8 research outputs found
Practitioner compression force variability in mammography : a preliminary study
Objective: This preliminary study determines
whether the absolute amount of breast compression
in mammography varies between
and within practitioners.
Methods: Ethics approval was granted. 488
clients met the inclusion criteria. Clients were
imaged by 14 practitioners. Collated data included
Breast Imaging Reporting and Data
System (BI-RADS) density, breast volume,
compression and practitioner code.
Results: A highly significant difference in
mean compression used by different practitioners
(p,0.0001 for each BI-RADS density)
was demonstrated. Practitioners applied compression
in one of three ways using either low,
intermediate or high compression force, with
no significant difference in mean compression
within each group (p50.99, p50.70, p50.54,
respectively). Six practitioners showed a significant
correlation (p,0.05) between compression
and BI-RADS grade, with a tendency
to apply less compression with increasing
BI-RADS density. When compression was
analysed by breast volume there was a wide
variation in compression for a given volume.
The general trend was the application of
higher compression to larger breast volumes
by all three practitioner groups.
Conclusion: This study presents an insight
into practitioner variation of compression
application in mammography. Three groups
of practitioners were identified: those who
used low, intermediate and high compression
across the BI-RADS density grades. There
was wide variation in compression for any
given breast volume, with trends of higher
compression demonstrated for increasing
breast volumes. Collation of further studies
will facilitate a new perspective on the analysis
of practitioner, client and equipment
variables in mammography imaging.
Advances in knowledge: For the first time, it
has been practically demonstrated that practitioners
vary in the amount of compression
applied to breast tissue during routine
mammography
Overview of the radiographers’ practice in 65 healthcare centers using digital mammography systems in Portugal
Purpose: To assess current practices in digital mammography (DM) in Portuguese healthcare providers using digital systems. To investigate compliance with European standards regarding mean glandular dose and quality control practice and to identify optimisation needs. Methods: Two questionnaires, targeted at breast radiographers and chief radiographers, were designed and applied in 65 imaging departments offering DM. Questions fielded were focused on the staff profile and technical/ clinical practice. Results: Prior to starting their activity in DM, 70% (82 out of 118) of the respondents received training in DM. The practice in 29 out of 59 providers was established by the manufacturers’ recommendations for image acquisition. Variations were observed between radiographers who belong to the same provider namely the selection of exposure parameters such as the target-filter combination and automatic mode. The use of the manual exposure mode was reported for imaging breast implants (44%) and surgical specimens (22%). The main causes of repeat examinations were skin folding (21%) and absence of pectoral muscle (PM) (20%). Conclusions: The study revealed opportunities to optimise radiographers’ practice in DM regarding the selection of exposure parameters. A robust and consistent training programme in DM and established local protocols can help to reduce the variations observed and improve clinical practice