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Mammography Imaging: Does Positioning Matter?

J Zhang

J Zhang1*, M Szabunio2 , (1) University of Kentucky, Lexington, KY, (2) University of Kentucky, Lexington, KY


SU-E-I-88 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose:In mammography, compression is imperative for quality images and glandular radiation exposure dose. The thickness of the compressed breast directly determines mammography acquisition parameters. The compressed thickness varies due to variation in technologist practice, even for the same patient imaged at different time. This study is to investigate potential effect of the variation in breast positioning on radiation dose and image quality.

Methods: Radiation dose at different thicknesses was measured with a BR-12 breast phantom for both conventional craniocaudal view and tomosynthesis in a Hologic Tomosynthesis mammography system. The CIRS stereotactic needle biopsy training phantom embedded dense masses and microcalcification in various sizes were imaged for image quality evaluation. Radiologists evaluated images. Clinical mammograms from the same patient but acquired at different time were retrospectively retrieved to evaluate potential effects of variation in positioning.

Results: Acquisition parameters (kVp and mAs) increase with the increased phantom thickness. Radiation exposure increases following an exponential trend. The stereotactic phantom images showed loss of spatial and contrast resolution with inappropriate positioning. The compressed pressure may not be a good indicator for appropriate positioning. The inclusion of different amount of pectoralis muscle may lead to the same compressed pressure but different compressed thickness. The initial retrospective study of 3 patients showed that there were potential large variations in positioning the same patient at different examination time, resulting in large variations in patient radiation dose and image quality.

Conclusion: Variations in patient positioning potentially influence patient radiation dose and image quality. The technologist has the critical responsibility to position patient to provide quality images in spite of different breast and body types. To reduce intra and inter practice variations in positioning patient, a training program among each breast imaging center may be a need.

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