Investigation of the dose distribution for a cone beam CT system dedicated to breast imaging

Comparisons of glandular breast dose between digital mammography, tomosynthesis and breast CT based on anthropomorphic patient-derived breast phantoms

PURPOSE

To evaluate the bias to the mean glandular dose (MGD) estimates introduced by the homogeneous breast models in digital breast tomosynthesis (DBT) and to have an insight into the glandular dose distributions in 2D (digital mammography, DM) and 3D (DBT and breast dedicated CT, BCT) x-ray breast imaging by employing breast models with realistic glandular tissue distribution and organ silhouette.

METHODS

A Monte Carlo software for DM, DBT and BCT simulations was adopted for the evaluation of glandular dose distribution in 60 computational anthropomorphic phantoms. These computational phantoms were derived from 3D breast images acquired via a clinical BCT scanner.

RESULTS

g·c·s·T conversion coefficients based on homogeneous breast model led to a MGD overestimate of 18% in DBT when compared to MGD estimated via anthropomorphic phantoms; this overestimate increased up to 21% for recently computed DgN_DBT conversion coefficients. The standard deviation of the glandular dose distribution in BCT resulted 60% lower than in DM and 55% lower than in DBT. The glandular dose peak - evaluated as the average value over the 5% of the gland receiving the highest dose - is 2.8 times the MGD in DM, this factor reducing to 2.6 and 1.6 in DBT and BCT, respectively.

CONCLUSIONS

Conventional conversion coefficients for MGD estimates based on homogeneous breast models overestimate MGD by 18%, when compared to MGD estimated via anthropomorphic phantoms. The ratio between the peak glandular dose and the MGD is 2.8 in DM. This ratio is 8% and 75% higher than in DBT and BCT, respectively.

Evaluation of Dose Homogeneity in Cone-Beam Breast Computed Tomography

The aim of this study is to determine, via measurements on phantoms and Monte Carlo (MC) simulations, the dose distribution of absorbed dose in a cone-beam breast computed tomography scan. The absorbed dose volume distribution was measured inside a polyethylene cylindrical phantom, simulating adipose breast tissue, using LiF:Mg,Ti thermoluminescence dosimeters. A reasonable agreement (between 2 and 8%) between the simulated and measured data was observed. The 3D distribution of absorbed dose was evaluated at 40, 60 and 80 kV in a phantom simulating a pendant breast. MC simulations indicate a significantly lower spread of volume dose than in mammography. The dose variation along the radial distance in the simulated phantoms was in the range of 4‒14%. These findings might be useful when devising models for breast imaging dose assessment that take into account the uneven distribution of the glandular mass in the breast volume.

Evaluation of the BreastSimulator software platform for breast tomography

The aim of this work was the evaluation of the software BreastSimulator, a breast x-ray imaging simulation software, as a tool for the creation of 3D uncompressed breast digital models and for the simulation and the optimization of computed tomography (CT) scanners dedicated to the breast. Eight 3D digital breast phantoms were created with glandular fractions in the range 10%-35%. The models are characterised by different sizes and modelled realistic anatomical features. X-ray CT projections were simulated for a dedicated cone-beam CT scanner and reconstructed with the FDK algorithm. X-ray projection images were simulated for 5 mono-energetic (27, 32, 35, 43 and 51 keV) and 3 poly-energetic x-ray spectra typically employed in current CT scanners dedicated to the breast (49, 60, or 80 kVp). Clinical CT images acquired from two different clinical breast CT scanners were used for comparison purposes. The quantitative evaluation included calculation of the power-law exponent, β, from simulated and real breast tomograms, based on the power spectrum fitted with a function of the spatial frequency, f, of the form S(f)  =  α/f   ^β . The breast models were validated by comparison against clinical breast CT and published data. We found that the calculated β coefficients were close to that of clinical CT data from a dedicated breast CT scanner and reported data in the literature. In evaluating the software package BreastSimulator to generate breast models suitable for use with breast CT imaging, we found that the breast phantoms produced with the software tool can reproduce the anatomical structure of real breasts, as evaluated by calculating the β exponent from the power spectral analysis of simulated images. As such, this research tool might contribute considerably to the further development, testing and optimisation of breast CT imaging techniques.

A model-based approach of scatter dose contributions and efficiency of apron shielding for radiation protection in CT

Given the contribution of scattered radiations to patient dose in CT, apron shielding is often used for radiation protection. In this study the efficiency of apron was assessed with a model-based approach of the contributions of the four scatter sources in CT, i.e. external scattered radiations from the tube and table, internal scatter from the patient and backscatter from the shielding. For this purpose, CTDI phantoms filled with thermoluminescent dosimeters were scanned without apron, and then with an apron at 0, 2.5 and 5 cm from the primary field. Scatter from the tube was measured separately in air. The scatter contributions were separated and mathematically modelled. The protective efficiency of the apron was low, only 1.5% in scatter dose reduction on average. The apron at 0 cm from the beam lowered the dose by 7.5% at the phantom bottom but increased the dose by 2% at the top (backscatter) and did not affect the centre. When the apron was placed at 2.5 or 5 cm, the results were intermediate to the one obtained with the shielding at 0 cm and without shielding. The apron effectiveness is finally limited to the small fraction of external scattered radiation.