乳房攝影的模式化乳房與等效假體之發展與應用

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研究生：	董尚倫 Dong, Shang-Lung
論文名稱：	乳房攝影的模式化乳房與等效假體之發展與應用 The development and application of a model breast and equivalent phantoms in mammography
指導教授：	莊克士 Chuang, Keh-Shih
口試委員:
學位類別：	博士 Doctor
系所名稱：	原子科學院 - 生醫工程與環境科學系 Department of Biomedical Engineering and Environmental Sciences
論文出版年：	2010
畢業學年度：	99
語文別：	英文
論文頁數：	94
中文關鍵詞：	乳房攝影、假體、劑量
相關次數：	點閱：1 下載：0
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Mammography is one of the important examinations used for the detection of breast cancer. The assessment of average glandular dose (AGD) and image quality are helpful for determining dose reduction strategies, and for developing new imaging techniques in mammography. To achieve these purposes, model breasts (mathematical phantoms) and breast phantoms are commonly applied in mammography. At present, the subjects used for the development of model breasts and breast phantoms are Western women. Few attempts have been made to investigate such information for Asian women. In view of the fact that the breast size of Taiwanese women is in general smaller than that of Western women, we explored four important topics in the present study. First was the development of an adjustable model breast for AGD assessment. The second was to develop equivalent breast phantoms for Taiwanese women. Third was to investigate breast dosimetry and age-related changes in AGD for Taiwanese women. The fourth was the development of an imaging-planning program of screen/film (SF) and computed radiography (CR) mammography for short chest-wall-to-nipple-distance (CWND) breasts.
A retrospective review of 4226 SF mammograms (craniocaudal views) was conducted in this study. Breast parameters, including compressed breast thickness (CBT), CWND, compressed breast width (CBW), and glandularity were measured. The equivalent thickness of a polymethylmethacrylate (PMMA) phantom was determined for each breast using the exposure factors. The AGD for each exposure was estimated. The equivalence of PMMA phantoms and breasts obtained above was applied to develop the imaging-planning program for short CWND breasts.
Results from the present study show that the average values of CBT, CWND, CBW, and glandularity of the women studied are 4.1 cm, 6.9 cm, 16.9 cm, and 54%, respectively. The average equivalent PMMA thickness is 4.0 cm, which is thinner than that reported in previous studies (4.5 cm). The mean AGD for Taiwanese women surveyed is 1.72 mGy, which is lower than those obtained for Western women in previous studies. The dose reduction is 4% between the age bands of 30-34 and 55-59 years, and 14% between the age bands of 30-34 and 65-69 years. By application of the imaging-planning program developed, adequately imaging parameters for short CWND breasts can be determined.
In conclusion, an adjustable model breast and the equivalent breasts of 2.5-6 cm PMMA phantoms were developed for the age groups 30-49 years and 50-69 years. In this study, the AGD to patients increased with increasing CBT. As the difference in age increases, the variation in AGD increased. With application of the imaging-planning program in mammography, the variation in image quality of short CWND breasts can be minimized.

Abstract----------------------------------------------------------------------------------I
Dedication-------------------------------------------------------------------------------III
Contents---------------------------------------------------------------------------------IV
List of figures----------------------------------------------------------------------------VII
List of tables--------------------------------------------------------------------------------X
Abbreviations/Acronym------------------------------------------------------------XII
Preface---------------------------------------------------------------------------------XIV
Overview of the dissertation---------------------------------------------------------XIV

CHAPTER 1    Introduction---------------------------------------------------------1
1    Introduction of mammography----------------------------------------------1
2    Literature review--------------------------------------------------------2
2.1    Breast, model breasts, and standard breast phantoms-----------------------2
2.2    Breast dosimetry assessment---------------------------------------------------3
2.3    Image quality assessment-------------------------------------------------------5
3    Specific Aims-------------------------------------------------------------6

