tomosynthesis and 2D mammography in women with implants were higher than those delivered during other mammographic techniques in women without implants.

Keywords:

Radiation dose

Thyroid

Lens

Mean glandular dose

Mammography

Breast implant

Resumen

Siempre ha existido preocupación por los efectos secundarios de métodos diagnósticos que utilizan radiaciones ionizantes. Durante una mamografía preocupa la dosis glandular promedio y la dosis de radiación dispersa. Evaluamos la dosis de radiación a la mama, glándula tiroides y cristalino con mamografía digital sin y con implante, tomosíntesis sin y con implante y mamografía con contraste.

Materiales y métodos

El estudio incluyó 212 mujeres sanas y con patología que fueron divididas en 5 grupos dependiendo de la modalidad mamográfica y de la presencia o no de implantes. Acudieron al Centro Clínico de Estereotaxia, CECLINES, en Caracas, Venezuela, entre junio y agosto de 2017. El análisis estadístico contempla una descripción de la población en estudio. Se comparó la dosis glandular promedio y la dosis en glándula tiroides y cristalino entre los grupos, utilizando el estadístico U de Mann Whitney.

Resultados

La dosis glandular promedio y la dosis de radiación recibida en la glándula tiroides y el cristalino están dentro de los valores aceptables. En pocas excepciones, la dosis glandular promedio por proyección estaba discretamente por encima de los 3 mGy. La radiación dispersa a glándula tiroides y cristalino durante una mamografía tiene una contribución muy pequeña a la dosis anual equivalente.

Conclusión

Las pacientes con implante (tomosíntesis y mamografía 2D) tuvieron la mayor mediana de dosis glandular promedio y dosis a glándula tiroides y cristalino mayor que las modalidades mamográficas sin implantes.

Palabras clave:

Dosis de radiación

Tiroides

Cristalino

Dosis glandular promedio

Mamografía

Prótesis mamaria

Article

These are the options to access the full texts of the publication Radiología (English Edition)

Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”

Purchase

Purchase article

Purchasing article the PDF version will be downloaded

Purchase now

Contact

Phone for subscriptions and reporting of errors

From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.

Calls from Spain

932 415 960

Calls from outside Spain

+34 932 415 960

E-mail

atencionalcliente@elsevier.com

References

[1]

CSN. Protección Radiológica/CSN [Internet]. En: Consejo de Seguridad Nuclear, ed. Madrid; 2012. 15 p. Available from: https://www.csn.es/documents/10182/914805/Protecciónradiológica.

[2]

Sociedad Argentina de Radioprotección. ICRP. Publicación 105 Protección Radiológica en Medicina. [Internet]. Primera. En: Sociedad Argentina de Radioprotección, ed. Ciudad Autónoma de Buenos Aires: International Commission on Radiological Protection.; 2011. p. 21-2. Available from: http://www.icrp.org/docs/P105Spanish.pdf.

[3]

I. Sechopoulos, S. Suryanarayanan, S. Vedantham, C. D’Orsi, A. Karellas.

Radiation dose to organs and tissues from mammography: Monte Carlo and phantom study.

Radiology., 246 (2008), pp. 434-443

https://dx.doi.org/10.1148/radiol.2462070256 | Medline

[4]

A.L. Chetlen, K.L. Brown, S.H. King, C.J. Kasales, S.E. Schetter, J.A. Mack, et al.

Scatter radiation dose from digital screening mammography measured in a representative patient population.

Am J Roentgenol., 206 (2016), pp. 359-365

[5]

I. Sechopoulos, R.E. Hendrick.

Mammography and the risk of thyroid cancer.

Am J Roentgenol., 198 (2012), pp. 705-707

[6]

M.J. Yaffe, J.G. Mainprize.

Risk of radiation-induced breast cancer from mammographic screening.

Radiology [Internet]., 258 (2011), pp. 98-105

https://dx.doi.org/10.1148/radiol.10100655 | Medline

http://pubs.rsna.org/doi/10.1148/radiol.10100655

[7]

E.D. Pisano, R.E. Hendrick, M.J. Yaffe, J.K. Baum, J.B. Cormack, L.A. Hanna, et al.

