title: Adverse effects of increased body weight on quantitative measures of mammographic image quality.
abstract: OBJECTIVE
  The purpose of our study was to show that compressed breast thickness on mammograms in overweight and obese women exceeds the thickness in normal-weight women and that increased thickness results in image degradation.
  
  
  METHODS
  Three hundred consecutive routine mammograms were reviewed. Patients were categorized according to body mass index. Compression thickness, compressive force, kilovoltage, and milliampere-seconds were recorded. Geometric unsharpness and contrast degradation were calculated for each body mass index category.
  
  
  RESULTS
  Body mass index categories were lean (3%), normal (36%), overweight (36%), and obese (25%). Body mass index was directly correlated with compressed thickness. In the mediolateral oblique view, the mean thickness of the obese category exceeded normal thickness by 18 mm (p < 0.01), corresponding to a 32% increase in geometric unsharpness. Mean obese thickness exceeded lean thickness by 33 mm (p < 0.01), corresponding to a 79% increase in unsharpness. Similar trends were observed for the craniocaudal view. In the mediolateral oblique projection, there was an increase of 1.0 kVp (p < 0.01) for obese compared with normal and 1.7 kVp (p < 0.01) between lean and obese, corresponding, respectively, to a 16% and a 25% decrease in image contrast because of scatter and kilovoltage changes. Milliampere-seconds increased by 47% on the mediolateral oblique images in the obese category compared with normal body mass index.
  
  
  CONCLUSIONS
  An increased body mass index was associated with greater compressed breast thickness, resulting in increased geometric unsharpness, decreased image contrast, and greater potential for motion unsharpness.
authors.affiliation: All authors: Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0326, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Guest
authors.forename: M A
authors.initials: MA
authors.lastname: Helvie
authors.forename: H P
authors.initials: HP
authors.lastname: Chan
authors.forename: L M
authors.initials: LM
authors.lastname: Hadjiiski
authors.forename: J E
authors.initials: JE
authors.lastname: Bailey
authors.forename: M A
authors.initials: MA
authors.lastname: Roubidoux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D004560:Electricity; D005260:Female; D006801:Humans; D008327:Mammography / Q000592:standards* / Q000706:statistics & numerical data*; D008875:Middle Aged; D009765:Obesity