Radiation dose in contrast-enhanced spectral Mammography in safe limits

The contrast-enhanced spectral mammography (CESM) radiation dose for system 1 is within an acceptable range as compared with other commonly performed mammographic examinations and should not preclude its use as a diagnostic breast imaging tool, revealed a study involving patient and phantom, vendor-specific average glandular dose (AGD) estimation was performed using two vendors (system 1 and system 2) in five imaging modes, including 2D, 3D, and CESM imaging.

These are the results from a study published in the American Journal of Roentgenology.

Jordana Phillips, Department of Radiology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts, and colleagues conducted the study to provide a more accurate estimation of the radiation dose of CESM relative to that of 2D digital mammography and tomosynthesis using phantom and patient data and an accepted dosimetry protocol that eliminates vendor-specific AGD estimates while including breast density.

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For the study, patient AGD was retrospectively estimated from 45 patients who underwent mammography with all imaging modes during 2012-2016. Patient and phantom AGD were estimated using accepted European and International Atomic Energy Agency protocols for dosimetry and were compared across imaging modes using a paired t-test with Bonferroni correction.

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Key Results:

• Phantom data showed that the imaging modes with the lowest to highest AGDs were system 1 2D, followed by system 2 2D and system 2 3D, which had comparable values, followed by system 1 CESM, and then by system 2 2D plus 3D.


• One hundred eighty views in 45 patients showed that the system 1 CESM AGD was 1.8 times greater than the system 1 2D AGD, 1.2 times greater than the system 2 2D AGD (p < 0.001), 1.2 times greater than the system 2 3D AGD, and 0.6 times less than the system 2 2D plus 3D AGD.

The findings were also presented at the Radiological Society of North America 2016 annual meeting, Chicago, IL, and the Society of Breast Imaging 2017 annual meeting, Los Angeles, CA.

For more information log on to 10.2214/AJR.17.19036