TY - JOUR
T1 - Mammography with and without radiolucent positioning sheets
T2 - Comparison of projected breast area, pain experience, radiation dose and technical image quality
AU - Timmers, Janine
AU - ten Voorde, Marloes
AU - van Engen, Ruben E.
AU - van Landsveld-Verhoeven, Cary
AU - Pijnappel, Ruud
AU - Droogh-de Greve, Kitty
AU - den Heeten, Gerard J.
AU - Broeders, Mireille J. M.
PY - 2015/10
Y1 - 2015/10
N2 - Purpose: To compare projected breast area, image quality, pain experience and radiation dose between mammography performed with and without radiolucent positioning sheets.Methods: 184 women screened in the Dutch breast screening programme (May-June 2012) provided written informed consent to have one additional image taken with positioning sheets. 5 cases were excluded (missing data). Pain was scored using the Numeric Rating Scale. Radiation dose was estimated using the Dance model and projected breast area using computer software. Two radiologists and two radiographers assessed image quality.Results: With positioning sheets significantly more pectoral muscle, lateral and medial breast tissue was projected (CC-views) and more and deeper depicted pectoral muscle (MLO-views). In contrast, visibility of white and darker areas was better on images without positioning sheets, radiologists were therefore better able to detect abnormalities (MLO-views). Women experienced more pain with positioning sheets (MLO-views only, mean difference NRS 0.98; SD 1.71; p = 0,00).Conclusion: Mammograms with positioning sheets showed more breast tissue. Increased breast thickness after compression with sheets resulted in less visibility of white and darker areas and thus reduced detection of abnormalities. Also, women experienced more pain (MLO-views) due to the sheet material. A practical consideration is the fact that more subcutaneous fat tissue and skin are being pulled forward leading to folds in the nipple area. On balance, improvement to the current design is required before implementation in screening practice can be considered. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
AB - Purpose: To compare projected breast area, image quality, pain experience and radiation dose between mammography performed with and without radiolucent positioning sheets.Methods: 184 women screened in the Dutch breast screening programme (May-June 2012) provided written informed consent to have one additional image taken with positioning sheets. 5 cases were excluded (missing data). Pain was scored using the Numeric Rating Scale. Radiation dose was estimated using the Dance model and projected breast area using computer software. Two radiologists and two radiographers assessed image quality.Results: With positioning sheets significantly more pectoral muscle, lateral and medial breast tissue was projected (CC-views) and more and deeper depicted pectoral muscle (MLO-views). In contrast, visibility of white and darker areas was better on images without positioning sheets, radiologists were therefore better able to detect abnormalities (MLO-views). Women experienced more pain with positioning sheets (MLO-views only, mean difference NRS 0.98; SD 1.71; p = 0,00).Conclusion: Mammograms with positioning sheets showed more breast tissue. Increased breast thickness after compression with sheets resulted in less visibility of white and darker areas and thus reduced detection of abnormalities. Also, women experienced more pain (MLO-views) due to the sheet material. A practical consideration is the fact that more subcutaneous fat tissue and skin are being pulled forward leading to folds in the nipple area. On balance, improvement to the current design is required before implementation in screening practice can be considered. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
KW - Mammography
KW - Performance
KW - Breast neoplasms
KW - Early detection of cancer
KW - Radiographic image enhancement
U2 - 10.1016/j.ejrad.2015.07.005
DO - 10.1016/j.ejrad.2015.07.005
M3 - Article
C2 - 26272030
SN - 0720-048X
VL - 84
SP - 1903
EP - 1909
JO - European Journal of Radiology
JF - European Journal of Radiology
IS - 10
ER -