Dataset Information

Evaluation of pressure-controlled mammography compression paddles with respect to force-controlled compression paddles in clinical practice.

ABSTRACT:

Objectives

To reduce pain and discomfort associated with breast compression in mammography, a pressure-controlled compression paddle was recently introduced. The objective was to evaluate the pressure-controlled paddle by comparing it to the standard force-controlled paddle.

Methods

Differences of compressed breast thickness (CBT), compression force, compression pressure, and average glandular dose (AGD) between annual follow-up full-field digital mammography exams of 3188 patients were retrospectively examined. Two groups were compared: (1) force-force group (FF-group), both examinations were performed with the force-controlled paddle, and (2) force-pressure group (FP-group), only the follow-up examination was performed with the pressure-controlled paddle. In an additional group of patients, pain scores on a scale of 0 (no pain at all) to 10 (worst pain imaginable) were evaluated prospectively (n?=?343) who were randomly assigned to either paddle.

Results

Median differences between follow-up exams in CBT, compression force, compression pressure, and AGD were for the FF- and FP-group respectively -?1.0 vs 0.0 mm (p??±?2 mm; ?force >?±?2 daN; ?pressure >?±?1 kPa and ?AGD >?±?0.1 mGy). The subanalysis dividing CBT into five categories revealed similar results. The median [interquartile range] pain scores were 6 [3, 7] and 5 [3, 7] for the force-controlled and pressure-controlled paddle, respectively, which was not significantly different (p?=?0.113).

Conclusions

We observed no clinically relevant differences in CBT, compression force, compression pressure, AGD, or pain score between the force- and pressure-controlled paddle. As such, we found no basis for preferring one paddle over the other.

Key points

• The pressure-controlled paddle did not show any clinically relevant changes in breast compression parameters compared to the force-controlled paddle. • The pressure-controlled paddle did not lead to significant reduction in pain scores indicated by the patients compared to the force-controlled paddle. • A large variation in compression force and compression pressure was observed in mammography exams for the both the force- and pressure-controlled compression paddle.

SUBMITTER: Jeukens CRLPN

PROVIDER: S-EPMC6443616 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Evaluation of pressure-controlled mammography compression paddles with respect to force-controlled compression paddles in clinical practice.

Jeukens C R L P N CRLPN van Dijk T T Berben C C Wildberger J E JE Lobbes M B I MBI

European radiology 20190107 5

<h4>Objectives</h4>To reduce pain and discomfort associated with breast compression in mammography, a pressure-controlled compression paddle was recently introduced. The objective was to evaluate the pressure-controlled paddle by comparing it to the standard force-controlled paddle.<h4>Methods</h4>Differences of compressed breast thickness (CBT), compression force, compression pressure, and average glandular dose (AGD) between annual follow-up full-field digital mammography exams of 3188 patient ...[more]

PMID: 30617472

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Project description:Importance:Many women dread undergoing mammography, and some may not attend or reattend breast cancer screening because of the discomfort or pain induced by breast compression. Objective:To evaluate the noninferiority of the self-compression mammography technique for reducing breast thickness compared with standard compression. Design, Setting, and Participants:This prospective, parallel-group, noninferiority randomized clinical trial was conducted from May 7, 2013, to October 26, 2015, at 6 cancer care centers in France. Participants were women aged 50 to 75 years, without a history of recent breast surgical procedure or treatment, and who could perform self-compression. Analyses were performed on intention-to-treat basis from January 27, 2017, to March 30, 2018. Interventions:Patients were randomized 1:1 to the self-compression group or the standard compression group. Main Outcomes and Measures:Primary end point was breast thickness expressed as the mean of 4 views: right and left craniocaudal and right and left mediolateral oblique. The predefined noninferiority margin was a difference of 3 mm, with a 1-sided 95% CI. Secondary end points included compression force, image quality, requirement for additional views, pain, and patient satisfaction and radiographer assessment questionnaires. Results:Among the 549 women randomized, 548 (97.3%) completed the trial. Of these, 275 (48.8%) (mean [SD] age, 61.35 [6.34] years) were randomized to the self-compression arm and 273 (48.5%) (mean [SD] age, 60.84 [6.41] years) to the standard compression arm. The difference in the mean thickness between the 2 arms was lower than the noninferiority margin, with an upper 1-sided 95% CI less than 3 mm (-0.17; 95% CI,-∞ to 1.89 mm; P < .05). Compression force was higher in the self-compression group compared with the standard compression arm for the 4 mammographic views. Pain was statistically significantly lower in the self-compression group (n = 274) compared with the standard compression group (n = 269) (median [interquartile range (IQR)] score, 2 [1-5] vs 3 [1-5]; P = .009). No difference was reported in the image quality scores of the 2 groups or in the number of additional views performed (median [IQR] extra views, 2 [2-2] vs 2 [2-3] extra views; P = .64), whatever the indication, including insufficient image quality (29 [16.8%] vs 27 [15.0%] insufficient quality views; P = .65). No adverse effects or pain were reported by the participants after the self-compression mammography. Conclusions and Relevance:Self-compression does not appear to be inferior to standard compression mammography in achieving minimal breast thickness without increasing pain or compromising image quality; this technique may be an effective option for women who want to be involved in their breast examination. Trial Registration:ClinicalTrials.gov identifier: NCT02866591.

Project description:Muscle activity and fatigue performance parameters were obtained and compared between both a smart compression garment and the gold-standard, a surface electromyography (EMG) system during high-speed cycling in seven participants. The smart compression garment, based on force myography (FMG), comprised of integrated pressure sensors that were sandwiched between skin and garment, located on five thigh muscles. The muscle activity was assessed by means of crank cycle diagrams (polar plots) that displayed the muscle activity relative to the crank cycle. The fatigue was assessed by means of the median frequency of the power spectrum of the EMG signal; the fractal dimension (FD) of the EMG signal; and the FD of the pressure signal. The smart compression garment returned performance parameters (muscle activity and fatigue) comparable to the surface EMG. The major differences were that the EMG measured the electrical activity, whereas the pressure sensor measured the mechanical activity. As such, there was a phase shift between electrical and mechanical signals, with the electrical signals preceding the mechanical counterparts in most cases. This is specifically pronounced in high-speed cycling. The fatigue trend over the duration of the cycling exercise was clearly reflected in the fatigue parameters (FDs and median frequency) obtained from pressure and EMG signals. The fatigue parameter of the pressure signal (FD) showed a higher time dependency (R2 = 0.84) compared to the EMG signal. This reflects that the pressure signal puts more emphasis on the fatigue as a function of time rather than on the origin of fatigue (e.g., peripheral or central fatigue). In light of the high-speed activity results, caution should be exerted when using data obtained from EMG for biomechanical models. In contrast to EMG data, activity data obtained from FMG are considered more appropriate and accurate as an input for biomechanical modeling as they truly reflect the mechanical muscle activity. In summary, the smart compression garment based on FMG is a valid alternative to EMG-garments and provides more accurate results at high-speed activity (avoiding the electro-mechanical delay), as well as clearly measures the progress of muscle fatigue over time.

Dataset Information

Evaluation of pressure-controlled mammography compression paddles with respect to force-controlled compression paddles in clinical practice.

Objectives

Methods

Results

Conclusions

Key points

Publications

Evaluation of pressure-controlled mammography compression paddles with respect to force-controlled compression paddles in clinical practice.

Similar Datasets

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