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

Sarno, Antonio; Mettivier, Giovanni; Bliznakova, Kristina; Hernandez, Andrew M.; Boone, John M.; Russo, Paolo

doi:10.1016/j.ejmp.2022.03.016

Cited by 8 publications

(10 citation statements)

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“…This new understanding of the more typical internal breast tissue distribution led to the realization that the current breast dosimetry models result, on average, to an overestimation of the mean glandular dose during mammography and DBT. [20][21]24 Furthermore, previous efforts for the development of dosimetry models for mammography and DBT mostly considered only the cranio-caudal (CC) projection, thus not accounting for possible differences in absorbed dose due to, for example, the presence of the pectoralis muscle in the medio-lateral-oblique (MLO) field of view. In the few studies where the pectoral muscle was accounted for, 9,25 it was simply modeled based on subjective opinion of a single expert reader.…”

Section: Introductionmentioning

confidence: 99%

“…This was shown for both uncompressed 19–22 and, recently, for compressed breasts, 23 by simulating the tissue displacement due to the mechanical compression during mammography and DBT. This new understanding of the more typical internal breast tissue distribution led to the realization that the current breast dosimetry models result, on average, to an overestimation of the mean glandular dose during mammography and DBT 20–21,24 . Furthermore, previous efforts for the development of dosimetry models for mammography and DBT mostly considered only the cranio‐caudal (CC) projection, thus not accounting for possible differences in absorbed dose due to, for example, the presence of the pectoralis muscle in the medio‐lateral‐oblique (MLO) field of view.…”

Section: Introductionmentioning

confidence: 99%

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Patient‐derived heterogeneous breast phantoms for advanced dosimetry in mammography and tomosynthesis

et al. 2022

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Background Understanding the magnitude and variability of the radiation dose absorbed by the breast fibroglandular tissue during mammography and digital breast tomosynthesis (DBT) is of paramount importance to assess risks versus benefits. Although homogeneous breast models have been proposed and used for decades for this purpose, they do not accurately reflect the actual heterogeneous distribution of the fibroglandular tissue in the breast, leading to biases in the estimation of dose from these modalities. Purpose To develop and validate a method to generate patient‐derived, heterogeneous digital breast phantoms for breast dosimetry in mammography and DBT. Methods The proposed phantoms were developed starting from patient‐based models of compressed breasts, generated for multiple thicknesses and representing the two standard views acquired in mammography and DBT, that is, cranio‐caudal (CC) and medio‐lateral‐oblique (MLO). Internally, the breast phantoms were defined as consisting of an adipose/fibroglandular tissue mixture, with a nonspatially uniform relative concentration. The parenchyma distributions were obtained from a previously described model based on patient breast computed tomography data that underwent simulated compression. Following these distributions, phantoms with any glandular fraction (1%–100%) and breast thickness (12–125 mm) can be generated, for both views. The phantoms were validated, in terms of their accuracy for average normalized glandular dose (DgN) estimation across samples of patient breasts, using 88 patient‐specific phantoms involving actual patient distribution of the fibroglandular tissue in the breast, and compared to that obtained using a homogeneous model similar to those currently used for breast dosimetry. Results The average DgN estimated for the proposed phantoms was concordant with that absorbed by the patient‐specific phantoms to within 5% (CC) and 4% (MLO). These DgN estimates were over 30% lower than those estimated with the homogeneous models, which overestimated the average DgN by 43% (CC), and 32% (MLO) compared to the patient‐specific phantoms. Conclusions The developed phantoms can be used for dosimetry simulations to improve the accuracy of dose estimates in mammography and DBT.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient‐derived heterogeneous breast phantoms for advanced dosimetry in mammography and tomosynthesis

et al. 2022

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“…12,14 The assumption of homogenous tissue distribution overestimates the DgN and the MGD by approximately 18-30% in mammography and DBT. [15][16][17] Since this article focuses on cone-beam breast CT geometry (CBBCT),the normalized glandular dose coefficient for CT (DgN CT ) is used throughout this study. In current radiation dosimetry protocols for CBBCT, the DgN CT is determined from MC simulations by assuming a semi-ellipsoidal breast with homogeneous tissue distribution and a specified fibroglandular weight fraction.…”

Section: Introductionmentioning

confidence: 99%

“…24 Studies using heterogeneous phantoms have also showed that the variation in dose distribution is lower with breast CT compared to digital mammography. 15,17 Another study reported on the MGD from non-contrast diagnostic CBBCT scans of individual breasts by computing the fibroglandular weight fraction and using an equivalent semi-ellipsoidal breast in terms of effective diameter at the chest-wall, chest-wall to nipple length, and fibroglandular weight fraction. 25 In all of the aforementioned studies, the DgN CT is reported for full-scan acquisition with a circular x-ray source trajectory spanning 2𝜋.…”

Section: Introductionmentioning

confidence: 99%

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Dedicated cone‐beam breast CT: Data acquisition strategies based on projection angle‐dependent normalized glandular dose coefficients

