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Title: TU-D-209-01: Dosimetry of Diagnostic Work Up Mammography

Abstract

Purpose: To investigate patient average glandular dose (AGD) characteristics of diagnostic mammography. Methods: The techniques used to image 14420 patients who received diagnostic work up mammography from October 2008 to December 2014 at one academic hospital were retrospectively collected. The most common diagnostic views and the techniques used for each according to compressed breast thickness were determined. For all techniques, 1st half value layer and air kerma output per tube current-exposure time product were measured; then the incident air kerma for each acquisition was calculated. The values for normalized glandular dose (DgN) were obtained with a validated Monte Carlo simulation of mammographic acquisition. The mono-energetic DgN results were combined according to relative fluence using the TASMICS model to obtain DgN coefficients for each spectrum. The spectral DgN and calculated incident air kerma were used to estimate AGD of patients with breast thickness ranging from 2 to 8 cm. Results: The most common views utilized during diagnostic mammography were magnification craniocaudal (24%), magnification mediolateral (19%), spot craniocaudal (28%), and spot mediolateral oblique (24%). The AGD increased with increasing breast thickness for both the magnification and spot views. The AGD for a 5.5 cm thick breast was approximately 6.8 mGy and 2.2more » mGy for the magnification and spot views, respectively. The AGD ranged from 3.6 mGy to 6.8 mGy for the magnification views and from 1.0 mGy to 3.1 mGy for spot views. The difference in AGD between the two magnification views or the two spot views was not significant. Conclusion: These results provide information on breast dose to which screening recalled women are exposed to. In addition to understanding the dose used for common clinical imaging tests, this data could be used when comparing use of mammography for diagnostic workup to other potential modalities, such as breast tomosynthesis and breast CT.« less

Authors:
 [1];  [2]
  1. Emory University, Atlanta, GA (United States)
  2. Radboud University Medical Centre, Nijmegen (Netherlands)
Publication Date:
OSTI Identifier:
22653973
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED SIMULATION; KERMA; MAMMARY GLANDS; MONTE CARLO METHOD; PATIENTS; RADIATION DOSES; THICKNESS