Diagnostic accuracy of digital versus film mammography : exploratory analysis of selected population subgroups in DMIST.

Radiology., 246 (2008), pp. 376-383

https://dx.doi.org/10.1148/radiol.2461070200 | Medline

[8]

P. Skaane, A.I. Bandos, E. Eben, I.N. Jebsen, M. Krager, U. Haakenaasen, et al.

two-view digital breast tomosynthesis screening with synthetically reconstructed projection images: comparison with digital breast tomosynthesis with full-field digital mammographic images.

Radiology., 271 (2014), pp. 655-663

https://dx.doi.org/10.1148/radiol.13131391 | Medline

[9]

M. Jochelson.

Contrast-enhanced digital mammography digital mammography contrast neovascularity MR imaging.

Radiol Clin NA [Internet]., 52 (2016), pp. 609-616

https://dx.doi.org/10.1016/j.rcl.2013.12.004

[10]

G. Eklund, R. Busby, S. Miller, J. Job.

Improved Imaging of the augmented breast.

AJR., 151 (1988), pp. 469-473

https://dx.doi.org/10.2214/ajr.151.3.469 | Medline

[11]

P. Skaane.

Breast cancer screening with digital breast tomosynthesis.

Breast Cancer., 24 (2017), pp. 32-41

https://dx.doi.org/10.1007/s12282-016-0699-y | Medline

[12]

S. Weigel, J. Gerss, H.-W. Hense, M. Krischke, A. Sommer, J. Czwoydzinski, et al.

Digital breast tomosynthesis plus synthesised images versus standard full-field digital mammography in population-based screening (TOSYMA): protocol of a randomised controlled trial.

BMJ Open., 8 (2018),

https://dx.doi.org/10.1136/bmjopen-2018-022991 | Medline

[13]

COVENIN. Protección Contra las Radiaciones Ionizantes Provenientes De Fuentes Externas Usadas en Medicina. Parte 1: Radiodiagnóstico Médico Y Odontológico 218-1. [Internet]. FONDONORMA. 2000. 2 p. Available from: https://app.box.com/s/9gatebve6vlqxehmcaf2pav2d7hz1wfn.

[14]

ICRP.

1990 Recommendation of the International Commission on Radiological Protection. Publication 60.

Ann ICRP [Internet]., 21 (1991),

https://journals.sagepub.com/doi/pdf/10.1177/ANIB_21_1-3

[15]

OIEA. Establecimiento de Niveles Orientativos en Radiografía General y Mamografía. IAEA-TECDOC-1646. [Internet]. Viena; 2010. 5-7 p. Available from: https://www-pub.iaea.org/MTCD/publications/PDF/TE_1646_CD/PDF/TECDOC_1646.pdf.

[16]

C. Soleldo, L. Carrizales, U. Cerezo.

Desarrollo de un Protocolo de Aseguramiento de Calidad en Mamografía Digital.

Rev Latinoam Fis Méd., 26 (2017), pp. 56-59

[17]

E. Sickles, C. D’Orsi, L. Bassett.

ACR BI-RADS® Mammography.

ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System, (2013),

[18]

C. Leal, N. Villa, L.I. Carrizales, D. Guacaran.

Estimación del kerma en procedimientos de cardiología intervencionista.

Research Gate [Internet],

https://www.researchgate.net/publication/274071442

[19]

L. Tabar, B. Vitak, T. Hsiu-Hsi, A. Ming-Fang, A. Cohens, T. Tot, et al.

Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades.

Radiology., 260 (2011), pp. 658-663

https://dx.doi.org/10.1148/radiol.11110469 | Medline

[20]

M. Pyka, P. Eschle, C. Sommer, Ms Weyland, R. Kubik, S. Scheidegger.

Effect of thyroid shielding during mammography: measurements on phantom and patient as well as estimation with Monte Carlo simulation.

