Distribution of Absorbed Dose in Cone-Beam Breast Computed Tomography: A Phantom Study With Radiochromic Films

Abstract

Cone-Beam Breast Computed Tomography (CBBCT) of the pendant breast with dedicated scanners is an experimental 3D X-ray imaging technique for breast cancer diagnosis under evaluation in comparison to conventional two-view 2-D mammography of the compressed breast. In CBBCT it is generally assumed that a more uniform distribution of the radiation dose to the breast volume can be obtained, with respect to mammography, at equal Mean Glandular Dose (MGD) levels. In fact, in CBBCT the X-ray beam rotates for 360 deg around the breast, while in each mammography view the breast is irradiated from one side only. Using a CBBCT laboratory scanner developed by our group, we have measured the distribution of the radiation dose in a hemi-ellipsoidal PMMA breast phantom of 14 cm diameter simulating the average uncompressed breast, using radiochromic films type XR-SP inserted at mid-plane in the phantom. The technique factors were 80 kVp (5.6 mm Al Half Value Layer), tube load in the range 23-100 mAs, for an air kerma at isocenter in the range 4.7-20 mGy, for a calculated MGD in the range 3.5-15 mGy for a 14 cm diameter breast of 50% glandularity. Results indicate that the dose decreases from the periphery to the center of the phantom, and that along a transverse profile, the relative dose variation Δ = ((edge-center)/center) is up to (25 ±4)% at a distance of 80 mm from the nipple. As for the relative dose variation along the phantom longitudinal axis, the maximum value at middle of the phantom measured is δ = ((nipple-chest wall)/chest wall) = -(15 ±4)%, indicating that the dose decreases from the chest wall toward the nipple. The values of the parameters Δ and δ depend also on the height of the X-ray tube focal spot with respect to the phantom vertex (nipple). Results are in rough agreement with similar previous determinations using thermoluminescence dosimeters.