28 August 1984 Digital Subtraction Angiography (DSA) Techniques For The Evaluation Of Breast Lesions
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Abstract
Digital subtraction angiography of the breast may permit the differentiation of benign and malignant breast lesions. We have developed specific techniques for performing DSAB. The patient is examined in an oblique prone position with the involved breast in an immobilization device of our own design. The immobilization device adapts to our angiographic patient table and provides a water bolus with slight compression. The central ray of the x-ray beam is positioned for a lateral view of the breast, similar to the lateral view obtained in a mammogram. Iodinated contrast is injected from a catheter position in the superior vena cava. A kilovoltage of 50 kVp is employed which produces a near optimal signal to noise ratio for iodine contrast. The iodine signal to noise ratio characteristics of breast DSA have been modeled using a computer program which estimates the x-ray spectrum, filtration effects(tube, tissue, iodine, and grid), and image intensifier energy absorption. The energy absorbed in the input phosphor of the image intensifier is determined using a Monte Carlo radiation transport technique. Images are acquired in a 512 x 512 x 10 matrix with a 9" image intensifier using a geometric magnification of approximately 2. Typically, 10 mAs per exposure is required. A maximum of 40 exposures are made in three phases totalling 5 minutes. The average absorbed dose to the breast for a single exposure is 48 millirads (6 cm thickness) as determined by a Monte Carlo radiation transport computation of energy absorbed in breast tissue.
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Michael J. Flynn, Laurens Ackerman, Scott Wilderman, Roger Block, Christine Watt, Matt Burke, P. C. Shetty, "Digital Subtraction Angiography (DSA) Techniques For The Evaluation Of Breast Lesions", Proc. SPIE 0486, Medical Imaging and Instrumentation '84, (28 August 1984); doi: 10.1117/12.943209; https://doi.org/10.1117/12.943209
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