Characterization of the homogeneous tissue mixture approximation in breast imaging dosimetry

Sechopoulos, Ioannis; Bliznakova, Kristina; Xulei, Qin; Baowei, Fei; Feng, Steve Si Jia

doi:10.1118/1.4737025

Title: Characterization of the homogeneous tissue mixture approximation in breast imaging dosimetry

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Abstract

Purpose: To compare the estimate of normalized glandular dose in mammography and breast CT imaging obtained using the actual glandular tissue distribution in the breast to that obtained using the homogeneous tissue mixture approximation. Methods: Twenty volumetric images of patient breasts were acquired with a dedicated breast CT prototype system and the voxels in the breast CT images were automatically classified into skin, adipose, and glandular tissue. The breasts in the classified images underwent simulated mechanical compression to mimic the conditions present during mammographic acquisition. The compressed thickness for each breast was set to that achieved during each patient's last screening cranio-caudal (CC) acquisition. The volumetric glandular density of each breast was computed using both the compressed and uncompressed classified images, and additional images were created in which all voxels representing adipose and glandular tissue were replaced by a homogeneous mixture of these two tissues in a proportion corresponding to each breast's volumetric glandular density. All four breast images (compressed and uncompressed; heterogeneous and homogeneous tissue) were input into Monte Carlo simulations to estimate the normalized glandular dose during mammography (compressed breasts) and dedicated breast CT (uncompressed breasts). For the mammography simulations the x-ray spectra used was that used duringmore »« less

Authors:

Sechopoulos, Ioannis; Bliznakova, Kristina; Xulei, Qin; Baowei, Fei; Feng, Steve Si Jia ^[1]

Department of Radiology and Imaging Sciences and Winship Cancer Institute, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 (United States)

Publication Date:: Wed Aug 15 00:00:00 EDT 2012

OSTI Identifier:: 22098955

Resource Type:: Journal Article

Journal Name:: Medical Physics

Additional Journal Information:: Journal Volume: 39; Journal Issue: 8; Other Information: (c) 2012 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0094-2405

Country of Publication:: United States

Language:: English

Subject:: 61 RADIATION PROTECTION AND DOSIMETRY; 60 APPLIED LIFE SCIENCES; APPROXIMATIONS; BIOMEDICAL RADIOGRAPHY; CAT SCANNING; CLASSIFICATION; COMPUTERIZED SIMULATION; DOSIMETRY; HEALTH HAZARDS; HOMOGENEOUS MIXTURES; IMAGES; MAMMARY GLANDS; METRICS; MONTE CARLO METHOD; PATIENTS; RADIATION DOSES; SKIN; TISSUE DISTRIBUTION; X RADIATION; X-RAY SPECTRA

Citation Formats


                    Sechopoulos, Ioannis, Bliznakova, Kristina, Xulei, Qin, Baowei, Fei, Feng, Steve Si Jia, Department of Medical Physics, University of Patras School of Health Sciences, 26500 Rio-Patras, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322, and Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 and Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia 30322. Characterization of the homogeneous tissue mixture approximation in breast imaging dosimetry.  United States: N. p., 2012. 
        Web.  doi:10.1118/1.4737025.

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                    Sechopoulos, Ioannis, Bliznakova, Kristina, Xulei, Qin, Baowei, Fei, Feng, Steve Si Jia, Department of Medical Physics, University of Patras School of Health Sciences, 26500 Rio-Patras, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322, & Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 and Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia 30322. Characterization of the homogeneous tissue mixture approximation in breast imaging dosimetry.  United States.  https://doi.org/10.1118/1.4737025

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                    Sechopoulos, Ioannis, Bliznakova, Kristina, Xulei, Qin, Baowei, Fei, Feng, Steve Si Jia, Department of Medical Physics, University of Patras School of Health Sciences, 26500 Rio-Patras, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322, and Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 and Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia 30322. 2012.  
        "Characterization of the homogeneous tissue mixture approximation in breast imaging dosimetry".  United States.  https://doi.org/10.1118/1.4737025.

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@article{osti_22098955,

  title        = {Characterization of the homogeneous tissue mixture approximation in breast imaging dosimetry},

  author       = {Sechopoulos, Ioannis and Bliznakova, Kristina and Xulei, Qin and Baowei, Fei and Feng, Steve Si Jia and Department of Medical Physics, University of Patras School of Health Sciences, 26500 Rio-Patras and Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 and Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 and Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia 30322},

  abstractNote = {Purpose: To compare the estimate of normalized glandular dose in mammography and breast CT imaging obtained using the actual glandular tissue distribution in the breast to that obtained using the homogeneous tissue mixture approximation. Methods: Twenty volumetric images of patient breasts were acquired with a dedicated breast CT prototype system and the voxels in the breast CT images were automatically classified into skin, adipose, and glandular tissue. The breasts in the classified images underwent simulated mechanical compression to mimic the conditions present during mammographic acquisition. The compressed thickness for each breast was set to that achieved during each patient's last screening cranio-caudal (CC) acquisition. The volumetric glandular density of each breast was computed using both the compressed and uncompressed classified images, and additional images were created in which all voxels representing adipose and glandular tissue were replaced by a homogeneous mixture of these two tissues in a proportion corresponding to each breast's volumetric glandular density. All four breast images (compressed and uncompressed; heterogeneous and homogeneous tissue) were input into Monte Carlo simulations to estimate the normalized glandular dose during mammography (compressed breasts) and dedicated breast CT (uncompressed breasts). For the mammography simulations the x-ray spectra used was that used during each patient's last screening CC acquisition. For the breast CT simulations, two x-ray spectra were used, corresponding to the x-ray spectra with the lowest and highest energies currently being used in dedicated breast CT prototype systems under clinical investigation. The resulting normalized glandular dose for the heterogeneous and homogeneous versions of each breast for each modality was compared. Results: For mammography, the normalized glandular dose based on the homogeneous tissue approximation was, on average, 27% higher than that estimated using the true heterogeneous glandular tissue distribution (Wilcoxon Signed Rank Test p= 0.00046). For dedicated breast CT, the overestimation of normalized glandular dose was, on average, 8% (49 kVp spectrum, p= 0.00045) and 4% (80 kVp spectrum, p= 0.000089). Only two cases in mammography and two cases in dedicated breast CT with a tube voltage of 49 kVp resulted in lower dose estimates for the homogeneous tissue approximation compared to the heterogeneous tissue distribution. Conclusions: The normalized glandular dose based on the homogeneous tissue mixture approximation results in a significant overestimation of dose to the imaged breast. This overestimation impacts the use of dose estimates in absolute terms, such as for risk estimates, and may impact some comparative studies, such as when modalities or techniques with different x-ray energies are used. The error introduced by the homogeneous tissue mixture approximation in higher energy x-ray modalities, such as dedicated breast CT, although statistically significant, may not be of clinical concern. Further work is required to better characterize this overestimation and potentially develop new metrics or correction factors to better estimate the true glandular dose to breasts undergoing imaging with ionizing radiation.},

  doi          = {10.1118/1.4737025},

  url          = {https://www.osti.gov/biblio/22098955},
  journal      = {Medical Physics},

  issn         = {0094-2405},

  number       = 8,

  volume       = 39,

  place        = {United States},

  year         = {Wed Aug 15 00:00:00 EDT 2012},

  month        = {Wed Aug 15 00:00:00 EDT 2012}

}

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