Background A curve-shaped compression paddle could reduce the pain experienced by some women at breast cancer screening. Purpose To compare curved and standard compression systems in terms of pain experience and image quality in mammography screening. Materials and Methods In this randomized controlled trial conducted between October 2021 and February 2022, participants screened at three screening sites in the Netherlands were randomized to either a curved-paddle or sham-paddle group. The sham paddle was a standard paddle that was presented as a new paddle. At a standard screening examination, one additional image was acquired with a curved or sham paddle. Pain was measured on a numerical rating scale (range, 0-10). Participants provided a pain score after compression with the standard and test paddles, resulting in two scores per participant. Differences in pain scores were compared between groups using analysis of covariance, adjusting for pain score after standard-paddle compression. Two radiographers and two radiologists performed unblinded paired comparisons of curved-paddle vs standard-paddle images, using standard image quality criteria (radiographers evaluated 1246 image pairs using 12 criteria; radiologists evaluated 320 image pairs using six criteria). The one-sample Wilcoxon signed-rank test was used to determine if there was a significant preference for either paddle. Results In total, 2499 female participants (mean age, 61.6 years ± 7.1 [SD]) were studied; 1250 in the curved-paddle group and 1249 in the sham-paddle group. The mean pain score decreased by an additional 0.19 points in the curved-paddle group compared with the sham-paddle group (95% CI: 0.09, 0.28; P < .001). In terms of image quality, the observers showed no preference or a preference for the standard paddle. Decreased image contrast (range Bonferroni-corrected P values: P < .001 to P > .99) and visibility of structures were the main concerns for curved-paddle images. Conclusion The use of the curved paddle resulted in a minimal pain reduction during mammography breast compression but image quality was reduced. © RSNA, 2024 Supplemental material is available for this article.

中文翻译：

---

乳腺癌筛查乳房 X 光检查的弯曲与标准压缩的疼痛体验和图像质量：随机对照试验。


背景 曲线形压缩板可以减轻一些女性在乳腺癌筛查中所经历的疼痛。目的 比较弯曲和标准加压系统在乳房 X 光检查中的疼痛体验和图像质量。材料和方法 在 2021 年 10 月至 2022 年 2 月期间进行的这项随机对照试验中，在荷兰三个筛查地点进行筛查的参与者被随机分为弯曲桨组或假桨组。假桨是作为新桨呈现的标准桨。在标准筛选检查中，使用弯曲桨或假桨获取另一幅图像。疼痛通过数字评定量表（范围：0-10）进行测量。参与者在使用标准板和测试板加压后提供疼痛评分，每个参与者得到两个分数。使用协方差分析比较各组之间疼痛评分的差异，并在标准桨压缩后调整疼痛评分。两名放射技师和两名放射科医生使用标准图像质量标准对弯曲桨图像与标准桨图像进行非盲配对比较（放射技师使用 12 个标准评估 1246 个图像对；放射科医生使用 6 个标准评估 320 个图像对）。使用单样本 Wilcoxon 符号秩检验来确定是否对任一桨有显着偏好。结果 总共对 2499 名女性参与者（平均年龄，61.6 岁 ± 7.1 [SD]）进行了研究；弯曲桨组有 1250 个，假桨组有 1249 个。与假桨组相比，弯曲桨组的平均疼痛评分额外降低了 0.19 分（95% CI：0.09, 0.28；P < .001）。 在图像质量方面，观察者对标准桨没有表现出偏好或偏好。图像对比度降低（Bonferroni 校正 P 值范围：P < .001 至 P > .99）和结构可见性是弯曲桨图像的主要问题。结论 使用弯曲桨可以最大限度地减少乳房 X 光检查乳房压迫过程中的疼痛，但图像质量有所下降。 © RSNA，2024 本文提供补充材料。