Citation Formats

Jallow, N, and Sechopoulos, I. TU-D-209-01: Dosimetry of Diagnostic Work Up Mammography. United States: N. p., 2016. Web. doi:10.1118/1.4957502.
Jallow, N, & Sechopoulos, I. TU-D-209-01: Dosimetry of Diagnostic Work Up Mammography. United States. doi:10.1118/1.4957502.
Jallow, N, and Sechopoulos, I. 2016. "TU-D-209-01: Dosimetry of Diagnostic Work Up Mammography". United States. doi:10.1118/1.4957502.
@article{osti_22653973,
title = {TU-D-209-01: Dosimetry of Diagnostic Work Up Mammography},
author = {Jallow, N and Sechopoulos, I},
abstractNote = {Purpose: To investigate patient average glandular dose (AGD) characteristics of diagnostic mammography. Methods: The techniques used to image 14420 patients who received diagnostic work up mammography from October 2008 to December 2014 at one academic hospital were retrospectively collected. The most common diagnostic views and the techniques used for each according to compressed breast thickness were determined. For all techniques, 1st half value layer and air kerma output per tube current-exposure time product were measured; then the incident air kerma for each acquisition was calculated. The values for normalized glandular dose (DgN) were obtained with a validated Monte Carlo simulation of mammographic acquisition. The mono-energetic DgN results were combined according to relative fluence using the TASMICS model to obtain DgN coefficients for each spectrum. The spectral DgN and calculated incident air kerma were used to estimate AGD of patients with breast thickness ranging from 2 to 8 cm. Results: The most common views utilized during diagnostic mammography were magnification craniocaudal (24%), magnification mediolateral (19%), spot craniocaudal (28%), and spot mediolateral oblique (24%). The AGD increased with increasing breast thickness for both the magnification and spot views. The AGD for a 5.5 cm thick breast was approximately 6.8 mGy and 2.2 mGy for the magnification and spot views, respectively. The AGD ranged from 3.6 mGy to 6.8 mGy for the magnification views and from 1.0 mGy to 3.1 mGy for spot views. The difference in AGD between the two magnification views or the two spot views was not significant. Conclusion: These results provide information on breast dose to which screening recalled women are exposed to. In addition to understanding the dose used for common clinical imaging tests, this data could be used when comparing use of mammography for diagnostic workup to other potential modalities, such as breast tomosynthesis and breast CT.},
doi = {10.1118/1.4957502},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels. Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from 4 Radiology residents and 2 breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADsmore » images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated. Results: Diagnostic error can be predicted reliably by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model (AUC=0.79). Personalized user modeling was far more accurate for the more experienced readers (average AUC of 0.837 0.029) than for the less experienced ones (average AUC of 0.667 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features. Conclusions: Diagnostic errors in mammography can be predicted reliably by leveraging the radiologists gaze behavior and image content.« less
  • Different computational methods based on empirical or semi-empirical models and sophisticated Monte Carlo calculations have been proposed for prediction of x-ray spectra both in diagnostic radiology and mammography. In this work, the x-ray spectra predicted by various computational models used in the diagnostic radiology and mammography energy range have been assessed by comparison with measured spectra and their effect on the calculation of absorbed dose and effective dose (ED) imparted to the adult ORNL hermaphroditic phantom quantified. This includes empirical models (TASMIP and MASMIP), semi-empirical models (X-rayb and m, X-raytbc, XCOMP, IPEM, Tucker et al., and Blough et al.), andmore » Monte Carlo modeling (EGS4, ITS3.0, and MCNP4C). As part of the comparative assessment, the K x-ray yield, transmission curves, and half value layers (HVLs) have been calculated for the spectra generated with all computational models at different tube voltages. The measured x-ray spectra agreed well with the generated spectra when using X-raytbc and IPEM in diagnostic radiology and mammography energy ranges, respectively. Despite the systematic differences between the simulated and reference spectra for some models, the student's t-test statistical analysis showed there is no statistically significant difference between measured and generated spectra for all computational models investigated in this study. The MCNP4C-based Monte Carlo calculations showed there is no discernable discrepancy in the calculation of absorbed dose and ED in the adult ORNL hermaphroditic phantom when using different computational models for generating the x-ray spectra. Nevertheless, given the limited flexibility of the empirical and semi-empirical models, the spectra obtained through Monte Carlo modeling offer several advantages by providing detailed information about the interactions in the target and filters, which is relevant for the design of new target and filter combinations and optimization of radiological imaging protocols.« less
  • X-ray mammography is the most sensitive imaging technique for early detection of breast cancer (diagnostics). It is performed by a radiological system equipped with a rotating molybdenum (Mo) anode tube with an additional Mo filter. In the production of X-ray, bremsstrahlung photons produce an intense diffuse radiation, affecting the contrast between normal and cancerous tissue. So it is known that a good mammographic imaging can help to detect cancer in the first stages avoiding surgery, amputation or even death. In the last years there has been some developments in new imaging techniques to improve the contrast spatial resolution between differentmore » tissues: digital imaging, or the so call digital mammography. Digital mammographic imaging is considered an improvement in the prevention of breast cancer due to the advantages it offers.« less
  • Phase contrast and scattering-based X-ray imaging can potentially revolutionize the radiological approach to breast imaging by providing additional and complementary information to conventional, absorption-based methods. We investigated native, non-fixed whole breast samples using a grating interferometer with an X-ray tube-based configuration. Our approach simultaneously recorded absorption, differential phase contrast and small-angle scattering signals. The results show that this novel technique - combined with a dedicated image fusion algorithm - has the potential to deliver enhanced breast imaging with complementary information for an improved diagnostic process.