數位乳房斷層攝影在臨床病灶的應用

Clinical Application of Digital Breast Tomosynthesis

吳慧真(Hui-Chen Wu) ； 王基誠(Chi-Cheng Wang) ； 許清寅(Chin-Yin Sheu) ； 鄭旭萌(She-Meng Cheng)

《台灣應用輻射與同位素雜誌》 16卷3期 (2020/09) Pp. 2031-2034

摘要

數位乳房斷層攝影（DBT）臨床應用之效益，包括找出乳房病灶、病人輻射劑量與乳房結構扭曲（architectural distortion）的檢測率。本研究收集2016年案例共50組，使用數位乳房斷層攝影Tomo Slice Indicator的功能，判定病灶正確的方位。利用ANOVA變異數分析比較傳統數位乳房攝影（2D）與數位乳房斷層攝影（DBT）的輻射劑量。另收集2015年4月至2018年5月使用DBT篩檢的患者中，有結構扭曲病灶的患者，並分析其臨床表現、影像學特徵及進行外科切片定位手術之結果。兩種儀器的劑量具有顯著性差異（p=0.000、p＜0.001），且數位乳房斷層攝影（DBT）劑量低於傳統數位乳房攝影（2D）約1 mSv，因數位乳房斷層攝影較傳統數位乳房攝影減少患者加拍或重拍影像。另分析75例乳房結構扭曲於DBT的檢測率，結果顯示其中31例確定為惡性，其陽性檢測率（PPV）為41.3%。因此，DBT能正確找到乳房病灶的方位、有效降低病人的輻射劑量，尤其是在乳房結構扭曲的患者中有更佳的影像表現，是幫助臨床判讀醫師判片良好的工具。

關鍵字

數位乳房斷層攝影 ； 結構扭曲病灶 ； Tomo Slice Indicator ； 陽性檢測率 ； 傳統數位乳房攝影

並列摘要

The purpose of this study used digital breast tomosynthesis (DBT) identification of breast lesions, patient radiation doses, and detection of breast architectural distortion. The study collected 50 cases since 2018. Using the DBT function key by tomo slice indicator to determine the correct location of breast lensions. Comparison of radiation doses between conventional two-dimensional digital mammography (2D) and digital breast tomosynthesis (DBT) using ANOVA variation analysis. Another we performed a retrospective study of 75 female patients with architectural distortion on screening from April 2015 to May 2018. In architectural distortion screening patients were analyzed to evaluate the image and clinical features, and wire localization for surgical excision biopsy. Two instruments have significant differences (p=0.000，p＜0.001). DBT dose is about 1mSV lower than conventional two-dimensional digital mammography (2D). Digital breast tomosynthesis reduces conventional two-dimensional digital mammography for patients' repeat and addition images. Another 75 cases of architectural distortion were detected in DBT. The results showed that 31 cases were determined to be malignant, and the positive predictive value (PPV) of wire localization for surgical excision biopsy was 41.3%.Therefore, DBT can correctly find the location of breast lesions and effectively reduce the radiation dose of patients. DBT is the most important examination to detect the lesion with architectural distortion. It is also a good tool for clinical breast radiologists to reading breast images.

並列關鍵字

Digital Breast Tomosynthesis(DBT) ； Architectural Distortion ； Tomo Slice Indicator ； Positive Predictive Value(PPV) ； Conventional Two-Dimensional Digital Mammography(2D)