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The radiation dose involved in any medical imaging modality that uses ionizing radiation needs to be well understood by the medical physics and clinical community. This is especially true of screening modalities. Digital breast tomosynthesis (DBT) has recently been introduced into the clinic and is being used for screening for breast cancer in the general population. Therefore, it is important that the medical physics community have the required information to be able to understand, estimate, and communicate the radiation dose levels involved in breast tomosynthesis imaging. For this purpose, the American Association of Physicists in Medicine Task Group 223 on Dosimetry in Tomosynthesis Imaging has prepared this report that discusses dosimetry in breast imaging in general, and describes a methodology and provides the data necessary to estimate mean breast glandular dose from a tomosynthesis acquisition. In an effort to maximize familiarity with the procedures and data provided in this Report, the methodology to perform the dose estimation in DBT is based as much as possible on that used in mammography dose estimation.

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Optically-stimulated luminescent (OSL) nanoDot dosimeters, commercially available from Landauer, Inc. (Glenwood, IL), were assessed for use in computed tomography (CT) for erasure and reusability, linearity and reproducibility of response, and angular and energy response in different scattering conditions. Following overnight exposure to fluorescent room light, the residual signal on the dosimeters was 2%. The response of the dosimeters to identical exposures was consistent, and reported doses were within 4% of each other. The dosimeters responded linearly with dose up to 1 Gy. The dosimeter response to the CT beams decreased with increased tube voltage, showing up to a -16% difference when compared to a 0.6-cm(3) NIST-traceable calibrated ionization chamber for a 135 kVp CT beam. The largest range in percent difference in dosimeter response to scatter at central and peripheral positions inside CTDI phantoms was 14% at 80 kVp CT tube voltage, when compared to the ionization chamber. The dosimeters responded uniformly to x-ray tube angle over the ranges of increments of 0° to 75° and 105° to 180° when exposed in air, and from 0° to 360° when exposed inside a CTDI phantom. While energy and scatter correction factors should be applied to dosimeter readings for the purpose of determining absolute doses, these corrections are straightforward but depend on the accuracy of the ionization chamber used for cross-calibration. The linearity and angular responses, combined with the ability to reuse the dosimeters, make this OSL system an excellent choice for clinical CT dose measurements.