2022

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Background: Dedicated cone-beam breast computed tomography (CBBCT) using short-scan acquisition is being actively investigated to potentially reduce the radiation dose to the breast.This would require determining the optimal x-ray source trajectory for such short-scan acquisition. Purpose: To quantify the projection angle-dependent normalized glandular dose coefficient (DgN CT ) in CBBCT, referred to as angular DgN CT , so that the x-ray ray source trajectory that minimizes the radiation dose to the breast for short-scan acquisition can be determined. Materials and Methods: A cohort of 75 CBBCT clinical datasets was segmented and used to generate three breast models -(I) patient-specific breast with heterogeneous fibroglandular tissue distribution and real breast shape, (II) patient-specific breast shape with homogeneous tissue distribution and matched fibroglandular weight fraction, and (III) homogeneous semi-ellipsoidal breast with patient-specific breast dimensions and matched fibroglandular weight fraction, which corresponds to the breast model used in current radiation dosimetry protocols. For each clinical dataset, the angular DgN CT was obtained at 10 discrete angles, spaced 36 • apart, for full-scan, circular, x-ray source trajectory from Monte Carlo simulations. Model III is used for validating the Monte Carlo simulation results. Models II and III are used to determine if breast shape contributes to the observed trends in angular DgN CT . A geometry-based theory in conjunction with center-of -mass (COM) based distribution analysis is used to explain the projection angle-dependent variation in angular DgN CT . Results: The theoretical model predicted that the angular DgN CT will follow a sinusoidal pattern and the amplitude of the sinusoid increases when the centerof -mass of fibroglandular tissue (COM f ) is farther from the center-of -mass of the breast (COM b ). It also predicted that the angular DgN CT will be minimized at x-ray source positions complementary to the COM f . The COM f was superior to the COM b in 80% (60/75) of the breasts. From Monte Carlo simulations and for homogeneous breasts (models II and III), the deviation in breast shape from a semi-ellipsoid had minimal effect on angular DgN CT and showed less than 4% variation. From Monte Carlo simulations and for model I, as predicted by our theory, the angular DgN CT followed a sinusoidal pattern with maxima and minima at x-ray source positions superior and inferior to the breast, respectively. For model I, the projection angle-dependent variation in angular DgN CT was 16.4%. Conclusion:The heterogeneous tissue distribution affected the angular DgN CT more than the breast shape. For model I, the angular DgN CT was lowest when the x-ray source was inferior to the breast. Hence, for short-scan CBBCT 1406

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Multiscale Monte Carlo simulations for dosimetry in x‐ray breast imaging: Part I ‐ Macroscopic scales

Massera,

Tomal,

Thomson

2023

Medical Physics

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BackgroundX‐ray breast imaging modalities are commonly employed for breast cancer detection, from screening programs to diagnosis. Thus, dosimetry studies are important for quality control and risk estimation since ionizing radiation is used.PurposeTo perform multiscale dosimetry assessments for different breast imaging modalities and for a variety of breast sizes and compositions. The first part of our study is focused on macroscopic scales (down to millimeters).MethodsNine anthropomorphic breast phantoms with a voxel resolution of 0.5 mm were computationally generated using the BreastPhantom software, representing three breast sizes with three distinct values of volume glandular fraction (VGF) for each size. Four breast imaging modalities were studied: digital mammography (DM), contrast‐enhanced digital mammography (CEDM), digital breast tomosynthesis (DBT) and dedicated breast computed tomography (BCT). Additionally, the impact of tissue elemental compositions from two databases were compared. Monte Carlo (MC) simulations were performed with the MC‐GPU code to obtain the 3D glandular dose distribution (GDD) for each case considered with the mean glandular dose (MGD) fixed at 4 mGy (to facilitate comparisons).ResultsThe GDD within the breast is more uniform for CEDM and BCT compared to DM and DBT. For large breasts and high VGF, the ratio between the minimum/maximum glandular dose to MGD is 0.12/4.02 for DM and 0.46/1.77 for BCT; the corresponding results for a small breast and low VGF are 0.35/1.98 (DM) and 0.63/1.42 (BCT). The elemental compositions of skin, adipose and glandular tissue have a considerable impact on the MGD, with variations up to 30% compared to the baseline. The inclusion of tissues other than glandular and adipose within the breast has a minor impact on MGD, with differences below 2%. Variations in the final compressed breast thickness alter the shape of the GDD, with a higher compression resulting in a more uniform GDD.ConclusionsFor a constant MGD, the GDD varies with imaging modality and breast compression. Elemental tissue compositions are an important factor for obtaining MGD values, being a source of systematic uncertainties in MC simulations and, consequently, in breast dosimetry.

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

Cited by 8 publications

References 36 publications

Patient‐derived heterogeneous breast phantoms for advanced dosimetry in mammography and tomosynthesis

Patient‐derived heterogeneous breast phantoms for advanced dosimetry in mammography and tomosynthesis

Dedicated cone‐beam breast CT: Data acquisition strategies based on projection angle‐dependent normalized glandular dose coefficients

Multiscale Monte Carlo simulations for dosimetry in x‐ray breast imaging: Part I ‐ Macroscopic scales

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