Determination of backscatter factors in breast tomosynthesis using MCNPX simulations and measurements.

The perspective of adding digital breast tomosynthesis (DBT) to standard mammography in screening raises concerns regarding the dose absorbed by the fibroglandular breast tissue. Thus, it is important to estimate accurately the mean glandular dose (MGD), although there are no standard protocols for dosimetry, concerning DBT. This study aims at introducing backscatter factors (BSF) to calculate the entrance surface air kerma (ESAK), directly on patients or phantoms, in order to be introduced in the formalism proposed by Dance et al. MCNPX simulations were performed, to mimic a DBT acquisition, for a wide range of X-ray spectra. A homogeneous breast phantom with 50 % of glandular tissue was considered and several thicknesses were evaluated. Dose measurements were performed, to validate and support the simulation results. The BSF may indicate a real MGD estimation in vivo for DBT examinations and contribute for the improvement of the current guidelines used in these applications.

Optimal photon energy comparison between digital breast tomosynthesis and mammography: a case study.

A comparison, in terms of the optimal energy that maximizes the image quality between digital breast tomosynthesis (DBT) and digital mammography (DM) was performed in a MAMMOMAT Inspiration system (Siemens) based on amorphous selenium flat panel detector. In this paper we measured the image quality by the signal difference-to-noise ratio (SDNR), and the patient risk by the mean glandular dose (MGD). Using these quantities we compared the optimal voltage that maximizes the image quality both in breast tomosynthesis and standard mammography acquisition mode. The comparison for the two acquisition modes was performed for a W/Rh anode filter combinations by using a 4.5 cm tissue equivalent mammography phantom. Moreover, in order to check if the used equipment was quantum noise limited, the relation of the relative noise with respect to the detector dose was evaluated. Results showed that in the tomosynthesis acquisition mode the optimal voltage is 28 kV, whereas in standard mammography the optimal voltage is 30 kV. The automatic exposure control (AEC) of the system selects 28 kV as optimal voltage both for DBT and DM. Monte Carlo simulations showed a qualitative agreement with the AEC selection system, since an optimal monochromatic energy of 20 keV was found both for DBT and DM. Moreover, the check about the noise showed that the system is not completely quantum noise limited, and this issue could explain the experimental slight difference in terms of optimal voltage between DBT and DM. According to these results, the use of higher voltage settings is not justified for the improvement of the image quality during a DBT examination.