乳房影像診斷之發展

The Development of Breast Imaging Techniques

許居誠(Giu-Cheng Hsu) ； 林文瓊(Wen-Chiung Lin)

《中華民國癌症醫學會雜誌》 24卷2期 (2008/04) Pp. 98-101

https://doi.org/10.6588/JCOS.2008.24.2.3

摘要

1960年美國德州M.D. Anderson Hospital的一位放射診斷科醫師，Dr. Robert Egan首度發表使用high-mAs, low-kVp的攝影技術，可以偵測觸診無法發現的乳癌，隨即在一項全國性的研究計劃中顯示：乳房攝影可以針對無症狀的婦女作為篩檢的工具。因此美國放射線學院American College of Radiology (ACR)成立了Mammography Committee，開始訓練放射師與醫師從事乳房攝影的技術和影像判讀。1970至1980年代乳房X光攝影的發展著重在：如何提高影像品質且盡可能的降低輻射劑量，1990年代因臨床實驗顯示：40歲以上婦女定期接受乳房X光攝影篩檢可降低20-30%死亡率，使得這項檢查廣泛的被使用，社會大眾與專家學者也開始重視它的安全性與品質。2000年首部全數位乳房X光攝影儀(Full Field Digital Mammography)經美國藥物食品管理局(FDA)核准上市，數位影像雖然具有曝光寬容度大、對比解析度高、容易存儲與傳輸等優點，對於年輕婦女或乳腺緻密型乳房的診斷能力較好，但整體而言，乳癌檢測的偽陽性與偽陰性結果與傳統乳房X光攝影沒有顯著的差異。因此如何搭配其他的影像學檢查，包括乳房超音波掃描、磁振造影、以及發展中的乳房斷層攝影合成影像等，以提高診斷率並減低偽陽性是醫學界努力的目標。

關鍵字

乳房影像檢查 ； 乳房攝影 ； 超音波 ； 磁振造影

並列摘要

In 1960, Dr. Robert Egan, a physician from the department of diagnostic radiology of M.D. Anderson Hospital, Texas premiered the high-mAs and low-kVp imaging techniques to detect breast cancer before it becomes palpable. He immediately proceeded to employ it as a screening tool for asymptomatic women with breast cancer in a nationwide research project. This project sooner demonstrated that mammography can be an effective tool in breast cancer screening for asymptomatic women. As a result of this, the American College of Radiology (ACR) established a mammography committee to train radiologists and technicians on the use of mammography as a screening tool. From 1970-1980, in the field of mammography, emphasis was put on increasing the quality of imaging and reducing radiation dose. In the 1990s, randomized clinical trials showed that mammography reduced breast cancer mortality rate of women over 40 by 20-30% resulting in the widespread use of mammography in breast cancer screening. Consequently, its safety and quality of imaging were further emphasized. In 2000, the first FDA approved Full Field Digital Mammography was available on the market. Despite the advantages it offers which includes better contrast resolution, easier image storage and transmit, better detection rates for younger women or those with dense breast tissue, on the whole it does not offer significantly higher detection rates than conventional film-screen mammography. Consequently, the main aim of researchers in this field is to improve breast cancer detection and diagnosis by employing additional supporting techniques such as breast ultrasound, magnetic resonance imaging, and digital tomosynthesis.

並列關鍵字

breast imaging ； mammography ； ultrasonography ； magnetic resonance imaging