CHAPTER 2    Development of an adjustable model breast for mammographic dosimetry assessment------------------15
1    Background--------------------------------------------------------------15
2    Motivation---------------------------------------------------------------15
3    Materials and method----------------------------------------------------16
3.1    Instruments and patients-------------------------------------------------16
3.2    Investigation of compressed breast parameters-------------------------16
3.3    Development of the adjustable breast model----------------------------18
3.4    Validation of the adjustable model breast-------------------------------18
4    Results-------------------------------------------------------------------18
4.1    CBT correction factors and measured breast parameters----------------18
4.2    Age-related changes in breast parameters-------------------------------19
4.3    The adjustable model breast---------------------------------------------19
4.4    Validation results--------------------------------------------------------20
5    Discussion---------------------------------------------------------------20
5.1    Validation and comparison----------------------------------------------20
5.2    Effect of age on breast parameters--------------------------------------21
5.3    Uncertainty and limitation-----------------------------------------------22

CHAPTER 3    Development of equivalent breast phantoms------------32
1    Background--------------------------------------------------------------32
2    Motivation--------------------------------------------------------------32
3    Materials and method----------------------------------------------------33
3.1    Instruments and patients-------------------------------------------------33
3.2    Estimation of breast composition----------------------------------------33
3.3    Development of the breast equivalent phantom-------------------------34
3.4    Determination of the equivalent breasts for PMMA phantoms---------35
4    Results-------------------------------------------------------------------35
4.1    Experimental validation-------------------------------------------------35
4.2    CBT and equivalent thicknesses of phantoms---------------------------35
4.3    Equivalent breasts of PMMA phantoms---------------------------------36
5    Discussion---------------------------------------------------------------36
5.1    Experimental uncertainty------------------------------------------------36
5.2    Distributions of glandularity, CBT, and equivalent thickness-----------37
5.3    Equivalence between PMMA phantoms and breasts--------------------38

CHAPTER 4    Investigation of age-related changes in average glandular dose------------------------------------------------------46
1    Background--------------------------------------------------------------46
2    Motivation--------------------------------------------------------------46
3    Materials and method----------------------------------------------------47
3.1    Patient data and baseline measurement----------------------------------47
3.2    Assessments of AGD----------------------------------------------------47
4    Results-------------------------------------------------------------------48
4.1    Performance of the X-ray unit and beam quality of patient exposures--48
4.2    Variations of breast parameters and conversion factors with age-------48
4.3    Variations of breast doses with age--------------------------------------49
5    Discussion---------------------------------------------------------------49
5.1    Age-related changes in breast parameters and beam quality------------49
5.2    Variations in conversion factors-----------------------------------------50
5.3    Age-related changes in breast doses-------------------------------------51
5.4    Uncertainty in AGD assessment-----------------------------------------52

CHAPTER 5    Development of an imaging-planning program for short chest-wall-to-nipple-distance breasts--------------62
1    Background--------------------------------------------------------------62
2    Motivation--------------------------------------------------------------62
3    Materials and method----------------------------------------------------63
3.1    Instruments--------------------------------------------------------------63
3.2    Image quality assessment for various tube loadings--------------------63
3.3    Development of the imaging-planning program------------------------64
3.4    Verifications of the imaging-planning program-------------------------65
4    Results-------------------------------------------------------------------67
4.1    Variations in image quality correlated with tube loadings--------------67
4.2    Basic data for the imaging-planning program---------------------------67
4.3    Verifications of the imaging-planning program-------------------------68

5    Discussion---------------------------------------------------------------69
5.1    Uncertainty analysis-----------------------------------------------------69
5.2    Variations in image quality correlated with tube loadings--------------69
5.3    Equivalence between thickness of PMMA phantom and CBT----------70
5.4    The imaging-planning program-----------------------------------------70
5.5    Verification of the imaging-planning program--------------------------71
5.6    Clinical application and generalization----------------------------------72

CHAPTER 6    Conclusions and future works--------------------------------83
1    Conclusions--------------------------------------------------------------83
2    Future works-------------------------------------------------------------84

Acknowledgements--------------------------------------------------------------86
References-----------------------------------------------------------------------------------87
List of Publications-----------------------------------------------------------------------91

                                

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