Eur Radiol Exp., 2 (2018), pp. 14

https://dx.doi.org/10.1186/s41747-018-0042-9 | Medline

[21]

C. Whelan, D. McLean, A. Poulos.

Investigation of thyroid dose due to mammography.

Australas Radiol., 43 (1999), pp. 307-310

https://dx.doi.org/10.1046/j.1440-1673.1999.433660.x | Medline

[22]

J.R. James, W. Pavlicek, J.A. Hanson, T.F. Boltz, B.K. Patel.

Breast radiation dose with CESM compared with 2D FFDM and 3D tomosynthesis mammography.

Am J Roentgenol., 208 (2017), pp. 362-372

[23]

J.E. Baek, B.J. Kang, S.H. Kim, H.S. Lee.

Radiation dose affected by mammographic composition and breast size: First application of a radiation dose management system for full-field digital mammography in Korean women.

World J Surg Oncol., 15 (2017), pp. 1-9

https://dx.doi.org/10.1186/s12957-016-1068-1 | Medline

[24]

I. Houben, P. Van de Voorde, C. Jeukens, J. Wildberger, L. Kooreman, M.L. Smidt, et al.

Contrast-enhanced spectral mammography as work-up tool in patients recalled from breast cancer screening has low risks and might hold clinical benefits.

Eur J Radiol [Internet]., 94 (2017), pp. 31-37

https://dx.doi.org/10.1016/j.ejrad.2017.07.004 | Medline

[25]

S. Badr, N. Laurent, C. Régis, L. Boulanger, S. Lemaille, E. Poncelet.

Dual-energy contrast-enhanced digital mammography in routine clinical practice in 2013.

Diagn Interv Imaging [Internet]., 95 (2014), pp. 245-258

https://dx.doi.org/10.1016/j.diii.2013.10.002 | Medline

[26]

R.L. Smathers, J.M. Boone, L.J. Lee, E.A. Berns, R.A. Miller, A.M. Wright.

Radiation dose reduction for augmentation mammography.

Am J Roentgenol., 188 (2007), pp. 1414-1421

[27]

T.M. Svahn, N. Houssami, I. Sechopoulos, S. Mattsson.

Review of radiation dose estimates in digital breast tomosynthesis relative to those in two-view full-field digital mammography.

Breast [Internet]., 24 (2015), pp. 93-99

https://dx.doi.org/10.1016/j.breast.2014.12.002 | Medline

[28]

L. Carrizales-Silva, C. Soteldo.

Estimación del Kerma en Piel en Cristalino y Tiroides en Pacientes Sometidas a Estudio de Mamografía.

Rev Latinoam Fis Méd [Internet]., 2 (2016), pp. 83-86

http://www.conscientia.com.mx/wp-content/uploads/2017/05/obesidad.pdf

[29]

FDA.

The Mammography Quality Standards Act Final Regulations: Preparing for MQSA Inspections; Final Guidance for Industry and FDA.

(2001), pp. 25

[30]

L.A. Chang, D.L. Miller, C. Lee, D.R. Melo, D. Villoing, V. Drozdovitch, et al.

Thyroid radiation dose to patients from diagnostic radiology procedures over eight decades: 1930-2010.

Health Phys., 113 (2017), pp. 1-16

https://dx.doi.org/10.1097/HP.0000000000000701 | Medline

[31]

ICRP. Las recomendaciones 2007 de la Comisión Internacional de Protección Radiológica. Publicación 103. [Internet]. Senda, ed. Sociedad Española de Protección Radiológica. 2007. 86-87 p. Available from: http://www.icrp.org/docs/P103_Spanish.pdf.

[32]

M.C. Thorne.

Regulating exposure of the lens of the eye to ionising radiations.

J Radiol Prot., 32 (2012), pp. 147-154

https://dx.doi.org/10.1088/0952-4746/32/2/147 | Medline

Mean glandular dose in the mammary gland and dose of radiation in the thyroid gland and lens in women with and without breast implants during different modalities of mammography

Article

Subscribe to our newsletter